Patients in hospital can be prone to sudden, life-threatening changes in their cardiovascular state. Haemodynamic parameters such as blood pressure, pulse transit time (PTT) and perfusion can be monitored in clinical situations to identify these changes as early as possible. Continuous blood pressure is usually monitored using a catheter placed into a major artery, but this is invasive and involves risk to the patient. In the last decade, the field of non-contact vital sign monitoring has emerged, with growing evidence that the remote photoplethysmogram (rPPG) signal can be used to estimate vital signs using video cameras. If the analysis of the rPPG signal can be expanded to include the estimation of haemodynamic parameters, it could result in methods for the continuous, non-contact monitoring of a subject's haemodynamic state. In a physiology study, a series of video recordings were made of 43 healthy volunteers. The subjects sat in a purpose-built chamber, and the composition of the air was carefully adjusted to cause the subjects to experience large, controlled changes in blood oxygen levels. To validate the video camera algorithms, reference data were also collected. Along with the volunteer study, a clinical study was performed to acquire data in a challenging clinical environment. Data were collected from patients on haemodialysis in the Renal Unit, a population likely to experience sudden changes in haemodynamics. The reference data from the Renal Unit study were analysed to determine the extent to which PTT and mean arterial pressure (MAP) are related. The correlation coefficients and linear fits were found on a global and a per-subject basis. In addition, the video recordings from the Physiology study were processed to derive rPPG signals, and these signals were analysed to obtain estimates for PTT. Local rPPG signals were also derived for different regions of interest, and the waveforms were analysed using a novel application of the technique of signal averaging to produce spatial maps of perfusion and blood flow. The correlation between conventionally measured PTT and MAP was found to be weaker in the haemodialysis population than has been shown elsewhere in the literature, except for a sub-set of patients. The results of the video analysis showed that PTT could be estimated robustly and consistently, although direct validation of these estimates was not possible because of the different method used to calculate the reference PTT. For most subjects, the spatial mapping methods produced robust maps that were consistent over time. These results suggest that it is possible to detect changes in haemodynamics using a video camera, and that this could have applications in healthcare, providing that challenges such as subject movement and clinical validation can be overcome.

Zugl.: Berlin, Techn. Universiẗat, Diss., 2008.

No description available.

This dissertation explores how people address problems of real human concern in situations of complexity, ambiguity, uniqueness, conflicting values and rapid change. Such circumstances stretch formal and idealistic rules and procedures to the breaking point. And yet, people in a variety of fields work through such difficulties in a pragmatic manner, at times finding ways to assert their humanity. Sensemaking and human- centred design are related activities through which many people approach such work. Through cases in digital innovation, global health care delivery and an unlikely voyage of the Amazon River, this portfolio shows that they are relevant to a wide range of settings. Rather than isolating the components or key variables of such work and taking their measure, this research advances a more holistic view of sensemaking and designing as sociomaterial practices. My research is grounded in performing the phenomenon of study, offering insights from complex practice rather than a spectator’s study of it. This ethnographic approach has yielded theoretical contributions related to designing for the emergence of practices, embodied sensemaking, a more substantive notion of what it means to be ‘human’ centred and more pragmatic ways of investigating sociomaterial practices. By discussing sensemaking and human-centred design as antidotes to failures of imagination in global health and development, this dissertation suggests a distinctive perspective on why these topics matter for the health of poor and marginalized people around the world.

