107 resultados para Overtime
Resumo:
We determined the direct cost of an Intensive Care Unit (ICU) bed in a tertiary referral Australian ICU and the cost drivers thereof, by retrospectively analysing a number of prospectively designed Hospital- and Unit-specific electronic databases. The study period was a financial year, from 1 July 2002 to 30 June 2003. There were 1615 patients occupying 5692 fractional occupied bed days at a total cost of A$15,915,964, with an average length of stay of 3.69 days (range 0.5-77, median 1.06, interquartile range 2.33). The main cost driver not incorporated into this analysis was blood products (paid for centrally). The average costs of an ICU day and total stay per patient were A$2670 and A$9852 respectively. Staff-related charges were 68.76%, with consumables related expenditure making up 19.65%, clinical support services 9.55% and capital equipment 2.04%. Overtime charges and nursing agency staff were 19.4% of staff-related charges (2.9% for agency staff), 3.9% lower than expenditure associated with full-time employment charges, such as pension and leave. The emergency nature of ICU means it is difficult to accurately set a nursing establishment to cater for all admissions and therefore it is hard to decide what is an acceptable percentage difference between agency/overtime costs compared with the costs associated with full-time staff appointments. Consumable expenditure is likely to increase the most with new innovation and therapies. Using protocol driven practices may tighten and control costs incurred in ICU.
Resumo:
A presente dissertação analisa como o Partido Social Cristão (PSC), ao longo do tempo, se apropriou da identidade religiosa de seus atores políticos que na sua maioria são membros da Frente Parlamentar Evangélica, os quais defendem no espaço público a “família tradicional”, em detrimento da pluralidade de arranjos familiares na contemporaneidade. Para explicitar o objeto - “família tradicional” e PSC -, foi necessário retroceder no tempo e investigar na historiografia os primórdios da inserção dos evangélicos na política brasileira. Em vista disso, analisamos a participação dos evangélicos nos respectivos períodos do Brasil: Colônia, Império e República. A dificuldade da entrada de evangélicos na política partidária, dentre outros fatores, se deve àinfluência do catolicismo no Estado. Assim sendo, averiguamos em todas as Constituições (1824, 1891, 1934, 1937, 1946, 1967, 1969 e 1988) o que a mesma diz no que tange a proibição e a liberdade religiosa no país. Logo, verificamos entre as Eras Vargas e República Populista, que ocorreu com intensidade a transição do apoliticismo para o politicismo entre os evangélicos brasileiros, porém, eles não recebiam o apoio formal de suas igrejas. Em seguida, a participação dos evangélicos na arena política durante a ditadura militar foi investigada com destaque para o posicionamento de vanguarda da IECLB, através do Manifesto de Curitiba e, também com a presença de parlamentares evangélicos no Congresso Nacional. A politização pentecostal é ressaltada em nosso trabalho, através do pioneirismo de Manoel de Mello e, depois na Redemocratização quando as instituições evangélicas se organizaram para eleger seus candidatos à Assembleia Nacional Constituinte. E, com o fim do regime militar, o PSC surge como partido “nanico”, contudo, deixa o anonimato e ganha visibilidade midiática quando o pastor e deputado, Marco Feliciano, assume a presidência da Comissão de Direitos Humanos e Minorias, em 2013. Esse é o pano de fundo histórico que projetou o PSC e seus atores no pleito de 2014 com o mote “família tradicional”.
Resumo:
This thesis analyses the work situation and class position of Brazilian engineers through a Marxist perspective. The research is based on two case studies, one focused on a large German steel company based in Brazil and the other on a large Brazilian energy corporation. The fieldwork involved 114 interviews, with engineers from different hierarchical positions in these two companies. Data was also gathered through interviews with representatives from the companies, the Council of Engineering, the Engineering Education System and the Engineers Trade Unions. The findings show that the engineering profession in Brazil has shifted from its initial condition as a liberal profession to an organizational profession, with the country's industrial deployment. Both companies consider all salaried workers as employees, including managers. Hence they are subject to the company's general personnel policies. The multinational company controls labour more rigidly than the national company, as well as reserving its top positions for its home country's executives. Although no deskilling process was found, engineers of both companies performed simple work, which required less engineering knowledge than they had learned from school. Engineers have little autonomy, authority and participation in decision making and are subject to direct supervision, performance evaluation, time control, overtime work, productivity and to poor working conditions in the multinational company. The majority of the engineers supervised other workers without being in a managerial position. They found that to move into management, was a good way to improve their autonomy, authority, prestige, salary, status, power and professional pride. Despite ideological divisions between capital and labour, most of the engineers were unionised and saw unions as the right way to deal with the employer.
