A dissertação Por que pacientes com câncer vão à Justiça? Um estudo sobre ações judiciais movidas contra o Sistema Único de Saúde (SUS) e contra os planos de saúde na Cidade de São Paulo descreve e analisa as decisões judiciais proferidas entre 2015 e 2017 pela segunda instância do Tribunal de Justiça do Estado de São Paulo em ações judiciais que demandaram tratamentos para neoplasias. Foram analisadas 1.951 decisões judiciais, sendo 157 delas (8,05% do total) relacionadas ao Sistema Único de Saúde (SUS) e 1.794 (91,95% do total) envolvendo empresas de planos e seguros de saúde privados. A maioria das decisões foi favorável (96,57%) tanto aos pacientes do SUS (88,54%) quanto da saúde suplementar (97,27%). A negativa de cobertura de quimioterapias foi o tema mais frequente nas decisões analisadas (47,00%), presente em 44,87% das decisões contra os planos de saúde e em 71,34% das decisões contra o SUS. O principal motivo alegado pelos gestores para essa recusa é o fato de o tratamento pleiteado não estar contemplado no Rol de Procedimentos e Eventos em Saúde da ANS ou nos protocolos do SUS. Conclui-se que os planos de saúde, se comparados ao SUS, são mais frequentemente reclamados na Justiça por pacientes de câncer, bem como que o Tribunal pesquisado tem posicionamento fortemente favorável aos pacientes. Há similaridades e diferenças na judicialização de tratamento para câncer demandados contra os setores público e privado da saúde. O estudo contribui para discussão e estudos futuros sobre a relação da judicialização da saúde com a qualidade da rede assistencial, a incorporação de tecnologias, as políticas públicas, a regulamentação e a fiscalização das atividades dos planos de saúde / The essay Why cancer patients go to justice? A study on lawsuits filed against health plans and against the SUS in the City of São Paulo describes and analyzes the judicial decisions handed down between 2015 and 2017 by the Court of Appeal of the State of São Paulo, in lawsuits that claimed for treatments for neoplasia. 1,951 judicial decisions were analyzed, being 157 of them (8,05%) related to the unified health system (SUS) and 1,794 (91,95%) involving companies of private health insurance plans. Most of the decisions was favorable (96,57%), both for SUS patients (88,54%) as for health plans patients (97,27%). The denial of coverage of chemotherapy was the most frequent issue in the decisions analyzed (47.00%), present in 44.87% of decisions against health plans and in 71.34% of decisions against the SUS. And the main reason alleged by the managers for such refusal, it was that the claimed treatment is not included in the list of procedures and events in the Health ANS or in protocols of the SUS. It is concluded that the health plans, if compared to the SUS, are most frequently claimed in court by cancer patients, and that the researched Court has a strong patient favorable position. There are similarities and differences in cancer treatment judicialization defendants against the public and private health sectors. The study contributes to the discussion and future studies on the relation of health judicialization to the quality of the health care network, the incorporation of technologies, public policies, regulation and supervision of health plan activities