Submitted by Silvana Teresinha Dornelles Studzinski (sstudzinski) on 2015-06-26T14:59:01Z No. of bitstreams: 1 GuilhermeMachado.pdf: 1086460 bytes, checksum: b94320cb60145c8bb354d504eb4322ff (MD5) / Made available in DSpace on 2015-06-26T14:59:01Z (GMT). No. of bitstreams: 1 GuilhermeMachado.pdf: 1086460 bytes, checksum: b94320cb60145c8bb354d504eb4322ff (MD5) Previous issue date: 2014-03-31 / Nenhuma / As Organizações Hospitalares de Ordem Religiosa convivem com uma crescente competição no segmento em que atuam, necessitando de representativos investimentos não só em tecnologia ou estrutura física, mas de metodologias de gestão que as auxiliem na obtenção de diferenciais competitivos e o devido cumprimento das estratégias e missão organizacionais. Contudo, tais métodos necessitam serem colocados em prática e esta implementação em ambientes dinâmicos, como a Saúde, requer um posicionamento estratégico institucional voltado para a Profissionalização, Responsabilidade Corporativa e Inovação na Gestão quanto se trata de Governança Corporativa. Portanto, neste estudo, procuramos analisar e propor melhorias no modelo de Governança Corporativa praticado na Organização Hospitalar de Ordem Religiosa, foco deste estudo de caso, a partir das práticas referenciadas pelo IBGC e sua conjugação com os modelos preconizados por Clayton Christensen e Lester Salamon. Um estudo exploratório-qualitativo foi realizado para alcançar esses objetivos. Inicialmente, dados secundários foram coletados a partir de relatórios. Observações participantes de reuniões do Conselho de Administração (Direção) da organização foram realizadas. Em seguida, dados primários foram coletados através de entrevistas em profundidade com Conselheiros, Consultores do Conselho, Executivos e Associadas. Todas as informações foram gravadas e transcritas e seus conteúdos analisados, utilizando-se um programa de análise de dados qualitativos (NVivo 10 ®). Os resultados sugerem a aplicabilidade das boas práticas de governança na Organização Hospitalar de Ordem Religiosa. O modelo de governança proposto para organização a partir do diagnostico realizado à luz da teoria, oferece a condição de que estudos futuros possam levar em consideração a aplicação deste modelo, de forma a analisar seus impactos e resultados. / The Hospital Organizations of Religious Order face an increased competition in the segment in which they operate, requiring significant investments not only in technology or physical structure, but also in management methodologies that help them to obtain competitive advantages and the due enforcement of the strategies and the organizational mission. However, such methods need to be put into practice and this implementation in dynamics environments, such as Health, requires an institutional strategic position facing the Professionalization, the Corporate Responsibility and the Innovation in Management when it comes to corporate governance. Therefore, the focus of this case study was analyze and propose improvements in the corporate governance model practiced in the Hospital Organization of Religious Order from the practices referenced by IBGC and its combination with models advocated by Clayton Christensen and Lester Salamon. An exploratory qualitative study was conducted to achieve these objectives. Initially, secondary data were collected from reports and participant observations were held in meetings of the Board of Directors (direction) of the organization. Then, primary data were collected through in-depth interviews with Directors, Consultants Council, Officers and Associates. All information were recorded and transcribed and their contents analyzed, using a program of Qualitative data analysis (NVivo ® 10). The results suggest the applicability of good governance practices in the Hospital Organization of Religious Order. The governance model proposed for the organization from the diagnostic based in the theory provides the condition that future studies may consider the application of this model in order to analyze their impact and results.

