A prática da reutilização de produtos médico-hospitalares de uso único vem sendo aplicada desde meados da década de setenta. A principal razão que tem contribuído para disseminação desta conduta pelas instituições hospitalares radicadas tanto nos países em desenvolvimento como naqueles considerados ricos, tem sido a aparente economia de custos. Apesar dos riscos relacionados com a prática da reutilização, como reações pirogênicas, danos ocasionados por bactérias consideradas patogênicas em pacientes imunologicamente comprometidos, danos na integridade fisica dos produtos, assim como aumento do período de permanência dos pacientes no hospital, têm despertado o interesse em avaliar aspectos fisicos e biológicos dos produtos médico-hospitalares reutilizados. Baseando-se nestas considerações foram aplicados desafios com esporos de Bacillus Subtilis varo niger ATCC 9372 e endotoxina bacteriana E. coli 055:B5. Os produtos desafiados foram cateteres intravenosos, torneira três vias e tubos de traqueostomia. A possível presença microbiana foi investigada após contaminação intencional dos esporos de B. Subtillis (107 ufc/unid.) com submissão das unidades contaminadas à limpeza e posterior esterilização, utilizando óxido de etileno/CFC na proporção 12:88. Os ciclos de reprocessamentos simulados de produtos médico-hospitalares consistiram de contaminação de cada unidade teste com carga microbiana, lavagem com detergente enzimático, secagem e esterilização. Ao término de cada ciclo de reprocessamento foram separadas unidades representativas para avaliação por contagem microbiana (pour plate), testes de esterilidade por inoculação direta e indireta, citotoxidade por cultura de células e microscopia eletrônica de varredura. A eficiência da esterilidade foi avaliada tanto por contagem microbiana como pelos testes de esterilidade, que resultaram em níveis microbianos de 103 ufc/unid. e detecção de contaminação até o 6° ciclo de reprocessamento nos cateteres intravenosos, tubos de traqueostomia e torneiras três vias. A segurança dos reprocessamentos dos produtos médico-hospitalares foi avaliada pela cultura de células de fibroblastos de camundongo (NCTC clone 929), as quais não apresentaram toxicidade. Entretanto, os resultados obtidos durante microscopia eletrônica de varredura comprovaram presença de carga microbiana após 10° ciclo de reprocessamento, assim como danos na superficie polimérica. Durante desafio com endotoxina bacteriana, que consistiu em contaminar as unidades com 200 UE, secagem e exposição ao ciclo de esterilização com óxido de etileno/CFC (12:88), verificou-se que após ciclos de reprocessamentos simulados, totalizando dez ciclos, foi possível detectar valores de recuperação de endotoxina em torno de 100%. Os cateteres-guia que foram adquiridos em instituição hospitalar após quatro reutilizações, apresentaram níveis de contaminação de 105 ufc/unid., assim como presença de bactérias consideradas patogênicas em pacientes comprometidos imunologicamente, já a detecção de endotoxina bacteriana nestes cateteres não foi considerada significativa. Logo, as avaliações aplicadas nas unidades submetidas aos ciclos de reprocessamentos simulados, assim como nos cateteres-guia reprocessados e reutilizados quatro vezes, refletiram a realidade de algumas instituições no âmbito nacional e internacional que praticam a reutilização de produtos médico-hospitalares de uso-único. Os resultados obtidos vêm enfatizar objeções quanto à prática da reutilização, considerando que a ausência de segurança pode ocasionar em danos ao paciente. / The practices of reutilization of single use hospital medical devices came into practice since mid seventies. The main reason that has contributed for dissemination of this practice by institutional hospitals in underdeveloped as well as those considered as rich countries has been the appellant economy of costs. Despite well known risks related with the practice of reutilization, such as pyrogenic reactions, damages caused by bacteria\'s considered pathogenic in patients immunologically compromised, damages to the physical integrity of the materials, as well as prolonged permanence of the patient in the hospital, has raised interests in the evaluation of physical and biological aspects of the reused medical device. Based on these considerations, challenges had been applied with spores of Bacillus