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Satisfações e insatisfações no trabalho de médicos do Programa Mais Médicos alocados no interior do estado de São PauloRodrigues, Louise Lopes January 2019 (has links)
Orientador: Eliana Goldfarb Cyrino / Resumo: Introdução: A Organização Mundial de Saúde recomenda uma razão de um médico para cada mil habitantes para que a população tenha um adequado acesso à saúde. Apesar de o Brasil possuir um número absoluto satisfatório de médicos, há no país uma distribuição desigual destes profissionais, com carência de médicos em comunidades remotas e vulneráveis, causando um grande impacto no bem-estar da população que ali se encontra e dificultando a universalização da saúde, como prevê os princípios do Sistema Único de Saúde. Diante disso, o Governo Federal criou, em 2013, o Programa Mais Médicos (PMM), com o intuito de suprir de forma emergencial a carência de médicos em regiões de difícil fixação dos mesmos. A literatura considera que o principal fator que leva um trabalhador a deixar uma organização é seu nível de insatisfação com a função que desempenha, o que também se faz verdadeiro na área da saúde. Sendo assim, podemos inferir que a insatisfação laboral do médico da Atenção Básica é um dos motivos da dificuldade de recrutá-los e fixá-los por um período mais longo. Objetivo: Este estudo se propõe a avaliar as satisfações e insatisfações no trabalho de médicos integrantes do PMM no município de Botucatu – SP, cidade universitária com elevado IDH e com razão médico-paciente de 6,25. Metodologia: Trata-se de pesquisa qualitativa, na qual foram feitas oito entrevistas semiestruturadas com médicos do PMM e uma entrevista com gestores da AB no município, as quais foram analisadas e categori... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: The World Health Organization recommends a ratio of one doctor per thousand inhabitants so that the population has adequate access to health. Although Brazil has a satisfactory absolute number of doctors, there is an unequal distribution of these professionals in the country, with a shortage of physicians in remote and vulnerable communities, causing a great impact on the well-being of the population that lives there and making it difficult to make health accessible for everyone, as foreseen by the principles of the Sistema Único de Saúde. Due to that, the Federal Government created in 2013 the More Doctors Program (PMM), with the aim of urgently supplying the shortage of doctors in regions that are difficult to set them down. The literature considers that the main factor that leads a worker to leave an organization is their level of dissatisfaction with the role they play, which is also true in the health field. Thus, we can infer that the dissatisfaction at work of the primary care physician is one of the reasons for the difficulty of recruiting them and fixing them for a longer period. Objective: This study aims to evaluate the satisfactions and dissatisfactions in the work of physicians of the PMM in the city of Botucatu - SP, a city with a renowned University, a high HDI and a physician-patient ratio of 6.25. Methodology: This is a qualitative research, in which eight semi-structured interviews were conducted with PMM physicians and one interview with healt... (Complete abstract click electronic access below) / Mestre
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Thinking more like a client. : Designfaktorer som påverkar valet av tjänsteföretag.Kjellin, Åsa, Stridsberg, Anna, Bornholm, Johanna, Kapsalis, Eugenia January 2007 (has links)
<p>Companies in the western world can no longer compete by using traditional means such as product and price since the commerce of services continually grows. To avoid similarity and increase competitive advantages modern companies have to be more specified. The competition between companies has increased and customers are harder to reach. Customers of today can afford luxury but trend indicates that originality, identity, and status are more important than factual needs. Products created and consumed at the same time within the service market are often very homogenous (similar). The small differences between companies make it hard to find the grounds of the consumer’s choice also making it imperative for companies to inter-pret the needs, habits, and expectancies of the consumer. A winning con-cept is hard to identify – individualism makes it harder to predict trends, product cycles becomes shorter, and the market becomes more casual, changeable, agile, lively, and impulsive. The purpose of this paper is to examine through quantitative survey which design factors create value for the consumer and how this affects the consumer choice. With prospective on the time of service the relation between consumer and company is evaluated in the moment of truth.