Caracterización y análisis del coste de mejora de la calidad de servicio en transporte urbano en autobús, basado en la metodología ABC (activity based costing)

El estudio de la calidad de servicio en transporte público ha tenido distintos enfoques, tanto en la investigación como en sus aplicaciones prácticas, tales como el desarrollo del método SERVQUAL, los proyectos QUATTRO y EQUIP de la Comisión Europea, el Transit Capacity and Quality of Service Manual y finalmente el estándar EN 13816, siendo la consideración principal la calidad desde el punto de vista del usuario, es decir, la calidad percibida, cuyo objetivo en la práctica trata de obtener un Índice de Satisfacción del Cliente como medida de la calidad global. Esta aproximación deja de lado aspectos tanto sobre calidad suministrada como sobre los suministradores del servicio, las administraciones y los operadores, particularmente en cuanto a las implicaciones económicas. El objetivo principal de la presente tesis es la estimación del impacto económico real de la mejora de atributos de calidad para un operador de autobús urbano. En el capítulo 2, se lleva a cabo un análisis del estado del arte sobre el estudio de la calidad, tanto de los métodos de estudio, como de su aplicación al campo de transporte público, y, específicamente, del estudio de costes. En los capítulos 3 y 4 se propone la aplicación de la metodología ABC (Activity Based Costing) para el caso de un contrato de servicio de transporte público en autobús en la Comunidad de Madrid, concretamente la conexión de Tres Cantos. Para ello se utilizan datos de encuestas de calidad esperada y percibida por los usuarios, junto con información económica y de actividad, así como entrevistas a personal de la empresa, conformando todo ello una metodología compacta de investigación y análisis. Los resultados de las encuestas y los análisis posteriores identificaron la frecuencia de servicio, la puntualidad de los autobuses y la seguridad de la conducción como las tres variables mas importantes desde el punto de vista del usuario, y ha sido en referencia a estas tres variables sobre las que se ha desarrollado la aplicación del método ABC contenida en el capítulo 5. Los resultados descritos en el capítulo 6 muestran la consistencia y la aplicabilidad de esta metodología, superando las simplificaciones de los procedimientos tradicionales contables. En cuanto a los resultados obtenidos, se ha comprobado que una aproximación tradicional basada en costes por kilometro puede llegar a sobrevalorar los costes asociados a mejoras de calidad hasta tres veces los costes calculados según el método ABC. Finalmente en el capítulo 7 se recogen las principales conclusiones y se apuntan algunas líneas futuras de investigación basadas en mejoras sobre la aplicación y transferibilidad de los resultados. The study of service quality and its implication for transport contracts has several approaches in research and practical applications, such as the development of the SERVQUAL method, the UE QUATTRO and EQUIP research projects, the Transit Capacity and Quality of Service Manual and finally the EN 13816 standard. In all cases the main stream is the consideration of quality from the user’s point of view, thus obtaining a Customer Satisfaction Index as a measurement of the overall service quality. This approach ignores quality consequences for transport providers, authorities and operators, particularly economic implications. The main target of this thesis is to estimate the real economic impact of improving quality attributes for a bus operator. Chapter 2 includes a thorough analysis of the state of the art of general methodologies on service quality, their applications for public transport, and particularly for quality costing. In chapters 3 and 4, the Activity Based Costing (ABC) methodology is proposed for a suburban bus contract in Madrid, Tres Cantos. Perceived and expected quality surveys are used together with economic and performance information, as well as interviews with key staff from the operator. The whole set of surveys, interviews and ABC methodology puts together a comprehensive approach for analysis and research. Surveys and subsequent analysis shows service headway, punctuality and safety as the three most important service attributes from the user’s point of view. The proposed methodology has been applied to these three variables, as described in chapter 5. Results obtained in chapter 6 show the consistency and practicality of this methodology, overcoming simplifications from traditional accounting procedures. According to the latter, a calculation of costs based on mileage can overvalue quality improvements up to three times the results following ABC methodology. Finally, in chapter 7, the main conclusions are highlighted and some future research is suggested in terms of application improvements as well as results transferability.

