Understanding the dynamics of information technology implementation: The case of clinical information systems

The ultimate intent of this dissertation was to broaden and strengthen our understanding of IT implementation by emphasizing research efforts on the dynamic nature of the implementation process. More specifically, efforts were directed toward opening the "black box" and providing the story that explains how and why contextual conditions and implementation tactics interact to produce project outcomes. In pursuit of this objective, the dissertation was aimed at theory building and adopted a case study methodology combining qualitative and quantitative evidence. Precisely, it examined the implementation process, use and consequences of three clinical information systems at Jackson Memorial Hospital, a large tertiary care teaching hospital.^ As a preliminary step toward the development of a more realistic model of system implementation, the study proposes a new set of research propositions reflecting the dynamic nature of the implementation process.^ Findings clearly reveal that successful implementation projects are likely to be those where key actors envision end goals, anticipate challenges ahead, and recognize the presence of and seize opportunities. It was also found that IT implementation is characterized by the systems theory of equifinality, that is, there are likely several equally effective ways to achieve a given end goal. The selection of a particular implementation strategy appears to be a rational process where actions and decisions are largely influenced by the degree to which key actors recognize the mediating role of each tactic and are motivated to action. The nature of the implementation process is also characterized by the concept of "duality of structure," that is, context and actions mutually influence each other. Another key finding suggests that there is no underlying program that regulates the process of change and moves it form one given point toward a subsequent and already prefigured end. For this reason, the implementation process cannot be thought of as a series of activities performed in a sequential manner such as conceived in stage models. Finally, it was found that IT implementation is punctuated by a certain indeterminacy. Results suggest that only when substantial efforts are focused on what to look for and think about, it is less likely that unfavorable and undesirable consequences will occur. ^

Design and Development of Network Monitoring Strategies in P4-enabled Programmable Switches

Network monitoring is of paramount importance for effective network management: it allows to constantly observe the network’s behavior to ensure it is working as intended and can trigger both automated and manual remediation procedures in case of failures and anomalies. The concept of SDN decouples the control logic from legacy network infrastructure to perform centralized control on multiple switches in the network, and in this context, the responsibility of switches is only to forward packets according to the flow control instructions provided by controller. However, as current SDN switches only expose simple per-port and per-flow counters, the controller has to do almost all the processing to determine the network state, which causes significant communication overhead and excessive latency for monitoring purposes. The absence of programmability in the data plane of SDN prompted the advent of programmable switches, which allow developers to customize the data-plane pipeline and implement novel programs operating directly in the switches. This means that we can offload certain monitoring tasks to programmable data planes, to perform fine-grained monitoring even at very high packet processing speeds. Given the central importance of network monitoring exploiting programmable data planes, the goal of this thesis is to enable a wide range of monitoring tasks in programmable switches, with a specific focus on the ones equipped with programmable ASICs. Indeed, most network monitoring solutions available in literature do not take computational and memory constraints of programmable switches into due account, preventing, de facto, their successful implementation in commodity switches. This claims that network monitoring tasks can be executed in programmable switches. Our evaluations show that the contributions in this thesis could be used by network administrators as well as network security engineers, to better understand the network status depending on different monitoring metrics, and thus prevent network infrastructure and service outages.

Construction Of A Manual Of Work Processes And Techniques From Centro De Dispensação De Medicamentos De Alto Custo (cedmac), Hospital De Clínicas, Unicamp.

The Centers for High Cost Medication (Centros de Medicação de Alto Custo, CEDMAC), Health Department, São Paulo were instituted by project in partnership with the Clinical Hospital of the Faculty of Medicine, USP, sponsored by the Foundation for Research Support of the State of São Paulo (Fundação de Amparo à Pesquisa do Estado de São Paulo, FAPESP) aimed at the formation of a statewide network for comprehensive care of patients referred for use of immunobiological agents in rheumatological diseases. The CEDMAC of Hospital de Clínicas, Universidade Estadual de Campinas (HC-Unicamp), implemented by the Division of Rheumatology, Faculty of Medical Sciences, identified the need for standardization of the multidisciplinary team conducts, in face of the specificity of care conducts, verifying the importance of describing, in manual format, their operational and technical processes. The aim of this study is to present the methodology applied to the elaboration of the CEDMAC/HC-Unicamp Manual as an institutional tool, with the aim of offering the best assistance and administrative quality. In the methodology for preparing the manuals at HC-Unicamp since 2008, the premise was to obtain a document that is participatory, multidisciplinary, focused on work processes integrated with institutional rules, with objective and didactic descriptions, in a standardized format and with electronic dissemination. The CEDMAC/HC-Unicamp Manual was elaborated in 10 months, with involvement of the entire multidisciplinary team, with 19 chapters on work processes and techniques, in addition to those concerning the organizational structure and its annexes. Published in the electronic portal of HC Manuals in July 2012 as an e-Book (ISBN 978-85-63274-17-5), the manual has been a valuable instrument in guiding professionals in healthcare, teaching and research activities.

