Ouvidoria do SUS: um instrumento de gestão participativa?

Nesta dissertação discute-se a ouvidoria pública brasileira quanto mecanismo de defesa dos direitos dos cidadãos, especificamente a Ouvidoria do Sistema Único de Saúde (SUS) no estado do Pará e se esta constitui-se enquanto um instrumento de gestão participativa, conforme preconiza o Ministério da Saúde. No estudo observaram-se os processos de implantação, implementação e descentralização no âmbito da gestão estadual da política pública no estado do Pará. Adotou-se abordagem qualitativa que possibilitou à investigação dos processos de relações sociais, cujos dados puderam ser obtidos através de documentos e entrevistas com os sujeitos envolvidos no tema em questão. Evidencia-se que a ouvidoria pública, como qualquer aparelho estatal é um espaço de luta política, desta forma teceu-se considerações sobre o Estado a partir de Marx, Gramsci e Poulantzas, destacando a reforma sofrida pelo Estado brasileiro dos anos 1990, a qual Behring caracterizou de contrarreforma por conta de sua tendência a amortizar direitos sociais e trabalhistas já conquistados. Em seguida apresentam-se pontos de vista diferente em relação à chamada democracia participativa que pode se identificar tanto com o pensamento liberal reformado ou colocar-se na perspectiva transformadora da sociedade por meio da radicalização da democracia. Embasado na matriz teórica marxista analisa-se a literatura existente sobre a ouvidoria pública e apresenta-se a Política Nacional de Gestão Estratégica e Participativa do SUS, cuja ouvidoria é um dos seus elementos. Os resultados mostraram que a forma como a Ouvidoria do SUS foi concebida e a concepção de participação adotada por esta a qual limitase a um mero instrumento de aferição da satisfação dos usuários são sem dúvida os principais obstáculos para que a Ouvidoria seja, de fato, um instrumento de gestão participativa.

Cross-layer optimizations for multimedia distribution over Wireless Multimedia Sensor Networks and Flying Ad-Hoc Networks with quality of experience support

The proliferation of multimedia content and the demand for new audio or video services have fostered the development of a new era based on multimedia information, which allowed the evolution of Wireless Multimedia Sensor Networks (WMSNs) and also Flying Ad-Hoc Networks (FANETs). In this way, live multimedia services require realtime video transmissions with a low frame loss rate, tolerable end-to-end delay, and jitter to support video dissemination with Quality of Experience (QoE) support. Hence, a key principle in a QoE-aware approach is the transmission of high priority frames (protect them) with a minimum packet loss ratio, as well as network overhead. Moreover, multimedia content must be transmitted from a given source to the destination via intermediate nodes with high reliability in a large scale scenario. The routing service must cope with dynamic topologies caused by node failure or mobility, as well as wireless channel changes, in order to continue to operate despite dynamic topologies during multimedia transmission. Finally, understanding user satisfaction on watching a video sequence is becoming a key requirement for delivery of multimedia content with QoE support. With this goal in mind, solutions involving multimedia transmissions must take into account the video characteristics to improve video quality delivery. The main research contributions of this thesis are driven by the research question how to provide multimedia distribution with high energy-efficiency, reliability, robustness, scalability, and QoE support over wireless ad hoc networks. The thesis addresses several problem domains with contributions on different layers of the communication stack. At the application layer, we introduce a QoE-aware packet redundancy mechanism to reduce the impact of the unreliable and lossy nature of wireless environment to disseminate live multimedia content. At the network layer, we introduce two routing protocols, namely video-aware Multi-hop and multi-path hierarchical routing protocol for Efficient VIdeo transmission for static WMSN scenarios (MEVI), and cross-layer link quality and geographical-aware beaconless OR protocol for multimedia FANET scenarios (XLinGO). Both protocols enable multimedia dissemination with energy-efficiency, reliability and QoE support. This is achieved by combining multiple cross-layer metrics for routing decision in order to establish reliable routes.

