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Gest?o de riscos prospectiva aplicada a erros de dispensa??o de medicamentos em um hospital universit?rioCavalcanti, Mabel Mendes 14 October 2016 (has links)
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Previous issue date: 2016-10-14 / Introdu??o: Os servi?os de sa?de t?m crescente uso de tecnologias e processos complexos que oferecem riscos elevados durante o cuidado ao paciente. M?todos prospectivos de identifica??o e redu??o de riscos podem ser ?teis, por?m h? pouca descri??o de sua aplica??o no contexto brasileiro. Objetivo: esse estudo objetiva analisar, identificar e priorizar as falhas no processo de dispensa??o de medicamentos em um hospital universit?rio, com propostas de a??es para redu??o do risco das falhas priorizadas. M?todo: trata-se de um estudo descritivo, desenvolvido em um hospital universit?rio, com uso do HFMEA segundo a Veteran Affairs, aplicado por equipe multiprofissional, durante 3 meses. Foram identificados e analisados modos de falha no processo de dispensa??o de medicamentos, segundo crit?rios de gravidade, frequ?ncia, criticidade, chance de detec??o e exist?ncia de medidas preventivas. Com as falhas priorit?rias, foi realizada an?lise das causas e plano de gerenciamento e monitoramento dos riscos. Resultados: destacaram-se 21 modos de falha na dispensa??o de medicamentos. Os subprocessos com maiores falhas foram, em ordem decrescente, ?separa??o do medicamento? (06), ?prepara??o da dose? (06), ?avalia??o da prescri??o? (03), ?unitariza??o dos medicamentos? e ?entrega da dose? (02), ?libera??o do medicamento? (01) e ?confer?ncia da dose? (01). Tr?s dessas falhas foram selecionadas para an?lise e interven??o: identifica??o errada do medicamento (na unitariza??o), medicamento separado diferente do prescrito (na separa??o do medicamento) e atraso na entrega de dose (na entrega da dose). Ap?s a an?lise das causas, estabeleceu-se algumas interven??es necess?rias, a saber: auditoria para avaliar a ades?o ao protocolo do subprocesso ?unitariza??o? e divulga??o dos resultados, constru??o de um protocolo operacional padr?o para o armazenamento de medicamentos com som e grafia semelhantes e implanta??o do protocolo de seguran?a na prescri??o, uso e administra??o de medicamentos. Conclus?o: o estudo permitiu analisar o processo de dispensa??o de medicamentos, onde identificou-se as poss?veis falhas que pudessem aumentar o risco de eventos adversos nessa etapa do processo de medica??o. O HFMEA foi ?til para auxiliar o grupo multidisciplinar a entender melhor as fragilidades no processo de trabalho e favoreceu a percep??o de falhas espec?ficas do contexto do hospital participante, al?m de auxiliar na prioriza??o de interven??es corretivas e possibilidade de melhorias para seguran?a na dispensa??o de medicamentos. / Introduction: health services have increasing use of complex technologies and processes that provide high risks for patient care. Prospective methods of identification and risk reduction can be helpful, but there is little description of your application in the Brazilian context. Objective: this study aims to analyze, identify and prioritize failures in the drug dispensing process in a university hospital, with proposals for actions to reduce the risk of prioritized failures. Method: it is a descriptive study, developed in a university hospital, using the HFMEA according to Veterans Affairs, implemented by multidisciplinary team for 3 months. They were identified and analyzed failure modes in the drug dispensing process, according to their severity and frequency, from the priority analysis of causes, management and monitoring of risks. Results: the highlights 21 ways to fail in dispensing drugs. Subprocesses with major failures were, in descending order, separation of the product (06), prepare the dose (06), evaluation of the prescription (03), unitarization of drugs and delivery of the dose (02), the drug release (01) and conference dose (01). Three of these failures were selected for analysis and intervention: "misidentification of medicine" (unitarization), "different separate drug's prescribed" (separation of the product) and "delay in dose delivery" (the drug release). After the analysis of the causes, we established some necessary interventions, namely: audit to assess adherence to the sub-process protocol "unitarization" and dissemination of results, construction of a standard operating protocol for storing medicines with sound and the like spelling and implementation of the security protocol in prescription, use and administration of medications. Conclusion: the study allowed us to analyze the process of dispensing drugs, where we identified the possible failures that could increase the risk of adverse events in this stage of the medication process. HFMEA was useful to assist multidisciplinary group better understand the weaknesses in the work process, which can help to faults, and assists in prioritizing corrective interventions and possible improvements to safety in dispensing drugs.
