771 resultados para Quality management in hospitals
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Objective: The aim of this study was to investigate the effects of exercise training on cardiovascular autonomic dysfunction in ovariectomized rats submitted to myocardial infarction. Methods: Female Wistar rats were divided into the following ovariectomized groups: sedentary ovariectomized (SO), trained ovariectomized (TO), sedentary ovariectomized infarcted (SOI), and trained ovariectomized infarcted (TOI). Trained groups were submitted to an exercise training protocol on a treadmill (8 wk). Arterial baroreflex sensitivity was evaluated by heart rate responses to arterial pressure changes, and cardiopulmonary baroreflex sensitivity was tested by bradycardic and hypotension responses to serotonin injection. Vagal and sympathetic effects were calculated by pharmacological blockade. Results: Arterial pressure was reduced in the TO in comparison with the SO group and increased in the TOI in relation to the SOI group. Exercise training improved the baroreflex sensitivity in both the TO and TOI groups. The TOI group displayed improvement in cardiopulmonary reflex sensitivity compared with the SOI group at the 16 mu g/kg serotonin dose. Exercise training enhanced the vagal effect in both the TO (45%) and TOI (46%) animals compared with the SO and SOI animals and reduced the sympathetic effect in the TOI (38%) in comparison with the SOI animals. Significant correlations were obtained between bradycardic baroreflex responses and vagal (r = -0.7, P < 0.005) and sympathetic (r = 0.7, P < 0.001) effects. Conclusions: These results indicate that exercise training in ovariectomized rats submitted to myocardial infarction improves resting hemodynamic status and reflex control of the circulation, which may be due to an increase in the vagal component. This suggests a homeostatic role for exercise training in reducing the autonomic impairment of myocardial infarction in postmenopausal women.
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Modular product architectures have generated numerous benefits for companies in terms of cost, lead-time and quality. The defined interfaces and the module’s properties decrease the effort to develop new product variants, and provide an opportunity to perform parallel tasks in design, manufacturing and assembly. The background of this thesis is that companies perform verifications (tests, inspections and controls) of products late, when most of the parts have been assembled. This extends the lead-time to delivery and ruins benefits from a modular product architecture; specifically when the verifications are extensive and the frequency of detected defects is high. Due to the number of product variants obtained from the modular product architecture, verifications must handle a wide range of equipment, instructions and goal values to ensure that high quality products can be delivered. As a result, the total benefits from a modular product architecture are difficult to achieve. This thesis describes a method for planning and performing verifications within a modular product architecture. The method supports companies by utilizing the defined modules for verifications already at module level, so called MPV (Module Property Verification). With MPV, defects are detected at an earlier point, compared to verification of a complete product, and the number of verifications is decreased. The MPV method is built up of three phases. In Phase A, candidate modules are evaluated on the basis of costs and lead-time of the verifications and the repair of defects. An MPV-index is obtained which quantifies the module and indicates if the module should be verified at product level or by MPV. In Phase B, the interface interaction between the modules is evaluated, as well as the distribution of properties among the modules. The purpose is to evaluate the extent to which supplementary verifications at product level is needed. Phase C supports a selection of the final verification strategy. The cost and lead-time for the supplementary verifications are considered together with the results from Phase A and B. The MPV method is based on a set of qualitative and quantitative measures and tools which provide an overview and support the achievement of cost and time efficient company specific verifications. A practical application in industry shows how the MPV method can be used, and the subsequent benefits
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In the UK, urban river basins are particularly vulnerable to flash floods due to short and intense rainfall. This paper presents potential flood resilience approaches for the highly urbanised Wortley Beck river basin, south west of the Leeds city centre. The reach of Wortley Beck is approximately 6km long with contributing catchment area of 30km2 that drain into the River Aire. Lower Wortley has experienced regular flooding over the last few years from a range of sources, including Wortley Beck and surface and ground water, that affects properties both upstream and downstream of Farnley Lake as well as Wortley Ring Road. This has serious implications for society, the environment and economy activity in the City of Leeds. The first stage of the study involves systematically incorporating Wortley Beck’s land scape features on an Arc-GIS platform to identify existing green features in the region. This process also enables the exploration of potential blue green features: green spaces, green roofs, water retention ponds and swales at appropriate locations and connect them with existing green corridors to maximize their productivity. The next stage is involved in developing a detailed 2D urban flood inundation model for the Wortley Beck region using the CityCat model. CityCat is capable to model the effects of permeable/impermeable ground surfaces and buildings/roofs to generate flood depth and velocity maps at 1m caused by design storm events. The final stage of the study is involved in simulation of range of rainfall and flood event scenarios through CityCat model with different blue green features. Installation of other hard engineering individual property protection measures through water butts and flood walls are also incorporated in the CityCat model. This enables an integrated sustainable flood resilience strategy for this region.