Analysing the complexity of the model-based decision making processes within the industrial management context

PURPOSE The decision-making process plays a key role in organizations. Every decision-making process produces a final choice that may or may not prompt action. Recurrently, decision makers find themselves in the dichotomous question of following a traditional sequence decision-making process where the output of a decision is used as the input of the next stage of the decision, or following a joint decision-making approach where several decisions are taken simultaneously. The implication of the decision-making process will impact different players of the organization. The choice of the decision- making approach becomes difficult to find, even with the current literature and practitioners’ knowledge. The pursuit of better ways for making decisions has been a common goal for academics and practitioners. Management scientists use different techniques and approaches to improve different types of decisions. The purpose of this decision is to use the available resources as well as possible (data and techniques) to achieve the objectives of the organization. The developing and applying of models and concepts may be helpful to solve managerial problems faced every day in different companies. As a result of this research different decision models are presented to contribute to the body of knowledge of management science. The first models are focused on the manufacturing industry and the second part of the models on the health care industry. Despite these models being case specific, they serve the purpose of exemplifying that different approaches to the problems and could provide interesting results. Unfortunately, there is no universal recipe that could be applied to all the problems. Furthermore, the same model could deliver good results with certain data and bad results for other data. A framework to analyse the data before selecting the model to be used is presented and tested in the models developed to exemplify the ideas. METHODOLOGY As the first step of the research a systematic literature review on the joint decision is presented, as are the different opinions and suggestions of different scholars. For the next stage of the thesis, the decision-making process of more than 50 companies was analysed in companies from different sectors in the production planning area at the Job Shop level. The data was obtained using surveys and face-to-face interviews. The following part of the research into the decision-making process was held in two application fields that are highly relevant for our society; manufacturing and health care. The first step was to study the interactions and develop a mathematical model for the replenishment of the car assembly where the problem of “Vehicle routing problem and Inventory” were combined. The next step was to add the scheduling or car production (car sequencing) decision and use some metaheuristics such as ant colony and genetic algorithms to measure if the behaviour is kept up with different case size problems. A similar approach is presented in a production of semiconductors and aviation parts, where a hoist has to change from one station to another to deal with the work, and a jobs schedule has to be done. However, for this problem simulation was used for experimentation. In parallel, the scheduling of operating rooms was studied. Surgeries were allocated to surgeons and the scheduling of operating rooms was analysed. The first part of the research was done in a Teaching hospital, and for the second part the interaction of uncertainty was added. Once the previous problem had been analysed a general framework to characterize the instance was built. In the final chapter a general conclusion is presented. FINDINGS AND PRACTICAL IMPLICATIONS The first part of the contributions is an update of the decision-making literature review. Also an analysis of the possible savings resulting from a change in the decision process is made. Then, the results of the survey, which present a lack of consistency between what the managers believe and the reality of the integration of their decisions. In the next stage of the thesis, a contribution to the body of knowledge of the operation research, with the joint solution of the replenishment, sequencing and inventory problem in the assembly line is made, together with a parallel work with the operating rooms scheduling where different solutions approaches are presented. In addition to the contribution of the solving methods, with the use of different techniques, the main contribution is the framework that is proposed to pre-evaluate the problem before thinking of the techniques to solve it. However, there is no straightforward answer as to whether it is better to have joint or sequential solutions. Following the proposed framework with the evaluation of factors such as the flexibility of the answer, the number of actors, and the tightness of the data, give us important hints as to the most suitable direction to take to tackle the problem. RESEARCH LIMITATIONS AND AVENUES FOR FUTURE RESEARCH In the first part of the work it was really complicated to calculate the possible savings of different projects, since in many papers these quantities are not reported or the impact is based on non-quantifiable benefits. The other issue is the confidentiality of many projects where the data cannot be presented. For the car assembly line problem more computational power would allow us to solve bigger instances. For the operation research problem there was a lack of historical data to perform a parallel analysis in the teaching hospital. In order to keep testing the decision framework it is necessary to keep applying more case studies in order to generalize the results and make them more evident and less ambiguous. The health care field offers great opportunities since despite the recent awareness of the need to improve the decision-making process there are many opportunities to improve. Another big difference with the automotive industry is that the last improvements are not spread among all the actors. Therefore, in the future this research will focus more on the collaboration between academia and the health care sector.