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Ciclo grav?dico puerperal: avalia??o da assist?ncia no servi?o p?blico de sa?deHolanda, Cristyanne Samara Miranda de 08 May 2015 (has links)
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Previous issue date: 2015-05-08 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Apesar dos avan?os na cobertura e qualidade do acompanhamento obst?trico, o atendimento ? mulher no ciclo grav?dico puerperal ainda est? marcado por imper?cia, falta de humaniza??o e aus?ncia de integra??o na rede de assist?ncia. Diante deste cen?rio, o estudo objetiva avaliar a assist?ncia prestada ? mulher no ciclo grav?dico puerperal pelo servi?o p?blico obst?trico de sa?de na regi?o Serid? do estado do Rio Grande do Norte. Pesquisa do tipo explorat?ria e descritiva, com abordagem quali-quantitativa, realizada nos munic?pios de Caic?, Currais Novos e Parelhas. A pesquisa aconteceu em duas fases distintas: Primeiramente, atrav?s da t?cnica qualitativa de grupo focal foi feito um levantamento de elementos que possibilitaram ao investigador a avalia??o da assist?ncia obst?trica; Posteriormente, foi constru?do e validado um question?rio de pesquisa que foi aplicado ?s mulheres dos munic?pios selecionados para o estudo. As informa??es colhidas durante o grupo focal foram transcritas e submetidas ao ALCESTE com o intuito de organizar os discursos em t?picos. A an?lise dos discursos possibilitou a constru??o de um instrumento para avalia??o da assist?ncia durante o ciclo. O question?rio passou pelo processo de valida??o aparente, antes de ser administrado. Utilizou-se a an?lise m?ltipla de regress?o log?stica para identifica??o dos fatores preditores que influenciam a insatisfa??o da assist?ncia. O resultado revelou um cen?rio inquietante e desafiador que remete ? constante avalia??o dos servi?os em busca da melhoria da assist?ncia. Enfatiza ainda a import?ncia de indicadores que refletem a realidade do servi?o p?blico de sa?de ser introduzidos nos instrumentos avaliativos, para nortear cientificamente a mudan?a das pr?ticas assistenciais. O estudo idenfificou que 41% das participantes avaliaram negativamente a assistencia recebida pelo servi?o p?blico. Os indicadores que est?o associados ? satisfa??o das mulheres foram: a participa??o da mulher na escolha do parto, a visita cl?nica e a comunica??o da alta hospitalar feita pelo profissional m?dico, a visita puerperal realizada pela ESF na primeira semana ap?s alta hospitalar e o acesso as orienta??o sobre os cuidados com o rec?m-nascido na primeira semana de vida. / Apesar dos avan?os na cobertura e qualidade do acompanhamento obst?trico, o atendimento ? mulher no ciclo grav?dico puerperal ainda est? marcado por imper?cia, falta de humaniza??o e aus?ncia de integra??o na rede de assist?ncia. Diante deste cen?rio, o estudo objetiva avaliar a assist?ncia prestada ? mulher no ciclo grav?dico puerperal pelo servi?o p?blico obst?trico de sa?de na regi?o Serid? do estado do Rio Grande do Norte. Pesquisa do tipo explorat?ria e descritiva, com abordagem quali-quantitativa, realizada nos munic?pios de Caic?, Currais Novos e Parelhas. A pesquisa aconteceu em duas fases distintas: Primeiramente, atrav?s da t?cnica qualitativa de grupo focal foi feito um levantamento de elementos que possibilitaram ao investigador a avalia??o da assist?ncia obst?trica; Posteriormente, foi constru?do e validado um question?rio de pesquisa que foi aplicado ?s mulheres dos munic?pios selecionados para o estudo. As informa??es colhidas durante o grupo focal foram transcritas e submetidas ao ALCESTE com o intuito de organizar os discursos em t?picos. A an?lise dos discursos possibilitou a constru??o de um instrumento para avalia??o da assist?ncia durante o ciclo. O question?rio passou pelo processo de valida??o aparente, antes de ser administrado. Utilizou-se a an?lise m?ltipla de regress?o log?stica para identifica??o dos fatores preditores que influenciam a insatisfa??o da assist?ncia. O resultado revelou um cen?rio inquietante e desafiador que remete ? constante avalia??o dos servi?os em busca da melhoria da assist?ncia. Enfatiza ainda a import?ncia de indicadores que refletem a realidade do servi?o p?blico de sa?de ser introduzidos nos instrumentos avaliativos, para nortear cientificamente a mudan?a das pr?ticas assistenciais. O estudo idenfificou que 41% das participantes avaliaram negativamente a assistencia recebida pelo servi?o p?blico. Os indicadores que est?o associados ? satisfa??o das mulheres foram: a participa??o da mulher na escolha do parto, a visita cl?nica e a comunica??o da alta hospitalar feita pelo profissional m?dico, a visita puerperal realizada pela ESF na primeira semana ap?s alta hospitalar e o acesso as orienta??o sobre os cuidados com o rec?m-nascido na primeira semana de vida.
