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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
211

Integração ensino-serviço-comunidade: um estudo de caso sobre a gestão municipal / Teaching-service-community integration: a case study about the municipal management

Ribeiro, Maíra Carolina Polydoro 19 August 2019 (has links)
Introdução - A integração ensino-serviço-comunidade (IESC) durante o processo formativo em saúde deriva das práticas realizadas por estudantes no interior dos hospitais, voltadas à aquisição de conhecimentos procedimentais. Recentemente, a inclusão dos estudantes na rede de serviços de saúde, em ambientes extra-hospitalares, esteve relacionada à inclusão dos aspectos humanistas e sociais nos currículos e à adoção da integralidade durante a formação superior. A aproximação entre os mundos do ensino e do trabalho abarca uma complexidade decorrente de seus diversos atores, mas também das transformações ocorridas no ensino superior, na concepção sobre o processo saúde-doença, na institucionalização crescente do trabalho em saúde e, consequentemente, na gestão dos serviços enquanto organizações. Aos gestores municipais incumbem o engendramento da integração ensino-serviço-comunidade e o enfrentamento do modelo biomédico vigente nas escolas e nas práticas profissionais, com vistas à qualificação do trabalho, da formação e da atenção à saúde. Objetivo - Conhecer e compreender os dispositivos e arranjos da gestão municipal para a integração ensino-serviço-comunidade e suas conexões com a formação em saúde no SUS. Método - Investigação qualitativa do tipo estudo de caso, que busca descrever, analisar o contexto, as relações e as percepções a respeito da integração ensino-serviço-comunidade sob a perspectiva da gestão municipal. A base empírica foi constituída por 19 entrevistas semiestruturadas com gestores estaduais/regionais, gestores municipais, gestores locais, preceptores e docentes de dois municípios da região do Grande ABC/SP, e por análise documental. Os dados foram submetidos à análise de conteúdo. Resultados e discussão - Cinco categorias analíticas emergiram dos dados produzidos: o lugar da IESC na gestão municipal, os pactos interorganizacionais, os cenários de prática, os preceptores e as atividades nos cenários de prática. Dentre as conquistas nesta área, estão a diversificação dos cenários de ensino-aprendizagem, a ampliação do escopo de ações oferecidas nas unidades de saúde pela presença dos estudantes, e a retomada dos estudos pelos trabalhadores que exercem a preceptoria. As iniciativas de integração ensino-serviço-comunidade ainda revelam relações assimétricas entre instituições de ensino e sistema de saúde, com maior interferência do primeiro sobre o segundo, com pouca participação dos alunos e da população na definição das parcerias e na pactuação das ações. Os responsáveis pela Educação Permanente em Saúde devem também participar da gestão da integração ensino-serviço-comunidade nos municípios, para que se possa pensar em uma proposta mais global que vise realizar simultaneamente convênios que envolvam EPS e IESC. Ainda, mecanismos de gestão colegiada e compartilhada, de múltiplas vias entre a gestão municipal e a atenção à saúde são facilitadores ao sucesso da IESC. No entanto, faltam políticas que assumam que o SUS é escola de forma contundente, com adequada legislação e financiamento que possibilitem as condições para a melhoria da formação, da gestão, da atenção e do controle social. / Introduction- The teaching-service-community integration, during the formative process in health derives from the practices performed by students inside the hospitals, focused on the acquisition of procedural knowledge. More recently, the inclusion of students in the health services network in extrahospital settings was related to the inclusion of humanistic and social aspects in the curricula and to the adoption of integrality during higher education. The approximation between the worlds of teaching and work encompasses a complexity arising from its various actors, but also from the transformations in higher education, conception about the health-disease process, the increasing institutionalization of health work and, consequently, the management of services as organizations. The municipal managers are responsible for engendering the teaching-service-community integration and coping with the biomedical model in force in schools and professional practices, with a view to qualifying work, training and health care. Objective - To know and understand the devices and arrangements of municipal management for the teaching-service-community integration and its connections with health education in SUS. Method - Qualitative research of the case study type, which seeks to describe, analyze the context, relationships and perceptions regarding the teaching-service-community integration from the perspective of municipal management. The empirical basis consisted of 19 semi-structured interviews with state / regional managers, municipal managers, local managers, preceptors and teachers from two municipalities in the region of the Grande ABC/SP, and by documentary analysis. The data were submitted to content analysis. Results and discussion - Five analytical categories emerged from the data produced: the place of the IESC in municipal management, the interorganizational pacts, the practice scenarios, the preceptors and the activities in the practice scenarios. Among the achievements in this area are the diversification of the teaching-learning scenarios, the expansion of the scope of actions offered in the health units by the presence of the students, and the resumption of studies by the workers who perform the preceptory. The initiatives of teaching-service-community integration still reveal asymmetrical relations between educational institutions and health system, with greater interference from the first to the second, with little participation of the students and the population in the definition of partnerships and in the agreement of actions. Those responsible for Permanent Education in Health should also participate in the management of the teaching-service-community integration in the municipalities, so that a more global proposal can be considered that will simultaneously carry out agreements involving EPS and IESC. Also, collegial and shared management mechanisms, with multiple paths between municipal management and health care, are facilitators of IESC\'s success. However, there is a lack of policies that assume that the SUS is a school, with adequate legislation and funding to enable conditions for the improvement of training, management, health care and social control.
212

