Lean Safety - Estudo do impacto do Lean Seis Sigma na Segurança

Lean Seis Sigma é uma filosofia que combina a estratégia Lean e Seis Sigma, para reduzir custos e melhorar a eficiência das empresas, reduzindo a variabilidade dos processos e eliminando desperdícios e atividades que não agregam valor. Esta é uma filosofia utilizada em vários setores, cujo sucesso depende sobretudo do envolvimento da gestão, dos funcionários e do compromisso com a melhoria da satisfação do cliente. Mas quando o foco é a produtividade e otimização dos processos, manter a segurança e o envolvimento dos colaboradores pode ser um desafio. Assim, é importante que a implementações de ferramentas de melhoria contínua, tenham em conta os aspetos relacionados com a Segurança Ocupacional, uma vez que a ocorrência de incidentes podem interromper a atividade e colocar em risco toda a desempenho das empresas. O objetivo deste trabalho é avaliar de que forma a implementação desta filosofia tem impacto na Segurança e Saúde do Trabalho, em especial se a maturidade de um sistema de melhoria pode afetar a cultura de segurança da empresa. Para tal desenvolveu-se um modelo conceptual que permite relacionar a maturidade de implementação de ferramentas Lean Seis Sigma com a cultura de segurança das empresas. O modelo foi validado através da realização de um inquérito dirigido a empresas que implementam ferramentas Lean ou Seis Sigma. O estudo estatístico efetuado aos resultados obtidos do inquérito, permitiu comprovar a fiabilidade do inquérito, uma vez que o valor obtido de Alfa de Cronbach foi de 0,92. No entanto não se conseguiu comprovar estatisticamente, que a maturidade de implementação de ferramentas Lean Seis Sigma está relacionada níveis de cultura de segurança superiores. No entanto este estudo permitiu concluir que as empresas, sobretudo do setor industrial português, que participaram na amostra, utilizam maioritariamente as ferramentas 5S, Gestão visual, Standard Work, Kaizen diário e Kanban, e que a certificação nos referenciais ISO 45001 e 14001 está relacionada afeta positivamente a cultura de segurança das organizações.Lean Six Sigma is a philosophy that combines the Lean and Six Sigma strategy to reduce costs and improve the efficiency of companies, reducing the variability of processes and eliminating waste and activities that do not add value. This is a philosophy used in several sectors, whose success depends mainly on the involvement of management, employees, and commitment to improving customer satisfaction. But when the focus is on productivity and process optimization, maintaining safety and employee involvement can be a challenge. Thus, it is important that the implementation of continuous improvement tools, consider aspects related to Occupational Safety, since the occurrence of incidents can interrupt the activity and endanger the entire performance of companies. The objective of this work is to evaluate how the implementation of these philosophies has an impact on Occupational Health and Safety, especially if the maturity of an improvement system can affect the company's safety culture. To this end, a conceptual model was developed that allows to relate the implementation maturity of Lean Six Sigma tools with the security culture of companies. The model was validated by conducting a questionnaire addressed to companies that implement Lean or Six Sigma tools. The statistical study carried out on the results obtained from the survey, allowed to prove the reliability of the survey, since the value obtained from Cronbach's alpha was 0.92. It was not possible to prove statistically, that the implementation maturity of Lean Six Sigma tools is related to higher levels of safety culture. However, this study allowed us to conclude that companies, mainly from the Portuguese industrial sector, which participated in the sample, mostly use the tools 5S, Visual Management, Standard Work, Daily Kaizen and Kanban, and that the certification in ISO 45001 and 14001 is related positively affects in the safety culture of organizations

Towards single-cell bioprinting:micropatterning tools for organ-on-chip development

Organs-on-chips (OoCs) hold promise to engineer progressively more human-relevant in vitro models for pharmaceutical purposes. Recent developments have delivered increasingly sophisticated designs, yet OoCs still lack in reproducing the inner tissue physiology required to fully resemble the native human body. This review emphasizes the need to include microarchitectural and microstructural features, and discusses promising avenues to incorporate well-defined microarchitectures down to the single-cell level. We highlight how their integration will significantly contribute to the advancement of the field towards highly organized structural and hierarchical tissues-on-chip. We discuss the combination of state-of-the-art micropatterning technologies to achieve OoCs resembling human-intrinsic complexity. It is anticipated that these innovations will yield significant advances in realization of the next generation of OoC models.</p