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Uso dos servi?os odontol?gicos e fatores associados em jovens do nordeste brasileiroFilgueira, Adriano de Aguiar 26 July 2017 (has links)
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Previous issue date: 2017-07-26 / A garantia do acesso universal definido pela Constitui??o brasileira de 1988 e os recentes avan?os alcan?ados com a implanta??o da Pol?tica Nacional de Sa?de Bucal trouxeram resultados positivos em rela??o ao acesso e uso dos servi?os odontol?gicos, entretanto essa evolu??o aconteceu de forma desigual entre os diferentes grupos populacionais do pa?s. Apesar de diversos modelos te?ricos tentarem explicar a influ?ncia de diferentes fatores no uso dos servi?os de sa?de, lacunas importantes ainda persistem e exigem novas pesquisas com diferentes abordagens para um melhor entendimento das rela??es entre os determinantes sociais de sa?de e o acesso e uso dos servi?os odontol?gicos. Este estudo tem por objetivo analisar o uso dos servi?os de sa?de bucal e os principais fatores determinantes associados em jovens na faixa et?ria de 17 a 21 anos no munic?pio de Sobral, Cear?, a partir de diferentes desenhos metodol?gicos. O primeiro desenho trata-se de uma abordagem transversal e relacional distintos desfechos ao uso dos servi?os odontol?gicos com determinantes individuais. O segundo tamb?m desenvolveu um estudo seccional, por?m abordou os fatores contextuais e as rela??es com o uso dos servi?os de sa?de bucal. Nesse segundo momento, tamb?m foram elaborados mapas tem?ticos para uma melhor visualiza??o da distribui??o espacial das vari?veis contextuais e dos desfechos utilizados. O terceiro desenho consistiu em um estudo de coorte, onde foram criados perfis de trajet?rias referentes ao uso dos servi?os odontol?gicos e, posteriormente, foram relacionados com fatores individuais em dois momentos distintos da vida: inf?ncia e juventude. A amostra para todos os desenhos teve origem em uma coorte de sa?de bucal realizada no munic?pio de Sobral com dados coletados nos anos de 2000, 2006 e 2012. Os resultados apontam a influ?ncia dos fatores socioecon?micos, principalmente nos primeiros anos de vida, no acesso e uso dos servi?os de sa?de bucal, bem como no tipo de servi?o utilizado. A dor de dente em algum momento da vida esteve associada com a ida ao consult?rio odontol?gico em algum momento da vida e de ter sofrido nega??o ao acesso. A presen?a de condi??es indicativas de tratamento odontol?gico esteve relacionada com o maior uso dos servi?os odontol?gicos e com o acesso oportuno a eles. A visita n?o regular ao cirurgi?o-dentista parece aumentar a probabilidade de problemas bucais na juventude. Pensar pol?ticas p?blicas que visem uma melhor distribui??o de renda e inclus?o social, bem como a??es de promo??o e preven??o em sa?de bucal, podem contribuir com a melhoria dos aspectos relacionados ao uso dos servi?os odontol?gicos. / The assurance of universal access defined by the Brazilian Constitution of 1988 and the recent advances achieved with the implementation of the National Oral Health Policy have brought positive results in relation to the access and use of dental services, however this increase occurred unequally between the different population groups all over the country. Although several theoretical models have been trying to explain the influence of several factors on the use of health services, important gaps still persist and require new research with different approaches to a better understanding of the relationships between the social determinants of health and the access and use of dental services. This study aims to assess the use of oral health services and the main associated factors in young people aged 17 to 21 years in the city of Sobral, Cear?, based on different methodological designs. The first design is a cross-sectional approach relating the different outcomes related to the use of dental services with individual determinants. The second one also developed a cross-sectional study, but it addressed the contextual factors and the relationships with the use of oral health services. Thematic maps were also made for a better visualization of the spatial distribution of the contextual variables and the outcomes