Modelo de referência para estruturar o Seis Sigma nas organizações

Este artigo apresenta o modelo de referência para estruturar o Seis Sigma, o qual é resultante da incorporação de teorias que contribuem para aumentar o potencial estratégico do Seis Sigma no sentido de incrementar o desempenho organizacional. em sua proposta, o modelo de referência engloba um direcionamento sobre certos requisitos primordiais para o sucesso do programa Seis Sigma. A base teórica de sustentação do modelo de referência foi construída a partir de estudos sobre a influência dos seguintes fatores: orientação estratégica e alinhamento estratégico; medição e gerenciamento do desempenho organizacional; uso de estatística (pensamento estatístico); capacitação/especialização de pessoas; implementação e gerenciamento de projetos; e uso de tecnologia de informação. Complementando a proposição do modelo, o artigo traz evidências empíricas acerca da contribuição dos fatores identificados na formulação do modelo de referência, expondo resultados decorrentes de estudos de caso realizados em quatro subsidiárias brasileiras de multinacionais de grande porte. A análise dos dados forneceu evidências positivas de que os fatores mencionados influenciam de forma efetiva o sucesso e a consolidação do Seis Sigma nas empresas estudadas.

Bone healing in critical-size defects treated with platelet-rich plasma: a histologic and histometric study in rat calvaria

Background and objective: The purpose of this study was to analyze histologically the influence of autologous platelet-rich plasma on bone healing in surgically created critical-size defects in rat calvaria.Material adn Methods: Thirty-two rats were divided into two groups: the control group (group C) and the platelet-rich plasma group. An 8-mm-diameter critical-size defect was created in the calvarium of each animal. In group C the defect was filled by a blood clot only. In the platelet-rich plasma group, 0.35 mL of platelet-rich plasma was placed in the defect and covered by 0.35 mL of platelet-poor plasma. Both groups were divided into subgroups (n = 8) and killed at either 4 or 12 wk postoperatively. Histometric (using image-analysis software) and histologic analyses were performed. The amount of new bone formed was calculated as a percentage of the total area of the original defect. Percentage data were transformed into arccosine for statistical analysis (analysis of variance, Tukey, p < 0.05).Results: No defect completely regenerated with bone. The platelet-rich plasma group had a statistically greater amount of bone formation than group C at both 4 wk (17.68% vs. 7.20%, respectively) and 12 wk (24.69% vs. 11.65%, respectively) postoperatively.Conclusion: Within the limits of this study, it can be concluded that platelet-rich plasma placed in the defects and covered by platelet-poor plasma significantly enhanced bone healing in critical-size defects in rat calvaria.

Labeling index in pituitary adenomas evaluated by means of MIB-1: is there a prognostic role? A critical review

Objective: The present article presents an overview of the literature, and analyses the methods and the primary questions related to assessment of proliferation index using the Ki-67/MIB-1 labeling index in pituitary adenomas. Although atypical adenomas are characterized by their atypical morphological features by an elevated mitotic index, a Ki-67 (MIB-1) labeling index greater than 3% and extensive nuclear staining for p53, use of the proliferation index (LI) of pituitary adenomas in assessing the degree of tumor aggressiveness is a controversial topic in the literature, and there are disparate results involving many studies.Methods: A review of literature was carried out to correlate the role of Ki-67 LI and its correlation with clinical findings, tumor size, invasiveness, recurrence, adenoma subtype, adenoma doubling time, and pituitary carcinomas is addressed. Results: The prognosis cannot be predicted on the basis of the Ki-67 LI alone. Although there is no direct relation between Ki-67 LI and some of these variables and controversial data were found regarding some topics, our review justify the use of Ki-67 in the analysis of pituitary adenomas as an additional information for clinical decision.Conclusion: Although assessment of proliferative may be helpful in predicting subsequent tumor recurrence or invasiveness, there are many other important and as yet unidentified factors pituitary tumors. It is clear that further research is needed to clarify these molecular mechanisms to predict those with a potentially poor clinical outcome.

A new approach to the experimental determination of the critical temperature of metamagnets

A new approach to the experimental determination of the critical temperature of metamagnetic samples with non-zero demagnetizing factors is presented. The method is applied to metamagnetic Ni(NO3)2·2H2O, allowing the conclusion that this salt exhibits a tricritical point. Pressure dependence of the critical temperature, and the existence of a pressure-induced metamagnetic transition are also reported. © 1986.

