Working in public health services in Brazil: The relationship between different rationalities

Success in a public health system is related to its ability to change its production process and to deal with general principles of the health system, such as universality and equity. The frameworks proposed by service marketing scholars have been developed primarily for private services; they focus on acceptance by the targeted client-users, and on the technical specifications of the new service delivery processes. Little attention has been given to the employees` point of view and their activities to maintain service operations modulated by innovation. In a public health system, workers make decisions in real time related to users` needs and the technical specifications of the process; therefore, it is very important to understand how the changes impact on employees` activities and on the quality delivered for citizens. This article discusses how changes implemented in Sao Paulo, Brazil impact the organizational parameters and working activities for front-line workers. (C) 2008 Elsevier Ltd. All rights reserved.

A retrospective study of Traumatic Dental Injuries in a Brazilian dental urgency service

Epidemiologic aspects of traumatic dental injuries (TDI) were evaluated in the permanent dentition in a sample of 847 patients treated at the Dental Urgency Service of the Dental School of the Federal University of Goiás, Brazil, between May 2000 and May 2008. The statistical treatment analyzed data from frequency distribution and chi-square test. The level of significance was set at 5% for all analyses. The results showed a higher incident among males (610; 72.01%) with mean age of 6-10 year-old. Uncomplicated crown fracture (without pulp exposure) (502; 26.95%), avulsion (341; 18.30%) and complicated crown fracture (with pulp exposure) (330; 17.71%) were the most prevalent TDI. The prevalence of trauma throughout the years showed proportionality, being observed a larger number of cases between July and September (249; 29.39%). The most affected teeth were the maxillary central incisors (65.65%), followed by the maxillary left lateral incisors (19.67%). In 311 participants (18.25%), only one tooth was involved, while in most patients (536; 81.75%), TDI occurred in more than one tooth. Significant proportion (82.27%) of traumatized teeth presented completely formed root apex. The main etiologic factors involved in TDI were falls (51.71%), traffic accidents (22.90%) and violence (5.67%). Based on the obtained data, it may be concluded that accurate policies of TDI prevention must be established, capable of stimulating the exposure of appropriate protocols for management of these lesions. The prevalence of TDI in Goiânia subpopulation is compared to the prevalence reported in epidemiological studies in others populations.

Ocorrências em pronto-socorro: eventos sentinela para o monitoramento da atenção básica de saúde

O estudo tem como ponto de partida a hipótese de que determinadas ocorrências nosológicas atendidas em pronto-socorro, escolhidas com base no conceito de evento sentinela, podem estar relacionadas a falhas da atenção básica e ser utilizadas na formulação de um indicador para o monitoramento desta atenção. Foram utilizados dados quantitativos e qualitativos sobre ocorrências previamente escolhidas e atendidas em pronto-socorro. Usando-se a triangulação de métodos, verificaram-se as diferenças das freqüências dessas ocorrências entre as áreas/unidades básicas de saúde (UBS) de procedência dos pacientes e as motivações determinantes da procura pelo pronto-socorro. As freqüências das ocorrências apresentaram valores de 30% a 42,8% conforme a área/UBS de procedência (Ç2 = 9,19 e p = 0,027). As entrevistas sugeriram a existência de causalidade entre o motivo declarado da procura do pronto-socorro e a atuação das unidades básicas. Conclui-se que: (1) a freqüência das ocorrências escolhidas foi influenciada pelas áreas/UBS de procedência das pessoas; (2) essa influência decorre, em parte, da situação da atenção básica; (3) o instrumental estudado é simples e pode contribuir para o gestor local no acompanhamento cotidiano da situação dos serviços básicos.

The Process of Simulation Authoring/Creation by Chemistry Teachers: A Service Learning Experience

Two case studies are presented to describe the process of public school teachers authoring and creating chemistry simulations. They are part of the Virtual Didactic Laboratory for Chemistry, a project developed by the School of the Future of the University of Sao Paulo. the documental analysis of the material produced by two groups of teachers reflects different selection process for both themes and problem-situations when creating simulations. The study demonstrates the potential for chemistry learning with an approach that takes students' everyday lives into account and is based on collaborative work among teachers and researches. Also, from the teachers' perspectives, the possibilities of interaction that a simulation offers for classroom activities are considered.

