A Look at Restaurant Commissaries

Restaurant commissaries range the full spectrum from simple storage of food and supplies to multi-million-dollar processing plants. The author discusses the cost effectiveness of commissary units, including their operating costs, quality control, and scope.

A comprehensive assessment of self -report experiences of adoptive parents of special needs children in Florida

Adoption of special needs children is now seen as a life long event whereby the adoptive child and family have unique needs. The need for postplacement resources throughout the life cycle of the adoption process is evident. This exploratory-descriptive research employed a random stratified cross-sectional design. The purpose of the study was to describe, identify, examine, and assess the relative influence of identified empirically and conceptually relevant variables of self-report experiences of adoptive parents of special needs children. Primary areas of exploration included: (1) adoptive children and families' characteristics, (2) postplacement service needs, utilization and satisfaction, and (3) adoptive parents' perceptions of their adoption experiences. A proportionate stratified random mail survey was used to obtain 474 families who had adopted special needs children from the 15 geographic districts which make up the state adoption social service agency in Florida. A 144-item survey questionnaire was used to collect basic information on demographic data, service provision, and adoption experiences. Four research questions were analyzed to test the effect the predictor variables had on willingness to adopt another special needs child, successful adoption, satisfying experience, and realism about problems. All four research questions revealed that the full model and the child's antecedent and the adoptive parents' intervening variable blocks were significant in explaining the variance in the dependent variables. The child's intervening variables alone were only significant in explaining the variance for one of the dependent variables. The results of the statistical analysis on the fifth research question and the three hypotheses determined that (1) only one postplacement service, crisis intervention, had a statistically significant impact on the adoptive parents' perceived level of satisfaction with the adoption experience; (2) adoptive parents who rate their adoption as successful are more likely to express a desire to adopt another special needs child; (3) the more adequate information on the child the adoptive parents perceived that they had prior to placement, the more they perceived they were realistic about the problems they would encounter; and (4) six specific postplacement services were found to be significant in predicting successful adoptions--crisis intervention, outpatient drug/alcohol treatment, maintenance subsidy, physical therapy, special medical equipment, and family counseling. Implications for the social work field and future research are discussed. ^

A planning model for needs analysis for subacute care

The purpose of this study is to produce a model to be used by state regulating agencies to assess demand for subacute care. In accomplishing this goal, the study refines the definition of subacute care, demonstrates a method for bed need assessment, and measures the effectiveness of this new level of care. This was the largest study of subacute care to date. Research focused on 19 subacute units in 16 states, each of which provides high-intensity rehabilitative and/or restorative care carried out in a high-tech unit. Each of the facilities was based in a nursing home, but utilized separate staff, equipment, and services. Because these facilities are under local control, it was possible to study regional differences in subacute care demand. Using this data, a model for predicting demand for subacute care services was created, building on earlier models submitted by John Whitman for the American Hospital Association and Robin E. MacStravic. The Broderick model uses the "bootstrapping" method and takes advantage of high technology: computers and software, databases in business and government, publicly available databases from providers or commercial vendors, professional organizations, and other information sources. Using newly available sources of information, this new model addresses the problems and needs of health care planners as they approach the challenges of the 21st century.

The Other Face of Cuban Medical Diplomacy: Domestic Impact

Since 1963 Cuba has provided medical assistance to third world countries while gaining international, political and economic support from its participating liaisons. But what exactly have been Cuba’s domestic consequences of such medical diplomacy? While the Cuban government sends many of its medical professionals and supplies abroad, the country suffers from extreme scarcity and a deterioration of its healthcare system. The purpose of my research is to enquire more on the consequences of such medical diplomacy on the Cuban healthcare system and how it has affected domestic medical infrastructure, health professionals working on the island as well as the quality of service. In carrying out this examination, I will rely on the use of information from books written by Cuban medical professionals on their personal experiences within the medical system, and patients treated on the island. I will also make active use of academic journals and articles on the Cuban healthcare system. Most of what has been written on Cuban medical diplomacy and internationalist missions are favorable critiques praising the Cuban government. Nevertheless, personal testimonies found in Dr. Dessy Mendoza Rivero’s Dengue: La Epidemia Secreta de Fidel Castro and in Dr. Jose Luis Comas and Dr. Luis Ovidio Gonzales’ Cuba: Medicina y Revolucion reveal a different side to this seemingly pleasant and good natured international exchange. As a Cuban who lived on the island, I personally suffered the consequences of such medical diplomacy and believe others will find benefit in arming themselves with knowledge on the issue.