</p> / <p>Företag i västvärlden kan inte längre vara med och konkurrera med traditionella medel som produkt och pris. Handeln med tjänster växer, för att undvika likriktning och öka konkurrensfördelarna ligger det i tiden för företag att nischa in sig. Konkurrensen om nya kunder hårdnar, och de blir allt svårare att nå. Kunder har idag råd med lyxvaror men trenden pekar på att originalitet, identitet och status är viktigare än faktiska behov. Inom tjänstemarknaden är produkterna som skapas och konsumeras vid samma tillfälle ofta mycket homogena. Det är svårt att veta på vilka grunder konsumenten väljer leverantör eftersom det ofta finns små skillnader mellan företagen. Det är viktigt för företag att förstå och tolka kunders behov, vanor och förväntningar. Det blir allt svårare att identifiera ett vinnande koncept – individualism bryter ner förmågan att förutse trender, produktlivscyklerna blir kortare, detta tillsammans med en mer flyktig, ombytlig, rörlig, livlig, impulsiv marknad. I uppsatsen undersöks vilka designfaktorer som skapar mervärde för kunden och påverkar valet av tjänsteföretag. Syftet med uppsatsen är att med hjälp av kvantitativ undersökning analysera vad det är som gör att kunderna väljer ett visst tjänsteföretag. Samt utvärdera om det går att uppfylla kundernas olika behov genom att addera nya faktorer till en tjänst för att skapa mervärde för kunden. Med perspektiv på servicetillfället utvärderas relationen mellan kund och företag i sanningens ögonblick.</p>
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Thinking more like a client. : Designfaktorer som påverkar valet av tjänsteföretag.Kjellin, Åsa, Stridsberg, Anna, Bornholm, Johanna, Kapsalis, Eugenia January 2007 (has links)
Companies in the western world can no longer compete by using traditional means such as product and price since the commerce of services continually grows. To avoid similarity and increase competitive advantages modern companies have to be more specified. The competition between companies has increased and customers are harder to reach. Customers of today can afford luxury but trend indicates that originality, identity, and status are more important than factual needs. Products created and consumed at the same time within the service market are often very homogenous (similar). The small differences between companies make it hard to find the grounds of the consumer’s choice also making it imperative for companies to inter-pret the needs, habits, and expectancies of the consumer. A winning con-cept is hard to identify – individualism makes it harder to predict trends, product cycles becomes shorter, and the market becomes more casual, changeable, agile, lively, and impulsive. The purpose of this paper is to examine through quantitative survey which design factors create value for the consumer and how this affects the consumer choice. With prospective on the time of service the relation between consumer and company is evaluated in the moment of truth. / Företag i västvärlden kan inte längre vara med och konkurrera med traditionella medel som produkt och pris. Handeln med tjänster växer, för att undvika likriktning och öka konkurrensfördelarna ligger det i tiden för företag att nischa in sig. Konkurrensen om nya kunder hårdnar, och de blir allt svårare att nå. Kunder har idag råd med lyxvaror men trenden pekar på att originalitet, identitet och status är viktigare än faktiska behov. Inom tjänstemarknaden är produkterna som skapas och konsumeras vid samma tillfälle ofta mycket homogena. Det är svårt att veta på vilka grunder konsumenten väljer leverantör eftersom det ofta finns små skillnader mellan företagen. Det är viktigt för företag att förstå och tolka kunders behov, vanor och förväntningar. Det blir allt svårare att identifiera ett vinnande koncept – individualism bryter ner förmågan att förutse trender, produktlivscyklerna blir kortare, detta tillsammans med en mer flyktig, ombytlig, rörlig, livlig, impulsiv marknad. I uppsatsen undersöks vilka designfaktorer som skapar mervärde för kunden och påverkar valet av tjänsteföretag. Syftet med uppsatsen är att med hjälp av kvantitativ undersökning analysera vad det är som gör att kunderna väljer ett visst tjänsteföretag. Samt utvärdera om det går att uppfylla kundernas olika behov genom att addera nya faktorer till en tjänst för att skapa mervärde för kunden. Med perspektiv på servicetillfället utvärderas relationen mellan kund och företag i sanningens ögonblick.
