ALTERNATIVAS COMUNICACIONAIS A ESTRATÉGIA DE SAÚDE DA FAMÍLIA

O estudo exploratório de caso que teve como objetivo analisar o processo de comunicação utilizado pelos profissionais da Estratégia de Saúde da Família, na Unidade de Saúde de Maruípe, no município de Vitória, capital do Espírito Santo. Como amostra, escolhemos a Região de Maruípe, que possui o maior número de habitantes da capital, segundo dados do IBGE/2000 e em que a estratégia atinge toda a população. A coleta de dados se realizou pela aplicação de questionários estruturados com perguntas abertas, semiabertas e fechadas aos integrantes de duas equipes de Saúde da Família que, voluntariamente, decidiram participar da pesquisa. Foram aplicados dois tipos diferentes de questionários: um para oito Agentes Comunitários de Saúde e outro para treze membros da equipe. Os dados foram quantificados e analisados qualitativamente visando refletir sobre a importância da comunicação nas ações de promoção e prevenção da saúde, e sua relação com a atenção básica municipal e a redução do número de internações nos hospitais por causas básicas. Com base na teoria crítica, na teoria do agir comunicativo de Habermas e nos recentes estudos latino-americanos sobre a importância da comunicação como insumo na saúde, analisamos os instrumentos de comunicação utilizados pela equipe e a forma como essa comunicação se estabelece, a fim de traçar um protocolo de sugestões para minimizar os problemas de comunicação no desenvolvimento das ações.

Measuring and managing performance in extended enterprises

Purpose - The purpose of this research paper is to demonstrate how existing performance measurement may be adopted to measure and manage performance in extended enterprises. Design/methodology/approach - The paper reviews the literature in performance measurement and extended enterprises. It explains the collaborative architecture of an extended enterprise and demonstrates this architecture through a case study. A model for measuring and managing performance in extended enterprises is developed using the case study. Findings - The research found that due to structural differences between traditional and extended enterprises, the systems required to measure and manage the performance of extended enterprises, whilst being based upon existing performance measurement frameworks, would be structurally and operationally different. Based on this, a model for measuring and managing performance in extended enterprises is proposed which includes intrinsic and extrinsic inter-enterprise coordinating measures. Research limitations/implications - There are two limitations this research. First, the evidence is based on a single case, thus further cases should be studied to establish the generalisibility of the presented results. Second, the practical limitations of the EE performance measurement model should be established through longitudinal action research. Practical implications - In practice the model proposed requires collaborating organisations to be more open and share critical performance information with one another. This will require change in practices and attitudes. Originality/value - The main contribution this paper makes is that it highlights the structural differences between traditional and collaborative enterprises and specifies performance measurement and management requirements of these collaborative organisations. © Emerald Group Publishing Limited.

Introduction: improving manufacturing performance through technology diffusion, implementation and management