Tua imensa torcida e bem feliz... da relação torcedor com o clube

Universidade Estadual de Campinas . Faculdade de Educação Física

A personagem desconstruida : argumentos para uma arte cenica não-logocentrica

Universidade Estadual de Campinas . Faculdade de Educação Física

A integralidade numa rede de proteção social ao adolescente: uma reflexão a partir do pensamento de Giles Lipovetsky

O propósito deste artigo é apresentar uma discussão sobre a integralidade como um paradigma, uma ideia-referência, do campo de conhecimento da Saúde Pública. Para isso apresentamos a exploração empírica dos elementos discursivos coletados numa rede de proteção social voltada ao adolescente dos quais deriva parte importante da prática de agentes de saúde. As experiências colhidas em campo a partir da ação dos articuladores da Política Municipal de Atenção à Criança e ao Adolescente, no Município de Suzano-SP, foram analisadas sob o ponto de vista de Gilles Lipovetsky. Essa análise situou a integralidade como ideia-referência proposta pelo campo de conhecimento da saúde pública, que questiona e provoca mudanças nas práticas médicas e de saúde inseridas na sociedade contemporânea, sobretudo no que se refere à atenção psicossocial.

Conhecimento e uso do Sistema de Informações sobre Orçamentos Públicos em Saúde (SIOPS) pelos gestores municipais, Pernambuco, Brasil

Considerando a importância do Sistema de Informações sobre Orçamentos Públicos em Saúde (SIOPS) como ferramenta para o planejamento, gestão e controle social dos gastos públicos em saúde, este trabalho teve como objetivo avaliar a relação entre a regularidade na alimentação do SIOPS e o conhecimento e uso do Sistema pelos gestores municipais do Estado de Pernambuco, Brasil. Foram selecionados dez municípios distribuídos nas cinco mesorregiões do estado, sendo cinco regulares e cinco irregulares na alimentação do Sistema, e aplicada uma entrevista semi-estruturada entre os secretários de saúde dos respectivos municípios. Com base na análise dos dados, foi identificado que o domínio de informática e o conhecimento do Sistema não interferem na regularidade da alimentação, em função do distanciamento entre os gestores das Secretarias de Saúde e o SIOPS, em geral alimentado por serviços terceirizados. Constata-se que as informações geradas não têm sido exploradas potencialmente pelos gestores enquanto instrumento de gestão.

Insulin Affects Tissue Organization and the Kinetics of Epithelial Cell Death in the Rat Ventral Prostate After Castration

Prostate growth and physiology are regulated by steroid hormones and modulated by multiple endocrine factors We investigated the action of insulin on the tissue organization and kinetics of epithelial cells in the rat ventral prostate (VP) in response to castration up to 120 hours after surgery by using an acute protocol of alloxan induced diabetes Diabetes caused a reduction in volume density (Vv(o)/) and volume of the epithelium The effects of castration on the epithelium were accelerated in the diabetic animals as determined by changes in V(o)/, and volume The smooth muscle cells became atrophic and apparently relaxed in response to castration in contrast to the spinous aspect observed in nondiabetic castrated rats Counting of apoptotic nuclei in the epithelium showed the classical apoptosis peak at 72 hours in nondiabetic rats and an advance of the apoptosis peak to 48 hours after castration in diabetic rats Insulin restored the time of the peak to 72 hours These results were confirmed after immunostaining for cleaved caspase 3 and suggest a survival and antiapoptotic effect on VP epithelial cells in both the presence and absence of androgen stimulation This idea is supported by the observation that insulin also reduced the overall rate of apoptosis at all experimental points analyzed before and after castration

Sistema de apoio à geração de ideias em grupo considerando as emoções e os aspectos sociais