MBSE-Ansatz für eine Vernetzte Stoffstrommodellierung zur Verbesserung der Partnersuche in der Kreislaufwirtschaft

Wieck, Franz, Kronenberg, Philipp, Löwer, Manuel 07 September 2021 (has links)
Globale Krisen, Rohstoffengpässe oder Preisschwankungen stellen die globalisierten Lieferkettensysteme der westlichen Produzenten vor große Herausforderungen. Das Konzept der Kreislaufwirtschaft ist eine Möglichkeit, sich angesichts dieser Herausforderungen robuster zu positionieren, um weniger abhängig von äußeren Einflüssen zu sein. Die größte Hürde bei dem Aufbau von Netzwerken für Kreislaufwirtschaftsprozesse ist die Identifikation von potentiellen Partnern auf Basis von Stoffstrommodellen. Ein erfolgreiches Mapping ist von vielen Faktoren abhängig. Aktuell existiert kein Ansatz, um die Stoffströme so zu modellieren, dass die Darstellung und Berechnung für eine Partnersuche in der Kreislaufwirtschaft geeignet ist. Um der Komplexität, sowohl der Stoffstrommodellierung, als auch der Partnersuche gerecht zu werden, wird hier ein MBSE-Ansatz gewählt - ein überlegener Modellierungsansatz im Detaillierungsgrad und der Adaptionsfähigkeit. Das Modell verknüpft die 3 Hauptelemente der Wertstromanalyse (Produktionsprozess, Materialfluss und Geschäftsprozess) und ermöglicht dadurch neuartige Kennzahlen zu ermitteln. Diese Kennzahlen und die detaillierte Modellierung schaffen eine verbesserte Informationslage, auf Basis derer die Effektivität der Partnersuche in der Kreislaufwirtschaft signifikant gesteigert wird. Nach einer theoretischen Herleitung der Modellierungslogik und der Erweiterung des bestehenden Ansatzes der nachhaltigen Wertstromanalyse (engl. Sustainable Value Stream Mapping – Sus-VSM) wird anhand eines Beispiels das MBSE-Modell implementiert und validiert. Dieser MBSE-Ansatz besitzt das Potential, die Beschreibung industrieller Produktions- und Herstellungsprozesse erheblich zu verfeinern und dadurch Analysen und Berechnungen zu optimieren, was zu einer besseren Vernetzung der Industrie führt. Die dadurch identifizierten industriellen Symbiosen fördern die Kreislaufwirtschaft maßgeblich und helfen Ressourcen nachhaltiger zu nutzen.
213

Naturbetesmarker & vildsvin : En kvalitativ studie om vildsvinsskador på naturbetesmark från markägarnas perspektiv / Pasturelands & wild boars : A qualitative study about wild boar damages on pasturelands from the landowners´ perspective