Atuação dos profissionais no atendimento às famílias nos centros de atenção psicossocial

This study aimed to evaluate the work of professionals to care for families in Psychosocial Care Centers ( C APS) of Rio Grande do Norte ( RN), from the roles and functions performed by these professional services. For this, it was pointed out the following objectives: To describe the profile and the activities conducted by mental health teams in the RN CAPS ; Know the opinion of professionals in the mental health teams of the poli ti c , practices and training in mental health; Check the suitability of the roles and functions of professionals working in the RN CAPS in relation to care for families . This is an analytic al cross - sectional study of quantitative and qualitative approach . Data were c ollected through a questionnaire in 33 CAPS RN, between March and October 2014 , after being approved by the Research Ethics Committee / UFRN , opinion nº217.808 , CAAE : 10650612.8. 1001.5537 , on March 1 2013. T he sample was adopted , defined by inclusion and exclusion criteria , and is composed of 183 professionals. The database preparation followed two steps: 1. Preparation and processing of data of closed questions of the questionnai re concerning the characterization and practices in mental health research subjects through informational resource Statistical Package for Social Scienses (SPSS) Statistics version 20.0 ; 2. To check the significance level was chosen by applying the chi - squ are test. Preparation and treatment of the corpus formed by the answers to open questions relating to the policies, practices and training in psychiatry through Analyse lexicale pair Contexte software d' un Ensemble of Segments of Texte ( ALCESTE) together a nd categorized by content analysis technique , Bardin (2004) . The data analysis is supported in the literature . It m ade explicit the results through three articles waxing the following results. In the first, participants profile was characterized by a predo minance of females (76.5 %), aged 40 - 58 years ( 61.7 %). They work between 30 and 40 hours per week (63.5 %), working in mental health for over 10 years ( 98.4%). The sample directs the care of family groups ( 65.7%), predominantly the care team of social worke rs, nurses, psychologists and occupational therapists . The doctor performs emergency care without interaction with the staff (48.6%) . On the difficulties encountered in services are ranked in : materials and supplies ( 75.1%), financial ( 78.5%) and structura l ( 66.9%). The second article contains qualitative data organized into five categories : Promoting the rehabilitation of users of CAPS ; Needs training ; Conflicts and satisfactions of teamwork ; Practices developed in CAPS ; Effective difficulties of Mental He alth Policy . The third article highlights the inadequacy of care for families ( 93.4%) and comparing the care families and groups in CAPS both types show to be inadequate : family ( 92.63%), groups ( 92, 60%). The main data obtained reveal the urgent need for transformation in psychosocial care . It shows also the importance of investments in inputs, physical structure and training of human resources for the CAPS.

Análise computacional de imagens de lâminas delgadas na predição dos parâmetros hidráulicos porosidade e condutividade hidráulica do aquífero Barreiras-RN