Aprendizaje integrado en arquitectura con modelos virtuales : implementación de metodología BIM en la docencia universitaria

Los procesos de diseño y construcción en Arquitectura han mostrado un desarrollo de optimización históricamente muy deficiente cuando se compara con las restantes actividades típicamente industriales. La aspiración constante a una industrialización efectiva, tanto en aras de alcanzar mayores cotas de calidad así como de ahorro de recursos, recibe hoy una oportunidad inmejorable desde el ámbito informático: el Building Information Modelling o BIM. Lo que en un inicio puede parecer meramente un determinado tipo de programa informático, en realidad supone un concepto de “proceso” que subvierte muchas rutinas hoy habituales en el desarrollo de proyectos y construcciones arquitectónicas. La inclusión y desarrollo de datos ligados al proyecto, desde su inicio hasta el fin de su ciclo de vida, conlleva la oportunidad de crear una realidad virtual dinámica y actualizable, que por añadidura posibilita su ensayo y optimización en todos sus aspectos: antes y durante su ejecución, así como vida útil. A ello se suma la oportunidad de transmitir eficientemente los datos completos de proyecto, sin apenas pérdidas o reelaboración, a la cadena de fabricación, lo que facilita el paso a una industrialización verdaderamente significativa en edificación. Ante una llamada mundial a la optimización de recursos y el interés indudable de aumentar beneficios económicos por medio de la reducción del factor de incertidumbre de los procesos, BIM supone un opción de mejora indudable, y así ha sido reconocido a través de la inminente implantación obligatoria por parte de los gobiernos (p. ej. Gran Bretaña en 2016 y España en 2018). La modificación de procesos y roles profesionales que conlleva la incorporación de BIM resulta muy significativa y marcará el ejercicio profesional de los futuros graduados en las disciplinas de Arquitectura, Ingeniería y Construcción (AEC por sus siglas en inglés). La universidad debe responder ágilmente a estas nuevas necesidades incorporando esta metodología en la enseñanza reglada y aportando una visión sinérgica que permita extraer los beneficios formativos subyacentes en el propio marco BIM. En este sentido BIM, al aglutinar el conjunto de datos sobre un único modelo virtual, ofrece un potencial singularmente interesante. La realidad tridimensional del modelo, desarrollada y actualizada continuamente, ofrece al estudiante una gestión radicalmente distinta de la representación gráfica, en la que las vistas parciales de secciones y plantas, tan complejas de asimilar en los inicios de la formación universitaria, resultan en una mera petición a posteriori, para ser extraída según necesidad del modelo virtual. El diseño se realiza siempre sobre el propio modelo único, independientemente de la vista de trabajo elegida en cada momento, permaneciendo los datos y sus relaciones constructivas siempre actualizados y plenamente coherentes. Esta descripción condensada de características de BIM preconfiguran gran parte de las beneficios formativos que ofrecen los procesos BIM, en especial, en referencia al desarrollo del diseño integrado y la gestión de la información (incluyendo TIC). Destacan a su vez las facilidades en comprensión visual de elementos arquitectónicos, sistemas técnicos, sus relaciones intrínsecas así como procesos constructivos. A ello se une el desarrollo experimental que la plataforma BIM ofrece a través de sus software colaborativos: la simulación del comportamiento estructural, energético, económico, entre otros muchos, del modelo virtual en base a los datos inherentes del proyecto. En la presente tesis se describe un estudio de conjunto para explicitar tanto las cualidades como posibles reservas en el uso de procesos BIM, en el marco de una disciplina concreta: la docencia de la Arquitectura. Para ello se ha realizado una revisión bibliográfica general sobre BIM y específica sobre docencia en Arquitectura, así como analizado las experiencias de distintos grupos de interés en el marco concreto de la enseñanza de la en Arquitectura en la Universidad Europea de Madrid. El análisis de beneficios o reservas respecto al uso de BIM se ha enfocado a través de la encuesta a estudiantes y la entrevista a profesionales AEC relacionados o no con BIM. Las conclusiones del estudio permiten sintetizar una implantación de metodología BIM que para mayor claridad y facilidad de comunicación y manejo, se ha volcado en un Marco de Implantación eminentemente gráfico. En él se orienta sobre las acciones docentes para el desarrollo de competencias concretas, valiéndose de la flexibilidad conceptual de los Planes de Estudio en el contexto del Espacio Europeo de Educación Superior (Declaración de Bolonia) para incorporar con naturalidad la nueva herramienta docente al servicio de los objetivos formativo legalmente establecidos. El enfoque global del Marco de Implementación propuesto facilita la planificación de acciones formativas con perspectiva de conjunto: combinar los formatos puntuales o vehiculares BIM, establecer sinergias transversales y armonizar recursos, de modo que la metodología pueda beneficiar tanto la asimilación de conocimientos y habilidades establecidas para el título, como el propio flujo de aprendizaje o learn flow BIM. Del mismo modo reserva, incluso visualmente, aquellas áreas de conocimiento en las que, al menos en la planificación actual, la inclusión de procesos BIM no se considera ventajosa respecto a otras metodologías, o incluso inadecuadas para los objetivos docentes establecidos. Y es esta última categorización la que caracteriza el conjunto de conclusiones de esta investigación, centrada en: 1. la incuestionable necesidad de formar en conceptos y procesos BIM desde etapas muy iniciales de la formación universitaria en Arquitectura, 2. los beneficios formativos adicionales que aporta BIM en el desarrollo de competencias muy diversas contempladas en el currículum académico y 3. la especificidad del rol profesional del arquitecto que exigirá una implantación cuidadosa y ponderada de BIM que respete las metodologías de desarrollo creativo tradicionalmente efectivas, y aporte valor en una reorientación simbiótica con el diseño paramétrico y fabricación digital que permita un diseño finalmente generativo. ABSTRACT The