used. The third study consisted of a cohort study, where trajectory profiles were created regarding the use of dental services and how they are related to individual factors in two different moments of life: childhood and youth. The sample for all the designs was originated from a cohort of oral health performed in the municipality of Sobral with data collected in the years 2000, 2006 and 2012. The results indicate the influence of socioeconomic factors, especially in the first years of life, in the access and use of oral health services, as well as the type of service used. The toothache at some point in life was associated with going to the dental office at some point in life and having been denied access. The presence of dental treatment needs was related to the greater use of dental services and early access to them. A non-regular visit to the dentist seems to increase the likelihood of oral problems in youth. To implement public policies that aim at a better distribution of income and social inclusion, as well as actions of promotion and prevention in oral health, can contribute to the improvement of aspects related to the use of dental services
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O impacto da internacionalização sobre o sistema de controle de gestão de empresas gaúchas: um estudo de caso múltiplo entre as empresas de capital aberto Fras-le S/A, Gerdau S/A e Forjas Taurus S/A / The impact of internationalization on the management control system in companies located at Rio Grande do Sul: a multiple case study among the publicly traded companies Fras-le S / A, Gerdau S / A and Forjas Taurus S / AEduardo Motta Tojal 03 March 2011 (has links)
O presente estudo buscou analisar os principais impactos sofridos pelos sistemas de controle de gestão das empresas em decorrência de sua internacionalização e consequente aumento da complexidade de suas operações. A pesquisa buscou analisar também algum afastamento ou aproximação da literatura pesquisada, sobre a forma como este processo de internacionalização acontece. Assim sendo, foram feitas comparações entre as características de controle e de internacionalização encontradas na literatura e as situações encontradas nas empresas entrevistadas nesta pesquisa. Para possibilitar tais comparações, foi realizada uma revisão da literatura sobre as teorias acerca do controle de gestão nas empresas, sobre os processos de internacionalização e também sobre as teorias de internacionalização de empresas, descritas pelos principais autores destas áreas. Definido o plano de referência, foi adotado o método de estudo de caso aplicado em três das maiores empresas do estado do Rio Grande do Sul, a Gerdau S/A, a Fras-le S/A e a Forjas Taurus S/A, a fim de explorar mais aprofundadamente os reais procedimentos e controles encontrados nestas empresas, de tamanha relevância para a economia Gaúcha e Brasileira, observando suas características em relação ao plano de referência proposto. Com base nas entrevistas presenciais realizadas, foi possível verificar a real importância dos sistemas de controle de gestão nas companhias internacionalizadas e o grande desafio que as empresas atravessam para conseguir monitorar e planejar, de forma eficiente, as complexas atividades realizadas em diferentes locais do mundo. Os principais achados indicam que os sistemas de controle sofrem vários impactos para adaptação aos diferentes mercados, sendo identificadas relevantes mudanças estruturais, conceituais e de acompanhamento e controle nos casos analisados. Deve-se destacar a grande impotância dos investimentos em tecnologia, pesquisa e desenvolvimento e a atenção constante que as empresas devem dispensar ao capital intelectual para a obtenção de eficiência e qualidade nas operações. Quanto às características do processo de internacionalização, foram encontradas aproximações relevantes entre teoria e prática. / This study investigates the main impacts in control systems of enterprises due to its internationalization and consequent increase in complexity of their operations. The research sought to examine further some clearance or approach in the literature, about how this process of internationalization happens. Therefore, comparisons were made between control and internationalization characteristics found in the literature and the real situations in the companies interviewed in this research. To enable such comparisons, we performed a literature review on the theories of management control in companies on the processes of globalization and also