Qualidade do serviço público odontológico no Brasil: a percepção de usuários e profissionais da saúde

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Validação de aplicativo comercial visando a incorporação da realidade aumentada a um modelo de avaliação pós-ocupação

Post-Occupancy Evaluation of buildings considers user satisfaction, building pathologies and performance, as well as users interventions in the built environment. The possibility of identifying interventions regardless of the user could provide a significant gain in the efficiency of Post-Occupancy Evaluations. We foresee the application of Augmented Reality (AR) to improve the identification of renovations by overlapping the construction information model with an image of the actual building. This article validates the use of AR on existing smartphone and tablet applications. This study proposes the incorporation of AR into the planning, execution and application of Post-Occupancy Evaluation. For the planning, this study proposes the development of a new research tool. With regards to the execution, this study examined the data collection conditions on site through the visualization of overlapping models. For the application, this study proposes displaying the results through the use of RA information layers. The transparency oft he RA model was used to allow comparison between the virtual model and the real model. The development and adaptation of the virtual model and the solution developed for the experiment of the RA proposal are presented and discussed. The experiment points to shortcomings that still make the proposed technological solution unfeasible.

Comunicação pública, transparência e políticas públicas: avaliação de informações em portais brasileiros de governo

An expansion of the professional field of Public Relations can be seen nowadays, influenced by factors such as the increasing use of information and communications technologies for the dissemination of information on public management and the potential creation of dialogue between government and citizens. Despite this trend, there is still a need for specific knowledge about normative aspects of public communication generated by governments on the internet and its role in the fulfillment of the right to information. This article offers a contribution to fulfill the gap of guidelines and standards for professional performance. It describes the results of empirical research which identified the potential contribution of government web portals of the main cities of São Paulo, in the southeastern Brazil, to the strengthening of citizenship, considered in its dimension of exercising the right to information about public policies, particularly those which have an impact on education. The depth and breadth of information were investigated according with twelve categories of evaluation: history; diagnoses; goals; goals; resources and current actions; planned resources and actions; efficiency; effectiveness; impact; cost-effectiveness; user satisfaction; and equity. The data found on the analyzed portals correspond to the average of 11% of which was considered, under the theoretical-methodological context of the research, as information necessary to comprise the full characterization of a public policy in relation to the categories of assessment. Opportunities to improve government web portals were detected, for which we suggest communication management strategies.

Democracia digital e redes sociais: Twitter como filtro de informação política

The internet, with its hypertext and multimedia features, can be a support for the dissemination of information in an attractive way, which may contribute to the strengthening of democracy. Recent innovation, social networks have been explored also as a resource to attract the interest of the broader public to information about public policies. This paper presents and discusses the results of an empirical study which assessed, through content analysis, the breadth and depth of information offered by the Sao Paulo state government and the federal government in texts accessed through Twitter to publicize purposes, lines of action and limits of public policy in the areas of welfare, health, education and environment . The results indicate that the information available tend to focus mainly on goals, resources and current actions of policies, whereas there can be found few data on planned features, relation between cost and effectiveness and user satisfaction.

Elaboração de um roteiro interpretativo para trilha de ciclista da Florestal Estadual Edmundo Navarro de Andrade, Rio Claro/SP

The State Forest Edmundo Navarro de Andrade (FEENA), Rio Claro/SP has a huge potential for cyclists tracks; the Unit already have a trail at the principal entrance, passing by firebreaks bordering the towers quadrants and finishing at the municipal road. This work aims the ambiental interpretation of this trail already established and implant activities planned before at the public use program of the State Forest according to the management plan of the Unit; to interpret the tracks for mountain bike cyclists; promote the conservation of natural, historic and cultural resources of the Forest. At the present work has been accomplished the Ambiental Interpretation through the panels, containing the characteristic native flora and fauna, the existing water resources at the Unit and also the representatives individuals of the exotic arboreal species, found around the trail. Ten points were chosen for interpretation, therefore, for preparation of the script it was considered besides the bibliographic literature, experiences of project team members at FEENA, Unit Management Plan knowledge relating the gaps in the public use program and field work. The panels contain figures and texts about the chosen topics, to promote a language easily understandable to the visitor and concomitantly, inform to the population who attends the Unit, increasing this way the user satisfaction

Elaboração de um roteiro interpretativo para trilha de ciclista da Florestal Estadual Edmundo Navarro de Andrade, Rio Claro/SP