As emoções dos indivíduos e o contexto social do grupo onde estes estão inseridos têm influência no seu desempenho no que se refere ao desenvolvimento de várias tarefas, incluindo as que são realizadas via electrónica. O processo de geração de ideias em grupo mediado por computador tem vantagens consideráveis em relação ao processo de geração de ideias em grupo tradicional, nomeadamente no que se refere ao aumento da sinergia entre os elementos do grupo, à existência da memória de grupo e à possibilidade dos elementos estarem dispersos no espaço e no tempo. Com isto em mente, o presente trabalho pretende analisar a importância do estado de espírito do participante e a influência que os vários aspectos sociais têm no participante, para assim ser possível tomar determinadas acções com o objectivo de potenciar o desempenho dos utilizadores ao longo da reunião de geração de ideias. Neste trabalho é analisada a influência que o estado de espírito dos participantes e o contexto social das reuniões podem ter no sucesso de uma reunião de geração de ideias electrónica. Considerando a influência de estes factores, é proposto um modelo que inclui essas variáveis no processo de geração de ideias em grupo mediado por computador. Com isto pretende-se demonstrar que a inclusão do modelo proposto numa ferramenta de apoio à geração de ideias em grupo permite melhorar o desempenho individual e consequentemente o desempenho do grupo, bem como a interacção entre todos os elementos. Assim, este trabalho pretende gerar sugestões com o objectivo de manter os participantes atentos e motivados para as tarefas que têm de realizar, nomeadamente a tarefa de geração de ideias. Com o objectivo de aplicar o modelo proposto é também apresentado neste trabalho uma nova ferramenta de geração de ideias em computador que considera o contexto emocional e social da reunião, o S-IGTAI (Social Idea Generation Tool for Ambient Intelligence). Através das interacções entre os participantes e a ferramenta S-IGTAI, é recolhida informação que será o input do modelo proposto, sendo que o output serão as sugestões enviadas para o facilitador. Estas sugestões têm o propósito que o facilitador realize recomendações aos participantes no sentido de manter os seus estados de espírito num nível positivo e eliminar a influência negativa dos vários aspectos sociais, potenciando dessa forma o desempenho de todos os participantes. Com a finalidade de validar o modelo proposto e a nova ferramenta (S-IGTAI) é apresentado um caso de estudo neste documento que permite realizar a avaliação do trabalho desenvolvido.

O envolvimento das famílias nas actividades de sala de aula de 1.º ciclo

Relatório de Estágio apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ensino do 1.º e do 2.º Ciclo do Ensino Básico

Variações do repertório clássico nas aulas de Técnica de Dança Clássica do 4º e do 5º ano da Escola de Dança Ana Mangerição

Relatório Final de Estágio apresentado à Escola Superior de Dança, com vista à obtenção do grau de Mestre em Ensino de Dança.

Credit risk measures: a case of renewable energy companies

The Basel III will have a significant impact on the European banking sector. In September 2010, supervisors of various countries adopted the new rules proposed by the prudential Committee on Banking Supervision to be applied to the business of credit institutions (hereinafter called ICs) in a phased manner from 2013, assuming to its full implementation by 2019. The purpose of this new regulation is to limit the excessive risk that these institutions took on the period preceding the global financial crisis of 2008. This new regulation is known in slang by Basel III. Depending on the requirement of Basel II for banks and their supervisors to assess the soundness and adequacy of internal risk measurement and credit management systems, the development of methodologies for the validation of internal and external evaluation systems is clearly an important issue . More specifically, there is a need to develop tools to validate the systems used to generate the parameters (such as PD, LGD, EAD and ratings of perceived risk) that serve as starting points for the IRB approach for credit risk. In this context, the work is composed of a number of approaches and tools used to evaluate the robustness of these elements IRB systems.

ERICA: prevalence of common mental disorders in Brazilian adolescents

ABSTRACT OBJECTIVE To describe the prevalence of common mental disorders in Brazilian adolescent students, according to geographical macro-regions, school type, sex, and age. METHODS We evaluated 74,589 adolescents who participated in the Cardiovascular Risk Study in Adolescents (ERICA), a cross-sectional, national, school-based study conducted in 2013-2014 in cities with more than 100,000 inhabitants. A self-administered questionnaire and an electronic data collector were employed. The presence of common mental disorders was assessed using the General Health Questionnaire (GHQ-12). We estimated prevalence and 95% confidence intervals of common mental disorders by sex, age, and school type, in Brazil and in the macro-regions, considering the sample design. RESULTS The prevalence of common mental disorders was of 30.0% (95%CI 29.2-30.8), being higher among girls (38.4%; 95%CI 37.1-39.7) when compared to boys (21.6%; 95%CI 20.5-22.8), and among adolescents who were from 15 to 17 years old (33.6%; 95%CI 32.2-35.0) compared to those aged between 12 and 14 years (26.7%; 95%CI 25.8-27.6). The prevalence of common mental disorders increased with age for both sexes, always higher in girls (ranging from 28.1% at 12 years to 44.1% at 17 years) than in boys (ranging from 18.5% at 12 years to 27.7% at 17 years). We did not observe any significant difference by macro-region or school type. Stratified analyses showed higher prevalence of common mental disorders among girls aged from 15 to 17 years of private schools in the North region (53.1; 95%CI 46.8-59.4). CONCLUSIONS The high prevalence of common mental disorders among adolescents and the fact that the symptoms are often vague mean these disorders are not so easily identified by school administrators or even by health services. The results of this study can help the proposition of more specific prevention and control measures, focused on highest risk subgroups.

Testing native speakers of German and Portuguese on the understanding of topological operators-line-region relations in gvSIG

Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies

Metodologia Seis Sigma: Implementação e Impacto nas PMEs Portuguesas

Dissertação de Mestrado em Gestão Integrada da Qualidade, Ambiente e Segurança