The role of technology management in achieving improved manufacturing performance has been receiving increased attention as enterprises are becoming more exposed to competition from around the world. In the modern market for manufactured goods the demand is now for more product variety, better quality, shorter delivery and greater flexibility, while the financial and environmental cost of resources has become an urgent concern to manufacturing managers. This issue of the International Journal of Technology Management addresses the question of how the diffusion, implementation and management of technology can improve the performance of manufacturing industries. The authors come from a large number of different countries and their contributions cover a wide range of topics within this general theme. Some papers are conceptual, others report on research carried out in a range of different industries including steel production, iron founding, electronics, robotics, machinery, precision engineering, metal working and motor manufacture. In some cases they describe situations in specific countries. Several are based on presentations made at the UK Operations Management Association's Sixth International Conference held at Aston University at which the conference theme was 'Achieving Competitive Edge: Getting Ahead Through Technology and People'. The first two papers deal with questions of advanced manufacturing technology implementation and management. Firstly Beatty describes a three year longitudinal field study carried out in ten Canadian manufacturing companies using CADICAM and CIM systems. Her findings relate to speed of implementation, choice of system type, the role of individuals in implementation, organization and job design. This is followed by a paper by Bessant in which he argues that a more a strategic approach should be taken towards the management of technology in the 1990s and beyond. Also considered in this paper are the capabilities necessary in order to deploy advanced manufacturing technology as a strategic resource and the way such capabilities might be developed within the firm. These two papers, which deal largely with the implementation of hardware, are supplemented by Samson and Sohal's contribution in which they argue that a much wider perspective should be adopted based on a new approach to manufacturing strategy formulation. Technology transfer is the topic of the following two papers. Pohlen again takes the case of advanced manufacturing technology and reports on his research which considers the factors contributing to successful realisation of AMT transfer. The paper by Lee then provides a more detailed account of technology transfer in the foundry industry. Using a case study based on a firm which has implemented a number of transferred innovations a model is illustrated in which the 'performance gap' can be identified and closed. The diffusion of technology is addressed in the next two papers. In the first of these, by Lowe and Sim, the managerial technologies of 'Just in Time' and 'Manufacturing Resource Planning' (or MRP 11) are examined. A study is described from which a number of factors are found to influence the adoption process including, rate of diffusion and size. Dahlin then considers the case of a specific item of hardware technology, the industrial robot. Her paper reviews the history of robot diffusion since the early 1960s and then tries to predict how the industry will develop in the future. The following two papers deal with the future of manufacturing in a more general sense. The future implementation of advanced manufacturing technology is the subject explored by de Haan and Peters who describe the results of their Dutch Delphi forecasting study conducted among a panel of experts including scientists, consultants, users and suppliers of AMT. Busby and Fan then consider a type of organisational model, 'the extended manufacturing enterprise', which would represent a distinct alternative pure market-led and command structures by exploiting the shared knowledge of suppliers and customers. The three country-based papers consider some strategic issues relating manufacturing technology. In a paper based on investigations conducted in China He, Liff and Steward report their findings from strategy analyses carried out in the steel and watch industries with a view to assessing technology needs and organizational change requirements. This is followed by Tang and Nam's paper which examines the case of machinery industry in Korea and its emerging importance as a key sector in the Korean economy. In his paper which focuses on Venezuela, Ernst then considers the particular problem of how this country can address the problem of falling oil revenues. He sees manufacturing as being an important contributor to Venezuela's future economy and proposes a means whereby government and private enterprise can co-operate in development of the manufacturing sector. The last six papers all deal with specific topics relating to the management manufacturing. Firstly Youssef looks at the question of manufacturing flexibility, introducing and testing a conceptual model that relates computer based technologies flexibility. Dangerfield's paper which follows is based on research conducted in the steel industry. He considers the question of scale and proposes a modelling approach determining the plant configuration necessary to meet market demand. Engstrom presents the results of a detailed investigation into the need for reorganising material flow where group assembly of products has been adopted. Sherwood, Guerrier and Dale then report the findings of a study into the effectiveness of Quality Circle implementation. Stillwagon and Burns, consider how manufacturing competitiveness can be improved individual firms by describing how the application of 'human performance engineering' can be used to motivate individual performance as well as to integrate organizational goals. Finally Sohal, Lewis and Samson describe, using a case study example, how just-in-time control can be applied within the context of computer numerically controlled flexible machining lines. The papers in this issue of the International Journal of Technology Management cover a wide range of topics relating to the general question of improving manufacturing performance through the dissemination, implementation and management of technology. Although they differ markedly in content and approach, they have the collective aim addressing the concepts, principles and practices which provide a better understanding the technology of manufacturing and assist in achieving and maintaining a competitive edge.