traditional architectural design and construction procedures have proven to be deficient where process optimization is concerned, particularly when compared to other common industrial activities. The ever‐growing strife to achieve effective industrialization, both in favor of reaching greater quality levels as well as sustainable management of resources, has a better chance today than ever through a mean out of the realm of information technology, the Building Information Modelling o BIM. What may initially seem to be merely another computer program, in reality turns out to be a “process” concept that subverts many of today’s routines in architectural design and construction. Including and working with project data from the very beginning to the end of its full life cycle allows for creating a dynamic and updatable virtual reality, enabling data testing and optimizing throughout: before and during execution, all the way to the end of its lifespan. In addition, there is an opportunity to transmit complete project data efficiently, with hardly any loss or redeveloping of the manufacture chain required, which facilitates attaining a truly significant industrialization within the construction industry. In the presence of a world‐wide call for optimizing resources, along with an undeniable interest in increasing economic benefits through reducing uncertainty factors in its processes, BIM undoubtedly offers a chance for improvement as acknowledged by its imminent and mandatory implementation on the part of governments (for example United Kingdom in 2016 and Spain in 2018). The changes involved in professional roles and procedures upon incorporating BIM are highly significant and will set the course for future graduates of Architecture, Engineering and Construction disciplines (AEC) within their professions. Higher Education must respond to such needs with swiftness by incorporating this methodology into their educational standards and providing a synergetic vision that focuses on the underlying educational benefits inherent in the BIM framework. In this respect, BIM, in gathering data set under one single virtual model, offers a uniquely interesting potential. The three‐dimensional reality of the model, under continuous development and updating, provides students with a radically different graphic environment, in which partial views of elevation, section or plan that tend characteristically to be difficult to assimilate at the beginning of their studies, become mere post hoc requests to be ordered when needed directly out the virtual model. The design is always carried out on the sole model itself, independently of the working view chosen at any particular moment, with all data and data relations within construction permanently updated and fully coherent. This condensed description of the features of BIM begin to shape an important part of the educational benefits posed by BIM processes, particularly in reference to integrated design development and information management (including ITC). At the same time, it highlights the ease with which visual understanding is achieved regarding architectural elements, technology systems, their intrinsic relationships, and construction processes. In addition to this, there is the experimental development the BIM platform grants through its collaborative software: simulation of structural, energetic, and economic behavior, among others, of the virtual model according to the data inherent to the project. This doctoral dissertation presents a broad study including a wide array of research methods and issues in order to specify both the virtues and possible reservations in the use of BIM processes within the framework of a specific discipline: teaching Architecture. To do so, a literature review on BIM has been carried out, specifically concerning teaching in the discipline of Architecture, as well as an analysis of the experience of different groups of interest delimited to Universidad Europea de Madrid. The analysis of the benefits and/or limitations of using BIM has been approached through student surveys and interviews with professionals from the AEC sector, associated or not, with BIM. Various diverse educational experiences are described and academic management for experimental implementation has been analyzed. The conclusions of this study offer a synthesis for a Framework of Implementation of BIM methodology, which in order to reach greater clarity, communication ease and user‐friendliness, have been posed in an eminently graphic manner. The proposed framework proffers guidance on teaching methods conducive to the development of specific skills, taking advantage of the conceptual flexibility of the European Higher Education Area guidelines based on competencies, which naturally facilitate for the incorporation of this new teaching tool to achieve the educational objectives established by law. The global approach of the Implementation Framework put forth in this study facilitates the planning of educational actions within a common perspective: combining exceptional or vehicular BIM formats, establishing cross‐disciplinary synergies, and sharing resources, so as to purport a methodology that contributes to the assimilation of knowledge and pre‐defined competencies within the degree program, and to the flow of learning itself. At the same time, it reserves, even visually, those areas of knowledge in which the use of BIM processes is not considered necessarily an advantage over other methodologies, or even inadequate for the learning outcomes established, at least where current planning is concerned. It is this last category which characterizes the research conclusions as a whole, centering on: 1. The unquestionable need for teaching BIM concepts and processes in Architecture very early on, in the initial stages of higher education; 2. The additional educational benefits that BIM offers in a varied array of competency development within the academic curriculum; and 3. The specific nature of the professional role of the Architect, which demands a careful and balanced implementation of BIM that respects the traditional teaching methodologies that have proven effective and creative, and adds value by a symbiotic reorientation merged with parametric design and digital manufacturing so to enable for a finally generative design.