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The Short-term Water Information and Forecasting Tools (SWIFT) is a suite of tools for flood and short-term streamflow forecasting, consisting of a collection of hydrologic model components and utilities. Catchments are modeled using conceptual subareas and a node-link structure for channel routing. The tools comprise modules for calibration, model state updating, output error correction, ensemble runs and data assimilation. Given the combinatorial nature of the modelling experiments and the sub-daily time steps typically used for simulations, the volume of model configurations and time series data is substantial and its management is not trivial. SWIFT is currently used mostly for research purposes but has also been used operationally, with intersecting but significantly different requirements. Early versions of SWIFT used mostly ad-hoc text files handled via Fortran code, with limited use of netCDF for time series data. The configuration and data handling modules have since been redesigned. The model configuration now follows a design where the data model is decoupled from the on-disk persistence mechanism. For research purposes the preferred on-disk format is JSON, to leverage numerous software libraries in a variety of languages, while retaining the legacy option of custom tab-separated text formats when it is a preferred access arrangement for the researcher. By decoupling data model and data persistence, it is much easier to interchangeably use for instance relational databases to provide stricter provenance and audit trail capabilities in an operational flood forecasting context. For the time series data, given the volume and required throughput, text based formats are usually inadequate. A schema derived from CF conventions has been designed to efficiently handle time series for SWIFT.
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Cultura organizacional e gestão de recursos humanos (GRH) são componentes fundamentais para a estratégia corporativa raramente estudada no contexto das pequenas e médias empresas (PME) no setor de serviços profissionais, um ambiente no qual o capital humano das empresas companhias é particularmente importante. Um estudo de caso de uma empresa de gestão de investimentos inglesa foi realizado. A PME quase triplicou o seu quadro de funcionários, de menos de 50 a mais de 140, nos últimos seis anos. Cultura e GRH foram pesquisadas tanto historicamente quanto no momento atual por meio de uma combinação de entrevistas individuais, observação direta durante as visitas ao local e análise documental. Foi verificado que a G RH (junto com um número de outras estruturas e processos internos) tornou-se mais formal, apesar do fato de que a empresa começou com políticas de RH relativamente desenvolvidas, em comparação com outras pequenas empresas. Uma possível explicação para esta estruturação das práticas de RH é que empresas do setor de serviços profissionais tendem a dar uma importância especial à qualidade da sua força de trabalho. Esta relativa estabilidade cultural pode ser explicada pelo fato da cultura ser forte e é mantida tanto inconscientemente quanto conscientemente, por meio de mecanismos como o planejamento de pessoal, recrutamento e remuneração. As conclusões, por conseguinte, demonstram que as atitudes e percepções nem sempre mudam tão rápido quanto sistemas organizacionais, e que a relação entre cultura e gestão de recursos humanos pode ser complexa; a formalização da GRH pode reforçar a mudança cultural em certos aspectos, ao mesmo tempo abrandá-lo em outros.
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In this paper I investigate the quality evolution ofBrazilian autos. To measure the quality evolution of Brazilian autos, I have assembled a data set for Brazilian passenger cars for the period 1960-1994, to which I have applied the hedonic pricing methodology. To the best of my k:nowledge, this is the first time an index of quality change has been constructed for the Brazilian automobile industry. The results presented here have two major implications. They allow a better -- ......... understanding of product innovation in Brazil's auto industry, and they provide a clearer explanation of the behavior of auto prices.
