Early detection of patients at risk for rheumatoid arthritis

__Abstract__ Rheumatoid arthritis (RA) is a systemic auto-immune disease mainly characterized by articular manifestations [1]. Patients present initially with synovitis and joint damage, while extra-articular manifestations such as vasculitis, pleuritis and pericarditis are manifestations of severe or longstanding disease [1,2]. The prevalence of RA is approximately 1% [2]. It affects most patients in the fifth decade of life with females more affected than males [2]. The etiopathogenesis is not fully understood. Genetic, epigenetic and environmental factors seem to play a role [3,4]. Before the articular manifestations other features of RA can already be present. Nielen et al showed in a retrospective cohort of RA patient that donated blood that 49% of the patients were positive for anti-citrullinated protein antibody’s (ACPA’s) and rheumatoid factor (RF) up to 15 years before onset of symptoms [5]. This suggests that the disease develops in different stages which was recently depicted by Hazes and Luime [6,7]. They illustrated RA as stages of plant growth, see figure 1. In the pre-articular phase, all the genetic potential for the development of RA is present, but there are no signs or symptoms of disease. This stage can than develop into an arthralgia phase in which clinically objective synovitis is still not present. In the first clinical phase, symptoms and signs of synovitis indicate the presence of inflammatory arthritis but the form of arthritis is not classifiable and the arthritis is hardly discernable from other inflammatory rheumatic diseases. In the next clinical phase, the disease develops and shows more features of its definite form, and in the third clinical phase the arthritis is fully classifiable as RA [6]

Implementation of the pull levelling project in a car radio assembly firm

This paper presents some results from the implementation of pull levelling strategy between the final assembly lines and the Original Equipment Manufacturing (OEM) clients of a car radio assembly firm. In order to respond quickly to the clients the firm maintained a stock level of, approximately, ten days of finished product for each client. This implies high costs for the firm. The implementation of the pull levelling strategy reduced these costs and increased the flexibility approaching the production to the demand, in quantity and in diversity, required by the clients. Additionally, this implementation permitted the detection of deviation, identification of problems, creation of standards and continuous improvement, stabilization of the upstream processes and the reduction of components stock. The performance indicators used by the firm to measure the performance of this implementation were the fulfillment (the achievement of the production levelling plan supplied by the Production Planning Department), the stock level, the Every Part Every Interval (EPEI) number and LIWAKS (accomplishment of the due date negotiate with the client)

Evolução e dinâmica dos usos agrários na Ilha de Santa Catarina

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Filosofia e Ciências Humanas, Programa de Pós-Graduação em Geografia, Florianópolis, 2012Desde o século XVII, a Ilha de Santa Catarina, porção insular do município de Florianópolis, vem abrigando atividades agrárias que se distribuem de maneira irregular em seu território. Esta pesquisa documenta historicamente e de forma sequencial, como os espaços rurais da Ilha de Santa Catarina foram sendo modificados e se adaptaram à substituição da base econômica local e regional, em um processo que está vinculado, sobretudo, ao avanço da urbanização em direção as áreas periurbanas e rurais do seu território. O avanço da urbanização ao longo do século XX reduziu a participação dos usos agrários na economia e na sociabilidade ilhéu. Atualmente, pode-se falar na existência de espaços em transição rural-urbana, que guardam características tipicamente rurais e que de maneira geral vêm cedendo à expansão de novos condomínios e empreendimentos imobiliários.Abstract : Since the 17th century, Santa Catarina´s Island, the insular portion of Florianopolis, has supported agricultural activities that are distributed irregularly in its territory. This research documents, historically and in a sequential way, how rural areas of the Island of Santa Catarina have been modified and adapted to the replacement of local and regional economic base, in a process that is linked mainly to the expansion of urban areas into periurban and rural territory. The progress of urbanization throughout the 20th century reduced the share of agricultural contribution in the economy and sociability of the islanders. Currently, one can speak of the existence of spaces in transition, some at a rapid pace and some at slow pace, which generally have yielded to the expansion of new condos and real estate development

Viver a rua ou viver na rua? Os «meninos de rua» na cidade do Mindelo em Cabo Verde