Soundscape quality analysis by fuzzy logic: A field study in Cordoba, Argentina

This research studies urban soundscapes through the comparative analysis of twelve public open spaces in the city of Córdoba (Argentina), taken as case studies. The work aims to examine selection of indicators and assessment tools intended to characterize soundscape quality. The field study was carried out through surveys and acoustic and psychoacoustic indicators, that are used together to objectively describe the sound quality of urban spaces. The study shows that, while there is a relationship of these indicators with the sound quality of the spaces, this is not linear. Their relative importance or influence depends on the interrelations occurring between the parameters studied. A model analyzing and correlating the parameters with the sound quality, based on the postulates of fuzzy logic, was applied as a tool of analysis, and it was seen to achieve a very close approximation to the subjective or perceptual response of the inhabitants. This close match between the model results and the perceptual response of the users confirms the fuzzy model as an effective tool for the study, not only of soundscapes, but also for those situations in which objective parameters must be related to the perceptual response of users.

Parceria escola-família: como envolver os pais nas práticas educativas na educação pré-escolar e ensino do 1º ciclo do ensino básico

Trabalho final apresentado para a obtenção do grau de mestre na área de Educação pré-escolar e ensino do 1º ciclo do ensino básico

Contribuições de experiências de estágio em CAPS III para a formação interdisciplinar em Saúde Mental na perspectiva da Reforma Psiquiátrica