Subtilis varo niger 9372 ATCC and bacterial endotoxin E. coli 055:B5. The selected materials includes, intravenous catheters, three-way stopcocks and traqueostomy tubes. The possible presence of bacteria was investigated after intentional contamination with spores of B. Subtillis (107 cfu/unit) followed by submission of the inoculated units to the cleaning process and posterior sterilization using ethylene oxide at 12:88. The simulated reprocessing cycles of the medical device had consisted of contamination of each test unit with predetermined microbial load, washing with enzymatic detergent, drying and sterilization. At the end of each reprocessing cycle, representative sarnples had been segregated to evaluate microbial count (pour plate), terility test through direct and indirect inoculation, cytotoxicity test through cell culture and scanning electron microscopy. The efficiency of the sterility was evaluated through microbial count, as for the sterility tests, that had resulted in microbial count of 103 cfu/unit and detection of contamination until the 6th cycle of reprocessing in the intravenous catheters, three-way stopcocks and traqueostomy tubes. The safety of these reprocessed medical devices was evaluated by mouse fibroblasts cell culture (NCTC clone 929), which didn\'t presented significant toxicity. However, the results obtained by scanning electron microscopy proved the presence of microbial load after 10th reprocessing cycle, as well as damages to the polymeric surface. During challenge with bacterial endotoxin, that consisted of contaminating the units with 200 EU, drying and submission to sterilization cycles with ethylene oxide/cfe (12:88), it was verified that after ten simulated reprocessing cycles, it was possible to recover around 100% of endotoxin. The catheter guide that were acquired from institutional hospital after four times reuse, had presented levels of contamination of 105 cfu/unit, as well as presenee of bacteria considered pathogenic in patients immunologically compromised, on the other hand the detention of bacterial endotoxin in these catheters was not considered significant. The evaluations studies condueted with the units submitted to the simulated reprocessing cycles, as well as the catheter guide reprocessed and reused four times, had reflected the reality of some national and foreign hospitais which reutilize single use medical device. The results obtained lead us to raise objections to the reusing practice, considering the absence of adequate patients safety.

Information is a significant asset to organizations, and a data breach from a cyberattack harms reputations and may result in a massive financial loss. Many senior managers lack the competencies to implement an enterprise risk management system and align organizational resources such as people, processes, and technology to prevent cyberattacks on enterprise assets. The purpose of this Delphi study was to explore how the managerial competencies for information security and risk management senior managers help in managing security objectives and practices to mitigate security risks. The National Institute of Standards and Technology framework served as the foundation for this study. The sample was made up of 12 information security practitioners, information security experts, and managers responsible for the enterprise information security management. Participants were from Fortune 500 companies in the United States. Selection was based on their level of experience and knowledge of the topic being studied. Data were collected using a 3 round Delphi study of 12 experts in information security and risk management. Statistical analysis was performed on the collected data during a 3 round Delphi study. The mean, standard deviation, majority agreement, and ranges were used to determine the final concensus for this research study. Findings of this study included the need for managerial support, risk management strategies, and developling the managerial and technical talent to mitigate and respond to cyberattacks. Findings may result in a positive social change by providing information that helps managers to reduce the number of data breaches from cyberattacks, which benefits companies, employees, and customers.

Thesis (doctoral)--Universität Freiburg im Breisgau. / Includes bibliographical references (p. 215-235).