O objetivo deste estudo foi analisar se a enfermeira da Saúde da Família (SF), no atual modelo de atenção, encontra possibilidades (ou brechas) para identificar demandas, necessidades e expectativas dos usuários a fim de implementar uma assistência integral. Por meio do trabalho da enfermeira, buscou-se identificar e analisar as ferramentas utilizadas para reconhecer e atender as demandas, necessidades e expectativas dos usuários. Por ser abordado o trabalho em saúde, adotou-se o referencial teórico do processo de trabalho em sua vertente marxista. Para responder ao objetivo, lançou-se mão da abordagem qualitativa, triangulando a entrevista semiestruturada e a observação participante. As entrevistas foram realizadas com 31 enfermeiras de Unidades de Saúde da Família (USFs) de Ribeirão Preto-SP, seguindo um roteiro pré-elaborado com questões referentes ao trabalho na SF oriundas da revisão de literatura. As observações foram realizadas com sete enfermeiras em três USFs distintas do mesmo município, durante uma semana típica de trabalho, mediante um roteiro de observação. As entrevistas foram interpretadas por meio da análise temática compondo o corpus principal de análise que foram confrontadas com o conteúdo das observações. A análise das entrevistas produziu três grandes unidades temáticas: Falando do contexto onde as práticas de saúde se desenvolvem, O trabalho em equipe e O trabalho das enfermeiras. A primeira unidade temática foi dividida em outros três subtemas e, de modo geral, evidenciou a forte presença da lógica biomédica de atendimento, tanto nos usuários quanto nos trabalhadores. A maioria dos usuários busca atenção imediata para suas queixas/problemas de saúde para os quais os trabalhadores produzem cuidados individuais, curativos, fragmentados e pontuais. Porém, nos atendimentos, há oportunidades nem sempre aproveitadas, para o trabalhador escutar as subjetividades do usuário e reconhecer as necessidades trazidas e travestidas em demandas. A segunda unidade temática revelou que o trabalho na SF, sob a perspectiva das enfermeiras, é organizado, majoritariamente, segundo a modalidade de equipe agrupamento, embora haja situações em que se evidencie a modalidade integração que revela pistas e brechas para um cuidado mais integral e integrado. Finalmente, a terceira unidade temática, dividida em quatro subtemas, mostrou que as dimensões do trabalho \"cuidar\" e \"gerenciar o cuidado\" envolvem a educação em saúde e se desenvolvem com o auxílio de tecnologias, em especial das leves, que favorecem a operacionalização das dimensões do trabalho da enfermeira na direção da integralidade da atenção, sendo, portanto, consideradas importantes brechas no trabalho. As enfermeiras ainda trouxeram vários conceitos, sentidos e dimensões da integralidade, compartilhando várias possibilidades para a leitura ampliada das necessidades de saúde dos usuários. As considerações finais ressaltam que a partir do trabalho das enfermeiras é possível verificar a importância das tecnologias leves no cotidiano do trabalho em equipe integrado, dentro e fora do sistema de saúde, para identificar e atender as necessidades dos usuários na perspectiva da integralidade da atenção. Além disso, abre possibilidades para se investigar novas tendências relacionadas ao trabalho das enfermeiras na AB / The objective of this study was to analyze whether the Family Health (FH) nurse, in the current care model, finds possibilities (or gaps) to identify users\' demands, needs and expectations in order to implement comprehensive care. Through the nurse\'s work, we aimed to identify and analyze the tools used to recognize and meet the users\' demands, needs and expectations. Because health work was addressed, the theoretical framework adopted was the work process in its Marxist perspective. To respond to the objective, the qualitative approach was used, triangulating the semistructured interview and participant observation. The interviews were carried out with 31 nurses from the Family Health Units (USFs) of Ribeirão Preto-SP, following a pre-elaborated script with questions related to FH work deriving from the literature review. Observations took place with seven nurses in three distinct USFs of the same city, during a typical workweek, through an observation script. The interviews were interpreted using thematic analysis, composing the main corpus of analysis, which was confronted with the content of the observations. The analysis of the interviews produced three major thematic units: Talking about the context in which health practices take place, Teamwork and The nurse\'s work. The first thematic unit was divided into three other subthemes and, overall, showed the strong presence of the biomedical care logic, in users as well as workers. Most users seek immediate care for their health complaints/problems, for which workers produce individual, curative, fragmented and punctual care. During care, however, there are opportunities left unused for the worker to listen to the subjectivities of the user and recognize the needs brought and disguised as demands. The second thematic unit revealed that the work in FH, from the nurses\' perspective, is mainly organized according to the team cluster modality, although there are situations in which there is evidence of the integration modality, revealing clues and gaps for a more integral and integrated care. Finally, the third thematic unit, divided into four subthemes, showed that the dimensions of \"caring\" and \"managing care\" work involve health education and are developed with the aid of technologies, especially light technologies, which favor the operationalization of the nurse\'s work dimensions towards care integrality, being therefore considered important gaps in the work. The nurses also brought various concepts, meanings and dimensions of integrality, sharing several possibilities for the extended reading of the users\' health needs. The final considerations point out that, based on the nurse\'s work, the importance of light technologies in daily integrated team work can be verified, inside and beyond the health system, to identify and meet the users\' needs from the perspective of care integrality. In addition, it opens possibilities to investigate new trends related to the nurse\'s work in basic care