Submitted by Anderson Silva (avargas@icict.fiocruz.br) on 2012-09-13T17:37:40Z No. of bitstreams: 1 Dissertacao completa Roberta Monteiro Raupp.pdf: 525614 bytes, checksum: 53041b4eca30850864770a00d1dd1244 (MD5) / Made available in DSpace on 2012-09-13T17:37:40Z (GMT). No. of bitstreams: 1 Dissertacao completa Roberta Monteiro Raupp.pdf: 525614 bytes, checksum: 53041b4eca30850864770a00d1dd1244 (MD5) / Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil / A pesquisa tem ocupado lugar de destaque no âmbito da Rede Brasileira de Bancos de Leite Humano (Rede BLH-BR). Este espaço de produção científica tem sido responsável por parte do avanço no conhecimento sobre a área de atuação dos bancos de leite humano (BLH) e de ações de apoio, promoção e proteção do aleitamento materno. Partindo do entendimento de que o processo de produção científica envolve elementos técnicos e humanos, este estudo é construído à luz da perspectiva epistemológica de Bruno Latour (1994, 2000), de Almeida (1999) e de Maia (2004). Com base nos estudos de Maia (2004), a presente investigação assumiu como pressuposto teórico o fato de ser o conhecimento o elemento que confere conectividade à Rede BLH-BR, permitindo assim que a mesma opere de fato como rede. Diante disso, faz-se mais do que oportuno buscar caminhos que permitam ampliar a compreensão sobre as dinâmicas que se estabelecem no âmbito da Rede BLH-BR, no que tange a construção e a apropriação do conhecimento. Por esta razão, “o conhecimento transladado no âmbito dos congressos da Rede BLH-BR” se configura como objeto do presente estudo. Face ao exposto e partindo da pergunta – “Quais os elementos estruturantes que norteiam a construção dos trabalhos científicos apresentados nos congressos da Rede BLH-BR?”, este estudo apresenta como objetivo traçar um panorama do conhecimento construído no âmbito Rede BLH-BR, a partir dos 860 trabalhos apresentados nos cinco congressos realizados pela Rede. Para tanto, buscou-se identificar as áreas temáticas de maior interesse para a construção do conhecimento, analisar a abordagem teórica e metodológica, e o caráter formal e informal dos trabalhos. Vale considerar que por ser uma pesquisa que se ergue no campo da Informação e da Comunicação em Saúde, buscou-se valorizar elementos que permitam ampliar a compreensão de como o conhecimento é capaz de se configurar em um agente indutor de transformações sociais no âmbito da Rede BLH. Os trabalhos dedicados à temática amamentação, quer em sua dimensão assistencial ou nos aspectos culturais que permeiam a prática representaram 68% do total de trabalhos apresentados. A Informação e Comunicação na Rede BLH-BR surge como área temática a partir do II Congresso e com uma frequência relativa, que oscilou de 0,6% a 2% do total de trabalhos nos eventos. A abordagem quantitativa predominou, representando 50% do total dos trabalhos. Contudo, percebe-se uma tendência de crescimento na utilização de preceitos metodológicos qualitativos. Comportamento, biologia e estatística se misturam em uma mesma trama, unindo biologia e sociedade em um tecido único: o tecido inteiriço das naturezas-culturas. Conclui-se que a Rede BLH-BR trabalha o conhecimento na perspectiva do híbrido e adota a mistura em sua totalidade, aliando o conhecimento acadêmico às necessidades provenientes da prática desenvolvida no cotidiano, utilizando canais formais e informais da comunicação científica. Este estudo foi mais uma oportunidade de evidenciar o quanto a força da Rede BLH-BR se relaciona com sua capacidade de transladar conhecimento, abrindo oportunidades para o aprendizado coletivo e fortalecendo os laços entre os seus integrantes. / Research has been in a featured position in the Human Milk Banks Brazilian Network scope. This area of scientific production has been responsible for part of the advances in knowledge about the field of human milk banksand about support actions, promotion and protection of breast-feeding. Based on the understanding that the scientific process involves technical and human elements, this study is constructed by the light of the epistemological perspective of Latour (1994, 2000), Almeida (1999) and Maia (2004). Based on Maia’s studies (2004), this research assumed as theoretical presupposition the fact the knowledge is the element which provides connectivity to the BLR-BR Network, allowing it to operate indeed as a network. Therefore, is it more than appropriate to look for ways which widen the understanding about the dynamics established within the BLH-BR Network, regarding the construction and appropriation of knowledge. For this reason, “knowledge transferred in the BLH-US Network congress scope” is set as object of this study. Given the above and based on the question – “What are the structural elements which guide the construction of scientific papers presented at BLH-BR Network conferences?”, this study presents as aim to draw a view of the knowledge constructed within the BLH-BR Network, from the 860 papers presented in the five conferences held by the Network. For this, the idea was to identify the thematic areas of greatest interest for the knowledge construction, the analysis of the theoretical and methodological approach and the formal and informal character of the papers. It is worth to consider that, for being a research which stands in the field of Health Information and Communication, elements which allow enlarging the understanding of how knowledge can be an inducing agent for social transformations within the BLH Network have been enriched. The works dedicated to the theme breast- feeding, both in the dimension of care or in the cultural aspects which permeate the practice, represent 68% in the total of works presented. Information and Communication in the BLH-BR Network come as thematic area from the II Conference and with a relative frequency, ranging from 0,6% to 2% in the total of works in the events. The quantitative approach prevailed, representing 50% in the total of papers. However, a growth trend is noticed in the use of qualitative methodological principles. Behavior, biology and statistics are mixed in the same plot, gathering biology and society in a single tissue: the whole tissue of nature-culture. The conclusion is that BLH-BR Network manages knowledge in the hybrid perspective and adopts the mixture in its entirety, combining academic knowledge to the needs of the developed practical in the everyday, using formal and informal channels of the scientific communication. This study has been one more opportunity of showing how the power of BLH-BR Network relates with its capacity of transferring knowledge, opening opportunities for the collective learning and strengthening the ties among its members.

