Gerenciamento de custos: aplicação do método de Custeio Baseado em Atividades em Centro de Material Esterilizado

Esta pesquisa exploratória descritiva, na modalidade de estudo de caso, teve por objetivo a aplicação do Custeio Baseado em Atividades (ABC) em Centro de Material e Esterilização (CME) de um hospital de ensino de capacidade extra. A coleta de dados ocorreu durante o ano de 2006, utilizando-se as técnicas de análise documental e observação direta não participante. A análise de processos possibilitou o conhecimento dos custos do ciclo/carga de desinfecção química ($9.95) e física ($12.63), e esterilização por vapor saturado sob pressão ($31.37) e por vapor de Baixa Temperatura e Formaldeído Gasoso ($255.28). As informações geradas pelo ABC resultaram na compreensão do processo gerador de custos e forneceram base para a mensuração de desempenho e melhorias de processos do CME.

Web-based Implementation of Winter Maintenance Decision Support System Using GIS and Remote Sensing, May 2005

Winter maintenance, particularly snow removal and the stress of snow removal materials on public structures, is an enormous budgetary burden on municipalities and nongovernmental maintenance organizations in cold climates. Lately, geospatial technologies such as remote sensing, geographic information systems (GIS), and decision support tools are roviding a valuable tool for planning snow removal operations. A few researchers recently used geospatial technologies to develop winter maintenance tools. However, most of these winter maintenance tools, while having the potential to address some of these information needs, are not typically placed in the hands of planners and other interested stakeholders. Most tools are not constructed with a nontechnical user in mind and lack an easyto-use, easily understood interface. A major goal of this project was to implement a web-based Winter Maintenance Decision Support System (WMDSS) that enhances the capacity of stakeholders (city/county planners, resource managers, transportation personnel, citizens, and policy makers) to evaluate different procedures for managing snow removal assets optimally. This was accomplished by integrating geospatial analytical techniques (GIS and remote sensing), the existing snow removal asset management system, and webbased spatial decision support systems. The web-based system was implemented using the ESRI ArcIMS ActiveX Connector and related web technologies, such as Active Server Pages, JavaScript, HTML, and XML. The expert knowledge on snow removal procedures is gathered and integrated into the system in the form of encoded business rules using Visual Rule Studio. The system developed not only manages the resources but also provides expert advice to assist complex decision making, such as routing, optimal resource allocation, and monitoring live weather information. This system was developed in collaboration with Black Hawk County, IA, the city of Columbia, MO, and the Iowa Department of transportation. This product was also demonstrated for these agencies to improve the usability and applicability of the system.

The differentiation of fibre- and drug type Cannabis seedlings by gas chromatography/mass spectrometry and chemometric tools

Cannabis cultivation in order to produce drugs is forbidden in Switzerland. Thus, law enforcement authorities regularly ask forensic laboratories to determinate cannabis plant's chemotype from seized material in order to ascertain that the plantation is legal or not. As required by the EU official analysis protocol the THC rate of cannabis is measured from the flowers at maturity. When laboratories are confronted to seedlings, they have to lead the plant to maturity, meaning a time consuming and costly procedure. This study investigated the discrimination of fibre type from drug type Cannabis seedlings by analysing the compounds found in their leaves and using chemometrics tools. 11 legal varieties allowed by the Swiss Federal Office for Agriculture and 13 illegal ones were greenhouse grown and analysed using a gas chromatograph interfaced with a mass spectrometer. Compounds that show high discrimination capabilities in the seedlings have been identified and a support vector machines (SVMs) analysis was used to classify the cannabis samples. The overall set of samples shows a classification rate above 99% with false positive rates less than 2%. This model allows then discrimination between fibre and drug type Cannabis at an early stage of growth. Therefore it is not necessary to wait plants' maturity to quantify their amount of THC in order to determine their chemotype. This procedure could be used for the control of legal (fibre type) and illegal (drug type) Cannabis production.