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Dimensioning Tools of MEA Actuator Systems, Including Modeling, Analysis and Technology ComparisonTorabzadeh-Tari, Mohsen January 2008 (has links)
Aircraft design is an example of complex engineering where dimensioning tools can be valuable for the designers and decision makers in the early stage of the development process. These tools can be in form of a database over key numbers for different components or technologies. One of the critical parts of an aircraft is the actuator system. Conventional hydraulic actuators are demanding regarding maintenance which implies high operation costs. Therefore in recent years the focus has been set on electro-hydrostatic and electro-mechanical actuators. The aim of this work is to build a platform which can make it easier for designers and decision makers to analyze, compare and optimize different technologies regarding the actuator system. For this reason a simplified quasi-static actuator model, including reactive power consumption has been developed. This model makes it possible to reduce the complexity of the actuator models to such extent that the resulting computional tool can be used for studies of the system performance during entire flight missions and/or for optimization. Power density, cost and weight of the actuator systems are some of the important key numbers for comparing purpose and as a platform for the dimensioning of the aircraft. The ambition is then to build up a database of different actuator solutions with the key technical parameters mentioned above, that can be used in modeling and dimensioning of an aircraft. In order to avoid time consuming finite element calculations when analyzing an electrical machine a reluctance network model can be used. The basic idea of the proposed network model is to divide the rotor and the stator into a grid of small reluctance elements and provide those that correspond to the permanent magnet and the air gap between the magnets with time varying reluctances. The suggested computationally approach constitute a fast way to evaluate permanent magnet electrical machines with the respect to their performance. A preferred electrical machine provided with balance teeth and concentrated windings showed good electromechanical and thermal behavior. A balance tooth is a tooth without winding between each adjacent phases that has a cooling effect on the nearest windings, resulting in less copper losses. The balance teeth increases the voltage-time area, leading to higher induced voltage and higher torque production. Another advantage of the chosen design is its redundancy and fault tolerance capabilities. The machine comprises two independent half machines that also offers a high level of redundancy with two separate power channels. / QC 20100914
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Optimal allocation of thermodynamic irreversibility for the integrated design of propulsion and thermal management systemsMaser, Adam Charles 13 November 2012 (has links)
More electric aircraft systems, high power avionics, and a reduction in heat sink capacity have placed a larger emphasis on correctly satisfying aircraft thermal management requirements during conceptual design. Thermal management systems must be capable of dealing with these rising heat loads, while simultaneously meeting mission performance. Since all subsystem power and cooling requirements are ultimately traced back to the engine, the growing interactions between the propulsion and thermal management systems are becoming more significant. As a result, it is necessary to consider their integrated performance during the conceptual design of the aircraft gas turbine engine cycle to ensure that thermal requirements are met. This can be accomplished by using thermodynamic modeling and simulation to investigate the subsystem interactions while conducting the necessary design trades to establish the engine cycle. As the foundation for this research, a parsimonious, transparent thermodynamic model of propulsion and thermal management systems performance was created with a focus on capturing the physics that have the largest impact on propulsion design choices. A key aspect of this approach is the incorporation of physics-based formulations involving the concurrent usage of the first and second laws of thermodynamics to achieve a clearer view of the component-level losses. This is facilitated by the direct prediction of the exergy destruction distribution throughout the integrated system and the resulting quantification of available work losses over the time history of the mission. The characterization of the thermodynamic irreversibility distribution helps give the designer an absolute and consistent view of the tradeoffs associated with the design of the system. Consequently, this leads directly to the question of the optimal allocation of irreversibility across each of the components. An irreversibility allocation approach based on the economic concept of resource allocation is demonstrated for a canonical propulsion and thermal management systems architecture. By posing the problem in economic terms, exergy destruction is treated as a true common currency to barter for improved efficiency, cost, and performance. This then enables the propulsion systems designer to better fulfill system-level requirements and to create a system more robust to future requirements.
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Rate Distortion Theory for Causal Video Coding: Characterization, Computation Algorithm, Comparison, and Code DesignZheng, Lin January 2012 (has links)
Due to the sheer volume of data involved, video coding is an important application of lossy source coding, and has received wide industrial interest and support as evidenced by the development and success of a series of video coding standards. All MPEG-series and H-series video coding standards proposed so far are based upon a video coding paradigm called predictive video coding, where video source frames Xᵢ,i=1,2,...,N, are encoded in a frame by frame manner, the encoder and decoder for each frame Xᵢ, i =1, 2, ..., N, enlist help only from all previous encoded frames Sj, j=1, 2, ..., i-1.
In this thesis, we will look further beyond all existing and proposed video coding standards,
and introduce a new coding paradigm called causal video coding, in which the encoder for each frame Xᵢ
can use all previous original frames Xj, j=1, 2, ..., i-1, and all previous
encoded frames Sj, while the corresponding decoder can use only all
previous encoded frames. We consider all studies, comparisons, and designs on causal video coding
from an information theoretic
point of view.