Resumo:
In this dissertation, I examine both theoretically and empirically the relationship between stock prices and income distribution using an endogenous growth model with social status impatience.^ The theoretical part looks into how status impatience and current economic status jointly determine time preference, savings, future economic status, stock prices, growth and wealth distribution in the steady state. This work builds on Burgstaller and Karayalcin (1996).^ More specifically, I look at (i) the effects of the distribution of status impatience levels on the distribution of steady state assets, incomes and consumption and (ii) the effects of changes in relative levels of status impatience on stock prices. Therefore, from (i) and (ii), I derive the correlation between stock prices, incomes and asset distribution. Also, the analysis of the stack market is undertaken in the presence of adjustment costs to investments.^ The empirical chapter looks at (i) the correlation between income inequality and long run economic growth on the one hand and (ii) the correlation between stock market prices and income inequality on the other. The role of stock prices and social status is examined to better understand the forces that enable a country to grow overtime and to determine why output per capita varies across countries. The data are from Summers and Heston (1988), Barro and Wolf (1989), Alesina and Rodrik (1994), Global financial Database (1997) and the World Bank. Data for social status are collected through a primary sample survey on the internet. Twenty-five developed and developing countries are included in the sample.^ The model developed in this study was specified as a system of simultaneous equations, in which per capita growth rate and income inequality were endogenous variables. Additionally, stock price index and social status measures were also incorporated. The results indicate that income inequality is inversely related to economic growth. In addition, increase in income inequality arising from higher stock prices constrains growth. Moreover, where social status is determined by income levels, it influences long run growth. Therefore, these results support findings of Persson and Tabellini (1994) and Alesina and Rodrik (1994). ^
Resumo:
This dissertation is a study of customer relationship management theory and practice. Customer Relationship Management (CRM) is a business strategy whereby companies build strong relationships with existing and prospective customers with the goal of increasing organizational profitability. It is also a learning process involving managing change in processes, people, and technology. CRM implementation and its ramifications are also not completely understood as evidenced by the high number of failures in CRM implementation in organizations and the resulting disappointments. ^ The goal of this dissertation is to study emerging issues and trends in CRM, including the effect of computer software and the accompanying new management processes on organizations, and the dynamics of the alignment of marketing, sales and services, and all other functions responsible for delivering customers a satisfying experience. ^ In order to understand CRM better a content analysis of more than a hundred articles and documents from academic and industry sources was undertaken using a new methodological twist to the traditional method. An Internet domain name (http://crm.fiu.edu) was created for the purpose of this research by uploading an initial one hundred plus abstracts of articles and documents onto it to form a knowledge database. Once the database was formed a search engine was developed to enable the search of abstracts using relevant CRM keywords to reveal emergent dominant CRM topics. The ultimate aim of this website is to serve as an information hub for CRM research, as well as a search engine where interested parties can enter CRM-relevant keywords or phrases to access abstracts, as well as submit abstracts to enrich the knowledge hub. ^ Research questions were investigated and answered by content analyzing the interpretation and discussion of dominant CRM topics and then amalgamating the findings. This was supported by comparisons within and across individual, paired, and sets-of-three occurrences of CRM keywords in the article abstracts. ^ Results show that there is a lack of holistic thinking and discussion of CRM in both academics and industry which is required to understand how the people, process, and technology in CRM impact each other to affect successful implementation. Industry has to get their heads around CRM and holistically understand how these important dimensions affect each other. Only then will organizational learning occur, and overtime result in superior processes leading to strong profitable customer relationships and a hard to imitate competitive advantage. ^
Resumo:
There are many factors which can assist in controlling the cost of labor in the food service industry. The author discusses a number of these, including scheduling, establishing production standards, forecasting workloads, analyzing employee turnover, combating absenteeism, and controlling overtime.