Guiding organs-on-chips towards applications:a balancing act between integration of advanced technologies and standardization

Organs-on-chips (OoC) are in vitro models that emulate key functionalities of tissues or organs in a miniaturized and highly controlled manner. Due to their high versatility, OoC have evolved as promising alternatives to animal testing for a more effective drug development pipeline. Additionally, OoC are revealing increased predictive power for toxicity screening applications as well as (patho-) physiology research models. It is anticipated that enabling technologies such as biofabrication, multimodality imaging, and artificial intelligence will play a critical role in the development of the next generation of OoC. These domains are expected to increase the mimicry of the human micro-physiology and functionality, enhance screening of cellular events, and generate high-content data for improved prediction. Although exponentially growing, the OoC field will strongly benefit from standardized tools to upgrade its implementational power. The complexity derived from the integration of multiple technologies and the current absence of concrete guidelines for establishing standards may be the reason for the slower adoption of OoC by industry, despite the fast progress of the field. Therefore, we argue that it is essential to consider standardization early on when using new enabling technologies, and we provide examples to illustrate how to maintain a focus on technology standards as these new technologies are used to build innovative OoC applications. Moreover, we stress the importance of informed design, use, and analysis decisions. Finally, we argue that this early focus on standards in innovation for OoC will facilitate their implementation

Bioluminescence imaging on-chip platforms for non-invasive high-content bioimaging

Incorporating non-invasive biosensing features in organ-on-chip models is of paramount importance for a wider implementation of these advanced in vitro microfluidic platforms. Optical biosensors, based on Bioluminescence Imaging (BLI), enable continuous, non-invasive, and in-situ imaging of cells, tissues or miniaturized organs without the drawbacks of conventional fluorescence imaging. Here, we report the first-of-its-kind integration and optimization of BLI in microfluidic chips, for non-invasive imaging of multiple biological readouts. The cell line HEK293T-GFP was engineered to express NanoLuc® luciferase under the control of a constitutive promoter and were cultured on-chip in 3D, in standard ECM-like hydrogels, to assess optimal cell detection conditions. Using real-time in-vitro dual-color microscopy, Bioluminescence (BL) and fluorescence (FL) were detectable using distinct imaging setups. Detection of the bioluminescent signals were observed at single cell resolution on-chip 20 min post-addition of Furimazine substrate and under perfusion. All hydrogels enabled BLI with higher signal-to-noise ratios as compared to fluorescence. For instance, agarose gels showed a ∼5-fold greater BL signal over background after injection of the substrate as compared to the FL signal. The use of BLI with microfluidic chip technologies opens up the potential for simultaneous in situ detection with continuous monitoring of multicolor cell reporters. Moreover, this can be achieved in a non-invasive manner. BL has great promise as a highly desirable biosensor for studying organ-on-chip platforms.</p

Transporte inter-hospitalar do doente crítico: representação social dos enfermeiros