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The Brazilian domestic debt has posed two challenges to policy-makers: it has grown very fast and its maturity is extremely short. This has prompted fears that a default or a compulsory lengthening scheme would be imposed. Here, we analyse the domestic public debt management experience in Brazil, searching for policy prescriptions for the next few years. After briefiy reviewing the recent domestic public debt history, we decompose the large rise in federal bonded debt during 1995-2000, searching for its macroeconomic causes. The main culprits are the extremely high interest payments-which, unti11998, were caused by the weak fiscal stance and the quasi-fixed exchange-rate regime; and since 1999, by the impact ofthe currency depreciation On the dollar-indexed and the externai debt-, and the accumulation of assets of doubtful value, much of which may have to be written off in the future. Simulation exercises of the net debt path for the near future underscore the importance of a tighter fiscal stance to prevent the debt-GDP ratio from growing further. Given the need to quickly lengthen the debt maturity, our main policy advice is to foster, and rely more on, infiation-linked bonds.
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Este artigo aborda aspectos relacionados ao uso de modelos de avaliação externa de serviços de saúde no Brasil, sobretudo acreditação hospitalar, a partir da experiência da autora com a implementação de modelos de avaliação da qualidade em hospitais, bem como de sua reflexão sobre acreditação enquanto objeto de estudo da pós-graduação. A autora aponta alguns dos resultados do uso destes modelos em hospitais e as especificidades de sua aplicação. Esses resultados são enumerados: aprimoramento da gestão, padronização de processos, treinamento de pessoal, trabalho em equipe, atenção focada no paciente, motivação, reconhecimento externo, mudança de cultura. A autora problematiza o modo como tais modelos têm sido empregados nos hospitais brasileiros
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Carcass and meat quality traits of thirty-six feedlot beef heifers from different genetic groups (GG) fed at two concentrate levels (CL) were evaluated using 12- Nellore (NE), 12 - 1/2Angus x 1/2Nellore (AN) and 12 - 1/2Simmental x 1/2Nellore (SN) animals. Six heifers of each GG were randomly assigned into one of two treatments: concentrate at 0.8% or 1.2% of body weight (BW). Heifers fed concentrate at 0.8% of BW had greater (P<0.05) dressing percentage. None of the proximate analysis components of the beef were affected (P>0.05) by either CL or GG. Heifers from the AN group had higher (P<0.05) carcass weights, 12th rib fat thickness and lower dressing percentage (P<0.05) compared to the other groups. NE heifers had greater WBSF values (P<0.05) than the other genetic groups. Data suggest that the concentrate level can be reduced without compromising meat quality traits. (C) 2011 Elsevier Ltd. All rights reserved.
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There has been much discussion on the importance of Brazilian ethanol in promoting a more sustainable society. However, there is a lack of analysis of whether sugarcane plants/factories that produce this ethanol are environmentally suitable. Thus, the objective of this study was to analyse stages of environmental management at four Brazilian ethanol-producing plants, examining the management practices adopted and the factors behind this adoption. The results indicate that (1) only one of the four plants is in the environmentally proactive stage; (2) all plants are adopting operational and organisational environmental management practices; (3) all plants have problems in communicating environmental management practices; and (4) the plant with the most advanced environmental management makes intense use of communication practices and is strongly oriented towards a more environmentally aware international market. This paper is an attempt to explain the complex relationship between the evolution of environmental management, environmental practices and motivation using a framework. The implications for society, plant directors and scholars are described, as well as the study's limitations.
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Having the objective of minimizing costs and improving their image in the consumer and export market, car battery industries began to seek environmental alternatives geared towards sustainable development. Reverse logistics flow represents an unprecedented tool for the economic and operational development of company activities, as well as a differential in the search for competitive advantages through environmentally correct practices. The aim of this paper is to describe the reverse logistics chain adopted by automotive battery industries in the midwest of the state of São Paulo, proposing a reverse logistics framework for small manufacturers that creates actions aimed at not harming the environment. (C) 2010 Elsevier Ltd. All rights reserved.