Let R*c(D₁,...,D_N) (R*p(D₁,...,D_N), respectively)
denote the minimum total rate required to achieve a given distortion
level D₁,...,D_N > 0 in causal video coding (predictive video coding, respectively).
A novel computation
approach is proposed to analytically characterize, numerically
compute, and compare the
minimum total rate of causal video coding R*c(D₁,...,D_N)
required to achieve a given distortion (quality) level D₁,...,D_N > 0.
Specifically, we first show that for jointly stationary and ergodic
sources X₁, ..., X_N, R*c(D₁,...,D_N) is equal
to the infimum of the n-th order total rate distortion function
R_{c,n}(D₁,...,D_N) over all n, where
R_{c,n}(D₁,...,D_N) itself is given by the minimum of an
information quantity over a set of auxiliary random variables. We
then present an iterative algorithm for computing
R_{c,n}(D₁,...,D_N) and demonstrate the convergence of the
algorithm to the global minimum. The global convergence of the
algorithm further enables us to not only establish a single-letter
characterization of R*c(D₁,...,D_N) in a novel way when the
N sources are an independent and identically distributed (IID)
vector source, but also demonstrate
a somewhat surprising result (dubbed the more and less coding
theorem)---under some conditions on source frames and distortion,
the more frames need to be encoded and transmitted, the less amount
of data after encoding has to be actually sent.
With the help of the algorithm, it is also shown by example that
R*c(D₁,...,D_N) is in general much smaller than the total rate
offered by the traditional greedy coding method by which each frame
is encoded in a local optimum manner based on all information
available to the encoder of the frame.
As a by-product, an extended Markov lemma is
established for correlated ergodic sources.
From an information theoretic point of view,
it is interesting to compare causal
video coding and predictive video coding,
which all existing video
coding standards proposed so far are based upon.
In this thesis, by fixing N=3,
we first derive a single-letter characterization
of R*p(D₁,D₂,D₃) for an IID
vector source (X₁,X₂,X₃) where X₁ and X₂ are independent, and then demonstrate the existence of such X₁,X₂,X₃ for which R*p(D₁,D₂,D₃)>R*c(D₁,D₂,D₃) under some conditions on source frames and distortion. This result makes causal video coding an attractive framework for future video coding systems and standards.
The design of causal video coding is also considered in the thesis from an information
theoretic perspective by modeling each frame as a stationary information source.
We first put forth a concept called causal scalar quantization, and then
propose an algorithm for designing optimum fixed-rate causal scalar quantizers
for causal video coding to minimize the total distortion among all sources.
Simulation results show that in comparison with fixed-rate predictive scalar quantization,
fixed-rate causal scalar quantization offers as large as 16% quality improvement (distortion reduction).
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Identification of emergent off-nominal operational requirements during conceptual architecting of the more electric aircraftArmstrong, Michael James 09 November 2011 (has links)
With the current increased emphasis on the development of energy optimized vehicle systems architectures during the early phases in aircraft conceptual design, accurate predictions of these off-nominal requirements are needed to justify architecture concept selection. A process was developed for capturing architecture specific performance degradation strategies and optimally imposing their associated requirements. This process is enabled by analog extensions to traditional safety design and assessment tools and consists of six phases: Continuous Functional Hazard Assessment, Architecture Definition, Load Shedding Optimization, Analog System Safety Assessment, Architecture Optimization, and Architecture Augmentation.
Systematic off-nominal analysis of requirements was performed for dissimilar architecture concepts. It was shown that traditional discrete application of safety and reliability requirements have adverse effects on the prediction of requirements. This design bias was illustrated by cumulative unit importance metrics. Low fidelity representations of the loss/hazard relationship place undue importance on some units and yield under or over-predictions of system performance.
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Sublime Subjects and Ticklish Objects in Early Modern English UtopiasMills, Stephen 02 December 2013 (has links)
Critical theory has historically situated the beginning of the “modern” era of subjectivity near the end of the seventeenth century. Michel Foucault himself once said in an interview that modernity began with the writings of the late seventeenth-century philosopher Benedict Spinoza. But an examination of early modern English utopian literature demonstrates that a modern notion of subjectivity can be found in texts that pre-date Spinoza. In this dissertation, I examine four utopian texts—Thomas More’s Utopia, Francis Bacon’s New Atlantis, Margaret Cavendish’s Description of a New World, Called the Blazing World, and Henry Neville’s Isle of Pines—through the paradigm of Jacques Lacan’s tripartite model of subjectivity—the Imaginary, the Symbolic, and the Real. To mediate between Lacan’s psychoanalytic model and the historical aspects of these texts, such as their relationship with print culture and their engagement with political developments in seventeenth-century England, I employ the theories of the Marxist-Lacanian philosopher, Slavoj Žižek, to show that “early modern” subjectivity is in in fact no different from critical theory’s “modern” subject, despite pre-dating the supposed inception of such subjectivity. In addition, I engage with other prominent theorists, including Fredric Jameson, Jacques Derrida, and Donna Haraway, to come to an understanding about the ways in which critical theory can be useful to understand not only early modern literature, but also the contemporary, “real” world and the subjectivity we all seek to attain.