on the theories of internationalization of firms, described by the principal authors of these areas. Set the reference plane, was adopted the method of case study applied in three major companies in the state of Rio Grande do Sul, Gerdau S/A, Fras-le S/A and Forjas Taurus S/A in order to seek a deeper exploration on the actual procedures and controls found in these companies, such relevance to the Brazilian and regional economy, noting their characteristics in relation to the reference plane proposed. From the interviews conducted in person, it was possible to verify the real importance of systems of management control in companies internationalized and the great challenge that companies go through to get to monitor and plan effectively, the complex activities that are held in different locations around the world. The main findings indicate that the control systems suffer various impacts to adapt to different markets and could be verifyed other some important structural, conceptual and monitoring and control changes in the cases analyzed. It is worth mentioning the great impotance of investments in technology, research and development and constant attention that companies should pay to the intellectual capital to achieve efficiency and quality in operations. Relevant approaches were found between theory and practice about the characteristics of the internationalization process.
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Rehabilitation assessment of the Pretoria State Garage to fit the Pretoria Technology ParkSetshedi, Gift Phalatse 21 July 2005 (has links)
INTRODUCTIONThis research investigates the assessment for the rehabilitation of the Pretoria State Garage (PSG) for the purpose of accommodating the Pretoria Technology Park (PTP). The Pretoria State Garage courtyard is comprised of industrial type of buildings, most of which stand obsolete due to a shift in the manufacturing process. These buildings are structurally sound and historically significant. They offer a major opportunity for conversion to attract business through providing relatively inexpensive commercial and industrial spaces to small and medium sized companies. The site is located in the southwest quadrant of Pretoria Central in which a number of sites and buildings are currently being downgraded in the urban revitalisation process, due to preferred, other technologies of construction. The assessment for the rehabilitation of the site evaluates the spatial qualities and the physical forms of buildings in relation to the new user, while the establishment of the PTP focuses on maintaining, elongating and innovating the industrial manufacturing tradition of the site. The incorporation of the PTP on the PSG site is implemented through the fitting process. RESEARCH AREAThe research focuses on the three main areas dealing with: <ul><li> Programming and planning of the Pretoria Technology Park </li><li>Rehabilitation assessment of the Pretoria State Garage</li><li> Architectural fitting process <br></li></ul> 1. Programming and planning of the Pretoria Technology Park The development methodology is employed for the establishment of a sustainable Pretoria Technology Park, which stems from local technology demand, supply and transfer. As a result, different centres are established to provide accommodation and services to major activities of the park dealing with administration, provision of advanced technology services and accommodation for technology-based firms. Individual centres are discussed according to their envisaged spatial qualities and design specifications. 2. Rehabilitation assessment of the Pretoria State Garage The rehabilitation assessment explores the historic significance and architectural values of the PSG. The outcome of the rehabilitation assessment defmes the manner and the degree in which various rehabilitation interventions could be executed. The process includes proposals for the demolition of unwanted structures and elements, investigating the long-term resilience of buildings to be retained and assessing negative physical features of the site. 3. Architectural fitting process Specific dimensions and spatial requirements of both the PSG (physical) and the PTP (intellectual) respectively are compared for the purpose of mutual fitting. / Dissertation (MArch)--University of Pretoria, 2005. / Architecture / unrestricted
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Educa??o permanente em sa?de na estrat?gia sa?de da fam?lia em busca da resolubilidade da produ??o do cuidadoAraujo, Bianca de Oliveira 30 March 2015 (has links)
