Fatores que afetam a satisfação e a fidelidade do cliente: um estudo com compradores de automóveis

This thesis presents a contribution to the study customer satisfaction models, analyzing the relationship between antecedent variables satisfaction and customer loyalty, through a survey with car s buyers in Natal. The theorical survey is focused in concepts of customer satisfaction and loyalty, and in the customer satisfaction index models. For the field survey, was applied a questionnaire, based on the Norwegian Customer Satisfaction Barometer (NCSB), considered by Johnson et al. (2001), with 106 customer of concessionary Fiat, the Pontanegra Automóveis. The main results obtained by the multiple regression analysis reveal that, considering the Fiat, the satisfaction is influencing by reliance degree in the firm seriousness and by complaining handling, the loyalty is influenced by possibility of again pay the same value if was again buy a car, the satisfaction degree with a car, affective commitment relationship firm customer of the own car and the complaining handling. Considering the concessionaire, the satisfaction is influenced by reliance degree in the firm seriousness, ability degree of the concessionaire in delivery service and by complaining handling, already the loyalty is influencing by possibility of again pay the same value if was again buy a car, affective commitment relations to be concessionaire s customer, by calculate commitment in relation the economic loss of bought this car of this firm and complaining handling

Põe tapioca, põe farinha d’água?: gastronomia do açaí e identidade socioespacial e cultural na Grande Belém

O presente trabalho teve como objetivo principal analisar as mudanças nas formas de venda e consumo do açaí na Região Metropolitana de Belém (RMB), e sua relação com a identidade de lugar de seus consumidores. O interesse pelo tema teve origem na observação da ocorrência da globalização do açaí, alimento base da dieta das populações amazônicas de origem ribeirinha que hoje é largamente consumido fora da Região Amazônica, em padrões muito diferentes daqueles nela estabelecidos. A escolha da RMB como lócus de pesquisa se justifica pelo fato de que nela se concentra alto consumo de açaí, nos padrões tradicionais e nos modernos, suscitando questionamentos sobre os efeitos dessa convivência na vida cotidiana dos que a habitam. Teoricamente, a pesquisa articula a definição de identidade de lugar de Abe-Lima (2012) com as elaborações de Henri Lefèbvre (1991) sobre a vida cotidiana no mundo moderno e com teoria dos circuitos econômicos de Milton Santos (2008). Metodologicamente, foi adotada uma estratégia multimétodos, envolvendo pesquisa documental, um painel de especialistas com 5 entidades de acompanhamento da produção de açaí, observações pautadas na etnografia urbana em 9 locais de venda e entrevistas semiabertas com 40 consumidores de açaí, maiores de 18 anos e residentes na RMB, recrutados por meio de cadeia tipo bola de neve. Além dos roteiros de entrevistas, foram utilizados como estratégias de coleta de dados diários de campo e fotografias. O conjunto dos dados foi submetido à técnica da análise de conteúdo temática, com eventual apoio do software QDA Miner Lite. Os resultados situaram a globalização do açaí em meados da década de 1990, momento de intensificação dos efeitos da metropolização em Belém, como o aumento populacional, a segregação espacial e a imposição de um ritmo de vida mais acelerado. As análises apontaram que tal processo significou a entrada do açaí no circuito superior da economia, com um processo produtivo mais organizado, utilizando mais tecnologia e envolvendo maiores volumes financeiros, atingindo escala industrial. No entanto, prevalece na RMB o processamento artesanal, em estruturas de pequeno porte, construídas em alvenaria, de organização simples e controle financeiro ausente. O consumo público aumentou, com grande número de locais especializados na oferta de açaí, em caráter de entretenimento, sendo incipiente a adesão a novos acompanhamentos, como granola e aveia. A preferência pelos acompanhamentos tradicionais, como farinha d’água ou de tapioca, açúcar e peixe, permanece, assim como pelo consumo privado, no âmbito da casa, que tem sido favorecido pela disponibilidade do serviço de entrega, recurso recente. A frequência geral de consumo diminuiu, em função do aumento de preço e de mudanças na rotina, como aumento da distância entre local de trabalho e residência. A pesquisa permitiu reafirmar a importância do açaí na vida cotidiana dos belenenses que o consomem, para os quais ele funciona como elemento de distintividade, continuidade, autoestima e autoeficácia, em estreita relação com aspectos próprios da metrópole. Por esse motivo, torna-se preocupante que o acesso a açaí de qualidade, nos padrões desejados pelos indivíduos, esteja tornando-SE privilégio inacessível aos consumidores de menor poder aquisitivo. Assim, espera-se que o conjunto de dados contribua para a compreensão da importância de políticas públicas voltadas ao açaí que considerem melhor as demandas daqueles que o consomem.