From Support to Control : A Configurational Perspective on Conjugal Quality

The topic of conjugal quality provides an empirical illustration of the relevance of the configurational perspective on families. Based on a longitudinal sample of 1,534 couples living in Switzerland drawn from the study "Social Stratification, Cohesion and Conflict in Contemporary Families", we show that various types of interdependencies with relatives and friends promote distinct conflict management strategies for couples as well as unequal levels of conjugal quality. We find that configurations characterized by supportive and non-interfering relationships with relatives and friends for both partners are associated with higher conjugal quality, while configurations characterized by interference are associated with lower conjugal quality.

Preventing Bullying and Harassment A Support Manual for Iowa’s Sample District Harassment and Bullying Policy, May 2005

Support manual for preventing bullying and harassment in school.

Guiding students through competence-based educational material

Student guidance is an always desired characteristic in any educational system, butit represents special difficulty if it has to be deployed in an automated way to fulfilsuch needs in a computer supported educational tool. In this paper we explorepossible avenues relying on machine learning techniques, to be included in a nearfuture -in the form of a tutoring navigational tool- in a teleeducation platform -InterMediActor- currently under development. Since no data from that platform isavailable yet, the preliminary experiments presented in this paper are builtinterpreting every subject in the Telecommunications Degree at Universidad CarlosIII de Madrid as an aggregated macro-competence (following the methodologicalconsiderations in InterMediActor), such that marks achieved by students can beused as data for the models, to be replaced in a near future by real data directlymeasured inside InterMediActor. We evaluate the predictability of students qualifications, and we deploy a preventive early detection system -failure alert-, toidentify those students more prone to fail a certain subject such that correctivemeans can be deployed with sufficient anticipation.

The role of the Teaching Quality and Innovation Support Unit in the ICT Engineering Studies at Universitat Pompeu Fabra

One of the strategies of Universitat Pompeu Fabra to support Quality Learning has been the creation of Units for the Support of Teaching Quality and Innovation within each faculty. In the seminar we will present the role and activities of the Polytechnic School Unit in charge or coordinating the efforts towards quality learning in the Information and Communication Technologies (ICT) Engineering Studies. We will also discuss how these activities are informed to relevant academic stakeholders.

A comparison of full-rate full-diversity 2x2 space-time codes for WiMAX systems

Multiple-input multiple-output (MIMO) techniques have become an essential part of broadband wireless communications systems. For example, the recently developed IEEE 802.16e specifications for broadband wireless access include three MIMOprofiles employing 2×2 space-time codes (STCs), and two of these MIMO schemes are mandatory on the downlink of Mobile WiMAX systems. One of these has full rate, and the other has full diversity, but neither of them has both of the desired features. The third profile, namely, Matrix C, which is not mandatory, is both a full rate and a full diversity code, but it has a high decoder complexity. Recently, the attention was turned to the decodercomplexity issue and including this in the design criteria, several full-rate STCs were proposed as alternatives to Matrix C. In this paper, we review these different alternatives and compare them to Matrix C in terms of performances and the correspondingreceiver complexities.

Material and Construction Optimization for Prevention of Premature Pavement Distress in PCC Pavements, September 2004

The chemistry of today’s concrete mixture designs is complicated by many variables, including multiple sources of aggregate and cements and a plethora of sometimes incompatible mineral and chemical admixtures. Concrete paving has undergone significant changes in recent years as new materials have been introduced into concrete mixtures. Supplementary cementitious materials such as fly ash and ground granulated blast furnace slag are now regularly used. In addition, many new admixtures that were not even available a few years ago now have widespread usage. Adding to the complexity are construction variables such as weather, mix delivery times, finishing practices, and pavement opening schedules. Mixture materials, mix design, and pavement construction are not isolated steps in the concrete paving process. Each affects and is affected by the other in ways that determine overall pavement quality and long-term performance. Equipment and procedures commonly used to test concrete materials and concrete pavements have not changed in decades, leaving serious gaps in our ability to understand and control the factors that determine concrete durability. The concrete paving community needs tests that will adequately characterize the materials, predict interactions, and monitor the properties of the concrete.