Introdução: A formação dos profissionais da área da saúde é fundamental para a transformação das práticas de cuidado e consolidação dos princípios e diretrizes do Sistema Único de Saúde (SUS). Sendo um desafio do SUS, esta questão também está presente no campo da Saúde Mental e é necessária para a consolidação da Reforma Psiquiátrica e construção e fortalecimento da Rede de Atenção Psicossocial. Proposição: Investigar e refletir sobre as experiências dos estudantes que realizaram estágio no Centro de Atenção Psicossocial (CAPS) III Itaim Bibi entre 2009 e 2014, no tocante à formação profissional em Saúde Mental na perspectiva da Reforma Psiquiátrica. Materiais e Métodos: Estudo qualitativo, com construção dos dados a partir da leitura de relatórios dos estudantes e de questionários com perguntas referentes à experiência dos estágios, que foram apresentadas aos participantes conforme orientações do método Delphi. As questões abordaram: motivos; expectativas; forma e qualidade de participação nas atividades; temas e estudos; trabalho em equipe; situações vivenciadas; influência na atuação profissional; apresentação do estágio e sugestões de alterações. As informações foram trabalhadas por meio de Análise de Conteúdo Temática. Resultados: Dos 52 convidados, 28 participaram da primeira rodada (53,85%), sendo: 14 terapeutas ocupacionais, 9 enfermeiros, 3 psicólogos e 2 estudantes de Serviço Social. O segundo questionário foi composto por afirmativas presentes nas respostas recebidas para que os participantes as avaliassem conforme grau de concordância da escala Likert. Nesta fase foram recebidas 26 respostas. Conclusões: Apesar das dificuldades vivenciadas, avaliou-se que a maior parte das experiências dos estágios foi positiva e possibilitou aprendizagens significativas sobre o modelo de atenção psicossocial, o funcionamento e dinâmica da instituição, o trabalho em equipe interdisciplinar e as produções de convivência, principalmente aos sujeitos que realizaram estágios com maior carga horária. Identificaram como importantes aprendizados as experiências de acompanhamento individual e grupal dos usuários, a construção de Projeto Terapêutico Singular e de redes, o trabalho territorial e intersetorial. A participação em reuniões, supervisões clínico-institucionais, multiprofissionais e em oficinas de reflexão com as docentes das Universidades foi considerada importante para a formação. O aprendizado de manejo de situações de crise e de conflitos e de técnicas de contenção foi considerado superficial. Identificou-se que modelo de gestão e o trabalho da equipe influenciam no desenvolvimento de autonomia e protagonismo dos estagiários. O fortalecimento da integração ensino-serviço-comunidade é necessário e a flexibilização das propostas instituídas poderia facilitar a construção conjunta dos planos de estágios. Como produtos desta pesquisa foram elaboradas propostas de modificações para melhor organização dos estágios no CAPS e para a integração ensino-serviço e de Plano de Estágio Supervisionado em Terapia Ocupacional para os estágios extracurriculares. Realizou-se também uma Revisão Integrativa das publicações científicas brasileiras sobre a formação de estudantes de graduação em Saúde Mental na perspectiva da Reforma Psiquiátrica. Por fim, compreendeu-se que as experiências ressoam nas práticas profissionais dos graduados de modo positivo. Os participantes que não atuam neste campo, disseram levar consigo a experiência do trabalho em equipe e de formas éticas e humanizadas de cuidado.

Capacity-building through English language training to improve long-term resettlement success: A case study of the refugees along the Thailand-Burma border

Achieving long-term resettlement success is a challenge for many refugees seeking to restart their lives after displacement and being uprooted from their lives. Refugees must deal with finding employment, integrating into a society immensely different from what they have known their whole lives, and starting over from scratch. Learning a new language enables refugees to progress towards integration and long-term resettlement success, however, resettled refugees face a multitude of barriers in the U.S. to accessing language classes and attaining English proficiency. This study seeks to bridge this problem by exploring the possibilities of implementing a standardized language training program in the refugee camps to better prepare refugees for resettlement. A case study of the refugees along the Thai-Burma border demonstrated the significance of learning English in the camps on eventual English proficiency as well as the need for increased partnerships to overcome the barriers of lack of motivation and lack of funding. The author explores the possibilities of implementing a language training program in the camps by determining need, interest, barriers, and perceptions through the use of interviews, surveys, and focus groups of camp refugees, resettled refugees, and key organizational representatives. The significance of these results offers the possibility of leveraging and unlocking resettlement as a durable solution for more of the world's refugees in protracted situations.