Johansson, Emil, Ågren, Jeanette January 2021 (has links)
Naturbetesmarker är ett av de artrikaste markslagen vi har, för att hålla dem öppna med betande djur finns ett miljöstöd från landsbygdsprogrammet utformat för att gynna den biologiska mångfalden. Vildsvinen (Sus Scrofa) har under de senaste årtiondena ökat markant, vilket har lett till stora ekonomiska konsekvenser för lantbruket genom skador på jordbruksmark. Av tidigare forskning kan vi se att skadorna inte påverkar den biologiska mångfalden negativt. Biologisk mångfald är en central del i det miljöstöd som lantbrukarna får för att hålla sina naturbetesmarker öppna. Men vad säger markägarna om vildsvinsproblematiken på naturbetesmark och hur ser de på framtiden? Studien utgår från markägarnas perspektiv, där vi undersöker hur markägarna upplever vildsvinsskador på deras naturbetesmarker och hur skadorna påverkar deras skötsel. Vi undersöker även hur markägarna upplever den rådgivning och stöd som de får från berörd myndighet samt vilka förändringar de vill se i vildsvinsförvaltningen. Vi valde i studien att använda oss av kvalitativa forskningsintervjuer, där sex markägare intervjuades. Resultatet i studien visar att markägarna upplever att det största problemet är att skadorna är tidskrävande och kostsamma att rätta till. Det framkom även kritik mot dagens utformning av miljöstödet och att trycket från vildsvinsstammen måste minska för att man ska orka att hålla sina marker öppna i framtiden. Slutsatsen är att det måste till ett större helhetsgrepp kring vildsvinsförvaltningen för att minska skadorna och mer individuell rådgivning för den enskilda markägaren. / Pasturelands is a land with high biodiversity, in order to keep them open with herbivores, there is environmental support from Landsbygdsprogrammet designed to benefit the biological diversity. Wild boars (Sus Scrofa) have increased markedly in recent decades, which has led to major economic consequences for agriculture and it´s land. From previous research, we can see that the damage does not adversely affect biodiversity. Biodiversity is a central part of the environmental support that the farmers receive to keep their pasturelands open. But what does landowners say about the problems with wild boar on pasturelands and how do they look on the future? The study is based on the landowners ‘perspective, we examine how landowners experience wild boar damage to their pasturelands and how the damage affects their management. We also examine how landowners experience the advice and support they receive from the authority and what changes they want to see in wild boar management. In the study, we choose to use qualitative research interviews, in which six landowners were interviewed. The result of the study show that landowners feel that the biggest problem is that the damage is time-consuming and costly to repair. There was also criticism of today´s design of environmental support and the pressure from the wild boar population must be reduced in order to keep their land open in the future. The conclusion is that there must be a greater holistic approach to wild management to reduce the damage and more individual advice for the individual landowner.
214

Validitet och användbarhet av appen Vitala : Med fokus på applikationens rehabiliteringsdel / Validity and usability of the application Vitala : Focus on the section for rehabilitation in the application

Lindqvist, Emil, Åslin, Fredrik January 2022 (has links)
Introduktion: Långvarig smärta kostar samhället mycket pengar varje år. Under 2020 och 2021 utvecklades applikationen Vitala som stöd för patienter med behov av fysisk aktivitet i sin rehabilitering av sjukdomar. I applikationen ingår en del som syftar till rehabilitering för personer med muskuloskeletala besvär i nacke, axlar, rygg och höft. Den här studien är den första av sitt slag som utvärderar rehabiliteringsdelen i Vitala. Syftet med denna studie var att undersöka användbarhet, deltagarnas förståelse för applikationens frågor och instruktioner, samt relevansen av Vitalas val av övningar för deras smärtmekanismer. Metod: Tio studiedeltagare med besvär i nacke-/skuldra och ländrygg-/höft sedan ≥4 veckor rekryterades genom en privat fysioterapi- och naprapatklinik i Stockholm. Deltagarna observerades när de använde applikationen för att diagnostisera sina besvär och deras förståelse för appens frågor och tester bedömdes. Efter användning skattades användbarhet genom frågeformulär (Health-ITUES och System Usability Scale). Validitet undersöktes genom att jämföra funktionsdiagnos och övningar som förskrevs av Vitala med en erfaren fysioterapeuts bedömning av funktionsdiagnos och rekommenderade övningar. Resultat: Användbarheten i rehabiliteringsdelen skattades mellan mycket bra och bästa tänkbara. Studiedeltagarna förstod frågor och instruktioner i 88% av fallen. Applikationens funktionsdiagnoser var i linje med fysioterapeutens i 9 av 10 fall. Överensstämmelsen av övningarna var fullständiga för fem av deltagarna, fyra saknade något element och endast en bedömdes bristfällig. Konklusion: Studiedeltagarna visade en god förståelse för Vitalas frågor och instruktioner, vilket var i linje med deras egna skattningar där appen bedömdes vara lätt att använda. En viss svårighet med att förstå vad som menades med begreppen smärta och besvär uppstod hos en del. Vitala hade en god överensstämmelse gällande övningar och funktionsdiagnos, med undantag för deltagare med patoanatomiska förändringar eller nociplastiska smärttillstånd.
215