The understanding of the occurrence and flow of groundwater in the subsurface is of fundamental importance in the exploitation of water, just like knowledge of all associated hydrogeological context. These factors are primarily controlled by geometry of a certain pore system, given the nature of sedimentary aquifers. Thus, the microstructural characterization, as the interconnectivity of the system, it is essential to know the macro properties porosity and permeability of reservoir rock, in which can be done on a statistical characterization by twodimensional analysis. The latter is being held on a computing platform, using image thin sections of reservoir rock, allowing the prediction of the properties effective porosity and hydraulic conductivity. For Barreiras Aquifer to obtain such parameters derived primarily from the interpretation of tests of aquifers, a practice that usually involves a fairly complex logistics in terms of equipment and personnel required in addition to high cost of operation. Thus, the analysis and digital image processing is presented as an alternative tool for the characterization of hydraulic parameters, showing up as a practical and inexpensive method. This methodology is based on a flowchart work involving sampling, preparation of thin sections and their respective images, segmentation and geometric characterization, three-dimensional reconstruction and flow simulation. In this research, computational image analysis of thin sections of rocks has shown that aquifer storage coefficients ranging from 0,035 to 0,12 with an average of 0,076, while its hydrogeological substrate (associated with the top of the carbonate sequence outcropping not region) presents effective porosities of the order of 2%. For the transport regime, it is evidenced that the methodology presents results below of those found in the bibliographic data relating to hydraulic conductivity, mean values of 1,04 x10-6 m/s, with fluctuations between 2,94 x10-6 m/s and 3,61x10-8 m/s, probably due to the larger scale study and the heterogeneity of the medium studied.

Análise de confiabilidade de um moto-ventilador centrífugo: aplicação no sistema de pressurização de subestação industrial para garantia da segurança operacional na indústria petroquímica

The need of the oil industry to ensure the safety of the facilities, employees and the environment, not to mention the search for maximum efficiency of its facilities, makes it seeks to achieve a high level of excellence in all stages of its production processes in order to obtain the required quality of the final product. Know the reliability of equipment and what it stands for a system is of fundamental importance for ensuring the operational safety. The reliability analysis technique has been increasingly applied in the oil industry as fault prediction tool and undesirable events that can affect business continuity. It is an applied scientific methodology that involves knowledge in engineering and statistics to meet and or analyze the performance of components, equipment and systems in order to ensure that they perform their function without fail, for a period of time and under a specific condition. The results of reliability analyzes help in making decisions about the best maintenance strategy of petrochemical plants. Reliability analysis was applied on equipment (bike-centrifugal fan) between the period 2010-2014 at the Polo Petrobras Guamaré Industrial, situated in rural Guamaré municipality in the state of Rio Grande do Norte, where he collected data field, analyzed historical equipment and observing the behavior of faults and their impacts. The data were processed in commercial software reliability ReliaSoft BlockSim 9. The results were compared with a study conducted by the experts in the field in order to get the best maintenance strategy for the studied system. With the results obtained from the reliability analysis tools was possible to determine the availability of the centrifugal motor-fan and what will be its impact on the security of process units if it will fail. A new maintenance strategy was established to improve the reliability, availability, maintainability and decreased likelihood of Moto-Centrifugal Fan failures, it is a series of actions to promote the increased system reliability and consequent increase in cycle life of the asset. Thus, this strategy sets out preventive measures to reduce the probability of failure and mitigating aimed at minimizing the consequences.

Análise de conteúdo e validação clínica do diagnóstico de enfermagem autocontrole ineficaz da saúde