The State Forest Edmundo Navarro de Andrade (FEENA), Rio Claro/SP has a huge potential for cyclists tracks; the Unit already have a trail at the principal entrance, passing by firebreaks bordering the towers quadrants and finishing at the municipal road. This work aims the ambiental interpretation of this trail already established and implant activities planned before at the public use program of the State Forest according to the management plan of the Unit; to interpret the tracks for mountain bike cyclists; promote the conservation of natural, historic and cultural resources of the Forest. At the present work has been accomplished the Ambiental Interpretation through the panels, containing the characteristic native flora and fauna, the existing water resources at the Unit and also the representatives individuals of the exotic arboreal species, found around the trail. Ten points were chosen for interpretation, therefore, for preparation of the script it was considered besides the bibliographic literature, experiences of project team members at FEENA, Unit Management Plan knowledge relating the gaps in the public use program and field work. The panels contain figures and texts about the chosen topics, to promote a language easily understandable to the visitor and concomitantly, inform to the population who attends the Unit, increasing this way the user satisfaction

New markov chain based methods for single and cross-domain sentiment classification

Nowadays communication is switching from a centralized scenario, where communication media like newspapers, radio, TV programs produce information and people are just consumers, to a completely different decentralized scenario, where everyone is potentially an information producer through the use of social networks, blogs, forums that allow a real-time worldwide information exchange. These new instruments, as a result of their widespread diffusion, have started playing an important socio-economic role. They are the most used communication media and, as a consequence, they constitute the main source of information enterprises, political parties and other organizations can rely on. Analyzing data stored in servers all over the world is feasible by means of Text Mining techniques like Sentiment Analysis, which aims to extract opinions from huge amount of unstructured texts. This could lead to determine, for instance, the user satisfaction degree about products, services, politicians and so on. In this context, this dissertation presents new Document Sentiment Classification methods based on the mathematical theory of Markov Chains. All these approaches bank on a Markov Chain based model, which is language independent and whose killing features are simplicity and generality, which make it interesting with respect to previous sophisticated techniques. Every discussed technique has been tested in both Single-Domain and Cross-Domain Sentiment Classification areas, comparing performance with those of other two previous works. The performed analysis shows that some of the examined algorithms produce results comparable with the best methods in literature, with reference to both single-domain and cross-domain tasks, in $2$-classes (i.e. positive and negative) Document Sentiment Classification. However, there is still room for improvement, because this work also shows the way to walk in order to enhance performance, that is, a good novel feature selection process would be enough to outperform the state of the art. Furthermore, since some of the proposed approaches show promising results in $2$-classes Single-Domain Sentiment Classification, another future work will regard validating these results also in tasks with more than $2$ classes.

A feasibility study for the provision of electronic healthcare tools and services in areas of Greece, Cyprus and Italy

Background Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at-risk" citizens, and a ferry. Conclusions The results proved the functionality and utilization of the platform in various rural places in Greece, Cyprus and Italy. However, further actions are needed to enable the local healthcare systems and the different population groups to be familiarized with, and use in their everyday lives, mature technological solutions for the provision of healthcare services.

DEVELOPING A METHOD FOR IDENTIFYING AND REDUCING FUNCTIONAL DISCREPANCIES OF INFORMATION SYSTEMS

Currently more than half of Electronic Health Record (EHR) projects fail. Most of these failures are not due to flawed technology, but rather due to the lack of systematic considerations of human issues. Among the barriers for EHR adoption, function mismatching among users, activities, and systems is a major area that has not been systematically addressed from a human-centered perspective. A theoretical framework called Functional Framework was developed for identifying and reducing functional discrepancies among users, activities, and systems. The Functional Framework is composed of three models – the User Model, the Designer Model, and the Activity Model. The User Model was developed by conducting a survey (N = 32) that identified the functions needed and desired from the user’s perspective. The Designer Model was developed by conducting a systemic review of an Electronic Dental Record (EDR) and its functions. The Activity Model was developed using an ethnographic method called shadowing where EDR users (5 dentists, 5 dental assistants, 5 administrative personnel) were followed quietly and observed for their activities. These three models were combined to form a unified model. From the unified model the work domain ontology was developed by asking users to rate the functions (a total of 190 functions) in the unified model along the dimensions of frequency and criticality in a survey. The functional discrepancies, as indicated by the regions of the Venn diagrams formed by the three models, were consistent with the survey results, especially with user satisfaction. The survey for the Functional Framework indicated the preference of one system over the other (R=0.895). The results of this project showed that the Functional Framework provides a systematic method for identifying, evaluating, and reducing functional discrepancies among users, systems, and activities. Limitations and generalizability of the Functional Framework were discussed.