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Previous issue date: 2015-03-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The development of educational activities to the health workers of Estrat?giaSa?de da Fam?lia ? ESF(Family Health Strategy program) is important to the achievement of an integral work. However it is necessary that such workers have their educational practices guided by the observance of Educa??o Permanente emSa?de ? EPS (Permanent Education in Health) to a major resolubility of the actions demanded by the population. This study aimed to analyze the practice of EPS developed in the Equipe de Sa?de da Fam?lia ? EqSF (Family THealth team) of the municipality of Cama?ari in the State of Bahia by seeking the resolubility of the production of the health care to the users of the ESF and to discuss the construction of knowledge and practices of the EPS to the EqSF by searching the resolubility of the production of health care. So as to this work could be possible we started a study with the discussion about the historicity of the formation of the health workers in Brazil and the main pedagogical conceptions which are present in the health field: Educa??oemServi?o (Education at Job), Educa??oContinuada (Continuing Education) and EPS practices. In the aftermath we discussed the resolubility and the wellness production. It is a matter of a qualitative study, of critical-analytical approach, in a perspective approximated to the dialectical method, having as background two Unidades de Sa?de da Fam?lia ? USF (Basic Health Care Unit), the Departamento de Aten??oB?sica ? DAB (Departament of Primary Health Care) and the Coordena??o de Educa??o Permanente emSa?de ? CEPS (Coordination of Permanent Education in Health) of the town of Cama?ari. The participants of the study constituted two groups: health workers of ESF (group I), DAB?s and CEPS?s managers (group II) summating 26 participants. We used as data collection techniques the semi-structured interview, the systematic observation and the document analysis, and as method of data analysis of content. From the confrontation of data emerged two categories: 1 ? The process of work of the ESF and the (dis)articulation of the EPS in the production of wellness; 2 ? Resolubility of the production of care in the ESF and the construction of knowledge and practices: the protagonism of the EPS. Concerning to the process of work of the EqSF the results foregrounded, there is the development of the group work of the ESF which were studied, notwithstanding the reference and counter-reference system of the municipality does not work out adequately. The comprehension about the EPS, in the vast majority of health workers is associated to knowledge qualification and updating; to the managers it is understood as a process of reflection of the practices to their transformation which is supposed to happen in a continuous and permanent way. We observed some aspects which damage the development of actions of the EPS such as: Professional turnover; lack of professionals with a suitable profile to work in the Primary Health Care; the need of more workers in the CEPS and with the necessary formation to perform such activities, lack of materials for holding such activities; and the fact related to the EPS not being considered as a priority by the management staff. We evinced also that the EPS influences both in the technical capability and EqSF team work and in the intersectoriality with other health services before the contributions of the educational activities to the empowerment of the work in the ESF what makes possible that the health workers develop actions of production of care with major resolubility. We consider that a comprehensive discussion about the EPS as a State policy is Paramount, giving to the health workers and the health managers a major comprehension. In the sense of giving resolubility to the needs of health of the population amidst a production of care to real health. / O desenvolvimento de atividades educativas para os trabalhadores de sa?de da Estrat?gia Sa?de da Fam?lia (ESF) ? importante para a realiza??o de um trabalho integral. Por?m, ? preciso que tais trabalhadores tenham suas pr?ticas educativas orientadas pela Educa??o Permanente em Sa?de (EPS) para a maior resolubilidade das a??es demandadas pela popula??o. Este estudo teve como objetivos analisar a pr?tica da EPS desenvolvida na EqSF do Munic?pio de Cama?ari-BA em busca da resolubilidade da