What Happened to Participation? Urban Development and Authoritarian Upgrading in Cairo's Informal Neighbourhoods

Participation appeared in development discourses for the first time in the 1970s, as a generic call for the involvement of the poor in development initiatives. Over the last three decades, the initial perspectives on participation intended as a project method for poverty reduction have evolved into a coherent and articulated theoretical elaboration, in which participation figures among the paraphernalia of good governance promotion: participation has acquired the status of “new orthodoxy”. Nevertheless, the experience of the implementation of participatory approaches in development projects seemed to be in the majority of cases rather disappointing, since the transformative potential of ‘participation in development’ depends on a series of factors in which every project can actually differ from others: the ultimate aim of the approach promoted, its forms and contents and, last but not least, the socio-political context in which the participatory initiative is embedded. In Egypt, the signature of a project agreement between the Arab Republic of Egypt and the Federal Republic of Germany, in 1998, inaugurated a Participatory Urban Management Programme (PUMP) to be implemented in Greater Cairo by the German Technical Cooperation (Deutsche Gesellschaft für Technische Zusammenarbeit, GTZ) and the Ministry of Planning (now Ministry of Local Development) and the Governorates of Giza and Cairo as the main counterparts. Now, ten years after the beginning of the PUMP/PDP and close to its end (December 2010), it is possible to draw some conclusions about the scope, the significance and the effects of the participatory approach adopted by GTZ and appropriated by the Egyptian counterparts in dealing with the issue of informal areas and, more generally, of urban development. Our analysis follows three sets of questions: the first set regards the way ‘participation’ has been interpreted and concretised by PUMP and PDP. The second is about the emancipating potential of the ‘participatory approach’ and its ability to ‘empower’ the ‘marginalised’. The third focuses on one hand on the efficacy of GTZ strategy to lead to an improvement of the delivery service in informal areas (especially in terms of planning and policies), and on the other hand on the potential of GTZ development intervention to trigger an incremental process of ‘democratisation’ from below.

Making a Difference Beyond the Workplace

Library and IT staff volunteer their time outside of work to many charitable organizations.

Communication about standard treatment options and clinical trials: can we teach doctors new skills to improve patient outcomes?

BACKGROUND: The International Breast Cancer Study Group conducted a phase III trial in Australian/New Zealand (ANZ) and Swiss/German/Austrian (SGA) centres on training doctors in clear and ethical information delivery about treatment options and strategies to encourage shared decision making. METHODS: Medical, surgical, gynaecological and radiation oncologists, and their patients for whom adjuvant breast cancer therapy was indicated, were eligible. Doctors were randomised to participate in a workshop with standardised teaching material and role playing. Patients were recruited in the experimental and control groups before and after the workshop. RESULTS: In ANZ centres, 21 eligible doctors recruited a total of 304 assessable patients. In SGA centres, 41 doctors recruited 390 patients. The training was well accepted. There was no overall effect on patient decisional conflict (primary endpoint) 2 weeks after the consultation. Overall, patients were satisfied with their treatment decision, their consultation and their doctors' consultation skills. Considerable variation was observed in patient outcomes between SGA and ANZ centres; the effect sizes of the intervention were marginal (<0.2). CONCLUSIONS: Shared decision making remains a challenge. A sustained training effect may require more intensive training tailored to the local setting. Cross-cultural differences need attention in conducting trials on communication interventions.