Guided reading is a common component of literacy instruction in elementary classrooms. The purpose of this research was to examine multiple areas of guided reading from the perspective of teachers who were using guided reading in their classrooms. Knowledge and beliefs, grouping, management and organization, dialogue, and assessment issues were the five instructional topics of guided reading that were investigated using a mixed methods approach. The research was carried out in a single school division located in northern Alberta and involved Kindergarten – Grade 3 language arts teachers. Survey data collected from 27 respondents were analyzed using an interpretational focus. The data were coded and categorized using the five identified instructional topics as a framework. Common themes and patterns of response were identified for each instructional topic. The survey findings were then used to generate a focus group agenda. The transcripts of three focus group sessions that involved 16 teacher participants were also analyzed using an interpretational focus. The findings of the study suggested that guided reading is an important component of early language arts instruction for the teachers who participated in this research. Two types of guided reading instruction were identified: a small group guided reading approach (Fountas & Pinnell, 1996) and a Four Blocks approach to guided reading (Cunningham, Hall, & Defee, 1991). The teacher participants identified a wide variety of goals and purposes in using guided reading. The grouping practices of the teachers shared some similarities and many teachers indicated that they used a variety of sources of information to determine students’ placement in guided reading groups. Repeatedly, the survey and focus group participants communicated how their guided reading instruction was affected by their perceptions of differences among students and classes as affecting their guided reading instruction. The teachers indicated that their continuous attempts to maintain balance and focus during guided reading instruction also affected their organization and management. The teachers’ responses to survey items and focus group questions that addressed dialogue also focused on maintaining balance and focus during guided reading instruction. The teachers also discussed how they used dialogue for instructional purposes and commented on their ability to maintain balance and focus during the discussions during guided reading lessons. Many teachers indicated that they used running records to inform their guided reading instruction. Various other assessment tools that are consistent with an assessment for learning focus were also identified by the teacher participants. Overall, many of the findings suggested that individual teachers have adapted their guided reading practices to such an extent that they are no longer consistent with a single guided reading approach. The findings of the research indicated a need for teachers the have opportunities to engage in reflective activities with respect to their guided reading practices.

Σκοπός της παρούσας μελέτης είναι η συστηματική διερεύνηση και η ερμηνεία των παραγόντων και μηχανισμών παρεμπόδισης των γυναικών από την ισότιμη συμμετοχή τους στη διοίκηση, με συνέπεια την υποεκπροσώπησή τους στην εκπαιδευτική διοικητική ιεραρχία. Επιπλέον η παρούσα εργασία διερευνά και την ανίχνευση των παραγόντων εκείνων που οδηγούν στη διεκδίκηση ή μη διοικητικών-διευθυντικών θέσεων από τους εκπαιδευτικούς, παίρνοντας ως παράδειγμα την περίπτωση της Πρωτοβάθμιας Εκπαίδευσης του Νομού Αχαΐας κατά τις κρίσεις του 2007 στην εκπαίδευση. Ως μεθοδολογικό εργαλείο χρησιμοποιήθηκε το ερωτηματολόγιο, μέσα από το οποίο αξιοποιήθηκαν ποσοτικά και ποιοτικά δεδομένα. Το ερωτηματολόγιο ήταν δομημένο με ερωτήσεις ως επί το πλείστον κλειστού τύπου και περιορισμένο αριθμό ανοικτών ερωτήσεων όπου αναμέναμε την προσωπική παρέμβαση-πρόταση των εκπαιδευτικών, για τη διερεύνηση του ζητήματος της παρουσίας των δύο φύλων στην εκπαιδευτική διοίκηση και συμπληρώθηκε από 185 εκπαιδευτικούς διοικητικά στελέχη και μη, της Πρωτοβάθμιας Δημοτικής Εκπαίδευσης του Νομού Αχαΐας. Στη συνέχεια παρουσιάζονται τα δεδομένα και αναλύονται ενώ στο τέλος της έρευνας γίνεται μια προσπάθεια ερμηνείας των δεδομένων αυτών και παρατίθενται οι προβληματισμοί για περαιτέρω έρευνα. / The purpose of this study is to systematically assess and evaluate the factors and mechanisms which prevent women from equal participation in management, resulting in their underrepresentation in educational administrative hierarchy. Furthermore, this work explores the detection of factors leading to the claim or non-claim of administrative-managerial positions by teachers, taking as an example the case of Primary Education of Achaia, in the 2007 selection procedure in education. The methodological tool was a questionnaire through which both quantitative and qualitative data were utilized. The questionnaire included mostly closed-type questions and a limited number of open questions through which we expected the teachers’ personal intervention-proposal, for exploring the issue of presence of the two genders in educational administration. The questionnaire was completed by 185 teachers, holders and non-holders of managerial posts working in Primary Education in the Prefecture of Achaia. Next the data are presented and analyzed while an attempt to interpret these data is ventured concluding the research. Finally, questions for further consideration and research are posed.