Implantation failures: Success of assisted hatching with quarter-laser zona thinning

Implantation failure after IVF is one of the factors associated with a reduced chance of pregnancy for some patients. Assisted hatching methodologies are designed to facilitate the embryo's escape from the zona pellucida, and this strategy has been suggested as a means of improving pregnancy rates in patients with previous implantation failure. The aim of this prospective and randomized study was to evaluate the efficacy of quarter-laser zona thinning assisted hatching (qLZT-AH) in improving the implantation of embryos in patients with previous implantation failure. A total of 150 patients with a history of previous implantation failure were treated with intracytoplasmic sperm injection, and allocated into two groups: group 1, only one previous implantation failure, and group 2, repeated implantation failures. The patients in each group were randomized at the time of embryo transfer into a control group (no qLZT-AH) or experimental group where qLZT-AH was performed. For patients with repeated implantation failures, the implantation rate in those who received laser-thinned embryos was significantly higher (P=0.02) than in those whose embryos were not laser-thinned (10.9 and 2.6% respectively). However, this difference was not observed in patients who presented with only one previous implantation failure. The data demonstrate that qLZT-AH is an effective strategy for improving the implantation of embryos in patients with repeated implantation failures.

Secretion of middle ear in infants - Occurrence, recurrence and related factors

Objective: The present study aimed at evaluating the occurrence and recurrence of middle ear effusion and possible associated factors in the first two years of life of 190 newborns and infants, participants in the interdisciplinary prevention, detection, and intervention program at the Clínica de Educação para Saúde of Universidade do Sagrado Coração, Methods: Newborns and infants were monthly submitted to anamneses, otoscopy, behavioral hearing assessment using sound instruments and pure tones (pediatric audiometry) and tympanometry. Results: The results revealed that 68.4% of infants presented one or more episodes of middle ear effusion during their two first years, with more recurrence among males. Peak occurrence was between four and 12 months of age and, the earlier the first episode, the higher the probability of recurrence. Greatest incidence was during May and August. It was found that, of the variables investigated, the period of exclusive breastfeeding actuated as a protector factor. With respect of risk factors, it was observed that passive smoking, gastro-esophageal reflux and respiratory allergy were related with the recurrences of effusion. Conclusion: Findings revealed the importance of periodic auditory follow-up for infants during their first two years of life, considered to be the critical period of auditory system maturation, during which sensory deprivation can be responsible for damage to the development of speech, language and other auditory abilities. Copyright © 2005 by Sociedade Brasileira de Pediatria.

Macroeconomic success and social vulnerability: lessons for Latin America from the Celtic Tiger

Includes bibliography

Demographic bottlenecks in tropical plant regeneration: A comparative analysis of causal influences

Mortality factors that act sequentially through the demographic transitions from seed to sapling may have critical effects on recruitment success. Understanding how habitat heterogeneity influences the causal factors that limit propagule establishment in natural populations is central to assess these demographic bottlenecks and their consequences. Bamboos often influence forest structure and dynamics and are a major factor in generating landscape complexity and habitat heterogeneity in tropical forests. To understand how patch heterogeneity influences plant recruitment we studied critical establishment stages during early recruitment of Euterpe edulis, Sloanea guianensis and Virola bicuhyba in bamboo and non-bamboo stands in the Brazilian Atlantic forest. We combined observational studies of seed rain and seedling emergence with seed addition experiments to evaluate the transition probabilities among regeneration stages within bamboo and non-bamboo stands. The relative importance of each mortality factor was evaluated by determining how the loss of propagules affected stage-specific recruitment success. Our results revealed that the seed addition treatment significantly increased seedling survivorship for all three species. E. edulis seedling survival probability increased in the addition treatment in the two stand types. However, for S. guianensis and V. bicuhyba this effect depended strongly on artificially protecting the seeds, as both species experienced increased seed and seedling losses due to post-dispersal seed predators and herbivores. Propagules of all three species had a greater probability of reaching subsequent recruitment stages when protected. The recruitment of large-seeded V. bicuhyba and E. edulis appears to be much more limited by post-dispersal factors than by dispersal limitation, whereas the small-seeded S. guianensis showed an even stronger effect of post-dispersal factors causing recruitment collapse in some situations. We demonstrated that E. edulis, S. guianensis and V. bicuhyba are especially susceptible to predation during early compared with later establishment stages and this early stage mortality can be more crucial than stand differences as determinants of successful regeneration. Among-species differences in the relative importance of dispersal vs. establishment limitation are mediated by variability in species responses to patch heterogeneity. Thus, bamboo effects on the early recruitment of non-bamboo species are patchy and species-specific, with successional bamboo patches exerting a far-reaching influence on the heterogeneity of plant species composition and abundance. © 2012 Perspectives in Plant Ecology, Evolution and Systematics.