Resumo:
In their study - From Clerk and Cashier to Guest Service Agent - by Nancy J. Allin, Director of Quality Assurance and Training and Kelly Halpine, Assistant Director of Quality Assurance and Training, The Waldorf-Astoria, New York, the authors state at the outset: “The Waldorf-Astoria has taken the positions of registration clerk and cashier and combined them to provide excellent guest service and efficient systems operation. The authors tell how and why the combination works. That thesis statement defines the article, and puts it squarely in the crosshairs of the service category. Allin and Halpine use their positions at the Waldorf-Astoria in New York City to frame their observations “The allocation of staff hours has been a challenge to many front office managers who try their hardest to schedule for the norm but provide excellent, efficient service throughout the peaks,” Allin and Halpine allude. “…the decision [to combine the positions of registration clerk and cashier] was driven by a desire to improve guest service where its impact is most obvious, at the front desk. Cross-trained employees speed the check-in and check-out process by performing both functions, as the traffic at the desk dictates,” the authors say. Making such a move has resulted in positive benefits for both the guests and the hotel. “Benefits to the hotel, in addition to those brought to bear by increased guest satisfaction, include greater flexibility in weekly scheduling and in granting vacations while maintaining adequate staffing at the desk,” say Allin and Halpine . “Another expected outcome, net payroll savings, should also be realized as a consequence of the ability to schedule more efficiently.” The authors point to communication as the key to designing a successful combination such as this, with the least amount of service disruption. They bullet-point what that communication should entail. Issues of seniority, wage and salary rates, organizational charting, filing, scheduling, possible probationary periods, position titles, and physical layouts are all discussed. “It is critical that each of the management issues be addressed and resolved before any training is begun,” Allin and Halpine suggest. “Unresolved issues project confusion and lack of conviction to line employees and the result is frustration and a lack of commitment to the combination process,” they push the thought Allin and Halpine insist: “Once begun, training must be ongoing and consistent.” In the practical sense, the authors provide that authorizing overtime is helpful in accomplishing training. “Training must address the fact that employees will be faced with guest situations which are new to them, for example: an employee previously functioning as a cashier will be faced with walking guests. Specific exercises should be included to address these needs,” say the authors.
Resumo:
The increasing emphasis on mass customization, shortened product lifecycles, synchronized supply chains, when coupled with advances in information system, is driving most firms towards make-to-order (MTO) operations. Increasing global competition, lower profit margins, and higher customer expectations force the MTO firms to plan its capacity by managing the effective demand. The goal of this research was to maximize the operational profits of a make-to-order operation by selectively accepting incoming customer orders and simultaneously allocating capacity for them at the sales stage. ^ For integrating the two decisions, a Mixed-Integer Linear Program (MILP) was formulated which can aid an operations manager in an MTO environment to select a set of potential customer orders such that all the selected orders are fulfilled by their deadline. The proposed model combines order acceptance/rejection decision with detailed scheduling. Experiments with the formulation indicate that for larger problem sizes, the computational time required to determine an optimal solution is prohibitive. This formulation inherits a block diagonal structure, and can be decomposed into one or more sub-problems (i.e. one sub-problem for each customer order) and a master problem by applying Dantzig-Wolfe’s decomposition principles. To efficiently solve the original MILP, an exact Branch-and-Price algorithm was successfully developed. Various approximation algorithms were developed to further improve the runtime. Experiments conducted unequivocally show the efficiency of these algorithms compared to a commercial optimization solver.^ The existing literature addresses the static order acceptance problem for a single machine environment having regular capacity with an objective to maximize profits and a penalty for tardiness. This dissertation has solved the order acceptance and capacity planning problem for a job shop environment with multiple resources. Both regular and overtime resources is considered. ^ The Branch-and-Price algorithms developed in this dissertation are faster and can be incorporated in a decision support system which can be used on a daily basis to help make intelligent decisions in a MTO operation.^
Resumo:
The increasing emphasis on mass customization, shortened product lifecycles, synchronized supply chains, when coupled with advances in information system, is driving most firms towards make-to-order (MTO) operations. Increasing global competition, lower profit margins, and higher customer expectations force the MTO firms to plan its capacity by managing the effective demand. The goal of this research was to maximize the operational profits of a make-to-order operation by selectively accepting incoming customer orders and simultaneously allocating capacity for them at the sales stage. For integrating the two decisions, a Mixed-Integer Linear Program (MILP) was formulated which can aid an operations manager in an MTO environment to select a set of potential customer orders such that all the selected orders are fulfilled by their deadline. The proposed model combines order acceptance/rejection decision with detailed scheduling. Experiments with the formulation indicate that for larger problem sizes, the computational time required to determine an optimal solution is prohibitive. This formulation inherits a block diagonal structure, and can be decomposed into one or more sub-problems (i.e. one sub-problem for each customer order) and a master problem by applying Dantzig-Wolfe’s decomposition principles. To efficiently solve the original MILP, an exact Branch-and-Price algorithm was successfully developed. Various approximation algorithms were developed to further improve the runtime. Experiments conducted unequivocally show the efficiency of these algorithms compared to a commercial optimization solver. The existing literature addresses the static order acceptance problem for a single machine environment having regular capacity with an objective to maximize profits and a penalty for tardiness. This dissertation has solved the order acceptance and capacity planning problem for a job shop environment with multiple resources. Both regular and overtime resources is considered. The Branch-and-Price algorithms developed in this dissertation are faster and can be incorporated in a decision support system which can be used on a daily basis to help make intelligent decisions in a MTO operation.