Submitted by pedro lacava (pedrolacava81@gmail.com) on 2018-08-21T23:41:12Z No. of bitstreams: 2 Tese mestrado revisada pra biblioteca pdf.pdf: 963157 bytes, checksum: 42bbb08bd8e02686a34793f4a8a38d37 (MD5) Tese mestrado revisada pra biblioteca pdf.pdf: 963157 bytes, checksum: 42bbb08bd8e02686a34793f4a8a38d37 (MD5) / Approved for entry into archive by Simone de Andrade Lopes Pires (simone.lopes@fgv.br) on 2018-08-22T17:06:00Z (GMT) No. of bitstreams: 2 Tese mestrado revisada pra biblioteca pdf.pdf: 963157 bytes, checksum: 42bbb08bd8e02686a34793f4a8a38d37 (MD5) Tese mestrado revisada pra biblioteca pdf.pdf: 963157 bytes, checksum: 42bbb08bd8e02686a34793f4a8a38d37 (MD5) / Approved for entry into archive by Suzane Guimarães (suzane.guimaraes@fgv.br) on 2018-08-22T17:34:35Z (GMT) No. of bitstreams: 2 Tese mestrado revisada pra biblioteca pdf.pdf: 963157 bytes, checksum: 42bbb08bd8e02686a34793f4a8a38d37 (MD5) Tese mestrado revisada pra biblioteca pdf.pdf: 963157 bytes, checksum: 42bbb08bd8e02686a34793f4a8a38d37 (MD5) / Made available in DSpace on 2018-08-22T17:34:35Z (GMT). No. of bitstreams: 2 Tese mestrado revisada pra biblioteca pdf.pdf: 963157 bytes, checksum: 42bbb08bd8e02686a34793f4a8a38d37 (MD5) Tese mestrado revisada pra biblioteca pdf.pdf: 963157 bytes, checksum: 42bbb08bd8e02686a34793f4a8a38d37 (MD5) Previous issue date: 2018-08-01 / O estudo de caso com desenho transversal descritivo e enfoque qualitativo teve por objetivos avaliar a qualidade da Governança Corporativa em instituição hospitalar filantrópica localizada no Município de São Paulo e analisar as práticas implementadas mediante diretrizes do Instituto Brasileiro de Governança Corporativa e da Healthcare Governance and Tranparency Association. As boas práticas de governança corporativa podem contribuir significativamente para que as instituições filantrópicas hospitalares de excelência, associadas ao PROADI, sejam mais competitivas e autossustentáveis, a fim de que não necessitem de substanciais capitais de investidores, os quais podem, pelo seu interesse intrínseco de ganho, modificar a estrutura de capital, resultando em perda da filantropia, descaracterizando a missão da organização e sua finalidade social. Antecedeu à coleta de dados, a elaboração de instrumento constituído por 220 questões fechadas, com opções de respostas pré-codificadas (sim ou não) referentes às práticas recomendadas de governança corporativa compreendidas em nove dimensões de análise. A coleta foi realizada por meio de entrevistas com os principais gestores da instituição, e para cada questão com resposta afirmativa realizou-se análise documental com o intuito de evidenciar as informações referidas pelos entrevistados. Os principais resultados foram: O índice geral de qualidade da governança corporativa alcançou adequação de 75%; As Dimensões Associações e Conduta, Conflito de Interesses e Divulgação de informações apresentaram-se totalmente adequadas às diretrizes preconizadas; As dimensões Auditoria Independente e Associação Marca/Imagem apresentaram níveis de adequação inferiores a 50%. Os resultados atenderam plenamente aos objetivos da pesquisa, assim como foi possível apontar desdobramentos para futuros estudos, tais como: a inclusão de novas dimensões específicas ao setor de saúde, avaliação e análise crítica pelas organizações no que diz respeito aos resultados decorrentes das práticas de governança corporativa e o aprofundamento da questão referente à atribuição ou não de pesos diferenciados para as dimensões. / This case study with a descriptive and qualitative focus aims at evaluating Corporate Governance in a philanthropic hospital located in the city of São Paulo and analyzes the practices implemented through the guidelines of the Brazilian Institute of Corporate Governance and the Healthcare Governance and Transparency Association. Good governance practices can be important to make philanthropic hospitals of excellence more competitive and self-sustaining, so that they do not need capital from third parties, who can, for their interest in profit-making, modify their social patrimony, causing a lack of philanthropy , misleading the organization's mission and its social purpose. Before the data collection, an instrument was created consisting of 220 closed questions, with the option of pre-coded answers (yes or no) referring to recommended governance practices comprised in nine dimensions of the analysis. The data was collected by interviewing the main managers of the institution, and each affirmative answer led us to carry out the document analysis in order to evidence the information mentioned by the interviewees. The main results were as follows: The overall report on the quality of corporate governance was 75%; The Dimensions Associations and Conduct, Conflict of Interests and Disclosure of Complementary Information seemed to be suitable to recommended guidelines; independent auditing dimensions and brand/image association showed adequacy index below 50%. The results met thoroughly the research objective, but we were also able to find other areas for future studies, such as: the inclusion of new actions in the health sector, evaluation and critical analysis by organizations that are relevant to governance practices results.