Informationssystem anpassade för nöjesparker utifrån säsongsanställdas perspektiv; En studie av användbarhet

Lindholm, Fredrik January 2023 (has links)
Inom organisationer och företag har IT-stöd blivit allt viktigare för organisationens konkurrenskraftighet och för att upprätthålla effektiva processer. En viktig aspekt i utvecklingen av IT-system är användbarhet. Denna studie utgick från frågeställningen “Hur väl fungerar managementsystem på nöjesparker utifrån säsongsanställdas perspektiv?”. Tidigare studier utförda på nöjesparker har inte analyserat managementsystem utan istället fokuserat på hur arbetsgivare kan motivera de anställda att arbeta vidare inom nöjesparken och vilka aspekter som är viktiga för att uppnå detta. Denna studie belyser användbarheten och förbättringsåtgärderna av de managementsystem som används av de säsongsanställda inom Parks and Resorts Scandinavia, som driver nöjesparkerna Furuvik, Gröna Lund, Kolmårdens Djurpark och Skara Sommarland. Koncernen använder sig idag av två olika managementsystem som är inköpta av två olika företag. I denna studie analyserades de olika systemen separat utifrån användbarhet och förbättringsåtgärder för respektive system. Till denna studie valdes en kvantitativ metod och en enkät skickades ut till personer som varit säsongsanställda under 2022 inom koncernen. Enkäten skickades ut till 5173 personer som varit säsongsanställda inom koncernen 2022 och för att mäta användbarheten användes System Usability Scale (SUS) av Brook (1996). Resultatet av studien visade att systemen fick ett SUS betyg på 73,34 respektive 72,77, vilket ansågs som ett relativt bra resultat för användbarheten. Resultatet visade även en trend att de yngre säsongsanställda jämfört med de äldre säsongsanställda, gav systemen ett högre betyg för användbarheten och att de båda systemen hade högre användbarhet på mobiltelefoner med operativsystemet iOS än andra plattformar. Beträffande förbättringsåtgärderna av systemen fanns det förslag från de säsongsanställda att schemat ska vara mer lättåtkomligt, att systemen ska vara lättare att navigera i och att informationen ska vara mer relevant för säsongsanställda. Resultatet av denna studie ger ny kunskap kring användbarhet av managementsystem som används inom nöjesparker och hur de kan anpassas utifrån de säsongsanställdas behov. / Within organizations and companies, IT support has become increasingly important for the organization's competitiveness and for maintaining efficient processes. An important aspect in the development of IT systems is usability. This study was based on the question "How well do management systems work at amusement parks from the perspective of seasonal employees?". Previous studies carried out on amusement parks have not analyzed management systems but instead focused on how employers can motivate employees to continue working within the theme park and which aspects are important to achieve this. This study highlights the usability and improvement measures of the management systems used by the seasonal employees within Parks and Resorts Scandinavia, which operates the amusement parks Furuvik, Gröna Lund, Kolmårdens Djurpark and Skara Sommarland. The group currently uses two different management systems that are purchased from two different companies. In this study, the different systems were analyzed separately based on usability and improvement measures for each system. A quantitative method was chosen for this study and a questionnaire was sent out to people who were seasonally employed during 2022 within the group. The questionnaire was sent out to 5173 people who had been seasonally employed within the group in 2022 and to measure usability the System Usability Scale (SUS) by Brook (1996) was used. The results of the study showed that the systems received a SUS rating of 73.34 and 72.77, respectively, which was considered a relatively good result for usability. The result also showed a trend that the younger seasonal employees, compared to the older seasonal employees, gave the systems a higher rating for usability and that both systems had higher usability on mobile phones with the iOS operating system than other platforms. Regarding the measures to improve the systems, there were suggestions from the seasonal employees that the schedule should be more easily accessible, that the systems should be easier to navigate, and that the information should be more relevant for seasonal employees. The results of this study provide new knowledge about the usability of management systems used in amusement parks and how they can be adapted based on the needs of the seasonal employees.
216