Resumo:
One commonality across the leadership and knowledge related literature is the apparent neglect of the leaders own knowledge. This thesis sought to address this issue through conducting exploratory research into the content of leader’s personal knowledge and the process of knowing it. The empirical inquiry adopted a longitudinal approach, with interviews conducted at two separate time periods with an extended time-interval between each. The findings from this research contrast with images of leadership which suggest leaders are in control of what they know, that they own their own knowledge. The picture that emerges is one of individuals struggling to keep abreast of the knowledge required to deal with the dynamics and uncertainties of organisational life. Much knowledge is tacit, provisional and perishable and the related process of knowing more organic, evolutionary and informal than any structured or orchestrated approach. The collective nature of knowing is a central feature, with these leaders embedded in networks of uncontrollable relationships. In view of the indeterminate nature of knowing, the boundary between what is known and what one needs to know is both amorphous and ephemeral, and the likelihood of knowledge-absences is escalated. A significant finding in this regard is the identification of two critical points where not-knowing is most likely (entry and exit from role) and the differing implications of each. Overtime the knowledge that is legitimised or prioritised is significantly altered as these leaders replace the dogmas that were previously held in high esteem with the lessons from their own experience. This experience brings increased self-knowledge and a deeper appreciation of the values and morals instilled in their early lives. In view of the above findings, this study makes theoretical contribution to a number of core literatures: authentic leadership, role transition and knowledge-absences. In terms of leadership development, the findings point to the necessity to prepare leaders for the challenges they will encounter at the pivotal stages of the leadership role.
Resumo:
Objective
To explore the concerns, needs and knowledge of women diagnosed with Gestational Diabetes Mellitus (GDM).
Design
A qualitative study of women with GDM or a history of GDM.
Methods
Nineteen women who were both pregnant and recently diagnosed with GDM or post- natal with a recent history of GDM were recruited from outpatient diabetes care clinics. This qualitative study utilised focus groups. Participants were asked a series of open-ended questions to explore 1) current knowledge of GDM; 2) anxiety when diagnosed with GDM, and whether this changed overtime; 3) understanding and managing GDM and 4) the future impact of GDM. The data were analysed using a conventional content analysis approach.
Findings
Women experience a steep learning curve when initially diagnosed and eventually become skilled at managing their disease effectively. The use of insulin is associated with fear and guilt. Diet advice was sometimes complex and not culturally appropriate. Women appear not to be fully aware of the short or long-term consequences of a diagnosis of GDM.
Conclusions
Midwives and other Health Care Professionals need to be cognisant of the impact of a diagnosis of GDM and give individual and culturally appropriate advice (especially with regards to diet). High quality, evidence based information resources need to be made available to this group of women. Future health risks and lifestyle changes need to be discussed at diagnosis to ensure women have the opportunity to improve their health.
Resumo:
This paper presents an integer programming model for developing optimal shift schedules while allowing extensive flexibility in terms of alternate shift starting times, shift lengths, and break placement. The model combines the work of Moondra (1976) and Bechtold and Jacobs (1990) by implicitly matching meal breaks to implicitly represented shifts. Moreover, the new model extends the work of these authors to enable the scheduling of overtime and the scheduling of rest breaks. We compare the new model to Bechtold and Jacobs' model over a diverse set of 588 test problems. The new model generates optimal solutions more rapidly, solves problems with more shift alternatives, and does not generate schedules violating the operative restrictions on break timing.