Personalized modeling for drug concentration prediction using Support Vector Machine

Building a personalized model to describe the drug concentration inside the human body for each patient is highly important to the clinical practice and demanding to the modeling tools. Instead of using traditional explicit methods, in this paper we propose a machine learning approach to describe the relation between the drug concentration and patients' features. Machine learning has been largely applied to analyze data in various domains, but it is still new to personalized medicine, especially dose individualization. We focus mainly on the prediction of the drug concentrations as well as the analysis of different features' influence. Models are built based on Support Vector Machine and the prediction results are compared with the traditional analytical models.

The infected aorta.

BACKGROUND: Despite the improvements achieved in antibiotic therapy, severe aortic infection resulting in mycotic aneurysms is still a highly lethal disease and surgical management remains a challenging task. PATIENTS AND METHODS: A total of 43 patients with severe aortic infections were analyzed and separated in four groups: (1) Infections of the aortic root Ventriculo-aortic disconnection due to deep aortic infection (6 patients). Two patients were operated using homo-composit grafts. Of the 6 patients total, one died early and two died late during a mean follow-up of 6 years. The two patients with homografts are still alive. (2) Infections of the ascending aorta and the aortic arch. In situ repair for mycotic aneurysmal lesions of the ascending aorta was performed in 6 patients using synthetic graft material in 4/6, biological material in 1/6 and direct suture in 1/6. Two patients had to be reoperated; one of them died early. There was no recurrent infection during a mean follow-up of 6 years. (3) Infections of the descending thoracic and thoraco-abdominal aorta in-situ repair for mycotic aneurysmal lesions of the descending and thoraco-abdominal aorta was performed in 12 patients using homografts in five. Two patients died early and two other patients died late during a mean follow-up of 6 years. (4) Infections of the infrarenal abdominal aorta. In this series of 19 patients with mycotic infrarenal aortic aneurysms, in situ reconstruction was performed in 12 (5/12 with homografts) and extra-anatomic reconstruction (axillo-femoral bypass) was performed in 7. Hospital mortality was 5/19 patients and another 5/19 patients died during a mean follow-up of 6 years. One of the early deaths was due to aortic stump rupture. Two patients with axillo-femoral reconstructions were later converted to descending-thoracic-aortic-bifemoral bypasses. Five thromboses of axillo-femoral bypasses were observed in three of the seven patients with extra-anatomic repairs. RESULTS: Infections of the aortic root, the ascending aorta and the aortic arch are approached with total cardio-pulmonary bypass, using cardioplegic myocardial protection and deep hypothermia with circulatory arrest if necessary. Proximal unloading and distal support using partial cardiopulmonary bypass is preferred for repair of infected descending and thoracoabdominal aortic lesions, whereas no such adjuncts are required for repair of infected infrarenal aortic lesions. CONCLUSIONS: The anatomical location of the aortic infection and the availability of homologous graft material are the main factors determining the surgical strategy.

Forças impulsoras e restritivas para trabalho em equipe em um Centro de Material e Esterilização de hospital escola

Estudo transversal descritivo exploratório que objetivou analisar forças impulsoras e restritivas para trabalho em equipe em um Centro de Material e Esterilização (CME) de um hospital escola, a partir de aproximação da Teoria de Campo de Kurt Lewin, em Goiânia, Goiás. Participaram 35 profissionais, que responderam a um questionário autoaplicável, baseado na referida teoria, que prevê que situações grupais são permeadas por forças que mobilizam positiva ou negativamente seus movimentos e dizem respeito ao envolvimento do sujeito (Eu), a interação do grupo (Outro) e ao ambiente de trabalho (Ambiente). Foi utilizada análise de conteúdo no tratamento dos dados distribuídos nas dimensões predefinidas. Os resultados consolidaram 1.990 registros, categorizados como maioria (59,3%) de forças impulsoras, predominantes na dimensão Eu. Nas dimensões Outro e Ambiente observou-se equilíbrio entre as forças. O delineamento do campo de forças permitiu uma visão objetiva, concreta das limitações, potenciais da equipe estudada e possibilidades para promover mudanças.

