The value of TPM for Portuguese companies

Purpose – The purpose of this paper is to assess the impact of a maintenance philosophy, Total Productive Maintenance (TPM), on the operational performance of the Portuguese industry, identifying how it enables the systematic reduction of waste in maintenance. Design/methodology/approach – A structured questionnaire was constructed and sent to 472 Portuguese enterprises, having obtained a sample constituted of 84 valid answers. With a five-point Likert scale, it was possible to assess the impact of the TPM on five operational performance dimensions, being them: quality, flexibility, productivity, safety and costs. Findings – It was found that the planned maintenance, together with education and training are the practices with the highest degree of implementation in the Portuguese industry, exceeding 70% for both. The productivity is the dimension with a higher degree of impact from the implementation of TPM and costs the dimension that suffered a lesser impact. Practical implications – This paper shows and analyses the current state of TPM implementation in the Portuguese industry and it will be useful for maintenance professionals, researchers and others concerned with maintenance, in order to understand the effects of TPM implementation on the operational performance of the Portuguese industries. Originality/value – The findings from this paper will be valuable for professionals who desire and are looking forward to implement an effective maintenance approach in the maintenance management system, in order to achieve the excellence in maintenance.info:eu-repo/semantics/publishedVersio

Hanseníase na região norte do Brasil: epidemiologia das internações nos últimos dez anos (2013-2022)

Objetivo: Caracterizar o perfil epidemiológico das internações por hanseníase na região norte do Brasil nos últimos dez anos. Métodos: Trata-se de um estudo transversal, retrospectivo, de perspectiva quantitativa, no qual os dados foram coletados a partir do Departamento de Informática do Sistema Único de Saúde - DATASUS - entre os anos de 2013 e 2022. As variáveis pesquisadas foram: total de internações, sexo, cor/raça e faixa etária. O período da pesquisa foi delimitado entre janeiro de 2013 e dezembro de 2022. Resultados: Foram registradas 3.115 internações por hanseníase entre os anos de 2013 e 2022. O maior número de casos foi registrado no ano de 2013, 440. O estado com maior número de casos foi o Tocantins, com 891 notificações. O sexo masculino foi responsável pela maioria das notificações, 2.238, e o sexo feminino registrou 915. A cor/raça parda apontou 1.902 internações. A faixa etária com o maior número de hospitalizações foi a de 40 a 49 anos, 589 casos. Conclusão: O número de internações por hanseníase apresenta um caráter oscilatório e aumentou nos últimos dois anos. O perfil epidemiológico das internações foi caracterizado por indivíduos do sexo masculino, pardos e na faixa etária de 40 a 49 anos

A social and ecological assessment of tropical land uses at multiple scales: the Sustainable Amazon Network

Science has a critical role to play in guiding more sustainable development trajectories. Here, we present the Sustainable Amazon Network (Rede Amazonia Sustentavel, RAS): a multidisciplinary research initiative involving more than 30 partner organizations working to assess both social and ecological dimensions of land-use sustainability in eastern Brazilian Amazonia. The research approach adopted by RAS offers three advantages for addressing land-use sustainability problems: (i) the collection of synchronized and co-located ecological and socioeconomic data across broad gradients of past and present human use; (ii) a nested sampling design to aid comparison of ecological and socioeconomic conditions associated with different land uses across local, landscape and regional scales; and (iii) a strong engagement with a wide variety of actors and non-research institutions. Here, we elaborate on these key features, and identify the ways in which RAS can help in highlighting those problems in most urgent need of attention, and in guiding improvements in land-use sustainability in Amazonia and elsewhere in the tropics. We also discuss some of the practical lessons, limitations and realities faced during the development of the RAS initiative so far.Keywords: Social–ecological systems, Tropical forests, Land use, Interdisciplinary research, Sustainability, Trade-off

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Experiencia didáctica del aprendizaje de la Matemática en la Universidad Internacional Sek – Ecuador

In all levels of education, for a good percentage of students, mathematics is one of the subjects that are more difficult to learn. For the university, is no exception in this issue, there may be some factors, such as: the methodology, academic rigor, objectives and expected learning outcomes, the interests of students, the minimum knowledge, etc. In this context, it is important to emphasize the importance of this science to the various professions, especially engineering, thus constituting one of the pillars supporting technical careers. In this document, deficiencies in mathematics to high school graduates enter college, in the case of the UISEK, real income profiles will be compared with the cases that reach high school profiles with the new educational model of education will be described average. A methodology is raised to improve the teaching - learning mathematics students in first semester of engineering from UISEK Ecuador.KEYWORDS: Learning; Math deficiencies; methodological approach; teaching; Pedagogy.En todos los niveles educativos, para un buen porcentaje de estudiantes, la Matemática es una de las asignaturas que resulta más difícil de aprender; el caso de la universidad, no es la excepción, en esta problemática, pueden haber algunos factores, por ejemplo: la metodología utilizada, la rigurosidad académica, los objetivos y resultados de aprendizaje esperados, los intereses de los estudiantes, los conocimientos mínimos, etc. En este contexto, es importante recalcar la importancia que tiene esta ciencia para las distintas profesiones, especialmente las ingenierías, constituyéndose así, en uno de los pilares que sustentan las carreras técnicas. En este documento, se describirá las deficiencias matemáticas que presentan los bachilleres al ingresar a la universidad, en el caso particular de la UISEK, se contrastará los perfiles reales de ingreso, con los supuestos perfiles que alcanzan los bachilleres con el nuevo modelo educativo de educación media. Se plantea una propuesta metodológica para mejorar los procesos de enseñanza - aprendizaje de la matemática en los estudiantes de primeros semestres de ingeniería de la UISEK-Ecuador