Cross-Layer Optimizations for Multimedia Distribution over Wireless Multimedia Sensor Networks and Flying Ad-Hoc Networks with Quality of Experience Support

The proliferation of multimedia content and the demand for new audio or video services have fostered the development of a new era based on multimedia information, which allowed the evolution of Wireless Multimedia Sensor Networks (WMSNs) and also Flying Ad-Hoc Networks (FANETs). In this way, live multimedia services require real-time video transmissions with a low frame loss rate, tolerable end-to-end delay, and jitter to support video dissemination with Quality of Experience (QoE) support. Hence, a key principle in a QoE-aware approach is the transmission of high priority frames (protect them) with a minimum packet loss ratio, as well as network overhead. Moreover, multimedia content must be transmitted from a given source to the destination via intermediate nodes with high reliability in a large scale scenario. The routing service must cope with dynamic topologies caused by node failure or mobility, as well as wireless channel changes, in order to continue to operate despite dynamic topologies during multimedia transmission. Finally, understanding user satisfaction on watching a video sequence is becoming a key requirement for delivery of multimedia content with QoE support. With this goal in mind, solutions involving multimedia transmissions must take into account the video characteristics to improve video quality delivery. The main research contributions of this thesis are driven by the research question how to provide multimedia distribution with high energy-efficiency, reliability, robustness, scalability, and QoE support over wireless ad hoc networks. The thesis addresses several problem domains with contributions on different layers of the communication stack. At the application layer, we introduce a QoE-aware packet redundancy mechanism to reduce the impact of the unreliable and lossy nature of wireless environment to disseminate live multimedia content. At the network layer, we introduce two routing protocols, namely video-aware Multi-hop and multi-path hierarchical routing protocol for Efficient VIdeo transmission for static WMSN scenarios (MEVI), and cross-layer link quality and geographical-aware beaconless OR protocol for multimedia FANET scenarios (XLinGO). Both protocols enable multimedia dissemination with energy-efficiency, reliability and QoE support. This is achieved by combining multiple cross-layer metrics for routing decision in order to establish reliable routes.

Understanding heterogeneity in post-implementation enterprise system usage: towards a fit/misfit-experience-outcome typology

The overarching objective of this dissertation is to uncover why and how individually experienced fits and misfits translate into different outcomes of user behavior and satisfaction and whether these individual fit/misfit outcomes are in line with organizational intent. In search of patterns and possible archetype users in the context of ES PIPs, this dissertation is the first study that specifically links the theoretical concepts of the aggregated individual fit experiences with the individual and organizational outcome of these experiences (i.e. behavioral reaction, user satisfaction, and alignment with organizational intent). The case study’s findings provide preliminary support for four archetype users characterized by specific fit/misfit experience-outcome patterns.

Evaluation of Video Transmission Energy Consumption and Quality

The widespread use of wireless enabled devices and the increasing capabilities of wireless technologies has promoted multimedia content access and sharing among users. However, the quality perceived by the users still depends on multiple factors such as video characteristics, device capabilities, and link quality. While video characteristics include the video time and spatial complexity as well as the coding complexity, one of the most important device characteristics is the battery lifetime. There is the need to assess how these aspects interact and how they impact the overall user satisfaction. This paper advances previous works by proposing and validating a flexible framework, named EViTEQ, to be applied in real testbeds to satisfy the requirements of performance assessment. EViTEQ is able to measure network interface energy consumption with high precision, while being completely technology independent and assessing the application level quality of experience. The results obtained in the testbed show the relevance of combined multi-criteria measurement approaches, leading to superior end-user satisfaction perception evaluation .

Factors associated with successful answering of clinical questions using an information retrieval system*

Objectives: Despite the growing use of online databases by clinicians, there has been very little research documenting how effectively they are used. This study assessed the ability of medical and nurse-practitioner students to answer clinical questions using an information retrieval system. It also attempted to identify the demographic, experience, cognitive, personality, search mechanics, and user-satisfaction factors associated with successful use of a retrieval system.