Implementação de uma estratégia de abastecimento de consumíveis atendendo a princípios Lean Thinking numa unidade de mobilidade elétrica

Dissertação de mestrado em Engenharia IndustrialO presente trabalho resulta de um projeto de dissertação inserido no âmbito do 4º semestre do Mestrado em Engenharia Industrial da Universidade do Minho. O principal objetivo do projeto incidiu na melhoria dos métodos de aprovisionamento e abastecimento de consumíveis na Fábrica Norte da Efacec Electric Mobility, através da aplicação de supermercados de fabrico e de outras ferramentas Lean. Para o cumprimento dos objetivos estabelecidos foi utilizada a metodologia de investigação Action Research. Esta investigação foi iniciada com uma revisão bibliográfica aos conceitos de Lean Prodution, gestão de stocks e Ergonomia. Seguiu-se uma breve apresentação do grupo Efacec e da empresa Efacec Electric Mobility, e encetou-se a análise crítica da situação atual com a caracterização da Fábrica Norte, onde foram identificados alguns problemas. Neste processo de diagnose foi utilizado um conjunto de ferramentas onde se inclui a análise ABC, o diagrama causa-efeito, a análise de Pareto, o diagrama de spaghetti, o diagrama BPML e o diagrama de sequência. Posteriormente, foram apresentadas propostas de melhoria assentes na aplicação de princípios e ferramentas Lean, nomeadamente, o Kaizen, os 5S, o Stantard Work e a Gestão Visual, com o objetivo de melhorar o funcionamento dos processos de aprovisionamento, abastecimento e o sistema produtivo na sua generalidade. Com a implementação dos supermercados de fabrico foi possível reduzir o valor do capital imobilizado em 7.000€. Foi ainda possível reduzir significativamente as distâncias percorridas pelos colaboradores, através da implementação do Mizusumashi, que se reflete numa redução das movimentações dos colaboradores, avaliada em cerca de 1.600€ anuais. A adoção do modelo proposto para a gestão dos artigos em armazém permitiria à empresa poupar um valor médio de 4.000€ em capital imobilizado. Os ganhos obtidos com os procedimentos criados para o processo de levantamento das necessidades de compra traduzem-se numa redução superior a 50% no tempo total de execução, para a qual também contribuiu a melhoria implementada na identificação dos artigos. A dashboard criada para o departamento de produção veio facilitar e agilizar a comunicação entre os diferentes setores da empresa. As restantes propostas foram enquadradas na persecução da melhoria contínua, direcionada a todos os colaboradores da empresa.This work is the output from the dissertation project which was developed during the 4th semester of the Master in Industrial Engineering of the University of Minho. The main objective was to improve the provision and supplying methods of consuming goods on one of Efacec Electric Mobility's factories (Fábrica Norte), thru the implementation of supermarket systems and other Lean tools and techniques. To achieve the established objectives for the project the research methodology used was Action-Research. This research started with a state-of-the-art review of Lean Production, inventory management and ergonomic concepts. Following this there was a brief presentation of the Efacec Corporation, focusing on Efacec Electric Mobility, and triggered an analysis of the as-is scenario which covered a characterization of the factory, identifying the main issues. During this diagnosis process, a set of tools was put in place such as the ABC analysis, cause-effect diagrams, Pareto analysis, spaghetti diagrams, BPML diagrams and the sequence diagrams. Furthermore, several solutions were presented based on Lean principles and tools such as Kaizen, 5S, Standard Work and Visual Management, which aimed to improve the provisioning, supplying and the production systems as a whole. The implementation of these supermarkets enabled a shrinkage of 7.000€ of the fixed asset along with another 4.000€ coming from the adoption of the proposed warehouse item's management model Another save was in the distance each employee had to cover per day which was achieved thru the implementation of Mizusumashi - this reflected a benefit of 1.600€ per year. Implementing the standard procedures for the requirement process has brought a 50% reduction of the execution times, value enhanced by the improving on item identification. Another considerable benefit, not measurable though, was the new production department's dashboard which enabled an easier and closer communication between the various departments within the company. All the remaining solution proposals are based on the idea of pursuit of continuous improvement, oriented to all employees