Critical currents and melting temperature of a two-dimensional vortex lattice with periodic pinning

The critical current and melting temperature of a vortex system are analyzed. Calculations are made for a two-dimensional film at finite temperature with two kinds of periodic pinning: hexagonal and Kagomé. A transport current parallel and perpendicular to the main axis of the pinning arrays is applied and molecular dynamics simulations are used to calculate the vortex velocities to obtain the critical currents. The structure factor and displacements of vortices at zero transport current are used to obtain the melting temperature for both pinning arrays. The critical currents are higher for the hexagonal pinning lattice and anisotropic for both pinning arrays. This anisotropy is stronger with temperature for the hexagonal array. For the Kagomé pinning lattice, our analysis shows a multi stage phase melting; that is, as we increase the temperature, each different dynamic phase melts before reaching the melting temperature. Both the melting temperature and critical currents are larger for the hexagonal lattice, indicating the role for the interstitial vortices in decreasing the pinning strength. © 2012 Springer Science+Business Media New York.

Platelet-Rich Plasma And Chronic Wounds: Remaining Fibronectin May Influence Matrix Remodeling And Regeneration Success

Background: Platelet-rich plasma has been largely used as a therapeutic option for the treatment of chronic wounds of different etiologies. The enhanced regeneration observed after the use of platelet-rich plasma has been systematically attributed to the growth factors that are present inside platelets' granules. Aim: We hypothesize that the remaining plasma and platelet-bound fibronectin may act as a further bioactive protein in platelet-rich plasma preparations. Methods: Recent reports were analyzed and presented as direct evidences of this hypotheses. Results: Fibronectin may directly influence the extracellular matrix remodeling during wound repair. This effect is probably through matrix metalloproteinase expression, thus exerting an extra effect on chronic wound regeneration. Conclusions: Physicians should be well aware of the possible fibronectin-induced effects in their future endeavors with PRP in chronic wound treatment. © 2013 International Society for Cellular Therapy.

A abordagem neoconservadora da crise na sociedade estadunidense e sua influência no governo de George W. Bush

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A Escola Cabana e a concepção de qualidade social de educação como política pública educacional para Belém/PA (1997-2004)

Tomando-se como referência as condições políticas e pedagógicas em que se realizam as políticas educacionais para a educação básica, este estudo analisou a concepção de qualidade social da educação, assumida pela Escola Cabana, no município de Belém/PA, no período de 1997 a 2004. Explicita os fatores e elementos necessários à educação de qualidade, bem como, analisa as contribuições e limites do Projeto Escola Cabana para construção do conceito de Qualidade Social da Educação como política pública. Realizou-se por meio de análise documental, assumindo a abordagem crítico-dialética como referencial teóricometodológico. A pesquisa desenvolveu-se, inicialmente, com um levantamento na produção bibliográfica existente das concepções de qualidade evidenciadas nas políticas educacionais, assim como das investigações realizadas sobre a Escola Cabana. A análise documental incidiu sobre os documentos oficiais produzidos pela Secretaria Municipal de Educação – SEMEC, sendo considerados como fontes primárias do estudo os planos de governo, os cadernos dos fóruns e conferências, os cadernos de educação e a proposta preliminar e final do Plano Municipal de Educação. Ao analisar tal política é possível apontar algumas considerações que indicam a referência da Qualidade Social da Educação, em um primeiro momento, como uma estratégia pela qual se alcançaria a inclusão social na escola, com sua ação centrada no processo de reorientação curricular, o qual envolve a organização do trabalho pedagógico por meio da resignificação do tempo para aprendizagem, da formação voltada para a cidadania e democracia, da instituição de processos democráticos de avaliação da aprendizagem, assim como, da organização do ensino por meio do trabalho coletivo e interdisciplinar com vistas à permanência com sucesso do aluno na escola. Em um segundo momento observa-se uma elaboração mais ampla e avançada para formulação da Qualidade Social da Educação como política pública, tendo em vista, o importante vínculo construído entre a organização educativa escolar e a garantia de condições estruturais e financeiras como responsabilidade do poder público na oferta da educação como direito público subjetivo.