The study aims to analyze the content and measures of accuracy of the nursing diagnosis Ineffective Self Health in patients undergoing hemodialysis. Study of nursing diagnosis validation carried out in two stages, namely: content analysis by judges and accuracy of clinical indicators. In the first stage, 22 judges evaluated the setting and location of the diagnosis, clinical indicators and etiological factors and their conceptual and empirical definitions. We used the binomial test to determine the proportion of the judges of the relevance of the components of the nursing diagnosis. In the second stage, we used the Latent Class Analysis for the diagnostic accuracy by evaluating 200 patients in a hemodialysis clinic in northeastern Brazil. Research approved by the Ethics Committee, under the Opinion No 387 837 and CAAE 18486413.0.0000.5537. The results show that the judges evaluated as pertinent clinical indicators 12 and 22 etiological factors. Proposed amendment of the nomenclature of five indicators and six factors and the implementation of a clinical indicator for etiology and three etiological factors for clinical indicators. In conceptual and empirical definitions, judges judged as not relevant the conceptual and empirical definitions of a clinical indicator, the conceptual definitions of two etiological factors and empirical definitions four etiological factors. Still, changes were suggested in the conceptual and empirical definitions of two clinical indicators, the conceptual definitions of 12 etiological factors and empirical definitions of 11 etiological factors. Clinical indicators analyzed in the first stage were validated clinically in patients undergoing hemodialysis. The most frequent clinical indicators were Changes in laboratory tests (100%) and daily life choices ineffective to achieve health goals (81%); and three etiological factors had a higher frequency, they are: unfavorable demographic factors (94.5%), beliefs (79%) and comorbidities (77.5%). From Latent class analysis, diagnosis prevalence was estimated at 66.28%. Clinical indicators that showed the best sensitivity measures for the nursing diagnosis Ineffective Self Health were: daily life choices ineffective to achieve health goals and Expression of difficulty with prescribed regimens. In turn, the clinical indicators of inappropriate medication use, no expression of desire to control the disease, irregular attendance to the dialysis sessions and infection were more specific as to that diagnosis. Non-adherence to treatment was the only indicator that showed confidence intervals with values for sensitivity and specificity, statistically above 0.5, being the one who has better diagnostic accuracy as the inference of the nursing diagnosis Ineffective Self Health in hemodialysis clientele. Thus, it is believed that the improvement of the components of diagnosis in question will contribute to the development of more reliable nursing interventions to the health status of the individual in hemodialysis, providing a more scientifically qualified care.

Análise de conteúdo e validação clínica do diagnóstico de enfermagem autocontrole ineficaz da saúde

The study aims to analyze the content and measures of accuracy of the nursing diagnosis Ineffective Self Health in patients undergoing hemodialysis. Study of nursing diagnosis validation carried out in two stages, namely: content analysis by judges and accuracy of clinical indicators. In the first stage, 22 judges evaluated the setting and location of the diagnosis, clinical indicators and etiological factors and their conceptual and empirical definitions. We used the binomial test to determine the proportion of the judges of the relevance of the components of the nursing diagnosis. In the second stage, we used the Latent Class Analysis for the diagnostic accuracy by evaluating 200 patients in a hemodialysis clinic in northeastern Brazil. Research approved by the Ethics Committee, under the Opinion No 387 837 and CAAE 18486413.0.0000.5537. The results show that the judges evaluated as pertinent clinical indicators 12 and 22 etiological factors. Proposed amendment of the nomenclature of five indicators and six factors and the implementation of a clinical indicator for etiology and three etiological factors for clinical indicators. In conceptual and empirical definitions, judges judged as not relevant the conceptual and empirical definitions of a clinical indicator, the conceptual definitions of two etiological factors and empirical definitions four etiological factors. Still, changes were suggested in the conceptual and empirical definitions of two clinical indicators, the conceptual definitions of 12 etiological factors and empirical definitions of 11 etiological factors. Clinical indicators analyzed in the first stage were validated clinically in patients undergoing hemodialysis. The most frequent clinical indicators were Changes in laboratory tests (100%) and daily life choices ineffective to achieve health goals (81%); and three etiological factors had a higher frequency, they are: unfavorable demographic factors (94.5%), beliefs (79%) and comorbidities (77.5%). From Latent class analysis, diagnosis prevalence was estimated at 66.28%. Clinical indicators that showed the best sensitivity measures for the nursing diagnosis Ineffective Self Health were: daily life choices ineffective to achieve health goals and Expression of difficulty with prescribed regimens. In turn, the clinical indicators of inappropriate medication use, no expression of desire to control the disease, irregular attendance to the dialysis sessions and infection were more specific as to that diagnosis. Non-adherence to treatment was the only indicator that showed confidence intervals with values for sensitivity and specificity, statistically above 0.5, being the one who has better diagnostic accuracy as the inference of the nursing diagnosis Ineffective Self Health in hemodialysis clientele. Thus, it is believed that the improvement of the components of diagnosis in question will contribute to the development of more reliable nursing interventions to the health status of the individual in hemodialysis, providing a more scientifically qualified care.