Atividades de promoção e prevenção em saúde em unidade ambulatorial geronto-geriátrica

En estudios encima de las alteraciones músculo esqueléticas en ancianos, observamos la carencia en losservicios de salud de una propuesta alternativa para minimizar los problemas ocasionados por estas alteracionesdel cotidiano de estos pacientes. Por lo tanto, se hace necesario preparar la población para entendereste proceso, utilizando el conocimiento y actividades que puedan promover una mejor calidad de vida.Objetivos: estimular en los alumnos de la graduación el aprendizaje de la gerontología/geriatría/reumatología;elevar la autoestima del anciano usando el conocimiento adquirido en el cuidado con la salud; identificarlas principales quejas de los ancianos en relación a las Alteraciones músculo esqueléticas. Metodología:Inicialmente los alumnos de graduación participaron del proceso de sensibilización y capacitación, utilizándosecomo estrategias: dinámicas de grupos entre otras técnicas, posteriormente fueron realizadostalleres temáticos con los ancianos seleccionados para participar del proyecto. Durante el desarrollo de lasactividades en grupos los temas trabajados estaban relacionados a las alteraciones músculo esqueléticas.Resultados: sensibilización y capacitación de los 04 alumnos de graduación del curso de Medicina en el áreageronto geriátrica y reumatológica, mayor conocimiento sobre las alteraciones y mejora en las actividadesde la vida cotidiana de los ancianos participantes de los talleres. Conclusión: las dinámicas desarrolladasen los talleres proporcionaron una mejora en la calidad de vida de los ancianos asistidos en el serviciominimizando los problemas de salud.Studies about elderly changes in muscle-skeletal disorders highlights the health service problems, whichdemands an alternative proposal to minimize the problems caused by those alterations in the daily lifeof the patients. Therefore, it is necessary to prepare the population to understand that process, through knowledge and activities that can promote a better life quality. Objectives: Stimulate undergraduate studentsto learn gerontology / geriatrics / rheumatology; raise the elderly self esteem using the gained knowledgeabout health care; identify elderly principal complaints related to muscle-skeletal changes. Methodology:Initially, undergraduate students participated in an awareness and capacitating process using strategies as:group dynamics, among other techniques; later, thematic workshops were held with elderly selected subjectschose to participate in the project. During the group activities, the developed themes were related to muscle-skeletal changes. Result: awareness and capacitation of 04 undergraduate students from the Medicinecourse in rheumatology and geront-geriatric, greater knowledge about alterations and improvement in thedaily life activities of the 26 elderly participants of the workshops. Conclusion: the developed dynamicsat the workshops provided an improvement in life quality of the elderly that are assisted by that service,minimizing their health problems.Em estudos sobre as alterações músculo-esqueléticas em idosos, observamos a carência nos serviços de saúde de uma proposta alternativa para minimizar os problemas ocasionados por essas alterações no dia a dia desses pacientes. Portanto, faz-se necessário preparar a população a entender este processo, utilizando o conhecimento e atividades que possam promover uma melhor qualidade de vida. Objetivos: Estimular, nos alunos da graduação, o aprendizado da gerontologia/geriatria/reumatologia; elevar a autoestima do idoso usando o conhecimento adquirido no cuidado com a saúde; identificar as principais queixas dos idosos em relação às alterações músculo-esqueléticas. Metodologia: Inicialmente os alunos de graduação participaram de processo de sensibilização e capacitação, utilizando-se como estratégias: dinâmicas de grupos, entre outras técnicas; posteriormente foram realizadas oficinas temáticas com os idosos selecionados a participar do projeto. Durante o desenvolvimento das atividades em grupos, os temas trabalhados estavam relacionados às alterações músculo-esqueléticas. Resultados: sensibilização e capacitação dos 04 alunos de graduação do curso de Medicina na área geronto-geriátrica e reumatológica; maior conhecimento sobre as alterações e melhoria nas atividades de vida diária dos 26 idosos participantes das oficinas. Conclusão:as dinâmicas desenvolvidas nas oficinas proporcionaram uma melhoria na qualidade de vida dos idosos assistidos no serviço, minimizando os problemas de saúde

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research