Effective coordination concept applied for phase change (GeTe)(m)(Sb(2)Te(3))(n) compounds

In this work, we employed the effective coordination concept to study the local environments of the Ge, Sb, and Te atoms in the Ge(m)Sb(2n)Te(m+3n) compounds. From our calculations and analysis, we found an average effective coordination number (ECN) reduction of 1.59, 1.42, and 1.37, for the Ge, Sb, Te atoms in the phase transition from crystalline, ECN=5.55 (Ge), 5.73 (Sb), 4.37 (Te), to the amorphous phase, ECN=3.96 (Ge), 4.31 (Sb), 3.09 (Te), for the Ge(2)Sb(2)Te(5) composition. Similar changes are observed for other compositions. Thus, our results indicate that the coordination changes from the crystalline to amorphous phase are not large as previously assumed in the literature, i.e., from sixfold to fourfold for Ge, which can contribute to obtain a better understanding of the crystalline to amorphous phase transition. (C) 2011 American Institute of Physics. [doi:10.1063/1.3533422]

Dignified death: Concept development involving nurses and doctors in Pediatric Intensive Care Units

The aim of this study was to develop the concept of the dignified death of children in Brazilian pediatric intensive care units (PICUs). The Hybrid Model for Concept Development was used to develop a conceptual structure of dignified death in PICUs in an attempt to define the concept. The fieldwork study was carried out by means of in-depth interviews with nine nurses and seven physicians working in PICUs. Not unexpectedly, the concept of dignified death was found to be a complex phenomenon involving aspects related to decisions made by the multidisciplinary team as well as those related to care of the child and the family. Knowledge of the concept`s dimensions can promote reflection on the part of healthcare professionals regarding the values and beliefs underlying their conduct in end-of-life situations. Our hope is that this study may contribute to theoretic and methodological development in the area of end-of-life care.

Friere`s Dialogic Concept Enables Family Health Program Teams to Incorporate Health Promotion

Objective The study analyzes the possibility of incorporating health promotion measures into the work processes of Family Health Program teams at a primary health care clinic in Brazil. Design and Sample We used the participatory research concept developed in 1968 by Freire. The study sample comprised the end-users of the health care system, together with 3 multidisciplinary teams. A total of 77 health care users and 55 health professionals participated in the study. Measures Culture circles composed of health care professionals, and users from different areas investigated generative topics, encoded/decoded topics, and engaged in critical probing for clarification. Topics affecting quality of life and health were heuristically evaluated. Results Although most topics were related to changing the focus of health care facilities, some were related to subsidizing community-based interventions, improving environmental strategies, individual skills, and public policies. Incorporating the novel health promotion measures and creating an expanded full-treatment clinic are important steps toward that goal. Conclusions Topics that can stimulate dialogue among the members of the culture circles include creating an environment of closer cultural contact, with repercussions for work processes, family health models, and general health models, as well as the inclusion of social aspects in the decision-making processes related to health issues that affect the living conditions of the population.

Innovation concept for measurement gross error detection and identification in power system state estimation

In this study, the innovation approach is used to estimate the measurement total error associated with power system state estimation. This is required because the power system equations are very much correlated with each other and as a consequence part of the measurements errors is masked. For that purpose an index, innovation index (II), which provides the quantity of new information a measurement contains is proposed. A critical measurement is the limit case of a measurement with low II, it has a zero II index and its error is totally masked. In other words, that measurement does not bring any innovation for the gross error test. Using the II of a measurement, the masked gross error by the state estimation is recovered; then the total gross error of that measurement is composed. Instead of the classical normalised measurement residual amplitude, the corresponding normalised composed measurement residual amplitude is used in the gross error detection and identification test, but with m degrees of freedom. The gross error processing turns out to be very simple to implement, requiring only few adaptations to the existing state estimation software. The IEEE-14 bus system is used to validate the proposed gross error detection and identification test.

Exploring the potential of functionally graded materials concept for the development of fiber cement

In this study we establish the concept of functionally graded fiber cement. We discuss the use of statistical mixture designs to choose formulations and present ideas for the production of functionally graded fiber cement components for Hatschek machines. The feasibility of producing functionally graded fiber cement by grading PVA fiber content has been experimentally evaluated. Thermogravimetric analysis (TG) was employed to assess fiber distribution profiles and four-point bending tests were applied to evaluate the mechanical performance of both conventional and graded composites. The results show that grading PVA fiber content is an effective way to produce functionally graded fiber cement, which allows for a reduction of the total fiber volume without a significant reduction on modulus of rupture of composite. TG tests were found adequate to assess the fiber content at different points in functionally graded fiber cements. (C) 2009 Elsevier Ltd. All rights reserved.