Changes In Neolithic Subsistence Patterns On Flores, Indonesia Inferred By Stable Carbon, Nitrogen, And Oxygen Isotope Analyses Of Sus From Liang Bua

Munizzi, Jordon 01 January 2013 (has links)
Despite an abundance of archaeological material recovered from sites in Island Southeast Asia, the timing and route by which cultigens first arrived in Wallacea remains unclear. Many of the staple crops now grown on these islands were domesticated in mainland Asia, and were deliberately introduced by humans at an unknown point during the Holocene, through several possible routes. In this study, the δ 13C, δ15N and δ18O values of subfossil bones and teeth attributed to Sus celebensis and Sus scrofa are analyzed. These materials, which span the last 5160 years at Liang Bua, Flores, Indonesia are used to determine if and when there was a shift towards agricultural intensification, and whether this intensification included the integration of domesticated C4 crops. The δ13C and δ15N values of the bone and dentin collagen samples indicate an abrupt shift towards enrichment in 13C and depletion in 15N at some time between 5160 and 2750 yBP. This hints at changes in human subsistence patterns that may have included the clearing of forests, and the integration of nonendemic C4 cultigens such as foxtail millet (Setaria italica) onto the island. No statistically significant variation in the δ 18O values of the enamel carbonate samples over time is observed, suggesting that once they appeared on Flores, semidomesticated pigs became an important part of the island ecosystem, and were bred and raised on Flores instead of being continuously imported from elsewhere.
217

Evaluation on Mobile Application for Health Intervention

Eliasi, Behnam January 2022 (has links)
With the rise of portable devices, the interest in health and medical applications(mhealth applications) has risen, and the importance of evaluating these applications is critical. The application stores on portable devices only require a good application quality and not the content. The content of the medical health applications could be harmful and need to be evaluated to decrease the potential health risks. In this report, a new mobile health application named POSITIVE gets evaluated with the help of interviewed questionnaires and user­personas. The POSITIVE application target is the older population with their aim to maintain and improve the intrinsic capacity involving primary care and caregivers. POSITIVE application content is monitored by customized exercise programs with medical tests with associated help devices.  The evaluation was done by creating user personas that give a user overview. User personas were designed with the help of data obtained through a interview protocol. The interview protocol was design for this specific evaluation with the help of research questionnaire tools. Questionnaire tools used for creating the interview protocol were the system usability scale(SUS), service user technology acceptability questionnaire(SUTAQ), patient activation measure(PAM), elderly information technology ability tool(EITAT), and mobile health app usability questionnaire(MAUQ) The results show that participants with a higher level of health problems had a lower exercise activity in the application. Participants with lower health problems have a higher exercise activity. Both participants’ groups liked the application’s design and felt it motivated them. Critiques towards the application were to have better customized exercises. / Med smarta mobila enheter växande tillgång har interesset för hälso och medicinska applikationer ökat där vikten att utvärdera dessa applikationer är mycket viktigt. Applikationsbutiker på mobila enheter har endast krav på bra kvalitet på funktioner men inte innehållet av applikationerna. Innehåll av medicinska eller hälsoapplikationer kan vara skadliga och behöver därför genomgå en utvärdering för att minska potentiella hälsorisker.  I denna rapport kommer en ny hälsoapplikation kallad POSITIVE att presenteras samt evalueras med hjälp av intervju protokoll och user personas. POSITIVEs målgrupp är den äldre populationen där deras mål är att förebygga skörhet bland äldre genom att involvera närstående, patienten samt primärvården. Applikationen innehåller ett anpassat och övervakat träningsprogram med medicinska tester som görs medtillhörande utrustning.  Evaluering utförs genom att skapa en ”user persona” som ger en överblick över användarna. User personan utformas med hjälp av data som erhålls genom intervju protokoll. Intervjuprotokollet är utformat med hjälp av forskade frågeformulärsverktyg. Frågeformulärsverktyg som använts till utformningen är system usability scale(SUS), service user technology acceptability questionnaire(SUTAQ), patient activation measure(PAM),eldery information technology ability tool(EITAT) och mobile health app usabilityquestionnaire(MAUQ). Resultatet visar att deltagare med fler hälsoproblem har mindre aktivitet i applikationen. Deltagare med mindre hälsoproblem har högre aktivitet i applikationen. Båda grupperna gillade designen på applikationen som ökade deras motivation. Kritik mot applikationen är att det borde funnits bättre anpassad träningsprogram.
218