Study of water use and supply in the district of Independencia, Peru

Peru is a developing country with abundant fresh water resources, yet the lack of infrastructure leaves much of the population without access to safe water for domestic uses. The author of this report was a Peace Corps Volunteer in the sector of water & sanitation in the district of Independencia, Ica, Peru. Independencia is located in the arid coastal region of the country, receiving on average 15 mm of rain annually. The water source for this district comes from the Pisco River, originating in the Andean highlands and outflowing into the Pacific Ocean near the town of Pisco, Peru. The objectives of this report are to assess the water supply and sanitation practices, model the existing water distribution system, and make recommendations for future expansion of the distribution system in the district of Independencia, Peru. The assessment of water supply will be based on the results from community surveys done in the district of Independencia, water quality testing done by a detachment of the U.S. Navy, as well as on the results of a hydraulic model built in EPANET 2.0 to represent the distribution system. Sanitation practice assessments will be based on the surveys as well as observations from the author while living in Peru. Recommendations for system expansions will be made based on results from the EPANET model and the municipality’s technical report for the existing distribution system. Household water use and sanitation surveys were conducted with 84 families in the district revealing that upwards of 85% store their domestic water in regularly washed containers with lids. Over 80% of those surveyed are drinking water that is treated, mostly boiled. Of those surveyed, over 95% reported washing their hands and over 60% mentioned at least one critical time for hand washing when asked for specific instances. From the surveys, it was also discovered that over 80% of houses are properly disposing of excrement, in either latrines or septic tanks. There were 43 families interviewed with children five years of age or under, and just over 18% reported the child had a case of diarrhea within the last month at the time of the interview. Finally, from the surveys it was calculated that the average water use per person per day is about 22 liters. Water quality testing carried out by a detachment of the U.S. Navy revealed that the water intended for consumption in the houses surveyed was not suitable for consumption, with a median E. coli most probable number of 47/100 ml for the 61 houses sampled. The median total coliforms was 3,000 colony forming units per 100 ml. EPANET was used to simulate the water delivery system and evaluate its performance. EPANET is designed for continuous water delivery systems, assuming all pipes are always flowing full. To account for the intermittent nature of the system, multiple EPANET network models were created to simulate how water is routed to the different parts of the system throughout the day. The models were created from interviews with the water technicians and a map of the system created using handheld GPS units. The purpose is to analyze the performance of the water system that services approximately 13,276 people in the district of Independencia, Peru, as well as provide recommendations for future growth and improvement of the service level. Performance evaluation of the existing system is based on meeting 25 liters per person per day while maintaining positive pressure at all nodes in the network. The future performance is based on meeting a minimum pressure of 20 psi in the main line, as proposed by Chase (2000). The EPANET model results yield an average nodal pressure for all communities of 71 psi, with a range from 1.3 – 160 psi. Thus, if the current water delivery schedule obtained from the local municipality is followed, all communities should have sufficient pressure to deliver 25 l/p/d, with the exception of Los Rosales, which can only supply 3.25 l/p/d. However, if the line to Los Rosales were increased from one to four inches, the system could supply this community with 25 l/p/d. The district of Independencia could greatly benefit from increasing the service level to 24-hour water delivery and a minimum of 50 l/p/d, so that communities without reliable access due to insufficient pressure would become equal beneficiaries of this invaluable resource. To evaluate the feasibility of this, EPANET was used to model the system with a range of population growth rates, system lifetimes, and demands. In order to meet a minimum pressure of 20 psi in the main line, the 6-inch diameter main line must be increased and approximately two miles of trench must be excavated up to 30 feet deep. The sections of the main line that must be excavated are mile 0-1 and 1.5-2.5, and the first 3.4 miles of the main line must be increased from 6 to 16 inches, contracting to 10 inches for the remaining 5.8 miles. Doing this would allow 24-hour water delivery and provide 50 l/p/d for a range of population growth rates and system lifetimes. It is expected that improving the water delivery service would reduce the morbidity and mortality from diarrheal diseases by decreasing the recontamination of the water due to transport and household storage, as well as by maintaining continuous pressure in the system to prevent infiltration of contaminated groundwater. However, this expansion must be carefully planned so as not to affect aquatic ecosystems or other districts utilizing water from the Pisco River. It is recommended that stream gaging of the Pisco River and precipitation monitoring of the surrounding watershed is initiated in order to begin a hydrological study that would be integrated into the district’s water resource planning. It is also recommended that the district begin routine water quality testing, with the results available to the public.

Provisión de servicios de procesado de imágenes basados en arquitecturas orientadas a servicios

Con este proyecto se pretende crear un procedimiento general para la implantación de aplicaciones de procesado de imágenes en cámaras de video IP y la distribución de dicha información mediante Arquitecturas Orientadas a Servicios (SOA). El objetivo principal es crear una aplicación que se ejecute en una cámara de video IP y realice un procesado básico sobre las imágenes capturadas (detección de colores, formas y patrones) permitiendo distribuir el resultado del procesado mediante las arquitecturas SOA descritas en la especificación DPWS (Device Profile for Web Services). El estudio se va a centrar principalmente en la transformación automática de código de procesado de imágenes escrito en Matlab (archivos .m) a un código C ANSI (archivos .c) que posteriormente se compilará para la arquitectura del procesador de la cámara (arquitectura CRIS, similar a la RISC pero con un conjunto reducido de instrucciones). ABSTRACT. This project aims to create a general procedure for the implementation of image processing applications in IP video cameras and the distribution of such information through Service Oriented Architectures (SOA). The main goal is to create an application that runs on IP video camera and carry out a basic processing on the captured images ( color detection, shapes and patterns) allowing to distribute the result of process by SOA architectures described in the DPWS specification (Device Profile for Web Services). The study will focus primarily on the automated transform of image processing code written in Matlab files (. M) to ANSI C code files (. C) which is then compiled to the processor architecture of the camera (CRIS architecture , similar to the RISC but with a reduced instruction set).