Perceptions Surrounding the Implementation of Colorado Senate Bill 10-191's New Teacher Evaluations

In 2013, many public education reform efforts in the United States of America center on testing and accountability. Recent data revealed that teachers have the single greatest in-school impact on student learning; however, the methods to assess teacher effectiveness are widely criticized for not holding teachers accountable and, consequently, are experiencing significant legislative attention. In 2010, Colorado passed Senate Bill 10-191: The Great Teachers and Leaders Act to improve student learning by revising teacher and principal evaluations, including linking them to student learning data, and eradicating tenure. Teachers, administrators, and policymakers hold critical roles in the implementation of this bill, yet little is known about how members of each group perceive their respective roles in the implementation. This explanatory sequential mixed methods study was designed to gather perception data from these three groups, through surveys and interviews. Data revealed that teachers and administrators do not have similar perceptions of many matters related to teacher evaluations, education reform, and the implementation of Senate Bill 10-191 (SB 191). The data also revealed that teachers and administrators expected they would agree on these matters. These collective findings led to multiple recommendations, such as the need for increased dialogue between teachers and administrators about their own perceptions of education reforms.

Epidemiologia da oclusão dentária na infância e os sistemas de saúde

O propósito deste estudo foi contribuir para a análise da epidemiologia da oclusão dentária na infância e discutir a implicação para os sistemas de saúde, examinando dados de prevalência de uma amostra probabilística (n=985) da população de 5 e 12 anos de idade na cidade de São Paulo, Brasil (1996); e estudos epidemiológicos transversais publicados nos últimos 70 anos. A prevalência na cidade, cresceu de 49,0 ± 4,5 por cento na dentição decídua para 71,3 ± 3,9 por cento na dentição permanente (p<0,001), sendo que a chance de ocorrência de oclusopatia moderada/severa foi quase duas vezes maior na segunda dentição (OR=1,87; IC95 por cento =1,43-2,45; pando comparada às dentições decídua/mista. Tanto a realização de estudos longitudinais quanto de levantamentos e triagens para a identificação e o tratamento dos casos mais severos, não apenas no período da dentição permanente, mas também nas dentições decídua/mista, combinado à introdução de ações de proteção específica em programas materno-infantis direcionadas ao desenvolvimento oro-facial dos zero aos 6 anos são medidas que devem ser consideradas no planejamento estratégico e normativo dos sistemas de saúde. Métodos de intervenção em saúde pública devem ser pesquisados e implementados o mais precocemente possível para aumentar a proporção da população com oclusão normal e reduzir o percentual de oclusopatia moderada/severa.

Protecting Children: The United States Did Not Get the Lead Out

The lack of education and awareness of the potential of lead based paint hazards in residents across the United States is still a problem today. Simple educational tools and regulation changes can protect children who are at risk from being harmed by this hazard. Currently, there is inadequate outreach to educate the general public about lead based paint. A questionnaire was provided to families that have children under the age of seven and that live in residences built prior to 1978. The research and questionnaires confirm that more education, as well as regulation changes, is needed to keep children safe from lead paint hazards.

El territorio tardoantiguo y altomedieval en el sureste de Hispania: Eio-Iyyuh como caso de estudio

Estudiamos las evidencias de la ocupación tardoantigua y altomedieval en el entorno de la ciudad de Eio-Iyyu (El Tolmo de Minateda, Hellín, Albacete). Mediante el reconocimiento superficial del terreno y la revisión de los materiales arqueológicos se propone la caracterización del poblamiento entre los ss. VII d.C. y IX d.C. El análisis ofrece una ocupación densa en la que empiezan a reconocerse espacios campesinos agregados que podría corresponder a aldeas campesinas.