Les coûts des dommages éléments naturels aux bâtiments et l'influence des facteurs du risque dans un contexte d'assurance immobilière : analyse de cas des innondations et de la grêle en Suisse

In Switzerland, the annual cost of damage by natural elements has been increasing for several years despite the introduction of protective measures. Mainly induced by material destruction building insurance companies have to pay the majority of this cost. In many European countries, governments and insurance companies consider prevention strategies to reduce vulnerability. In Switzerland, since 2004, the cost of damage due to natural hazards has surpassed the cost of damage due to fire; a traditional activity of the Cantonal Insurance company (EGA). Therefore, the strategy for efficient fire prevention incorporates a reduction of the vulnerability of buildings. The thesis seeks to illustrate the relevance of such an approach when applied to the damage caused by natural hazards. It examines the role of insurance place and its involvement in targeted prevention of natural disasters. Integrated risk management involves a faultless comprehension of all risk parameters The first part of the thesis is devoted to the theoretical development of the key concepts that influence risk management, such as: hazard, vulnerability, exposure or damage. The literature on this subject, very prolific in recent years, was taken into account and put in perspective in the context of this study. Among the risk parameters, it is shown in the thesis that vulnerability is a factor that we can influence efficiently in order to limit the cost of damage to buildings. This is confirmed through the development of an analysis method. This method has led to the development of a tool to assess damage to buildings by flooding. The tool, designed for the property insurer or owner, proposes several steps, namely: - Vulnerability and damage potential assessment; - Proposals for remedial measures and risk reduction from an analysis of the costs of a potential flood; - Adaptation of a global strategy in high-risk areas based on the elements at risk. The final part of the thesis is devoted to the study of a hail event in order to provide a better understanding of damage to buildings. For this, two samples from the available claims data were selected and analysed in the study. The results allow the identification of new trends A second objective of the study was to develop a hail model based on the available data The model simulates a random distribution of intensities and coupled with a risk model, proposes a simulation of damage costs for the determined study area. Le coût annuel des dommages provoqués par les éléments naturels en Suisse est conséquent et sa tendance est en augmentation depuis plusieurs années, malgré la mise en place d'ouvrages de protection et la mise en oeuvre de moyens importants. Majoritairement induit par des dégâts matériels, le coût est supporté en partie par les assurances immobilières en ce qui concerne les dommages aux bâtiments. Dans de nombreux pays européens, les gouvernements et les compagnies d'assurance se sont mis à concevoir leur stratégie de prévention en termes de réduction de la vulnérabilité. Depuis 2004, en Suisse, ce coût a dépassé celui des dommages dus à l'incendie, activité traditionnelle des établissements cantonaux d'assurance (ECA). Ce fait, aux implications stratégiques nombreuses dans le domaine public de la gestion des risques, résulte en particulier d'une politique de prévention des incendies menée efficacement depuis plusieurs années, notamment par le biais de la diminution de la vulnérabilité des bâtiments. La thèse, par la mise en valeur de données actuarielles ainsi que par le développement d'outils d'analyse, cherche à illustrer la pertinence d'une telle approche appliquée aux dommages induits par les phénomènes naturels. Elle s'interroge sur la place de l'assurance et son implication dans une prévention ciblée des catastrophes naturelles. La gestion intégrale des risques passe par une juste maîtrise de ses paramètres et de leur compréhension. La première partie de la thèse est ainsi consacrée au développement théorique des concepts clés ayant une influence sur la gestion des risques, comme l'aléa, la vulnérabilité, l'exposition ou le dommage. La littérature à ce sujet, très prolifique ces dernières années, a été repnse et mise en perspective dans le contexte de l'étude, à savoir l'assurance immobilière. Parmi les paramètres du risque, il est démontré dans la thèse que la vulnérabilité est un facteur sur lequel il est possible d'influer de manière efficace dans le but de limiter les coûts des dommages aux bâtiments. Ce raisonnement est confirmé dans un premier temps dans le cadre de l'élaboration d'une méthode d'analyse ayant débouché sur le développement d'un outil d'estimation des dommages aux bâtiments dus aux inondations. L'outil, destiné aux assurances immobilières, et le cas échéant aux propriétaires, offre plusieurs étapes, à savoir : - l'analyse de la vulnérabilité et le potentiel de dommages ; - des propositions de mesures de remédiation et de réduction du risque issues d'une analyse des coûts engendrés par une inondation potentielle; - l'adaptation d'une stratégie globale dans les zones à risque en fonction des éléments à risque. La dernière partie de la thèse est consacrée à l'étude d'un événement de grêle dans le but de fournir une meilleure compréhension des dommages aux bâtiments et de leur structure. Pour cela, deux échantillons ont été sélectionnés et analysés parmi les données de sinistres à disposition de l'étude. Les résultats obtenus, tant au niveau du portefeuille assuré que de l'analyse individuelle, permettent de dégager des tendances nouvelles. Un deuxième objectif de l'étude a consisté à élaborer une modélisation d'événements de grêle basée sur les données à disposition. Le modèle permet de simuler une distribution aléatoire des intensités et, couplé à un modèle d'estimation des risques, offre une simulation des coûts de dommages envisagés pour une zone d'étude déterminée. Les perspectives de ce travail permettent une meilleure focalisation du rôle de l'assurance et de ses besoins en matière de prévention.