Use of Drop-nets for Wild Pig Damage and Disease Abatement

Gaskamp, Joshua Alden 14 March 2013 (has links)
Numerous trap designs have been used in efforts to capture wild pigs (Sus scrofa); however, drop-nets have never been examined as a potential tool for wild pig control. I implemented a 2-year study to compare the effectiveness and efficiency of an 18.3 x 18.3 m drop-net and a traditional corral trap for trapping wild pigs. In spring 2010, treatment units were randomly selected and multiple trap sites were identified on 4,047 ha in Love County, Oklahoma. Trap sites were baited with whole corn and monitored with infrared-triggered cameras during pre-construction and capture periods. Unique pigs using trap sites were identified 5 days prior to trap construction and used in mark-recapture calculations to determine trap effectiveness. Three hundred fifty-six pigs were captured in spring of 2010 and 2011. I documented maximum captures of 27 and 15 pigs with drop-nets and corral traps, respectively. I removed 86 and 49% of the unique pigs from treatment units during the course of the study using drop-nets and corral traps, respectively. Catch per unit effort was 1.9 and 2.3 h/pig for drop-nets and corral traps, respectively. Wild pigs did not appear to exhibit trap shyness around drop-nets, which often facilitated the capture of entire sounders in a single drop. Use of drop-nets also eliminated capture of non-target species. During my study, damage by wild pigs was reduced by 90% across the study area, verifying control reduces damage on native rangelands. Population monitoring for pseudorabies virus, brucellosis, and porcine reproductive and respiratory syndrome resulted in exposure rates of 24, 0.4, and 0.4%, respectively. Removal of wild pigs reduced rooting damage and probability of encountering pig borne diseases of importance to livestock and human health. My research confirms drop-nets can be an effective tool for removal of wild pigs.
219

Razvoj metoda dijagnostike usisnog sistema motora sa unutrašnjim sagorevanjem / Development of an IC Engine Intake Air Path Fault Diagnosis Method

Nikolić Nebojša 03 July 2015 (has links)
<p style="text-align: justify;">U radu je razvijen jedan matematički model za simuliranje ponašanja nekih važnih radnih parametara motora SUS, kada u njegovom usisnom sistemu postoje neispravnosti tipa: &bdquo;nepredviđeni ulaz vazduha u usisni kolektor&ldquo;, &bdquo;pogrešno očitavanje senzora masenog protoka vazduha&ldquo;, &bdquo;pogrešno očitavanje senzora pritiska u usisnom kolektoru&ldquo;, &bdquo;pogrešno očitavanje senzora temperature u usisnom kolektoru&ldquo; i &bdquo;umanjen EGR protok&ldquo;. Na osnovu rezultata ovog modela predložen je novi dijagnostički koncept, u okviru kojeg je razvijen jedan model za prepoznavanje pomenutih neispravnosti. Predloženi koncept je proveren na realnim podacima, prikupljenim ispitivanjem jednog stvarnog motora u laboratorijskim uslovima, pri čemu su dobijeni zadovoljavajući rezultati.</p> / <p>A mathematical model capable of simulating some important IC engine operating parameters behavior when a fault in its intake air path exists. The faults considered are of the following types: &bdquo;air leakage in the intake path&ldquo;, &bdquo;faulty mass air flow sensor&ldquo;, &bdquo;faulty manifold absolute pressure sensor&ldquo;, &bdquo;faulty intake air temperature sensor&ldquo; and &bdquo;clogged EGR pipe&ldquo;. Relying on the data obtained by the fault simulator, a novel diagnosis concept is proposed. A model for fault detection and diagnosis was developed in the scope of the concept. The proposed concept was tested on the real data collected from an automobile IC engine in the laboratory conditions and satisfying results were obtained.</p>
220