A dinâmica geográfica da construção de um território para moradias sociais: estudo testemunhal do empreendimento Vitória Brasil em Uberlândia (MG)

This work describes and analyzes the situation planned with the current, according to the housing development project style of social interest (Gleba 9), named Victory Brazil at Shopping Park II neighborhood, located in the southern sector of Uberlândia (MG), built with Program resources Minha Casa, Minha Vida (PMCMV). The specific objectives are: to present the housing policy of social interest directed to the Minha Casa, Minha Vida in the city of Uberlândia, from its history to its current information; trace the environmental characterization of the housing Vitoria Brazil through the development of thematic maps; identify the impacts generated by the housing projects of social interest; and show through interviews with 25 residents of Vitoria Brazil, the structural problems of the houses. Therefore, the research became quali-quantitative with descriptive approach and use of semi- structured interviews to collect data. In addition, the iconographic sources, ie photographs of the problems raised by the residents of the whole Victory Brazil and maps of the study area, enlarged the qualitative and dialogic nature of this study, as there is opportunity to contextualize specific way what was reported the residents interviewed. We understand that the city is intrinsically related to the design of agglomeration, characterized by the production of the possessor market capitalism a public administration system that is guided by the ideals of consumption and utilization of space, and its inhabitants are high class with the construction of equipment and adequate social services. One of the important biases to solving the problems of urbanization is by the intervention of the government through public policies through the master plan so that would allow prospects to enable the population of low-income housing in locations that offer housing and decent urbanization conditions.

Avaliação da soldagem GMAW mecanizada e automatizada para união de dutos utilizando fontes convencional e com controle de curto- circuito

Welding is one of the most employed process for joining steel pipes. Although, manual welding is still the most used one, mechanized version and even automatized one have increased its demand. Thus, this work deals with girth welding of API 5L X65 pipes with 8” of nominal diameter and 8.0 mm thickness, beveled with V-30º narrow gap. Torch is moved by a bug carrier (mechanized welding) and further the parameters are controlled as a function of angular position (automatized welding). Welding parameters are presented for filling the joint with two-passes (root and filling/capping passes). Parameters for the root pass were extracted from previous author´s work with weldments carried out in plates, but validated in this work for pipe welding. GMAW processes were assessed with short-circuit metal transfer in both conventional and derivative modes using different technologies (RMD, STT and CMT). After the parameter determination, mechanical testing was performed for welding qualification (uniaxial tension, face and root bending, nick break, Charpy V-notch impact, microhardness and macrograph). The initially obtained results for RMD and CMT were acceptable for all testing and, in a second moment, also for the STT. However, weld beads carried out by using the conventional process failed and revealed the existence of lack of fusion, which required further parametrization. Thus, a Parameter-Variation System for Girth Welding (SVP) was designed and built to allow varying the welding parameters as a function of angular position by using an inclinometer. The parameters were set for each of the three angular positions (flat, vertical downhill and overhead). By using such equipment and approach, the conventional process with parameter variation allowed reducing the welding time for joint accomplishment of the order of 38% for the root pass and 30% for the filling/capping pass.

Laser machining steel for moulds: a case study

Laser beam machining is a non-traditional subtractive manufacturing process, a form of machining, in which a laser is directed towards the work piece for machining. This process uses thermal energy to remove material from metallic or non-metallic surfaces. The laser is focused onto the surface to be worked and the thermal energy of the laser is transferred to the surface, heating and melting or vaporizing the material. Laser beam machining is best suited for brittle materials with low conductivity, but can be used on most materials. The role of the technical equipment in laser milling is to perform a controllable action of the laser radiation on the material to be treated. The laser is the main unit of the equipment and it is characteristics determine to great extent the qualitative and quantitative parameters of the technological treatments. In this work, I had to study the laser milling process parameter selection for process planning operations from start to finish. It was important to have an understanding about laser milling and laser processing parameters for different materials. As a result from the laser milling, the surface finish will have different surface properties such as, surface hardness, surface roughness, friction and tribology etc.. During the process, I gained knowledge about the historical and conceptual framework of laser milling, the different parameters of a laser milling and how the laser milling parameters influence the surface properties of the machined parts.