Evaluation of quality of life related to nutritional status

The way in which the quality of life related to health (HRQoL) is affected by the nutritional status of the patient is a subject of constant interest and permanent debate. The purpose of the present paper is to review those studies that relate HRQoL to nutritional status and examine the tools (questionnaires) that they use to investigate this relationship. A critical review of published studies was carried out via an investigation of the following databases: MEDLINE (via PubMed); EMBASE; The Cochrane Library; Cumulative Index to Nursing and Allied Health Literature (CINAHL); Institute for Scientific Information (ISI) Web of Science; Latin American and Caribbean Health Sciences Literature (LILACS); Spanish Health Sciences Bibliographic Index (IBECS). The search was carried out from the earliest date possible until July 2007.The medical subject heading terms used were ‘quality of life’, ‘nutritional status’ and ‘questionnaires’. The articles had to contain at least one questionnaire that evaluated quality of life. Twenty-eight documents fulfilling the inclusion criteria were accepted, although none of them used a specific questionnaire to evaluate HRQoL related to nutritional status. However, some of them used a combination of generic questionnaires with the intention of evaluating the same. Only three studies selectively addressed the relationship between nutritional status and quality of life, this evaluation being performed not by means of specific questionnaires but by statistical analysis of data obtained via validated questionnaires.

Monitoring an earthfill dam using differential SAR interferometry: La Pedrera dam, Alicante, Spain

Surface displacement at the dykes of La Pedrera reservoir (SE Spain) has been measured by satellite differential Synthetic Aperture Radar (SAR) interferometry. At the main dyke, a displacement of about 13 cm along the satellite line of sight has been estimated between August 1995 and May 2010, from a dataset composed by ERS-1, ERS-2 and Envisat-ASAR images. Two independent short-term processing tasks were also carried out with ERS-2/Envisat-ASAR (from June 2008 to May 2010) and TerraSAR-X (from August 2008 to June 2010) images which have shown similar spatial and temporal displacement patterns. The joint analysis of historical instrument surveys and DInSAR-derived data has allowed the identification of a long-term deformation process which is reflected at the dam's surface and is also clearly recognizable in the inspection gallery. The plausible causes of the displacements measured by DInSAR are also discussed in the paper. Finally, DInSAR data have been used to compute the long-term settlement of La Pedrera dam, showing a good agreement with external studies. Consequently, this work demonstrates the integration of DInSAR with in-situ techniques which helps provide a complete spatial vision of the displacements in the dam thereby helping to differentiate the causal mechanisms.

Intelligent Decision-Making System Frameworks for a Digital Plan of Work: A Theoretical Investigation for the Construction Industry

The construction industry is characterised by fragmentation and suffers from lack of collaboration, often adopting adversarial working practices to achieve deliverables. For the UK Government and construction industry, BIM is a game changer aiming to rectify this fragmentation and promote collaboration. However it has become clear that there is an essential need to have better controls and definitions of both data deliverables and data classification. Traditional methods and techniques for collating and inputting data have shown to be time consuming and provide little to improve or add value to the overall task of improving deliverables. Hence arose the need in the industry to develop a Digital Plan of Work (DPoW) toolkit that would aid the decision making process, providing the required control over the project workflows and data deliverables, and enabling better collaboration through transparency of need and delivery. The specification for the existing Digital Plan of Work (DPoW) was to be, an industry standard method of describing geometric, requirements and data deliveries at key stages of the project cycle, with the addition of a structured and standardised information classification system. However surveys and interviews conducted within this research indicate that the current DPoW resembles a digitised version of the pre-existing plans of work and does not push towards the data enriched decision-making abilities that advancements in technology now offer. A Digital Framework is not simply the digitisation of current or historic standard methods and procedures, it is a new intelligent driven digital system that uses new tools, processes, procedures and work flows to eradicate waste and increase efficiency. In addition to reporting on conducted surveys above, this research paper will present a theoretical investigation into usage of Intelligent Decision Support Systems within a digital plan of work framework. Furthermore this paper will present findings on the suitability to utilise advancements in intelligent decision-making system frameworks and Artificial Intelligence for a UK BIM Framework. This should form the foundations of decision-making for projects implemented at BIM level 2. The gap identified in this paper is that the current digital toolkit does not incorporate the intelligent characteristics available in other industries through advancements in technology and collation of vast amounts of data that a digital plan of work framework could have access to and begin to develop, learn and adapt for decision-making through the live interaction of project stakeholders.

A biblioteca escolar como comunidade colaborativa : um contributo para o desenvolvimento profissional docente

Dissertação apresentada à Escola Superior de Educação do Instituto Politécnico de Castelo Branco para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Supervisão e Avaliação Escolar.