Caracterização do serviço de odontologia hospitalar em um hospital de ensino / Characterization of an Oral Medicine Service in a Brazilian teaching hospital

Costa, Leandro Fabiano Alves da 07 February 2018 (has links)
A prestação do serviço de Odontologia dentro do ambiente hospitalar teve início devido aos benefícios observados com o trabalho de equipes multidisciplinares no cuidado com a saúde. De modo geral, os pacientes são atendidos pelos cirurgiõesdentistas dentro dos hospitais terciários porque sua condição de saúde impede a realização dos procedimentos em consultórios ou unidades de saúde, devido, entre outros, à dificuldade de locomoção ou falta de equipe treinada para atender portadores de enfermidades sistêmicas. Estudos que enfocam esse tema têm observado benefícios importantes na condição de saúde do paciente. Dessa forma, o presente trabalho teve como objetivos: Caracterizar o Serviço de Odontologia Hospitalar no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP, nos seguintes aspectos: 1) assistencial: relacionar as atividades quanto ao número de atendimentos por tipo, procedência do paciente (internado ou ambulatorial), patologias de base e enfermaria específica; 2) financeiro: identificar a receita SUS dos procedimentos odontológicos realizados e identificar os custos do Serviço de Odontologia Hospitalar, e 3) percepção dos profissionais cirurgiõesdentistas e Chefes das especialidades médicas usuárias dos serviços de odontologia hospitalar, quanto aos serviços prestados, e a satisfação dos usuários pacientes. Foi realizada uma pesquisa exploratória descritiva com dados relativos ao ano de 2016, através de um estudo de caso. Para identificar a percepção dos profissionais e satisfação dos pacientes com os serviços odontológicos prestados pelo Hospital foram aplicados (em 2017) questionários específicos. Os resultados demonstraram prevalência de atendimentos ambulatoriais, sendo que os principais procedimentos realizados foram tratamentos periodontais, cirurgias e laserterapia. Quanto ao aspecto financeiro, observou-se que nem todos os procedimentos são reembolsados pelo SUS e seus custos ultrapassam o valor recebido. A receita media SUS e o custo por atendimentos foram R$ 59,91 e R$ 5,36 respectivamente. O estudo permitiu também concluir que a percepção / satisfação nas três esferas analisadas é positiva em relação do serviço prestado. Espera-se que as informações encontradas forneçam subsídios para a melhoria contínua do serviço existente dentro do hospital, bem como para outros gestores que desejam implantar a Odontologia Hospitalar em outros centros de referência. / The provision of Dentistry service within the hospital environment began due to the benefits observed with multidisciplinary healthcare providers working together. In general, patients are attended by dentists at tertiary referral hospitals because their health condition which prevents the procedures to be performed in the clinic or health units, due, among others, to the difficulty of locomotion or lack of trained personnel to attend patients with systemic diseases. Studies that focus on this theme have observed important benefits in patient\'s health condition. Thus, the present study aimed to characterize the activities and procedures performed by the team of dental surgeons at Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP in 2016 under the following aspects: 1) assistential: to relate the activities regarding the number of attendances according to the patient origin (ambulatory or nursery) and base pathology; 2) financial: identify the oral care procedures SUS revenues obtained and the costs incurred providing the service, and 3) stakeholders perception / satisfaction: evaluate the perception / satisfaction regarding the contribution of the service in the three mains spheres that comprise it: the dentists who provides care, the physician who works together with the dentistry staff and the patient. To meet these objectives, the descriptive exploratory research was chosen through case reports. To measure the perception / satisfaction specific questionnaires were applied for each group in 2017. The results demonstrated the prevalence of ambulatory care and the main procedures performed were periodontal treatments, surgeries and laser therapy. As for the financial aspect, it was observed that the service is deficient, since not all procedures are reimbursed by SUS and the costs exceed the amount received. In average, SUS reimbursed R$5,36 per procedure while the calculated costs were R$ 59,91. The study also concluded that the perception / satisfaction in the three spheres analyzed are positive in relation to the service provided. It is expected the results obtained will provide subsidies for the continuous improvement of the existing service within the hospital, as well for other managers who wish to implement Oral Service Medicine in other referral hospitals.

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