Resumo:
An increasingly older population will most likely lead to greater demands on the health care system, as older age is associated with an increased risk of having acute and chronic conditions. The number of diseases or disabilities is not the only marker of the amount of health care utilized, as persons may seek hospitalization without a disease and/or illness that requires hospital healthcare. Hospitalization may pose a severe risk to older persons, as exposure to the hospital environment may lead to increased risks of iatrogenic disorders, confusion, falls and nosocomial infections, i.e., disorders that may involve unnecessary suffering and lead to serious consequences. Aims: The overall aim of this thesis was to describe and explore individual trajectories of cognitive development in relation to hospitalization and risk factors for hospitalization among older persons living in different accommodations in Sweden and to explore older persons' reasons for being transferred to a hospital. Methods: The study designs were longitudinal, prospective and descriptive, and both quantitative and qualitative methods were used. Specifically, latent growth curve modelling was used to assess the association of cognitive development with hospitalization. The Cox proportional hazards regression model was used to analyse factors associated with hospitalization risk overtime. In addition, an explorative descriptive design was used to explore how home health care patients experienced and perceived their decision to seek hospital care. Results: The most common reasons for hospitalization were cardiovascular diseases, which caused more than one-quarter of first hospitalizations among the persons living in ordinary housing and nursing home residents (NHRs). The persons who had been hospitalized had a lower mean level of cognitive performance in general cognition, verbal, spatial/fluid, memory and processing speed abilities compared to those who had not been hospitalized. Significantly steeper declines in general cognition, spatial/fluid and processing speed abilities were observed among the persons who had been hospitalized. Cox proportional hazards regression analysis showed that the number of diseases, number of drugs used, having experienced a fall and being assessed as malnourished according to the Mini Nutritional Assessment scale were related to an increased hospitalization risk among the NHRs. Among the older persons living in ordinary housing, the risk factors for hospitalization were related to marital status, i.e., unmarried persons and widows/widowers had a decreased hospitalization risk. In addition, among social factors, receipt of support from relatives was related to an increased hospitalization risk, while receipt of support from friends was related to a decreased risk. The number of illnesses was not associated with the hospitalization risk for older persons in any age group or for those of either sex, when controlling for other variables. The older persons who received home health care described different reasons for their decisions to seek hospital care. The underlying theme of the home health care patients’ perceptions of their transfer to a hospital involved trust in hospitals. This trust was shared by the home health care patients, their relatives and the home health care staff, according to the patients. Conclusions: This thesis revealed that middle-aged and older persons who had been hospitalized exhibited a steeper decline in cognition. Specifically, spatial/fluid, processing speed, and general cognitive abilities were affected. The steeper decline in cognition among those who had been hospitalized remained even after controlling for comorbidities. The most common causes of hospitalization among the older persons living in ordinary housing and in nursing homes were cardiovascular diseases, tumours and falls. Not only health-related factors, such as the number of diseases, number of drugs used, and being assessed as malnourished, but also social factors and marital status were related to the hospitalization risk among the older persons living in ordinary housing and in nursing homes. Some risk factors associated with hospitalization differed not only between the men and women but also among the different age groups. The information provided in this thesis could be applied in care settings by professionals who interact with older persons before they decide to seek hospital care. To meet the needs of an older population, health care systems need to offer the proper health care at the most appropriate level, and they need to increase integration and coordination among health care delivered by different care services.