Automatic control of attenuation in a digital communication network

This thesis describes the investigation of an adaptive method of attenuation control for digital speech signals in an analogue-digital environment and its effects on the transmission performance of a national telecommunication network. The first part gives the design of a digital automatic gain control, able to operate upon a P.C.M. signal in its companded form and whose operation is based upon the counting of peaks of the digital speech signal above certain threshold levels. A study was ma.de of a digital automatic gain control (d.a.g.c.) in open-loop configuration and closed-loop configuration. The former was adopted as the means for carrying out the automatic control of attenuation. It was simulated and tested, both objectively and subjectively. The final part is the assessment of the effects on telephone connections of a d.a.g.c. that introduces gains of 6 dB or 12 dB. This work used a Telephone Connection Assessment Model developed at The University of Aston in Birmingham. The subjective tests showed that the d.a.g.c. gives advantage for listeners when the speech level is very low. The benefit is not great when speech is only a little quieter than preferred. The assessment showed that, when a standard British Telecom earphone is used, insertion of gain is desirable if speech voltage across the earphone terminals is below an upper limit of -38 dBV. People commented upon the presence of an adaptive-like effect during the tests. This could be the reason why they voted against the insertion of gain at level only little quieter than preferred, when they may otherwise have judged it to be desirable. A telephone connection with a d.a.g.c. in has a degree of difficulty less than half of that without it. The score Excellent plus Good is 10-30% greater.

Evolutionary neural networks : models and applications

The scaling problems which afflict attempts to optimise neural networks (NNs) with genetic algorithms (GAs) are disclosed. A novel GA-NN hybrid is introduced, based on the bumptree, a little-used connectionist model. As well as being computationally efficient, the bumptree is shown to be more amenable to genetic coding lthan other NN models. A hierarchical genetic coding scheme is developed for the bumptree and shown to have low redundancy, as well as being complete and closed with respect to the search space. When applied to optimising bumptree architectures for classification problems the GA discovers bumptrees which significantly out-perform those constructed using a standard algorithm. The fields of artificial life, control and robotics are identified as likely application areas for the evolutionary optimisation of NNs. An artificial life case-study is presented and discussed. Experiments are reported which show that the GA-bumptree is able to learn simulated pole balancing and car parking tasks using only limited environmental feedback. A simple modification of the fitness function allows the GA-bumptree to learn mappings which are multi-modal, such as robot arm inverse kinematics. The dynamics of the 'geographic speciation' selection model used by the GA-bumptree are investigated empirically and the convergence profile is introduced as an analytical tool. The relationships between the rate of genetic convergence and the phenomena of speciation, genetic drift and punctuated equilibrium arc discussed. The importance of genetic linkage to GA design is discussed and two new recombination operators arc introduced. The first, linkage mapped crossover (LMX) is shown to be a generalisation of existing crossover operators. LMX provides a new framework for incorporating prior knowledge into GAs.Its adaptive form, ALMX, is shown to be able to infer linkage relationships automatically during genetic search.

Combining data driven programming with component based software development:with applications in geovisualisation and dynamic data driven application systems

Software development methodologies are becoming increasingly abstract, progressing from low level assembly and implementation languages such as C and Ada, to component based approaches that can be used to assemble applications using technologies such as JavaBeans and the .NET framework. Meanwhile, model driven approaches emphasise the role of higher level models and notations, and embody a process of automatically deriving lower level representations and concrete software implementations. The relationship between data and software is also evolving. Modern data formats are becoming increasingly standardised, open and empowered in order to support a growing need to share data in both academia and industry. Many contemporary data formats, most notably those based on XML, are self-describing, able to specify valid data structure and content, and can also describe data manipulations and transformations. Furthermore, while applications of the past have made extensive use of data, the runtime behaviour of future applications may be driven by data, as demonstrated by the field of dynamic data driven application systems. The combination of empowered data formats and high level software development methodologies forms the basis of modern game development technologies, which drive software capabilities and runtime behaviour using empowered data formats describing game content. While low level libraries provide optimised runtime execution, content data is used to drive a wide variety of interactive and immersive experiences. This thesis describes the Fluid project, which combines component based software development and game development technologies in order to define novel component technologies for the description of data driven component based applications. The thesis makes explicit contributions to the fields of component based software development and visualisation of spatiotemporal scenes, and also describes potential implications for game development technologies. The thesis also proposes a number of developments in dynamic data driven application systems in order to further empower the role of data in this field.