Estudo sobre a distribuição da malária no Pará e sua correlação com fatores ambientais e socioeconômicos

A malária é uma doença parasitária causada por protozoários do gênero Plasmodium que completam seu ciclo de desenvolvimento alternando entre hospedeiros humanos e mosquitos do gênero Anopheles. No contexto mundial, constitui um grave problema de saúde pública que afeta principalmente os países em desenvolvimento de clima tropical e subtropical. No Brasil, acredita-se que 99,5% dos casos registrados de malária encontram-se na Amazônia Legal. Muito do sucesso deste agravo nesta região deve-se a fatores biológicos e ambientais que favorecem níveis altos de vetores, além de fatores sociais que comprometem os esforços para controlar a doença. Assim, o objetivo deste trabalho foi estudar o perfil epidemiológico da malária no Pará, durante uma série histórica (1999 – 2003), analisando a influência de variáveis ambientais e socioeconômicas sobre a prevalência dos casos. Para tal foram calculados os índices parasitários anuais (IPA) de cada município e, através de um SIG, estes dados foram georreferenciados e estudados de forma temporal e espacial. Dados sobre o desmatamento no Estado foram analisados, através de uma regressão por permutação, para tentar explicar a variação temporal da malária. Para o estudo espacial foi testada (regressão múltipla) a influência das variáveis: temperatura, pluviosidade, altitude, educação, longevidade e renda, sobre a prevalência da malária. No estudo temporal a malária apresentou uma tendência decrescente no Estado, entretanto, apenas 31 municípios apresentaram a mesma tendência, não houve tendência crescente, os 112 municípios restantes apresentaram tendência estável. Além disso, muitos municípios alternaram aumento e diminuição dos casos ao longo da série, indicando uma boa ação de controle, mas uma fraca atuação da vigilância. Neste contexto o desmatamento parece influenciar a série temporal da malária, obteve-se resultados significativos em dois (2001 e 2002) dos três anos estudados. No estudo espacial o modelo final adotado, apesar de uma baixo poder explicativo (R²=0.31), apresentou três variáveis significativas: número de meses secos, renda e educação. No entanto, o resultado das duas primeiras não se apresenta de uma forma direta, sendo reflexo de outras atividades. Apesar da escala adotada e de problemas na agregação dos dados (só estão disponíveis por município), este trabalho apresenta resultados relevantes que podem auxiliar os gestores da saúde (ou de endemias) a direcionar ações de controle para as áreas apontadas como críticas, atuando nos fatores de maior significância, obtendo assim melhor aproveitamento dos recursos humanos e materiais disponíveis.

Análise das tensões em próteses unitárias implantossuportadas com diferentes tipos de conexões e qualidade óssea: estudo pelo método dos elementos finitos tridimensionais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Relationships between growth of the preovulatory follicle and gestation success in lactating dairy cows

This report summarizes three studies conducted with lactating dairy cows aiming to increase pregnancy rates to fixed time artificial insemination (TAI) protocols. Experiment 1 was designed to determine if changing the timing of PGF2 alpha treatment during an E2/P4-based program would affect fertility to TAI or fixed-time embryo transfer (TET). In experiment 2, pregnancy rates to AI were compared following synchronized ovulation using two protocols that have been developed to reduce the period between follicular wave emergence and TAI. The Ovsynch-type protocol utilizes GnRH to synchronize the follicular wave by inducing ovulation of a dominant follicle at the beginning of the protocol, and to synchronize ovulation at the end of the protocol allowing TAI. In contrast, E2/P4-based protocols utilize E2 products in the presence of P4 to induce atresia of antral follicles and synchronize emergence of a new follicular wave. At the end of E2/P4-based protocol another E2 treatment in the absence of P4 is used to induce LH release and synchronize ovulation and allow TAI. Experiment 3 was designed to determine whether increasing the length time interval with reduced circulating P4 (proestrus) would increase fertility in a TAI program that utilized E2 and P4 to synchronize ovulation of cycling, lactating dairy cows. The overall conclusions are that circulating concentrations of progesterone and estradiol prior to and circulating concentrations of progesterone following ovulation can affect fertility in cattle. In addition, small increases in P4 concentrations near the time of AI, due to lack of complete CL regression, result in reductions in fertility. Earlier treatment with PGF2 alpha should allow greater time for CL regression, an increase in estradiol and subsequent reductions in circulating P4 that could be critical for fertility. Optimization of follicle size in TAI programs is clearly an intricate balance between oocyte quality, adequate circulating E2 near AI, and adequate circulating P4 after AI.