Failure criteria play a vital role in the numerical analysis of reinforced concrete structures. The current failure criteria can be classified into two types, namely the empirical and theoretical failure criteria. Empirical failure criteria normally lack reasonable theoretical backgrounds, while theoretical ones either involve too many parameters or ignore the effects of intermediate principal stress on the concrete strength. Based on the octahedral shear stress model and the concrete tensile strength under the state of triaxial and uniaxial stress, a new failure criterion, that is, the simplified unified strength theory (UST), is developed by simplifiing the five-parameter UST for the analysis of reinforced concrete structures. According to the simplified UST failure criterion, the concrete strength is influenced by the maximum and intermediate principal shear stresses together with the corresponding normal stresses. Moreover, the effect of hydrostatic pressure on the concrete strength is also taken into account. The failure criterion involves three concrete strengths, namely the uniaxial tensile and compressive strengths and the equal biaxial compressive strength. In the numerical analysis, a degenerated shell element with the layered approach is adopted for the simulation of concrete structures. In the layered approach, concrete is divided into several layers over the thickness of the elements and reinforcing steel is smeared into the corresponding number of layers of equivalent thickness. In each concrete layer, three-dimensional stresses are calculated at the integration points. For the material modelling, concrete is treated as isotropic material until cracking occurs. Cracked concrete is treated as an orthotropic material incorporating tension stiffening and the reduction of cracked shear stiffness. Meanwhile, the smeared craclc model is employed. The bending reinforcements and the stirrups are simulated using a trilinear material model. To verify the correctness of the simplified UST failure criterion, comparisons are made with concrete triaxial empirical results as well as with the Kupfer and the Ottosen failure criteria. Finally, the proposed failure criterion is used for the flexural analysis of simply supported reinforced concrete beams. Also conducted are the punching shear analyses of single- and multi-column-slab connections and of half-scale flat plate models. In view of its accuracy and capabilities, the simplified UST failure criterion may be used to analyse beam- and slab-type reinforced concrete structures.

<p>Reports of software a development projects that miss schedule, exceeds budget and deliver products with poor quality are abundant in the literature. Both researchers and the industry are seeking methods to counter these trends and improve software quality.</p><p>Software Process Improvement is a systematic approach to improve the capabilities and performance of software organizations. One basic idea is to assess the organizations’ current practice and improve their software process on the basis of the competencies and experiences of the practitioners working in the organization. A major challenge is to create strategies and mechanisms for managing relevant and updated knowledge about software development and maintenance. Insights from the field of knowledge management are therefore potentially useful in software process improvement efforts to facilitate the creation, modification, and sharing of software processes in any organization.</p><p>In the work presented in this thesis, we have made an overview of empirical studies on the effect of knowledge management in software engineering. We have categorized these studies according to a framework and we report findings on the major concepts that have been investigated empirically, as well as the research methods applied within the field. We have also investigated two main strategies for knowledge management, codification and personalization, through the application of four concrete methods in a software process improvement setting: Mentoring, Rational Unified Process, Process Workshops and Post Mortem Analysis.</p><p>We have classified the work in this thesis within three main themes:</p><p>RT1: Previous research on knowledge management in software engineering.</p><p>RT2: Application of knowledge management to improve the software process through codification of knowledge.</p><p>RT3: Application of knowledge management to improve the software process through personalization of knowledge.</p><p>The main contributions are:</p><p>C1: An overview of the research literature on empirical studies of knowledge management in software engineering.</p><p>C2: A method for tailoring the Rational Unified Process to the development process of a software consulting company.</p><p>C3: Improvements of the Process Workshops method by contextualization.</p><p>C4: Improvement of the root-cause analysis phase of the lightweight Post Mortem Analysis for more effective project retrospectives.</p><p>C5: Proposed methods to increase the learning effect of mentor programs in software engineering.</p>

<p>The world of systems engineering methods is changing as rigorous ‘off-the-shelf’ systems engineering methods become more popular. One example of such a systems engineering method is Rational Unified Process. In order to cover all phases in a software development process, and a wide range of project-types, such methods need to be of an impressive size. Thus, the need for configuring such methods in a structured way is increasing accordingly. In this thesis, method configuration is considered as a particular kind of method engineering that focuses on tailoring a standard systems engineering method. We propose a meta-method for method configuration based on two fundamental values: standard systems engineering method’s rationality and reuse. A conceptual framework is designed, introducing the concepts Configuration Package and Configuration Template. A Configuration Package is a pre-made ideal method configuration suitable for a delimited characteristic of a (type of) software artifact, or a (type of) software development project, or a combination thereof. Configuration Templates with different characteristics are built combining a selection of Configuration Packages and used as a base for a situational method. The aim of the proposed meta-method is to ease the burden of configuring the standard systems engineering method in order to reach an appropriate situational method.</p>

<p>Att designa en generell och utbyggbar mjukvara är inte enkelt, då det krävs en bred kompetens inom många olika områden. Vi belyser i detta arbete en del av problematiken kring design. Utgångspunkten är ett praktikfall vars målmiljö rör processer och integrationer. Huvudfokus ligger på designmönster, men även en bredare genomgång av ämnen så som utvecklingsmetodik, Service Oriented Architecture (SOA), Web Services (WS) och utvecklingsmiljöer presenteras. Arbetet bedrivs i enlighet med riktlinjer från Rational Unified Process (RUP) och slutprodukten är en checklista på tre punkter. De tre punkterna speglar de lärdomar vi dragit av arbetet genom saker vi gjort och saker vi borde ha gjort. God design kan uppnås genom att förstå den uppgift man åtagit sig, utvärdera sitt resultat och delresultat samt genom användandet av rätt verktyg. Framtida forskningsområden med anknytning till vårt rör förslagsvis metoders betydelse för mjukvarudesign, dynamiska perspektiv hos utvecklare och mer enhetlighet kring begreppet SOA.</p>