Submitted by Silvana Teresinha Dornelles Studzinski (sstudzinski) on 2015-06-23T14:32:23Z No. of bitstreams: 1 Marcelo Antunes Marciano.pdf: 3212195 bytes, checksum: d0978d66fd9d22e11d99ba2207b6a553 (MD5) / Made available in DSpace on 2015-06-23T14:32:23Z (GMT). No. of bitstreams: 1 Marcelo Antunes Marciano.pdf: 3212195 bytes, checksum: d0978d66fd9d22e11d99ba2207b6a553 (MD5) Previous issue date: 2014 / Nenhuma / Este trabalho investiga como aumentar a qualidade dos serviços entregues à população pela gestão de operações em serviços de saúde, tanto no sistema público quanto na saúde suplementar, mais especificamente, em operadoras de plano de saúde e em hospitais do estado do Rio Grande do Sul (RS). O objetivo principal do presente trabalho consiste em analisar possibilidades de elevar a qualidade do sistema de saúde público e suplementar do estado do Rio Grande do Sul à luz do sistema dinâmico em que se inserem. Os objetivos específicos são: Mapear o sistema de saúde, por meio do pensamento sistêmico, e propor pontos de alavancagem à qualidade do sistema de saúde pública do RS; e Analisar a aderência aos critérios do Managed Care e de inovações em gestão de saúde, pelos atores “operadora de plano de saúde” e “hospital”. A dissertação é formada por dois artigos, cada um entregando um objetivo específico, e por capítulos adicionais que consolidam a entrega do objetivo geral. Quanto aos procedimentos metodológicos, a pesquisa parte de um paradigma positivista e orienta-se qualitativamente, fazendo uso de entrevistas, análise documental, coleta de dados secundários em bancos de dados de acesso público, análise por julgamento em dinâmica de grupo multidisciplinar e modelagem. Como resultados obteve-se a construção de um mapa que evidencia os atores e as relações desse sistema dinâmico, possibilitando a identificação de possíveis cenários, pontos de alavancagem e a sugestão de estratégias para auxiliar no aumento da qualidade do sistema de saúde pública do RS, bem como a construção de uma ferramenta, no caso, um questionário, por meio do qual foi possível verificar que os atores hospitalares contatados encontram-se mais aderentes do que as operadoras de plano de saúde contatadas com relação às boas práticas de gestão orientadoras do estudo. Argumenta-se que um sistema integrado de gestão, padronizado, empregado de forma sistêmica, com auxílio de estratégia organizacional, de inovações e com foco na cadeia de valor, contempla aspectos assistenciais, econômicos e competitivos, desses atores e, como consequência, pode contribuir para que as operadoras e hospitais possam aumentar a qualidade dos serviços prestados. / This work examines how to improve quality in health services, both in the public system and in supplementary health, more specifically, in health insurance companies and hospitals in the state of Rio Grande do Sul (RS). The main goal of the present work is to improve quality for the public and supplementary health systems in the state of Rio Grande do Sul under the dynamic system they are included into. Specific goals are: Mapping the health system through systemic thinking, proposing points of leverage regarding the quality of the public health system in RS; and analyzing the compliance with the Managed Care criteria and innovation in health management by the players, namely, “health insurance companies” and “hospitals”. The work is composed of two articles, each delivering a specific goal, and by additional chapters that consolidate the delivery of the general goal. As for the methodological procedures, the research develops from a positivist paradigm and it is based on a qualitative perspective, making use of interviews, document analysis, secondary data collection in public-access databases, analysis based on multidisciplinary group dynamics assessment and modeling. As a result, this led to the creation of a map that highlights players and relations of this dynamic system, allowing for the identification of possible scenarios, points of leverage, and the suggestion of strategies to help improve the quality of the public health system in RS, as well as the awareness that contacted hospital players were found to be more compliant than the contacted health insurance companies as far as good management practices that guided this study are concerned. We argue that a integrated and standardized management system, which is systematically used, with the help of organizational strategies, innovation, and a focus on the value chain, takes into account assistance-related, economic, and competitive aspects of these players and, as a consequence, it may contribute to improve quality to services provided.

Made available in DSpace on 2015-07-22T20:49:31Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-11-26 / Este trabalho verifica a capacidade de uma organização em empreender projetos; identificando se a mesma tem processos de gerenciamento organizacional de projetos e como implementa esse gerenciamento através de melhores práticas, aceitas mundialmente. Para tanto, foi realizada a aplicação do modelo OPM3® em organização de saúde, o qual consiste de um aplicativo de software com 151 questões que elabora relatórios e gráficos da existência ou não dessas melhores práticas. Aplicado em uma organização multinacional, reconhecida internacionalmente como de excelência em gerenciamento de projetos, obtendo um alto grau de maturidade que pode servir como balizador para outras organizações. / This work verify the capacity of an organization to undertake projects, and as to identify if the organization it has processes of management and as to implement this project management through currently accepted of world-wide form. For in such a way, the application of model OPM3® in health organization was carried through, which consists of an applicatory one of software with 151 questions that elaborates reports and graphs of the existence or not of these best practices. Applied in a multinational organization, recognized internationally as of excellence in management project, getting one high degree of maturity that can serve as maker for other organizations. / TEDE / BV UNIFESP: Teses e dissertações