Background: the need for differentiated care and the completion of complementary diagnostic tests requires the interhospital transport of critically ill patients. Aim: to explore the social representation of nurses experience the interhospital transport of critical patients. Methodology: it was based on a qualitative study, of the exploratory type with a sample of 110 nurses. Data collection using online questionnaire and data analysis with the IRAMUTEQ tool. Results: through similitude analysis we verified that medication is a central nucleus, branching into: material, PCR, monitoring and stability. Conclusion: the transport of critically ill patients is likely to trigger various experiences, as it requires from nurses, in the exercise of professional responsibility, high levels of knowledge and confidence, promoters of the most appropriate choices for the quality and efficiency of care provided.Marco contextual: la necesidad de atención diferenciada y la realización de pruebas diagnósticas complementarias requiere el transporte interhospitalario de pacientes críticos. Por lo tanto, el presente estudio tuvo como objetivo analizar las experiencias de las enfermeras en el cuidado del paciente crítico durante este tipo de transporte. Objetivo: explorar la representación social de las enfermeras, experimentar el transporte interhospitalario de pacientes críticos. Metodología: se basó en un estudio cualitativo, del tipo exploratorio con una muestra constituida por 110 enfermeros. Recopilación de datos con cuestionarios en línea y análisis de datos con la herramienta IRAMUTEQ. Resultados: através del análisis de similitud se verificó que la medicación es el núcleo central, ramificándose en: material, PCR, monitorización y estabilidad. Conclusión: es probable que el transporte de pacientes en estado crítico desencadene diversas experiencias, como exige de las enfermeras, en el ejercicio de la responsabilidad profesional, altos niveles de conocimiento y confianza, promotores de las opciones más apropiadas para la calidad y eficiencia de la atención brindada.Enquadramento: a necessidade de cuidados diferenciados e realização de exames complementares de diagnóstico obriga a que se proceda ao transporte inter-hospitalar do doente em estado crítico. Objetivo: explorar a representação social dos enfermeiros experienciam sobre o transporte inter-hospitalar do doente crítico. Metodologia: estudo qualitativo, do tipo exploratório com uma amostra constituída por 110 enfermeiros. Recolha de dados com recuso a questionário online e análise de dados com a ferramenta IRAMUTEQ. Resultados: através da análise de similitude verificou-se que a medicação é o núcleo central da interpretação das vivências dos enfermeiros no transporte inter-hospitalar do doente crítico, ramificando-se em quatro: material, paragem cardiorrespiratória, monitorização e estabilidade. Conclusão: o transporte do doente crítico é suscetível de despoletar diversas vivências, por exigir do enfermeiro, no exercício da responsabilidade profissional, elevados níveis de conhecimento e confiança, promotores das escolhas mais adequadas à qualidade e eficiência dos cuidados prestados

Composição e abundância de macrófitas num troço do rio Ovelha

As macrófitas fluviais são um grupo relevante para a avaliação ecológica dos rios. Numa amostragem realizada num troço de 100 m do rio Ovelha, localizado a 217 m de altitude, na freguesia de Fornos, Marco de Canaveses, estudou-se a abundância, composição e distribuição das macrófitas. Verificou-se que o troço estudado é pobre em macrófitas, apresentando uma riqueza específica baixa, o que poderá estar relacionado, sobretudo, com o substrato rochoso. Considerando os resultados obtidos é fundamental que, futuramente, sejam estudadas as macrófitas conjuntamente com outros elementos biológicos, no sentido de se proceder a uma correta monitorização do estado ecológico do rio Ovelha.info:eu-repo/semantics/publishedVersio

Investigating the role of symptom valorisation in tuberculosis patient delay in urban areas in Portugal