produ??o do cuidado em sa?de aos usu?rios da ESF e discutir a constru??o de saberes e pr?ticas da EPS para a EqSF em busca da resolubilidade da produ??o do cuidado em sa?de. Para tanto iniciamos o estudo com a discuss?o sobre a historicidade da forma??o dos trabalhadores de sa?de no Brasil e as principais concep??es pedag?gicas presentes na sa?de: Educa??o em Servi?o, Educa??o Continuada e EPS. Posteriormente, discutimos a resolubilidade e a produ??o do cuidado. Trata-se de um estudo qualitativo, de abordagem cr?tico anal?tica, numa perspectiva aproximada do m?todo Dial?tico, tendo como cen?rios duas Unidades de Sa?de da Fam?lia (USF), o Departamento de Aten??o B?sica (DAB) e a Coordena??o de Educa??o Permanente em Sa?de de Cama?ari-BA. Os participantes do estudo foram constitu?dos de dois grupos: trabalhadores de sa?de da ESF (Grupo I), gestores do DAB e da CEPS (Grupo II), totalizando 26 participantes. Utilizamos como t?cnicas de coleta de dados a entrevista semi-estruturada, a observa??o sistem?tica e a an?lise de documentos, e como m?todo de an?lise de dados a an?lise de conte?do. A partir do confronto dos dados emergiram duas categorias: 1- PROCESSO DE TRABALHO DA ESF E A (DES) ARTICULA??O DA EPS NA PRODU??O DO CUIDADO: o pensar e o agir dos protagonistas; 2- RESOLUBILIDADE DA PRODU??O DO CUIDADO NA ESF E A CONSTRU??O DE SABERES E PR?TICAS: o protagonismo da EPS. Quanto ao processo de trabalho das EqSF os resultados evidenciaram que h? o desenvolvimento do trabalho em equipe nas USF estudadas, entretanto, ainda n?o flui adequadamente o sistema de refer?ncia e contrarrefer?ncia do munic?pio. A compreens?o sobre a EPS, na maioria dos trabalhadores de sa?de, est? associada ? capacita??o e atualiza??o dos conhecimentos; para os gestores ela ? entendida como um processo de reflex?o das pr?ticas para a sua transforma??o que deve acontecer de forma cont?nua e permanente. Observamos alguns aspectos que prejudicam o desenvolvimento das a??es de EPS como: rotatividade profissional; falta de profissionais com o perfil adequado para atuarem na Aten??o B?sica; necessidade de mais trabalhadores na CEPS e com a forma??o adequada para tal; falta de materiais para realiza??o das atividades; e a EPS n?o ser vista como prioridade pela gest?o. Evidenciamos tamb?m que a EPS influencia tanto na capacidade t?cnica e trabalho em equipe da EqSF quanto na intersetorialidade com os outros servi?os de sa?de, diante das contribui??es das atividades educativas para o desenvolvimento do trabalho na ESF, o que vem possibilitar a consolida??o da ESF, uma vez que permite que os trabalhadores de sa?de desenvolvam a??es de produ??o do cuidado com maior resolubilidade. Consideramos que ? necess?ria uma ampla discuss?o sobre a EPS enquanto uma pol?tica de Estado, oportunizando os trabalhadores de sa?de e gestores uma maior compreens?o, no sentido de dar resolubilidade ?s necessidades de sa?de da popula??o mediante uma produ??o do cuidado na sa?de efetiva.
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Příprava a charakterizace SA vrstev z vinyltriethoxysilanu / Deposition and characterization of SA layers from vinyltriethoxysilaneVeverka, Miroslav January 2008 (has links)
Development of composite material is very much progressive sector and leads to evolution of material with new property. This type of material has one, but important deficiency. It is small adhesion armature to matrix. My study is sight on improvement adhesion the surface by deposition self assembled (SA) monolayer from organosilanes. Property of this layer, like thickness, surface tension, homogenity and wettability, was evaluated by the contact angle measurement and spektroscopical elipsometri.
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Samovolně seskupené vrstvy na bázi křemíku / Self-assembled layers based on siliconBábík, Adam January 2009 (has links)
Thin film deposition, characterization and properties of self-assembled monolayers based on silicon were studied with emphasis on the SA monolayers deposited from vinyltriethoxysilane and vinyltrichlorsilane. The thesis is aimed at basic properties of the SA monolayer and explanation of its growth. Methods and techniques used for analysis of the monolayer were described as well. Contact angle measurements and an evaluation of the surface free energy are depicted in details. The deposited SA layers were observed with respect to their chemical composition and surface morphology by X-ray photoelectron spectroscopy (XPS), ellipsometry and atomic force microscopy (AFM).