Problématique : L’innovation responsable en santé est un domaine en croissance qui vise à contribuer à une meilleure gouvernance des systèmes de santé. Par contre, il y a actuellement très peu d’outils qui rendent plus opérationnels ses concepts et qui visent à soutenir des choix éclairés par les détenteurs d’enjeux du domaine de la santé. Objectifs : Ce projet de recherche a pour objectifs d’évaluer la fiabilité d’un Outil de dépistage et d’évaluation de l’innovation responsable en santé (IRS) et d’accroitre sa fiabilité lors de son application. Méthodes : Le devis de recherche mixte repose sur l’évaluation quantitative de la fiabilité de l’outil par le biais d’une mesure d’accord interjuges et sur le développement et l’évaluation quantitative et qualitative d’un Guide d’utilisation visant à accroitre la facilité d’utilisation de l’outil. Des entrevues semi-dirigées ont été conduites auprès de (n=6) participants et participantes, afin de faire ressortir les points de convergence et de divergence concernant le Guide d’utilisation. Résultats : Les coefficients de Gwet calculés pour l’accord interjuges varient entre 0,693 et 1, ce qui signifie que l’accord varie de « substantiel » à « parfait ». Les commentaires des participants et des participantes ont fait ressortir que le Guide d’utilisation était complet sur le plan de l’information présentée, bien qu’un peu redondant. Des recommandations sont proposées afin de réviser le guide. Conclusion : Ce projet contribue à la santé publique en produisant des connaissances utiles sur l’application d’outils par des équipes interdisciplinaires. L’Outil IRS dont la fiabilité est maintenant mieux connue pourra également, à plus long terme, favoriser les initiatives responsables en santé. / Abstract Introduction: Responsible innovation in health is a growing field of research that aims to contribute to better governance of health systems. There are currently very few tools to support its operationalization and the choices stakeholders in the health field make. Objectives: The objectives of this research project are to assess the reliability of a Responsible Innovation in Health (RIH) screening and assessment Tool and how its reliability may be increased during its application. Methods: The mixed methods study design is based on the quantitative evaluation of the reliability of the Tool by means of a measure of interrater agreement and on the development and evaluation of a user guide aiming to increase the usability of the Tool. Semi-structured interviews were conducted with (n = 6) participants, in order to highlight the points of convergence and divergence concerning the user guide. Results: The Gwet coefficients calculated for the interrater agreement vary between 0.693 and 1, which means that the agreement varies from “substantial” to “perfect”. Participants’ comments indicated that the user guide was comprehensive in terms of the information presented, although somewhat redundant. Recommendations are suggested in order to revise the guide. Conclusion: This project contributes to public health by producing useful knowledge on the application of tools by interdisciplinary teams. The IRS Tool, whose reliability is now better known, may also, in the longer term, encourage responsible health initiatives.

Made available in DSpace on 2011-05-04T12:36:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / A presente dissertação teve como objetivo geral a elaboração de um modelo de gestão para alinhar os projetos do Museu da Vida às estratégias corporativas. Nesse sentido, buscou situar o segmento museus de ciências como instituições importantes ao desenvolvimento de um Sistema Nacional de Inovação, bem como estabelecer a diferenciação entre o objeto de estudo e os demais museus de ciências, que em geral, comungam de uma mesma missão (guarda-chuva). Nessa análise foi possível identificar um conjunto de diretrizes, proposições e metas elaboradas para adequar o museu às estratégias corporativas. O modelo de gestão foi estruturado após análise dos principais modelos de gestão de portfólio. Sugere-se ao final para a implantação do modelo a criação de um Núcleo de Inovação Permanente para o Museu da Vida, o NIP-MV. / The present work had as objective the elaboration of a management model to line up the projects of the Museum of Life to the corporative strategies. The work sought to point out the segment of science museums as important institutions to the development of a National System of Innovation, as well as establishing the differentiation of the object study and the to other science museums, that in general, shares the same mission. In this analysis it was possible to identify a set directives, proposals elaborated and goals adjust the museum to the corporative strategies. The management model was structured analysis of the main models of portfólio management. It is suggested at the end for the implantation of the model the creation of a Nucleus of Permanent Innovation for the Museum of Life, the NIP-MV.