A techno-economic assessment of the use of fast pyrolysis bio-oil from UK energy crops in the production of electricity and combined heat and power

This thesis investigates the cost of electricity generation using bio-oil produced by the fast pyrolysis of UK energy crops. The study covers cost from the farm to the generator’s terminals. The use of short rotation coppice willow and miscanthus as feedstocks was investigated. All costs and performance data have been taken from published papers, reports or web sites. Generation technologies are compared at scales where they have proved economic burning other fuels, rather than at a given size. A pyrolysis yield model was developed for a bubbling fluidised bed fast pyrolysis reactor from published data to predict bio-oil yields and pyrolysis plant energy demands. Generation using diesel engines, gas turbines in open and combined cycle (CCGT) operation and steam cycle plants was considered. The use of bio-oil storage to allow the pyrolysis and generation plants to operate independently of each other was investigated. The option of using diesel generators and open cycle gas turbines for combined heat and power was examined. The possible cost reductions that could be expected through learning if the technology is widely implemented were considered. It was found that none of the systems analysed would be viable without subsidy, but with the current Renewable Obligation Scheme CCGT plants in the 200 to 350 MWe range, super-critical coal fired boilers co-fired with bio-oil, and groups of diesel engine based CHP schemes supplied by a central pyrolysis plant would be viable. It was found that the cost would reduce with implementation and the planting of more energy crops but some subsidy would still be needed to make the plants viable.

Fault diagnosis scheme for open-circuit faults in switched reluctance motor drives using fast Fourier transform algorithm with bus current detection

Reliability of power converters is of crucial importance in switched reluctance motor drives used for safety-critical applications. Open-circuit faults in power converters will cause the motor to run in unbalanced states, and if left untreated, they will lead to damage to the motor and power modules, and even cause a catastrophic failure of the whole drive system. This study is focused on using a single current sensor to detect open-circuit faults accurately. An asymmetrical half-bridge converter is considered in this study and the faults of single-phase open and two-phase open are analysed. Three different bus positions are defined. On the basis of a fast Fourier transform algorithm with Blackman window interpolation, the bus current spectrums before and after open-circuit faults are analysed in details. Their fault characteristics are extracted accurately by the normalisations of the phase fundamental frequency component and double phase fundamental frequency component, and the fault characteristics of the three bus detection schemes are also compared. The open-circuit faults can be located by finding the relationship between the bus current and rotor position. The effectiveness of the proposed diagnosis method is validated by the simulation results and experimental tests.

Examining argumentative coherence in essays by undergraduate students of English as a foreign language in Mainland China and their English speaking peers in the United States

I conducted this study to provide insights toward deepening understanding of association between culture and writing by building, assessing, and refining a conceptual model of second language writing. To do this, I examined culture and coherence as well as the relationship between them through a mixed methods research design. Coherence has been an important and complex concept in ESL/EFL writing. I intended to study the concept of coherence in the research context of contrastive rhetoric, comparing the coherence quality in argumentative essays written by undergraduates in Mainland China and their U.S. peers. In order to analyze the complex concept of coherence, I synthesized five linguistic theories of coherence: Halliday and Hasan's cohesion theory, Carroll's theory of coherence, Enkvist's theory of coherence, Topical Structure Analysis, and Toulmin's Model. Based upon the synthesis, 16 variables were generated. Across these 16 variables, Hotelling t-test statistical analysis was conducted to predict differences in argumentative coherence between essays written by two groups of participants. In order to complement the statistical analysis, I conducted 30 interviews of the writers in the studies. Participants' responses were analyzed with open and axial coding. By analyzing the empirical data, I refined the conceptual model by adding more categories and establishing associations among them. The study found that U.S. students made use of more pronominal reference. Chinese students adopted more lexical devices of reiteration and extended paralleling progression. The interview data implied that the difference may be associated with the difference in linguistic features and rhetorical conventions in Chinese and English. As far as Toulmin's Model is concerned, Chinese students scored higher on data than their U.S. peers. According to the interview data, this may be due to the fact that Toulmin's Model, modified as three elements of arguments, have been widely and long taught in Chinese writing instruction while U.S. interview participants said that they were not taught to write essays according to Toulmin's Model. Implications were generated from the process of textual data analysis and the formulation of structural model defining coherence. These implications were aimed at informing writing instruction, assessment, peer-review, and self-revision.