Reports of software a development projects that miss schedule, exceeds budget and deliver products with poor quality are abundant in the literature. Both researchers and the industry are seeking methods to counter these trends and improve software quality. Software Process Improvement is a systematic approach to improve the capabilities and performance of software organizations. One basic idea is to assess the organizations’ current practice and improve their software process on the basis of the competencies and experiences of the practitioners working in the organization. A major challenge is to create strategies and mechanisms for managing relevant and updated knowledge about software development and maintenance. Insights from the field of knowledge management are therefore potentially useful in software process improvement efforts to facilitate the creation, modification, and sharing of software processes in any organization. In the work presented in this thesis, we have made an overview of empirical studies on the effect of knowledge management in software engineering. We have categorized these studies according to a framework and we report findings on the major concepts that have been investigated empirically, as well as the research methods applied within the field. We have also investigated two main strategies for knowledge management, codification and personalization, through the application of four concrete methods in a software process improvement setting: Mentoring, Rational Unified Process, Process Workshops and Post Mortem Analysis. We have classified the work in this thesis within three main themes: RT1: Previous research on knowledge management in software engineering. RT2: Application of knowledge management to improve the software process through codification of knowledge. RT3: Application of knowledge management to improve the software process through personalization of knowledge. The main contributions are: C1: An overview of the research literature on empirical studies of knowledge management in software engineering. C2: A method for tailoring the Rational Unified Process to the development process of a software consulting company. C3: Improvements of the Process Workshops method by contextualization. C4: Improvement of the root-cause analysis phase of the lightweight Post Mortem Analysis for more effective project retrospectives. C5: Proposed methods to increase the learning effect of mentor programs in software engineering.

Sjöfartsektorn är en betydande källa för svavel- och kväveutsläpp. Depositioner av oxiderat svavel, dvs. sulfat, och oxiderat kväve dvs. nitrat, i form av våt och torrdeposition bidrar till försurning och försämrad luftkvalitet. Styrmedel för att minska svavelutsläppen har under de senaste åren bidragit till minskade svavelutsläpp. Det har t.ex. införts begränsningar i hur mycket svavel som fartygsbränslen får innehålla. För att studera sjöfartens utsläpp av svavel- och kväveföroreningar har vi i denna studie använt en kemisk transportmodell för atmosfären ”the Unified EMEP Model”, för att simulera utsläppsspridningen under 2005. Deposition av svavel- och kväveföreningar från sjöfart har på landsnivå jämförts med den totala depositionen från alla utsläppskällor i Europa. Studier har även gjorts av hur mycket svavel- och kväveföreningar som har deponerats i Östersjöbassängen och dess omgivande länder från sjöfart i olika havsområden. Resultaten visar att svavel- och kväveföroreningar deponeras med hög koncentration nära utsläppskällan. Dock sprids de även långt från källan, koncentrationerna minskar med ökade avstånd. Deposition i norra Europa från sjöfart är som störst nära stora hamnar, spår i depositionsfälten syns även ut över Atlanten mot Amerika. Länder omgärdade av farvatten får högre koncentrationer relativt länder med mindre eller ingen sjötrafik i närheten. För att studera hur skrovlighetslängden över hav påverkar spridningen av svavel har Charnock-parametern varierats mellan 0,00072 och 0,085. Studien visar ingen tydlig påverkan på spridningen pga. variationer i skrovlighetslängden. En förklaring till detta resultat kan vara, att upplösningen i modellen är för grov för att kunna studera de små variationer som uppstår i depositionsfältet på grund av olika skrovlighetslängder. För att studera hur variationer i bl.a. nederbörd påverkar spridningen av svavel och kväve har månadsvis variation av svavel- och kvävedepositioner i Östersjön gjorts. / The shipping sector is a significant source of sulfur- and nitrogen-emissions. Depositions of oxidized sulfur and nitrogen i.e. sulfate and nitrate, in the form of wet and dry deposition contribute to acidification and deterioration of air quality. Political instruments to reduce sulfur emissions during the last years have contributed to the reduction of sulfur emissions, i.e. new instruments have been implemented in form of restrictions in sulfur content in ships fuel. The shipping sector’s emissions of sulfur and nitrogen have been studied by using “the Unified EMEP Model”, a chemical atmospheric transport model, with data collected during the year 2005. The deposition of sulfur and nitrogen from shipping in different countries has been compared to the total deposition from all sources in Europe. Deposition of sulfur and nitrogen in the Baltic Sea and the countries in the in the draining basin from individual sea has also been studied. The results have shown that deposition of sulfur and nitrogen is intense near the source. But it also spread far away from the source, however with decreasing concentrations in relation with distance to the source. Depositions in the north of Europe from shipping are highest near big ports and   Clear tracks from shipping in the depositions field are obtained near big ports and also in the Atlantic and the Mediterranean Sea. Countries with longer coastline have higher concentrations than those with less or none sea traffic in the near region. To study how roughness length over sea impacts the spread of sulfur the Charnock-parameter has been varied from 0,00072 to 0,085. The study doesn’t provide any clear findings of influence of the parameter in spread of sulfur. A theory to this result is the low resolution in the model. It is probably too small differences in the depositions field due to the roughness length. Monthly variations of sulfur and nitrogen deposits in the Baltic Sea have been made in order to study how variations in such precipitation affect the distribution of sulfur and nitrogen.