Resumo:
Building and maintaining muscle is critical to the quality of life for adults and elderly. Physical activity and nutrition are important factors for long-term muscle health. In particular, dietary protein – including protein distribution and quality – are under-appreciated determinants of muscle health for adults. The most unequivocal evidence for the benefit of optimal dietary protein at individual meals is derived from studies of weight management. During the catabolic condition of weight loss, higher protein diets attenuate loss of lean tissue and partition weight loss to body fat when compared with commonly recommended high carbohydrate, low protein diets. Muscle protein turnover is a continuous process in which proteins are degraded, and replaced by newly synthesized proteins. Muscle growth occurs when protein synthesis exceeds protein degradation. Regulation of protein synthesis is complex, with multiple signals influencing this process. The mammalian target of rapamycin (mTORC1) pathway has been identified as a particularly important regulator of protein synthesis, via stimulation of translation initiation. Key regulatory points of translation initiation effected by mTORC1 include assembly of the eukaryotic initiation factor 4F (eIF4F) complex and phosphorylation of the 70 kilodalton ribosomal protein S6 kinase (S6K1). Assembly of the eIF4F initiation complex involves phosphorylation of the inhibitory eIF4E binding protein-1 (4E-BP1), which releases the initiation factor eIF4E and allows it to bind with eIF4G. Binding of eIF4E with eIF4G promotes preparation of the mRNA for binding to the 43S pre-initiation complex. Consumption of the amino acid leucine (Leu) is a key factor determining the anabolic response of muscle protein synthesis (MPS) and mTORC1 signaling to a meal. Research from this dissertation demonstrates that the peak activation of MPS following a complete meal is proportional to the Leu content of a meal and its ability to elevate plasma Leu. Leu has also been implicated as an inhibitor of muscle protein degradation (MPD). In particular, there is evidence suggesting that in muscle wasting conditions Leu supplementation attenuates expression of the ubiquitin-proteosome pathway, which is the primary mode of intracellular protein degradation. However, this is untested in healthy, physiological feeding models. Therefore, an experiment was performed to see if feeding isonitrogenous protein sources with different Leu contents to healthy adult rats would differentially impact ubiquitin-proteosome (protein degradation) outcomes; and if these outcomes are related to the meal responses of plasma Leu. Results showed that higher Leu diets were able to attenuate total proteasome content but had no effect on ubiquitin proteins. This research shows that dietary Leu determines postprandial muscle anabolism. In a parallel line of research, the effects of dietary Leu on changes in muscle mass overtime were investigated. Animals consuming higher Leu diets had larger gastrocnemius muscle weights; furthermore, gastrocnemius muscle weights were correlated with postprandial changes in MPS (r=0.471, P<0.01) and plasma Leu (r=0.400, P=0.01). These results show that the effect of Leu on ubiquitin-proteosome pathways is minimal for healthy adult rats consuming adequate diets. Thus, long-term changes in muscle mass observed in adult rats are likely due to the differences in MPS, rather than MPD. Factors determining the duration of Leu-stimulated MPS were further investigated. Despite continued elevations in plasma Leu and associated translation initiation factors (e.g., S6K1 and 4E-BP1), MPS returned to basal levels ~3 hours after a meal. However, administration of additional nutrients in the form of carbohydrate, Leu, or both ~2 hours after a meal was able to extend the elevation of MPS, in a time and dose dependent manner. This effect led to a novel discovery that decreases in translation elongation activity was associated with increases in activity of AMP kinase, a key cellular energy sensor. This research shows that the Leu density of dietary protein determines anabolic signaling, thereby affecting cellular energetics and body composition.
Resumo:
Esta dissertação tem por objetivo analisar as mudanças ocorridas na representação feminina, ao longo do tempo, em contos de fadas e suas adaptações, através de um viés comparativo. Para esta pesquisa, selecionamos como corpus as duas versões do conto “Branca de Neve”, dos Irmãos Grimm – uma publicada entre os anos de 1812 e 1815 e a outra publicada em 1822 –, e o filme Espelho, espelho meu (2012), dirigido por Tarsem Singh com história de Melissa Wallack e roteiro de Jason Keller e Marc Klein. Nossa análise pauta-se nas informações obtidas em História da vida privada, organizada por Georges Duby e Philiphe Ariès (1991) e Minha história das mulheres, de Michelle Perrot (2008). Como principal fundamentação teórica, utilizamos as concepções de Linda Hutcheon, em especial aquelas constantes em seu livro Uma teoria da adaptação (2013). Além disso, durante a escrita desta dissertação, também fizemos uso dos estudos de Bruno Bettelheim (2007), Tomás Enrique Creus (2006) e Carl Gustav Jung (2000). Ao longo deste estudo, procuramos ainda compreender as mudanças na representação feminina nos contos de fadas clássicos, comparando-se as adaptações referidas, relacionando-as com as alterações sociais acontecidas ao longo do tempo.