Jazz band arranging : original big band arrangements

This paper examines five big band arrangements written during a period of two semesters from 1998-1999. I will provide an overview and performance considerations for each arrangement. Each arrangement uses common conventions such as unison lines, octave doubling, four and five part voicings, found in closed, semi-open, and open position. Approach techniques include diatonic, dominant, diminished, chromatic, and parallel. Choice was based primarily on two considerations: desired texture and the best voice leading options identified to provide each part with a swinging line and maintain melodic integrity. Other conventions applied include chord substitution, upper structure triads, and altered and diminished scales to provide harmonic contrast and color. Each arrangement supplied new challenges and the tunes selected provided the arranger with a diverse experience of styles. The inherent qualities of the melody and harmonic progression of each piece were the primary considerations for selection.

“Acham que brotamos das fontes dessa cidade?”: uma etnografia sobre o cotidiano de sobrevivência de pessoas em situação de rua em Nata/RN

Through participant observation, held in the administrative region east of Natal / RN, this research aimed to understand about the daily life of men and women living on the streets in the city. How they relate to the space where they live? In this relationship, which uses and survival strategies triggered by this social segment? These were some of the questions that guided this research, in order to highlight the specificities of this way of life and the possible consequences that such a situation could reverberate. In this sense, there was an effort to keep up with people on the streets, their itineraries and seize their narratives. Along the search path - which took place intermittently between the years 2011-2015 - attended spaces of occupation and traffic of this population group in the street, as well as insert me and got involved in events, forums, seminars, meetings and subject of joints on the streets as a political movement (MNPR / RN). They are considered in this study as people on the street to those who occupy the street as their main space of survival and ordering of daily life: in the streets sleep, feed themselves, meet the physiological and hygienic needs, and is where draw sustenance. The street is taken in this research in its broadest sense, including all possible places relatively protected from the cold, rain and exposure to violence, thus includes both open and public spaces: as squares and parks; but also closed and private places: hostels, abandoned warehouses, prisons, etc. It was observed that in none of these spaces guys on the street are established in a fixed manner, in contrast, they experience the roaming, which in part is due to urban systems - which tends to stigmatize them and delete them places - and the very need to survive, because while living in the street differentiated practices are triggered, and these differ from the dominant mode of sedentary life.

“Acham que brotamos das fontes dessa cidade?”: uma etnografia sobre o cotidiano de sobrevivência de pessoas em situação de rua em Nata/RN

Through participant observation, held in the administrative region east of Natal / RN, this research aimed to understand about the daily life of men and women living on the streets in the city. How they relate to the space where they live? In this relationship, which uses and survival strategies triggered by this social segment? These were some of the questions that guided this research, in order to highlight the specificities of this way of life and the possible consequences that such a situation could reverberate. In this sense, there was an effort to keep up with people on the streets, their itineraries and seize their narratives. Along the search path - which took place intermittently between the years 2011-2015 - attended spaces of occupation and traffic of this population group in the street, as well as insert me and got involved in events, forums, seminars, meetings and subject of joints on the streets as a political movement (MNPR / RN). They are considered in this study as people on the street to those who occupy the street as their main space of survival and ordering of daily life: in the streets sleep, feed themselves, meet the physiological and hygienic needs, and is where draw sustenance. The street is taken in this research in its broadest sense, including all possible places relatively protected from the cold, rain and exposure to violence, thus includes both open and public spaces: as squares and parks; but also closed and private places: hostels, abandoned warehouses, prisons, etc. It was observed that in none of these spaces guys on the street are established in a fixed manner, in contrast, they experience the roaming, which in part is due to urban systems - which tends to stigmatize them and delete them places - and the very need to survive, because while living in the street differentiated practices are triggered, and these differ from the dominant mode of sedentary life.

A study of the situations, features, and coping mechanisms experienced by Irish psychiatric nurses experiencing moral distress

Purpose: The purpose of this study was toinvestigate moral distress in Irish psychiatric nurses. Design: A qualitative descriptive methodology was used. Findings: The study confirmed the presence of moral distress and the situations that gave rise to moral distress within psychiatric nurses working in acute care settings. Practice Implications: The findings indicate that while multidisciplinary teams appear to function well on the surface, situations that give rise to moral distress are not always acknowledged or dealt with effectively. Furthermore, unresolved moral conflict impacts upon the quality of clinical decision-making by not allowing open and transparent discussions that allow clinicians the opportunity to address their concerns adequately.