Diploma thesis deals with project design of an e-commerce creation with using tools and methods of project management in a non-profit organization. The first part of the thesis focuses on the theoretical basis of project management. The analytical part deals with the description of the organization and his current situation. The last part contains the main project proposal.

Deficient executive functioning influences significantly the ability to manage every day life requirements. Nowdays different structured programmes for EF rehabilitation are available for aquired brain damage patiens. Their efficiency had been confirmed by meta- analysis, yet cognitive-behavioural rehabilitation programmes in clinical praktice still lack some kind of systematic intervention particularly aimed at EF. The topic of the theoretical part is an introduction of selected theoretical models of EF and a summary of existing knowledge about EF rehabilitation. I have created a rehabilitation programme specificly focused on the ability of planning and organizing acitivities, which are complex abilities closely linked to the primary components of EF. This programme was created to help patiens with aquired brain damage to work on improvment of such abilities, whose disruption makes managing every day life requirements difficult. Along with that we tried to improve the quality of their lifes. This programme is also being introduced wihin the theoretical part of this work. Further the process of research is being analyzed. The rehabilitation programme was used with 9 aquired brain damage patiens and it's efficiency was measured. Reasons why I used small-n design are analyzed in detail as well as the...

The thesis analyses causes of the lack of medical workers providing nursing care in inpatient facilities and observes in broader connections the progress of present staff condition. By means of managerial methods for determining number of nursing staff, it discovers, whether it is possible to define the number of nurses in inpatient medical facilities as insufficient, or whether the present number of nurses is critical with its origin in lack of other nursing employees. This thesis is supposed to show that the lack of nurses is not only a problem in the last few years, but it has been here since the beginning of the 20th century and it has been connected with all social events to present days. Starting point of the evaluation of the situation will be a brief historical excursus with a brief analysis of professional, legislative and social impacts which influenced the number of nursing employees in the past and their consequences up to now. It studies the methods of determining, attracting and hiring the nursing emplyees. The theoretical part will state and analyse determination of necessary nursing employees for inpatient wards according to managerial viewpoint. After 1989, there was an attempt to change the planned health care system by implementing modern namagerial activities. In the end, the...

