Outsourcing da manutenção industrial : da subcontratação às parcerias estudo de caso na Portucel Setúbal

Mestrado em Gestão e Estratégia IndustrialApresentado actualmente como importantíssimo contributo para a construção de vantagens concorrenciais das empresas, o outsourcing surge como uma ferramenta de gestão que deve ser ponderada numa perspectiva estratégica, implicando alterações organizacionais, por vezes profundas. Numa forma mais restrita, a manutenção industrial, exige uma especial ponderação por parte da empresa, matéria que é objecto de enquadramento teórico, dando expressão a um conjunto de instrumentos apoiantes da tomada de decisão. O percurso explicitado baseia-se na premissa de que o estádio do ciclo de vida das indústrias, e a sua ligação com o ciclo de inovação, ganham especial relevo na implementação de uma estratégia de outsourcing da manutenção industrial. A manutenção surge, neste contexto, como uma actividade potenciadora do ciclo de inovação no processo, beneficiando quer das parcerias efectuadas com os próprios fabricantes do equipamento, detentores por esta via da tecnologia instalada, quer através de técnicas de melhoria contínua, indutoras do aumento da eficácia e da disponibilidade dos equipamentos, conduzindo por esta via, a uma maior eficiência do processo produtivo. Assim, estabeleceram-se os limites da subcontratação como componente da estratégia empresarial e os conceitos que fundamentam a decisão estratégica em apreço, analisando-se quais as determinantes tecnológicas que levam a esta opção, num quadro em que se contemplaram as várias formas de relacionamento contratual que uma empresa pode estabelecer com os fornecedores. A partir deste enquadramento deduzem-se os critérios de escolha dos fornecedores, em coerência com os pressupostos enunciados. Para submeter a teste esta dedução, realizou-se uma pesquisa sobre um caso de experiência efectiva, concretamente na Portucel Setúbal, empresa do sector industrial da pasta e papel, através da qual se identificaram, e validaram à luz da teoria, quer os critérios adoptados para a escolha do fornecedor quer os principais contornos de relacionamento estabelecidos sobre a forma contratual.Presented nowadays as most important contribute for the construction of competitive advantages for companies, the outsourcing comes as a management tool that must be thought in a strategically perspective, implying organizational changes, sometimes profound. In a more restricted way, industrial maintenance demands a special attention from the company, a matter that is a subject within theoretical fitting, giving expression to a combination of instruments supporting the decision making. This detailed way lays on the premise that a stadium of the life cycle of the industries and its connection to the cycle of innovation, get a special relief to the implementation of an outsourcing strategy for industrial maintenance. Maintenance appears, within this context as a potential activity in the cycle of the process innovation, taking benefits either from the partnerships with the manufacturers of the equipments, by this way owners of the installed technology, and by the techniques of continuum improvement, inducing the increasing of effectiveness and availability of the equipments, leading this way to a higher efficiency in the producing process. Thus, the limits to subcontracts were established as a component of the business-related strategy and the concepts that fundament the strategic decision in regard analysing which are the technological determinants that lead to this option, within a view from where the various ways of contractual relations that a company may keep with the manufacturers were contemplated. Throughout this framing the criteria to the choice of the suppliers are deducted, coherently with the given presupposes. In order to test this deduction, a research was made on an effective case of experiment, namely at Portucel - Setúbal, company under the sector of pulp and paper industry, throughout which were identified and validated by the theoretical light, either the adopted criteria to the choice of the suppliers and the main lines of the relationship established on the contractual way.info:eu-repo/semantics/publishedVersio

Arquiteturas da saúde na segunda metade do século XIX e os modelos de ensino nas academias portuguesas

The historical intertwining of production hospitals in Brazil and Portugal in the second half of the nineteenth century demands to understand the context of training and academic work of its designers, highlighting the fundamental matrix formation up to: the drawing as design technique and representation of architecture. In this essay, we will adopt the Warburg point of view to understand the History of Art as part of a Theory of Culture, where several factors contribute to the assembly of an iconographic constellation to be read in transdisciplinary sense to allowfor the understanding of the historical, aesthetic and social role of hospitals understood as urban monuments in their respective contexts. The objects in study are the Hospital Dom Luis I of the Royal Society Portuguese Beneficent in Belém, designed in 1870 by the former student of the Academy of Fine Arts of Lisbon Frederico José Branco and the Psychiatric Hospital of Conde de Ferreira. The last belongs to Holy House of Mercy of Porto, built for this purpose in 1868, under the traces of the engineer and Full Professor of Civil Architecture Chair of the Fine Arts Academy Port Manuel de Almeida Ribeiro. These buildings are icons of the Portuguese capital investments in Brazil and Brazilian called ‘return-trip’ in Portugal, representing the Portuguese-Brazilian relations in the second half of the nineteenth century.O entrelaçamento histórico entre a construção de hospitais de raiz no Brasil e em Portugal na segunda metade do século XIX demanda a compreensão do contexto de formação e atuação acadêmica de seus projetistas, evidenciando a matriz fundamental da formação à altura: o desenho como técnica de concepção e representação da Arquitetura. Neste ensaio, adotaremos o olhar warburguiano ao entender a História da Arte como parte de uma teoria da cultura, em que fatores vários contribuem para a montagem de uma constelação iconográfica, a ser lida em sentido transdisciplinar que permita renovar e ampliar os cânones históricos preexistentes. Assim, a iconografia servirá de evidência para a compreensão do papel histórico, estético e social dos nosocômios, entendidos como monumentos urbanos em seus respectivos contextos. Temos como edifícios em foco neste estudo o Hospital D. Luiz I, da Real Sociedade Beneficente Portuguesa em Belém, projetado em 1870 pelo ex-aluno da Academia de Belas Artes de Lisboa, Frederico José Branco, e o Hospital de Alienados do Conde de Ferreira, pertencente à Santa Casa de Misericórdia do Porto, construído de raiz em 1868, sob a traça do engenheiro e lente proprietário da Cadeira de Arquitetura civil da Academia de Belas-Artes do Porto, Manuel de Almeida Ribeiro. Esses edifícios são ícones das inversões de capital de portugueses no Brasil e dos chamados brasileiros de “torna-viagem” em Portugal, representando as relações luso-brasileiras na segunda metade do século XIX

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status