We present a study of high-resolution long-slit spectra of the Narrow-Line Regions (NLRs) of NGC 4151 (a Seyfert 1 galaxy) and NGC 1068 (a Seyfert 2 galaxy) obtained with the Space Telescope Imaging Spectrograph (STIS) aboard the Hubble Space Telescope (HST). The spectra were retrieved from the Multimission Archive at Space Telescope (MAST) and were obtained from five and seven orbits of HST time resulting in five and seven parallel slit configurations at position angles of 52 degrees and 38 degrees for NGC 4151 and NGC 1068 respectively. The spectra have a spatial resolution of 0.2 arcsecond across and 0.1 arcsecond along each slit. Observations of [O III] emission from the NLRs were made using the medium resolution G430M grating aboard HST. The spectral resolving power of the grating, R~9000, resulted in the detection of multiple kinematic components of the [O III] emission line gas along each slit. Radial velocities of the components were measured using a Gaussian fitting procedure. Biconical outflow models were generated to match the data and for comparison to previous models done with lower dispersion observations. The general trend is an increase in radial velocity roughly proportional to distance from the nucleus, followed by a linear decrease after roughly 100 pc. This is similar to that seen in other Seyfert galaxies, indicating common acceleration and deceleration mechanisms. The full-width at half-maximum (FWHM) of the emission lines reaches a maximum of 1000 km/s near the nucleus, and generally decreases with increasing distance to about 100 km/s in the extended narrow-line region (ENLR), starting at about 400 pc from the nucleus. In addition to the bright emission knots, which generally fit our model, there are faint high velocity clouds that do not fit the biconical outflow pattern of our kinematic model. A comparison of our observations with high-resolution radio maps shows that the kinematics of the faint NLR clouds may be affected by the radio lobes that comprise the inner jet. However, the bright NLR clouds show a smooth transition across the radio knots in radial velocity and velocity dispersion plots and remain essentially undisturbed in their vicinity, indicating that the radio jet is not the principal driving force on the outflowing NLR clouds. A dynamical model was developed for NGC 1068; it includes forces of radiation pressure, gravity, and drag due an ambient medium, simultaneously acting on the NLR clouds. The velocity profile from this model was too steep to fit the data, which show a more slowly increasing velocity profile. Gravity alone was not able to slow down the clouds but with the drag forces included, the clouds could slow down, reaching systemic velocities at distances that depend on the column densities of the NLR gas and density of the intercloud medium. A biconical model using the geometric parameters from our kinematic fit, and the velocity law from the dynamic fit, was used to match the data. The resulting dynamic model represented a poor fit to the data, indicating the need for additional dynamical considerations.

Although originally designed as an extension for the Unifi ed Modeling Language (UML), today, the Object Constraint Language (OCL) has been broadly adopted in the context of both UML and other modeling and domain-specifi c languages. However, appropriate tooling, supporting modelers and software developers on using OCL is still scarce and lacks important features such as debugging support. As OCL constraints are likely to become rather complex for real world examples, it is hard to comprehend the in uence of single OCL expressions and subexpressions on the result of a completely evaluated OCL constraint in the context of speci fic constrained objects. Therefore, debugging is of topmost importance for both constraint comprehension and maintenance. Thus, the major task of this work is to develop a graphical debugger integrated into Dresden OCL and the Eclipse Integrated Development Environment (IDE) to fill this gap.