Exploring business models to provide a foundation for enhanced eye care services in high street optometric practice

High street optometric practices are for-profit businesses. They mostly provide sight testing and eye examination services and sell optical products, such as spectacles and contact lenses. The sight testing services are often sold at a vastly reduced price and profits are generated primarily through high margin spectacle sales, in a loss leading strategy. Published literature highlights weaknesses in this strategy as it forms a barrier to widening the scope of services provided within optometric practices. This includes specialist non-refraction based services, such as shared care. In addition this business strategy discourages investment in advanced diagnostic equipment and higher professional qualifications. The aim of this thesis was to develop a greater understanding of the traditional loss-leading strategy. The thesis also aimed to assess the plausibility of alternative business models to support the development of specialist non-refraction services within high street optometric practice. This research was based on a single independent optometric practice that specialises in advanced retinal imaging and offers a broad range of shared care services. Specialist non-refraction based services were found to be poor generators of spectacle sales likely due to patient needs and presenting concerns. Alternative business strategies to support these services included charging more realistic professional fees via cost-based pricing and monthly payment plans. These strategies enabled specialist services to be more self-sustainable with less reliance on cross-subsidy from spectacle sales. Furthermore, improving operational efficiency can increase stand-alone profits for specialist services.Practice managers may be reluctant to increase professional fees due to market pressures and confidence. However, this thesis found that patients were accepting of increased professional fees. Practice managers can implement alternative business models to enhance eye care provision in high street optometric practices. These alternative business models also improve revenues and profits generated via clinical services and improve patient loyalty.

Survey on demand side sensitivity to power quality in Ireland

Power systems require a reliable supply and good power quality. The impact of power supply interruptions is well acknowledged and well quantified. However, a system may perform reliably without any interruptions but may have poor power quality. Although poor power quality has cost implications for all actors in the electrical power systems, only some users are aware of its impact. Power system operators are much attuned to the impact of low power quality on their equipment and have the appropriate monitoring systems in place. However, over recent years certain industries have come increasingly vulnerable to negative cost implications of poor power quality arising from changes in their load characteristics and load sensitivities, and therefore increasingly implement power quality monitoring and mitigation solutions. This paper reviews several historical studies which investigate the cost implications of poor power quality on industry. These surveys are largely focused on outages, whilst the impact of poor power quality such as harmonics, short interruptions, voltage dips and swells, and transients is less well studied and understood. This paper examines the difficulties in quantifying the costs of poor power quality, and uses the chi-squared method to determine the consequences for industry of power quality phenomenon using a case study of over 40 manufacturing and data centres in Ireland.

La escuela con los pies en el aire. Hacer escuela, entre la desigualdad y la emancipación

El propósito de este trabajo de investigación es relevar la experiencia de una escuela pública del distrito de La Matanza, en el conurbano bonaerense. Esta institución enclavada en una zona popular, Villa Scasso, fue creada hace trece años y atiende a una población infantil y juvenil de educación especial. El motivo de la investigación no se centra en la especificidad de este campo educativo sino en el proceso de construcción de una propuesta pedagógica que tensiona las formas escolares, amplía las fronteras educativas y transforma el tiempo y el espacio escolar. La atención de la presente indagación está puesta en problematizar la relación de la educación con la desigualdad y la igualdad, con el objetivo de abrir nuevos interrogantes sobre el carácter de determinación que se le otorga a la pobreza, la marginalidad y la exclusión en el terreno educativo, en particular en su relación con las escuelas de sectores populares. Las infancias populares acceden a circuitos de escolarización diferenciados, pero su carácter reproductor y/o emancipador configura un discurso que no se clausura a priori. Esta tesis doctoral abre interrogantes sobre esta problemática y documenta una experiencia educativa que "hace escuela" de manera "especial"