Com a realização do trabalho, que agora se apresenta, tem-se como finalidade refletir sobre os eventuais motivos que permitem a existência de «crianças de rua». Sustentados num paradigma metodológico de caracter exploratório, o esforço recaiu numa compreensão sobre as conexões das necessidades dos participantes (no que concerne desejos e motivações para as crianças andarem e para saírem da rua) bem como uma reflexão acerca das diferentes implicações subjacentes e latentes. Intentou-se, assim compreender o que leva, numa sociedade global, onde o acesso a informações e conhecimentos é, hoje, de mais fácil acesso, crianças a irem para a rua e, mais concretamente, perceber o porquê de aí estarem e, uma vez aí, como vivem a rua e na rua. Tendo em conta os discursos das crianças, direcionou-se o trabalho no sentido da sua desconstrução, mostrando que a rua aparece como escolha natural dos participantes, ainda que os fatores desta escolha tenham variado.With the achievement of this work, that now is presented, has the goal to reflect about the eventual reasons that allows the existence of “street children”. Sustained in a methodological paradigm of exploratory character, the reinforcement fell in an understanding about the connexion of a need for participants (in what concerns desires and motivations for the children walking and going out of the street, as well as a reflection about the different underlying and latent implications.) It is brought as well, understanding what it takes, in a global society, where the access to information and knowledge is, today, of an easy access, children to go outside and, more specifically, understanding the reason why being there and, since there, how they live the street and in the street. Taking into account the children’s speeches, it is directed the work in the sense of its construction, showing that the street appears as a natural choice of the participants, even if the factors of this choice has varied

Preparation of a textile and clothing company to lean implementation by identifying ergonomic and environmental risks

This paper intends to identify ergonomic and environmental risks, in the different sectors of the Portuguese Textile and Clothing Industry (TCI). This identification will be used in order to have a better understanding of the risks in each sector of TCI. Knowing these risks, some more focused proposals oriented by a Lean methodology, could be recommended to eliminate them more rapidly. The Lean methodology to implement Lean in TCI is already in development and includes ergonomic and sustainable tools to solve the problems related with the identified risks. These tools will allow analysing and evaluating the risks to improve the work environment

How could the TRIZ tool help continuous improvement efforts of the companies?

This paper objective is to explore TRIZ tool as a tool that could be helpful during Lean implementation, in particular, during the continuous improvement process efforts. Attending to the already published papers regarding Lean and TRIZ, at least since 2004, this synergy is viable and sustainable. This paper presents TRIZ principles and discusses their relation With Lean Production principles. Additionally, presents some TRIZ tools and explain how they can be useful in the context of the methodology in development to be applied in Textile and Clothing Industry.PEst-C/EEI/UI0319/201

Metodologias para implementar Lean Production : uma revisão critica de literatura

Neste artigo pretende-se fazer uma revisão crítica de literatura sobre metodologias para implementar Lean Production. Lean Production é um modelo de organização da produção focado no cliente que procura a eliminação dos desperdícios (actividades que não acrescentam valor ao produto) e a entrega atempada de produtos, trazendo muitos benefícios para as empresas. O Lean Production utiliza ferramentas que vão permitir a melhoria dos processos, assim como melhorar os fluxos quer de materiais, quer de informação. Mas a utilização e implementação destas ferramentas exige uma mudança de cultura e estratégia empresarial, muitas vezes, uma mudança contra-intuitiva aos hábitos das pessoas. Para implementar Lean Production é necessário, assim, um caminho que conduza as empresas numa bem sucedida implementação. Neste artigo descreve-se algumas metodologias desenvolvidas para a implementação do Lean Production e faz-se uma reflexão sobre o que uma metodologia deve incluir

Implementar o modelo de produção Lean na ITV para promover sistemas eco eficientes

O modelo de produção Lean é um modelo de organização da produção focado no cliente e na entrega atempada de produtos eliminando os desperdícios (i.e. atividades que não acrescentam valor ao produto) e respeitando as pessoas e o ambiente para reduzir os custos e aumentar a produtividade. Para o conseguir, este modelo recorre a princípios e ferramentas com objetivo de melhorar os processos e os fluxos de materiais, de informação e de pessoas. Nesta procura de melhoria é obrigatório reduzir os consumos de água, energia, matérias-primas e emissão de substâncias tóxicas que vão contaminar o solo, ar e água. Evidencia-se assim, neste artigo, esta relação entre o modelo de produção Lean e a eco-eficiência dos sistemas de produção, designada na literatura anglo-saxónica como Lean-Green.The Lean production model is a model of production organization focused on the customer and timely delivery of products, eliminating waste (e.g activities that do not add value to the product) and respecting people and the environment to reduce costs and increase productivity. To achieve this, this model uses principles and tools in order to improve the processes and flow of materials, information and people. In this quest for improvement it is mandatory to reduce the consumption of water, energy, raw materials and emission of toxic substances that will contaminate the soil, air and water. In this article, emphasis is given on the relationship between the model of lean manufacturing and ecoefficiency of production systems, known in the literature as Lean-Green