<p>Идеја рада је да се, релативно новом методом операционих истраживања, односно, методом Анализе обавијања података или ДЕА методом одреди ефикасност државних средњих машинских техничких школа (ДСМТШ). С тим у вези су објашњени основни појмови који се односе на: организацију, структуру организације, менаџмент знања, мерење ефикасности и ефективности организационих система, затим појам непрофитних организацијa, где је акценат стављен на школе и начин њиховог функционисања. Промене у било којој сфери људског деловања носе са собом одређене ризике али и побољшања и унапређења. Промене у образовном систему су посебно осетљиве, јер се евентуалне грешке у образовању рефлектују са извесним закашњењима која могу бити крајње непожељна, пошто је потребно одређено време да образовани кадрови заузму своје место у привреди и друштву једне земље. Општепозната је ствар да се богатство једне нације, између осталог, цени и кроз образовне ресурсе којима та земља располаже. Настојање у раду је било да се употребом ДЕА методе пронађу решења која би унапредила рад и ефикасност средњих школа, како машинских (и осталих стручних школа) тако и гимназија. ДЕА метода за неефикасне јединице (школе) идентификује узорне јединице (школе), које би са улазима/излазима посматране јединице (школе) биле ефикасне. ДЕА метода<br />проналази начине како да неефикасне школе постану ефикасне а ефикасне школе<br />како да постану још ефикасније. Респектујући сазнања која се односе на област<br />операционих истраживања, нарочито у подручју деловања непрофитних организација као што су школе, може се закључити да је у истраживањима 1994/1998. године и 2004/2008. године дошло до значајног напретка у постигнућима ученика у учењу.<br />&nbsp;</p> / <p>Ideja rada je da se, relativno novom metodom operacionih istraživanja, odnosno, metodom Analize obavijanja podataka ili DEA metodom odredi efikasnost državnih srednjih mašinskih tehničkih škola (DSMTŠ). S tim u vezi su objašnjeni osnovni pojmovi koji se odnose na: organizaciju, strukturu organizacije, menadžment znanja, merenje efikasnosti i efektivnosti organizacionih sistema, zatim pojam neprofitnih organizacija, gde je akcenat stavljen na škole i način njihovog funkcionisanja. Promene u bilo kojoj sferi ljudskog delovanja nose sa sobom određene rizike ali i poboljšanja i unapređenja. Promene u obrazovnom sistemu su posebno osetljive, jer se eventualne greške u obrazovanju reflektuju sa izvesnim zakašnjenjima koja mogu biti krajnje nepoželjna, pošto je potrebno određeno vreme da obrazovani kadrovi zauzmu svoje mesto u privredi i društvu jedne zemlje. Opštepoznata je stvar da se bogatstvo jedne nacije, između ostalog, ceni i kroz obrazovne resurse kojima ta zemlja raspolaže. Nastojanje u radu je bilo da se upotrebom DEA metode pronađu rešenja koja bi unapredila rad i efikasnost srednjih škola, kako mašinskih (i ostalih stručnih škola) tako i gimnazija. DEA metoda za neefikasne jedinice (škole) identifikuje uzorne jedinice (škole), koje bi sa ulazima/izlazima posmatrane jedinice (škole) bile efikasne. DEA metoda<br />pronalazi načine kako da neefikasne škole postanu efikasne a efikasne škole<br />kako da postanu još efikasnije. Respektujući saznanja koja se odnose na oblast<br />operacionih istraživanja, naročito u području delovanja neprofitnih organizacija kao što su škole, može se zaključiti da je u istraživanjima 1994/1998. godine i 2004/2008. godine došlo do značajnog napretka u postignućima učenika u učenju.<br />&nbsp;</p> / <p>The idea of the thesis is to determine the effectiveness of state technical schools using a relatively new research method called Data Envelopment Analysis Method or DEA. In relation to that are explained the basic terms connected with: organization, organization structure, management of knowledge, measuring of efficacy and effectiveness of organization systems, then the term of non &ndash; profit organizations, where schools and the way they function are stressed. Changes in any sphere of human activity carry with them certain risks but also improvement and promotion. Changes in the educational systems are specifically delicate because possible mistakes in education are reflected with certain delay which can be extremely undesirable since a certain amount of time is necessary for the trained stuff to occupy their place in the economy and society of a country. It is universally acknowledged that the wealth of a nation is, among other thing, valued trough its educational resources. The purpose of this thesis is to, using the DEA method, find solutions which will improve the work and effectiveness of secondary schools, technical as well as others, and grammar schools. DEA method helps inefficient units (schools) identify exemplary unit (school) which will provide them with the necessary inputs/outputs to make them efficient. DEA method finds ways to make ineffective school effective and effective schools even more effective. Acknowledging the information on operation<br />research, especially in the field of the activities of non &ndash; profit organizations such as<br />schools, it can be concluded that the research conducted from 1994 till 1998 and from 2004 till 2008 show a considerable progress in the student achievement in learning.</p>