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Fundamentalní akciová analýza vybraných evropských výrobců osobních automobilů / Share Fundamental Analysis of Selected European Car ManufacturersGaluška, Radek January 2012 (has links)
The aim of this diploma thesis is an analysis of selected joint-stock companies of the European automotive industry for the purpose of selecting the most advantageous investment opportunities. The theoretical part of the thesis summarizes the most common approaches and methods of fundamental analysis of shares. In the practical part, these findings applied to the analysis by BMW AG, Daimler AG, Fiat SpA, PSA SA, Renault SA and Volkswagen AG. The investment recommendation is proposed in the basis of the comparision of the results gathered by the analysis.
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The role of price sensitivity and pricing in the demand for accommodation of local visitors to the Kruger National ParkSchutte, Ignatius Christian 11 June 2013 (has links)
The need for the study was prompted by discussions with my fellow photographers and friends that fewer people visited the Kruger National Park the last few years. Various reasons were given for it. I discussed it with Professors G. Puth and A. N. Schreuder, and members of the National Parks Board. Initially it was decided that a study should be done of why there was a decrease in the demand for accommodation in the Park, and how it could possibly be improved. Mr. P. Fearnhead and Professor A. N. Schreuder suggested that it would be better if a price sensitivity study should be done with a new computer program, namely conjoint analysis. This type of study has not been done in South Africa before. One of the major purposes of a conjoint analysis is to measure consumer preferences among competitive products and services. Basically it measures preferences of tourists by making trade-offs between five attributes and seventeen levels, and that consumers make complex decisions not on one factor alone but on several factors "jointly". Thus it was named conjoint analysis. Ranking a number of different combinations of attribute levels on a nine-point rating scale indicated their preferences. The results were then processed by a computer program, Conjoint Value Analysis (CVA), Version 2.0 system. They indicated their preferences by ranking a number of different combinations of attribute levels to give utility values for the attributes. Six representative camps (three large and three small ones) were used for a stratified sample of 428 respondents. The findings will give recommendations that can be used. AFRIKAANS : Die behoefte vir die studie is aangespoor deur gesprekke met my medefotograwe en vriende dat minder mense die Nasionale Kruger Wildtuin die laaste aantal jare besoek het. Veskeie redes is daarvoor gegee. Ek het dit met Professore G. Puth en A. N. Schreuder, en lede van die Nasionale Parkeraad bespreek. Oorspronklik is besluit dat 'n studie gedoen behoort te word oar hoekom daar 'n afname in die vraag vir akkommodasie in die Wildtuin was, en hoe dit moontlik verbeter kon word. Mnr. P. Fearnhead en Professor A. N. Schreuder het voorgestel dat dit beter sou wees indien 'n prysssensitiwiteit-studie met 'n nuwe rekenaarprogram, nl. gesamentlike analise ("conjoint analysis"), gedoen sou word. Hierdie tipe studie was nag nie voorheen in Suid-Afrika gedoen nie. Een van die hoof oogmerke van 'n gesamentlike analise is om verbruiksvoorkeure tussen mededingende produkte en dienste te meet. Basies meet dit voorkeure van toeriste deur kompromiee ("trade-offs") tussen vyf eienskappe en sewentien vlakke te maak, en dat verbruikers komplekse besluite maak nie oar een eienskap aileen nie, maar verskeie eienskappe gesamentlik ("jointly"). Daarom is dit gesamentlike analise ("conjoint analysis") genoem. Hulle voorkeure word gewys deur die toekenning van 'n rangorde aan 'n aantal veskillende kombinasies van eienskap-vlakke op 'n nege-punt skattingskaal. Die resultate is daarna deur 'n rekenaarprogram, Conjoint Value Analysis (CVA), Version 2.0 sisteem, verwerk. Hulle wys hulle voorkeure deur die toekenning van 'n rangorde van 'n aantal van verskillende kombinasies van eienskap-vlakke om nuttigheidswaardes vir die eienskappe te gee. Ses verteenwoordigende kampe (drie grates en drie kleintjies) is gebruik vir 'n gestratifiseerde steekproef van 428 respondente. Die bevindings sal aanbevelings gee wat gebruik kan word. / Dissertation (MCom)--University of Pretoria, 1999. / Marketing Management / MCom / Unrestricted
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