URBANTB group: Patrícia Soares (Representative of the consortium), Mário Carreira, Sofia Pereira, Catarina Alves, Filipe Alves, Ana Rodrigues, Ana Moreira, Márcia Cardoso, Sandra Mota, Ana Gomes, Liliana Ferreira, Marta Lopes, Isabel Correia, Juan Rachadell, Maria Gameiro, Ângela Dias, Manuel Pereira, Jorge Gonçalves, Maria Gonçalves, Adriana Taveira, Celene Neves, Lucinda Silva, Maria Mendes, Maria Teixeira, Maria Pereira, Milena Piedade, Antónia Teixeira & Carlos Carvalho.Background: Diagnosis delay contributes to increased tuberculosis (TB) transmission and morbimortality. TB incidence has been decreasing in Portugal, but median patient delay (PD) has risen. Symptom valorisation may determine PD by influencing help-seeking behaviour. We aimed to analyse the association between symptom valorisation and PD, while characterising individuals who disregarded their symptoms. Methods: A cross-sectional study was conducted among TB patients in Lisbon and Oporto in 2019 - 2021. Subjects who delayed seeking care because they did not value their symptoms or thought these would go away on their own were considered to have disregarded their symptoms. PD was categorised using a 21-day cut-off, and a 30-day cut-off for sensitivity analysis. We estimated the effect of symptom valorisation on PD through a directed acyclic graph. Then, a multivariable regression analysis characterised patients that disregarded their symptoms, adjusting for relevant variables. We fitted Poisson regression models to estimate crude and adjusted prevalence ratios (PR). Results: The study included 75 patients. Median PD was 25 days (IQR 11.5-63.5), and 56.0% of participants had PD exceeding 21 days. Symptom disregard was reported by 38.7% of patients. Patients who did not value their symptoms had higher prevalence of PD exceeding 21 days compared to those who valued their symptoms [PR 1.59 (95% CI 1.05-2.42)]. The sensitivity analysis showed consistent point estimates but wider confidence intervals [PR 1.39 (95% CI 0.77-2.55)]. Being a smoker was a risk factor for symptom disregard [PR 2.35 (95% CI 1.14-4.82)], while living in Oporto [PR 0.35 (95% CI 0.16-0.75)] and having higher household incomes [PR 0.39 (95% CI 0.17-0.94)] were protective factors. Conclusions: These findings emphasise the importance of symptom valorisation in timely TB diagnosis. Patients who did not value their symptoms had longer PD, indicating a need for interventions to improve symptom recognition. Our findings also corroborate the importance of the socioeconomic determinants of health, highlighting tobacco as a risk factor both for TB and for PD.This work was supported by the Fundação para a Ciência e Tecnologia (FCT, Portugal) [Grant: PTDC/SAU-PUB/31346/2017]. The present publication was funded by Fundação para a Ciência e Tecnologia (FCT, Portugal) national support through Comprehensive Health Research Centre (CHRC) [UIDP/04923/2020].info:eu-repo/semantics/publishedVersio

Arbustus unedo essence: morphological and genetic characterization of the strawberry tree of Castelo de Paiva

O medronheiro é um arbusto da região mediterrânica que pode ser encontrada por todo o país. Ao contrário do que verifica na região sul do país, no concelho de Castelo de Paiva é atribuída uma reduzida importância económica a esta espécie. Com o intuito de preservar e potenciar a produção desta espécie e contribuir para a dinamização da economia do concelho, procedeu-se à caracterização morfológica e genética de uma amostra da população de medronheiros de Castelo de Paiva. A caracterização morfológica e genética foi realizada para um total de 10 genótipos. Para tal recolheram-se 70 folhas aleatoriamente em cada árvore. Em 40 folhas mediu-se o comprimento, largura, comprimento do pedúnculo, peso fresco, peso seco e determinou-se a área foliar. Dos caracteres morfológicos analisados, aqueles que se revelaram mais úteis na distinção dos vários genótipos foram: comprimento do pedúnculo, peso fresco e peso seco. As restantes 30 folhas foram utilizadas para a caracterização genética. Esta caracterização foi realizada recorrendo a um marcador de DNA, ISSR. Os 5 primeiros exemplaresutilizados na técnica de ISSR demonstraram-se polimórficos. Os resultados da caracterização genética sugerem que a variabilidade genética na população é média a alta.The strawberry tree is a shrub native in the Mediterranean region and it can be found throughout Portugal. Unlike the case in the southern region of the country, in Castelo de Paiva a minor economic importance is given to this species. In order to preserve, to enhance the production of this species and to contribute to the boosting of the economy of the region, we proceeded to the characterization of a small sample population of this fruit tree of Castelo de Paiva in what concerns to its morphology and genetics. The morphological and genetic characterization was performed for a total of 10 genotypes. For this, 70 leaves were randomly collected from each tree. For 40 leaves, it was measured the length, the width, the peduncle length, the wet weight, the dry weight and determined the leaf area. Of the morphological characteristics analyzed, the ones that proved most useful in distinguishing the various genotypes were: the length peduncle, the wet weight and the dry weight. The remaining 30 leaves were used in the genetic characterization. This characterization was performed using a DNA marker, the ISSR. The 5 primers used in the ISSR technique proved to be polymorphic. The results from the genetic characterization suggest that variability in population genetics is medium to high