Hepatic Actinomycosis

Actinomycosis is a rare disorder caused by an anaerobic gram-positive bacillus (Actinomyces), predominantly by the Actinomyces israelii species. Only 20% of cases show an abdominal manifestation, the appendix and ileocecal valve being the most frequent locations. Definitive diagnosis is based on microbiological cultures, microscopy or macroscopy examination. Nevertheless, histological examination of the percutaneous biopsy and blood microbiological cultures are rarely positives. Preoperative diagnosis is hampered by the lack of specific clinical and imaging manifestations, which often mimic malignancy. The rate of preoperative diagnosis is less than 10%, however, the outcome is excellent, with a low mortality rate. The authors describe the case of a patient who was diagnosed with primary hepatic actinomycosis only by a histological examination of the surgical specimen of left hepatectomy extended to segments V and VIII, for suspected malignant lesion. This case demonstrates the difficulties in diagnosing hepatic actinomycosis

Influence of the hydrolysis and condensation time on the preparation of hybrid materials

This work describes the hydrolytic sol-gel synthesis of silica particles prepared by a modified Stöber route, using the organofunctionalized alkoxide 3-methacryloxypropyl trimethoxysilane and tetraethylorthosilicate. The silica particles were obtained through basic catalysis from a mixture of precursor alkoxides, water, and isopropyl alcohol. Samples were prepared with change to the pre-hydrolysis and condensation time of tetraethylortosilicate, followed by addition of the organosilane 3-methacryloxypropyl trimethoxysilane. Eu3+ ions were added to the alkoxides mixture, in order to obtain structural information about the silica particles. The samples were centrifuged, washed with ethanol, and dried at 50 ºC. The xerogel was analyzed by thermogravimetric analysis, photoluminescence, transmission electron microscopy, and infrared spectroscopy. The photoluminescence spectra revealed Eu3+ lines characteristic of the ion 5D0 <img src="/img/revistas/mr/2011nahead/aop_0408-10_set.jpg" alt="" align="absmiddle"> 7F J (J = 0, 1, 2, 3, 4) transition. The thermogravimetric curve and infrared spectra confirmed the presence of the alkoxide organic group and water in the materials. Transmission electron microscopy showed spherical particles with varied size. The time of pre-hydrolysis and condensation as well as the addition of 3-methacryloxypropyl trimethoxysilane affect the final shape and size of the materials, so they can be used as control factors

O impacto das próteses implantosuportadas na harmonia facial

Many patients seeking dental care wish to improve facial and smile aesthetics to be accepted in modern day society. In denture wearers, the physiological resorption causes atrophy mainly in the maxilla, being necessary to carry out reconstruction techniques and sometimes orthognathic surgery to improve occlusal stability and facial harmony. The aim of this study is to discuss the features related to the rehabilitation of edentulous patients with indication for reconstruction of the maxilla using bone grafts and orthognathic surgery by means of a clinical case. In the present case, after the prosthetic rehabilitation, the patient was full satisfied with obtained results and dismissed the initially proposed surgical protocol. Therefore, professionals should provide therapeutic options but the patient’s opinion should prevail provided its clinical feasibility.Grande parte da população que procura atendimento odontológico deseja melhorar a estética facial e a do sorriso, para ser inserida na sociedade em que vive. Nos indivíduos usuários de próteses totais, a reabsorção fisiológica causa uma atrofia, principalmente da maxila, sendo necessária a realização de técnicas reconstrutoras e, às vezes, de movimentação das bases ósseas, para maior estabilidade oclusal e harmonia facial. O objetivo deste trabalho foi abordar as características relacionadas com a reabilitação dos pacientes edêntulos, com indicação para a reconstrução dos maxilares com enxerto ósseo e cirurgia ortognática, por meio de um caso clínico. Sendo que após a reabilitação com as próteses implantossuportadas, a paciente se mostrou amplamente satisfeita com o resultado estético-funcional alcançado e se recusou a submeter-se à cirurgia ortognática proposta no planejamento. Com isso, os profissionais devem apresentar as opções terapêuticas aos pacientes, porém, deve prevalecer a queixa principal dos mesmos, desde que seja uma modalidade de tratamento viável