Creating and modelling personal socio-economic networks in on-line banking

The banking industry is observing how new competitors threaten its millennial business model by targeting unbanked people, offering new financial services to their customer base, and even enabling new channels for existing services and customers. The knowledge on users, their behaviour, and expectations become a key asset in this new context. Well aware of this situation, the Center for Open Middleware, a joint technology center created by Santander Bank and Universidad Politécnica de Madrid, has launched a set of initiatives to allow the experimental analysis and management of socio-economic information. PosdataP2P service is one of them, which seeks to model the economic ties between the holders of university smart cards, leveraging on the social networks the holders are subscribed to. In this paper we describe the design principles guiding the development of the system, its architecture and some implementation details.

How small and medium enterprises can begin their implementation of ITIL?

Sequencing of Information Technology Infrastructure Library (ITIL) processes related to their order of implementation is one of the pending issues in the ITIL handbooks. Other frameworks and process models related to service management (e.g., COBIT, COSO and CMMI-SVC) are quite well described in the literature and their handbooks. However, the identifi cation of the fi rst process to be implemented has not been deeply analysed in the previous frameworks and models, and it is also a complex question to answer for organizations, especially Small and Medium Enterprises (SMEs). Moreover, SMEs are the organizations that have the largest presence in the world economy; offi cial data of General Business Directory, show that their range of presence in different countries around the world is between 93% and 99%, and the average of employment contribution is around 60%. Consequently, the improvement of information technology service management is of vital importance to accomplish in this type of enterprises. This research has focused on two surveys that aim at helping SMEs to select the ITIL process by which starting the implementation of ITIL. In the fi rst survey, data were gathered through a questionnaire to SMEs registered in the region of Madrid. The second survey obtained data from experts and enterprises in countries as Spain, Ecuador, Chile, Luxembourg, Colombia, Norway, El Salvador, and Venezuela. Finally, the results of both surveys show that the tendency for starting an ITIL implementation in SMEs points to one of the processes included in the Service Operation.

Web-based distance continuing education: a new way of thinking for students and instructors

As people have more difficulty taking time away from work to attend conferences and workshops, the idea of offering courses via the Web has become more desirable. Addressing a need voiced by Medical Library Association membership, the authors developed a Web-based continuing-education course on the subject of the librarian's role in evidence-based medicine. The aim of the course was to provide medical librarians with a well-constructed, content-rich learning experience available to them at their convenience via the Web. This paper includes a discussion of the considerations that need to be taken into account when developing Web-based courses, the issues that arise when the information delivery changes from face-to-face to online, the changing role of the instructor, and the pros and cons of offering Web-based versus traditional courses. The results of the beta test and future plans for the course are also discussed.

Donación voluntaria de sangre de cordón umbilical en el Hospital Universitario Virgen de la Arrixaca (2010-2011). Situación actual e influencia de las variables obstétrico-fetales

Objetivos: A principios de 2010 el Hospital Universitario Virgen de la Arrixaca puso en marcha, en el servicio de partos, el protocolo de donación voluntaria de sangre de cordón umbilical (SCU). Desde la reflexión y la autoevaluación, planteamos un análisis de nuestra situación actual a través del estudio de la influencia de las variables obstétrico-fetales en la calidad de las muestras. Métodos: Con este fin hemos planteado un trabajo de tipo observacional, descriptivo, retrospectivo y de corte transversal desde mayo de 2010 a noviembre de 2011, con el objetivo de aumentar la calidad de las unidades de SCU y optar por una gestión eficiente que haga sostenible el proyecto. Resultados: Se obtuvieron 123 donaciones potenciales de sangre de cordón y del análisis multivariable de las mismas obtuvimos una correlación positiva significativa entre el número de leucocitos, las semanas de gestación y el parto vaginal. El peso inicial de la unidad se incrementó significativamente a mayor peso del recién nacido y paridad de la donante. Conclusiones: Como conclusiones del estudio nos planteamos esbozar posibles factores predictivos que permitan seleccionar las muestras de mayor calidad y sean complemento de los actuales estándares elaborados por el Banco Público de Málaga. En este sentido nuestros resultados sugieren que en los partos con más semanas de gestación, paridad de la gestante y peso del recién nacido, así como en los partos vaginales, encontramos mayores posibilidades de obtener muestras de alta calidad.