Research involving biological material from forensic autopsies: legal and ethical issues.

Recommendations and laws do not always contain specific and clear provisions on the use of cadaveric material in research, and even more rarely do they address explicitly the ethical issues related to research on material obtained during forensic autopsy. In this article we analyse existing legal frameworks in Europe by comparing the legal provisions in 2 European Countries which are member states of the Council of Europe, the UK and Switzerland. They were chosen because they have distinct legal frameworks that make comparisons interesting. In addition, the detailed laws of the UK and a specific law project and national ethical recommendations in Switzerland permit us to define more clearly the legal range of options for researchers using cadaveric material obtained during forensic investigations. The Human Tissue Act 2004 in England, Wales and Northern Ireland, its Scottish equivalent with the same title (2006) and the national ethical guidelines in Switzerland all require consent from the deceased person, an appropriate relative or a person with power of attorney for healthcare decisions before cadaveric biological material can be obtained and used for research. However, if the purpose of the autopsy is purely forensic, no such authorization will be sought to carry out the autopsy and related analyses, which might include genetic testing. In order to be allowed to carry out future research projects, families need to be approached for informed consent, unless the deceased person had left written directives including permission to use his or her tissues for research.

Social support, socioeconomic and clinical risk: comparison between to neighborhoods in a Brazilian upcountry town

The objective of this study was to compare the perceptions of two families living in two different neighborhoods (rated according to risk levels) regarding social support. A questionnaire was designed to assess social support according to the following dimensions: instrumental, emotional, religious, and support from friends, neighbors and family. The sample was comprised as follows: considering the 114 families living in neighborhood 1, 52 families were interviewed; and among the 162 families living in neighborhood 2, 60 families were interviewed. No significant difference was found related to instrumental, religious and emotional support, including the support from relatives among the families from both neighborhoods. The results disagree with the reviewed literature, which indicated a strong association between social support and families living at socioeconomic risk. In conclusion, social support is important for families, regardless of their risk stratification.