Fundamental studies of the application of wheat for malting and brewing

Wheat (Triticum aestivum L.) has a long tradition as a raw material for the production of malt and beer. While breeding and cultivation efforts for barley have been highly successful in creating agronomically and brew- technical optimal specialty cultivars that have become well established as brewing barley varieties, the picture is completely different for brewing wheat. An increasing wheat beer demand results in a rising amount of raw material. Wheat has been - and still is – grown almost exclusively for the baking industry. It is this high demand that defines most of the wheat breeding objectives; and these objectives are generally not favourable in brewing industry. It is of major interest to screen wheat varieties for brewing processability and to give more focus to wheat as a brewing cereal. To obtain fast and reliable predications about the suitability of wheat cultivars a new mathematical method was developed in this work. The method allows a selection based on generally accepted quality characteristics. As selection criteria the parameters raw protein, soluble nitrogen, Kolbach index, extract and viscosity were chosen. During a triannual cultivation series, wheat varieties were evaluated on their suitability for brewing as well as stability to environmental conditions. To gain a fundamental understanding of the complex malting process, microstructural changes were evaluated and visualized by confocal laser scanning and scanning electron microscopy. Furthermore, changes observed in the micrographs were verified and endorsed by metabolic changes using established malt attributes. The degradation and formation of proteins during malting is essential for the final beer quality. To visualise fundamental protein changes taking place during malting, samples of each single process step were analysed and fractioned according their solubility. Protein fractions were analysed using a Lab-on-a-chip technique as well as OFFgel analysis. In general, a different protein distribution of wheat compared to barley or oat could be confirmed. During the malting process a degradation of proteins to small peptides and amino acids could be observed in all four Osborn fractions. Furthermore, in this study a protein profiling was performed to evaluate changes during the mashing process as well as the influence of grist composition. Differences in specific protein peaks and profile were detected for all samples during mashing. This study investigated the suitability of wheat for malting and brewing industry and closed the scientifical gap of amylolytic, cytolytic and proteolytic changes during malting and mashing.

Constraint-force-based approach of modelling compliant mechanisms: principle and application

Numerous works have been conducted on modelling basic compliant elements such as wire beams, and closed-form analytical models of most basic compliant elements have been well developed. However, the modelling of complex compliant mechanisms is still a challenging work. This paper proposes a constraint-force-based (CFB) modelling approach to model compliant mechanisms with a particular emphasis on modelling complex compliant mechanisms. The proposed CFB modelling approach can be regarded as an improved free-body- diagram (FBD) based modelling approach, and can be extended to a development of the screw-theory-based design approach. A compliant mechanism can be decomposed into rigid stages and compliant modules. A compliant module can offer elastic forces due to its deformation. Such elastic forces are regarded as variable constraint forces in the CFB modelling approach. Additionally, the CFB modelling approach defines external forces applied on a compliant mechanism as constant constraint forces. If a compliant mechanism is at static equilibrium, all the rigid stages are also at static equilibrium under the influence of the variable and constant constraint forces. Therefore, the constraint force equilibrium equations for all the rigid stages can be obtained, and the analytical model of the compliant mechanism can be derived based on the constraint force equilibrium equations. The CFB modelling approach can model a compliant mechanism linearly and nonlinearly, can obtain displacements of any points of the rigid stages, and allows external forces to be exerted on any positions of the rigid stages. Compared with the FBD based modelling approach, the CFB modelling approach does not need to identify the possible deformed configuration of a complex compliant mechanism to obtain the geometric compatibility conditions and the force equilibrium equations. Additionally, the mathematical expressions in the CFB approach have an easily understood physical meaning. Using the CFB modelling approach, the variable constraint forces of three compliant modules, a wire beam, a four-beam compliant module and an eight-beam compliant module, have been derived in this paper. Based on these variable constraint forces, the linear and non-linear models of a decoupled XYZ compliant parallel mechanism are derived, and verified by FEA simulations and experimental tests.