Aunt Sammy's radio recipes revised.

Have also Braille edition [1932]

A Comparison of Paediatric Occupational Therapy University Program Curricula in New Zealand, Australia, and Canada

Comparisons were made of the paediatric content of professional entry-level occupational therapy university program curricula in Australia, New Zealand, and Canada using an ex post facto surveymethodology. The findings indicated that in Australia/New Zealand, paediatrics made up 20% of the total curriculum, but only 13% in Canada. Canadian reference materials were utilized less often in Canadian universities than in Australia/New Zealand. Theories taught most often in Australia/New Zealand were: Sensory Integration, Neurodevelopmental Therapy, Client-Centered Practice, Playfulness, and the Model of Human Occupation. In Canada, the most frequent theories were: Piaget’s Stages ofCognitive/Intellectual Development, Neurodevelopmental Therapy, Erikson’s Eight Stages of Psychosocial Development and Sensory Integration. The most frequently taught paediatric assessment tools in both regions were the Bruininks-Oseretsky Test of Motor Proficiency and Miller Assessment for Preschoolers. Paediatric interventionmethods taught to students in all three countries focused on activities of daily living/self-care, motor skills, perceptual and visual motor integration, and infant and child development. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website: ©2006 by The Haworth Press, Inc. All rights reserved.]

Development and evaluation of a youth mental health community awareness campaign - The Compass Strategy

Background: Early detection and treatment of mental disorders in adolescents and young adults can lead to better health outcomes. Mental health literacy is a key to early recognition and help seeking. Whilst a number of population health initiatives have attempted to improve mental health literacy, none to date have specifically targeted young people nor have they applied the rigorous standards of population health models now accepted as best practice in other health areas. This paper describes the outcomes from the application of a health promotion model to the development, implementation and evaluation of a community awareness campaign designed to improve mental health literacy and early help seeking amongst young people. Method: The Compass Strategy was implemented in the western metropolitan Melbourne and Barwon regions of Victoria, Australia. The Precede-Proceed Model guided the population assessment, campaign strategy development and evaluation. The campaign included the use of multimedia, a website, and an information telephone service. Multiple levels of evaluation were conducted. This included a cross-sectional telephone survey of mental health literacy undertaken before and after 14 months of the campaign using a quasi-experimental design. Randomly selected independent samples of 600 young people aged 12 - 25 years from the experimental region and another 600 from a comparison region were interviewed at each time point. A series of binary logistic regression analyses were used to measure the association between a range of campaign outcome variables and the predictor variables of region and time. Results: The program was judged to have an impact on the following variables, as indicated by significant region-by-time interaction effects ( p < 0.05): awareness of mental health campaigns, self-identified depression, help for depression sought in the previous year, correct estimate of prevalence of mental health problems, increased awareness of suicide risk, and a reduction in perceived barriers to help seeking. These effects may be underestimated because media distribution error resulted in a small amount of print material leaking into the comparison region. Conclusion: We believe this is the first study to apply the rigorous standards of a health promotion model including the use of a control region to a mental health population intervention. The program achieved many of its aims despite the relatively short duration and moderate intensity of the campaign.

A study of outcomes measures in forensic mental health

Outcomes measures, which is the measurement of effectiveness of interventions and services has been propelled onto the health service agenda since the introduction of the internal market in the 1990s. It arose as a result of the escalating cost of inpatient care, the need to identify what interventions work and in what situations, and the desire for effective information by service users enabled by the consumerist agenda introduced by Working for Patients white paper. The research reported in this thesis is an assessment of the readiness of the forensic mental health service to measure outcomes of interventions. The research examines the type, prevalence and scope of use of outcomes measures, and further seeks a consensus of views of key stakeholders on the priority areas for future development. It discusses the theoretical basis for defining health and advocates the argument that the present focus on measuring effectiveness of care is misdirected without the input of users, particularly patients in their care, drawing together the views of the many stakeholders who have an interest in the provision of care in the service. The research further draws on the theory of structuration to demonstrate the degree to which a duality of action, which is necessary for the development, and use of outcomes measures is in place within the service. Consequently, it highlights some of the hurdles that need to be surmounted before effective measurement of health gain can be developed in the field of study. It concludes by advancing the view that outcomes research can enable practitioners to better understand the relationship between the illness of the patient and the efficacy of treatment. This understanding it is argued would contribute to improving dialogue between the health care practitioner and the patient, and further providing the information necessary for moving away from untested assumptions, which are numerous in the field about the superiority of one treatment approach over another.