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Ränteavdragsbegränsningarna i svensk rätt : Varför infördes reglerna, hur ska de tillämpas och hur ser framtiden ut på området?Jönsson, Tobias January 2012 (has links)
Den 1 januari 2009 trädde en ny lagstiftning i kraft gällande ränteavdragsbegränsningar i syfte att förhindra skatteupplägg med ränteavdrag inom en intressegemenskap. Förändringarna innebar att en huvudregel infördes vilken stipulerar att bolag inom en intressegemenskap inte får dra av ränteutgifter avseende en intern skuld som hänför sig till förvärv av delägarrätter inom koncernen. Till huvudregeln infördes två undantag som stadgar att avdrag ändock får göras om särskilda krav är uppfyllda. Undantagen kom att benämnas tioprocentsregeln och ventilen. När det gäller tillämpningen av tioprocentsregeln ligger svårigheten i att utföra det så kallade hypotetiska testet där man ska beräkna till vilken skattesats det räntemottagande bolaget ska beskattas till om det endast hade haft ränteinkomsten som sin enda inkomst. Tillämpningsproblemet gällande ventilen är att det är en lagregel vilken vilar på domstolens subjektiva värderingar av affärsmässigheten i de uppkomna skuldförhållandena. Trots införandet av de nya reglerna uppmärksammade Skatteverket att skatteplaneringsförfaranden fortfarande föreligger varför ett nytt lagförslag nu har publicerats av Finansdepartementet. Förslaget innebär i kort tre stora förändringar av de nuvarande reglerna. Samtliga interna lån ska numera omfattas, en omvänd ventil införs vilken ger Skatteverket rätt att neka avdrag oavsett till vilken skattesats ränteinkomsten beskattas till samt att avdrag enligt ventilen endast ska kunna medges gällande ränteutgifter som betalas till bolag belägna i ett land inom EES eller till ett land vilket Sverige har ett skatteavtal med. Huruvida lagförslaget kommer att antas eller inte är i nuläget oklart. Flera remissinstanser har varit kritiska till förslaget, framförallt gällande den omvända ventilen då man anser att den leder till stor rättsosäkerhet. / On January 1st 2009, a new legislation was set in force with regards to deduction limitations on interests in order to prevent tax schemes with the use of interest deductions within a corporate group. The changes that were made imposed a general rule which stipulates that companies within a corporate group are not allowed to deduct interests regarding internal debts if that debt relates to an acquisition of shares in a company within the corporate group. To the general rule two exceptions were introduced which stipulates that deductions can be made if certain requirements are fulfilled. The exceptions were called the ten percent-rule and “ventilen”. Regarding the application of the ten percent-rule the difficulty lies in the performing of the so called hypothetical test in which you have to calculate to what tax rate the interest-receiving company will be taxed at if it only had the interest as it´s only income. The application problem regarding “ventilen” is based on the fact that it is a rule which rests on the Court’s subjective evaluation of the commercial reasonableness of the transaction. Despite the introduction of the new rules the Swedish Tax Authorities noticed that tax schemes still exists why a new proposal now has been published by the Ministry of Finance. The proposal contains in short of three major changes to the current rules. All internal loans are now covered, a reverse ”ventil” is introduced which gives the Tax Authorities a right to deny deductions regardless of what tax rate the income is taxed to and finally that deductions according to “ventilen” only will be allowed regarding interest payments to a country within the EEA or to a country which Sweden has a tax agreement with. Whether the proposal will be adopted or not is currently unclear and several respondents have been critical to the proposal.
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Multivariates nichtparametrisches Behrens-Fisher-Problem mit Kovariablen / Multivariate nonparametric Behrens-Fisher-Problem with covariatesZapf, Antonia 23 October 2009 (has links)
No description available.
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