MODELING OF AN INFORMATION SYSTEM FOR WINE TRACEABILITY BASED ON A SERVICE ORIENTED ARCHITECTURE

The purpose is to present a scientific research that led to the modeling of an information system which aimed at the maintenance of traceability data in the Brazilian wine industry, according to the principles of a service-oriented architecture (SOA). Since 2005, traceability data maintenance is an obligation for all producers that intend to export to any European Union country. Also, final customers, including the Brazilian ones, have been asking for information about food products. A solution that collectively contemplated the industry was sought in order to permit that producer consortiums of associations could share the costs and benefits of such a solution. Following an extensive bibliographic review, a series of interviews conducted with Brazilian researchers and wine producers in Bento Goncalves - RS, Brazil, elucidated many aspects associated with the wine production process. Information technology issues related to the theme were also researched. The software was modeled with the Unified Modeling Language (UML) and uses web services for data exchange. A model for the wine production process was also proposed. A functional prototype showed that the adopted model is able to fulfill the demands of wine producers. The good results obtained lead us to consider the use of this model in other domains.

A New Approach for Video Adaptation through Overlay Services Networks

Video adaptation is an extensively explored content providing technique aimed at appropriately suiting several usage scenarios featured by different network requirements and constraints, user`s terminal and preferences. However, its usage in high-demand video distribution systems, such as CNDs, has been badly approached, ignoring several aspects of optimization of network use. To address such deficiencies, this paper presents an approach for implementing the adaptation service by exploring the concept of overlay services networks. As a result of demonstrate the benefits of this proposal, it is made a comparison of this proposed adaptation service with other strategies of video adaptation.

New concept for lifting in onshore oil wells

This paper presents the development of a prototype of a tubular linear induction motor applied to onshore oil exploitation, named MAT AE OS (which is the Portuguese acronym for Tubular Asynchronous Motor for Onshore Oil Exploitation). The function of this motor is to directly drive the sucker-rod pump installed in the down hole of the oil well. Considering the drawbacks and operational costs of the conventional oil extraction method, which is based on the walking beam and rod, string system, the developed prototype is intended to become a feasible alternative from both technical and economic points of view. At the present time, the MAT AE OS prototype is installed in a test bench at the Applied Electromagnetism Laboratory at the Escola Politecnica da Universidade de Sao Paulo. The complete testing system is controlled and supervised by special software, enabling good flexibility in operation, data acquisition, and performance analysis. The test results indicate that the motor develops a constant lift force along the pumping cycle, as shown by the measured dynamometric charts. Also, the evaluated electromechanical performance seems to be superior to that obtained by the traditional method. The system utilizing the MAT AE OS prototype allows the complete elimination of the rod string sets required by the conventional equipment, indicating that the new system may advantageously replace the surface mechanical components presently utilized.

Application of the essential work of fracture method in ranking the performance in service of high-density polyethylene resins employed in pressure pipes

High-density polyethylene resins have increasingly been used in the production of pipes for water- and gas-pressurized distribution systems and are expected to remain in service for several years, but they eventually fail prematurely by creep fracture. Usual standard methods used to rank resins in terms of their resistance to fracture are expensive and non-practical for quality control purposes, justifying the search for alternative methods. Essential work of fracture (EWF) method provides a relatively simple procedure to characterize the fracture behavior of ductile polymers, such as polyethylene resins. In the present work, six resins were analyzed using the EWF methodology. The results show that the plastic work dissipation factor, beta w(p), is the most reliable parameter to evaluate the performance. Attention must be given to specimen preparation that might result in excessive dispersion in the results, especially for the essential work of fracture w(e).

Application of thermal sums concept to estimate the time to harvest new banana hybrids for export

Application of the thermal sum concept was developed to determine the optimal harvesting stage of new banana hybrids to be grown for export. It was tested on two triploid hybrid bananas, FlhorBan 916 (F916) and FlhorBan 918 (F918), created by CIRAD`s banana breeding programme, using two different approaches. The first approach was used with F916 and involved calculating the base temperature of bunches sampled at two sites at the ripening stage, and then determining the thermal sum at which the stage of maturity would be identical to that of the control Cavendish export banana. The second approach was used to assess the harvest stage of F918 and involved calculating the two thermal parameters directly, but using more plants and a longer period. Using the linear regression model, the estimated thermal parameters were a thermal sum of 680 degree-days (dd) at a base temperature of 17.0 degrees C for cv. F916, and 970 dd at 13.9 degrees C for cv. F918. This easy-to-use method provides quick and reliable calculations of the two thermal parameters required at a specific harvesting stage for a given banana variety in tropical climate conditions. Determining these two values is an essential step for gaining insight into the agronomic features of a new variety and its potential for export. (C) 2011 Elsevier B.V. All rights reserved.

Stability property of matchings is a natural solution concept in coalitional market games

Stability of matchings was proved to be a new cooperative equilibrium concept in Sotomayor (Dynamics and equilibrium: essays in honor to D. Gale, 1992). That paper introduces the innovation of treating as multi-dimensional the payoff of a player with a quota greater than one. This is done for the many-to-many matching model with additively separable utilities, for which the stability concept is defined. It is then proved, via linear programming, that the set of stable outcomes is nonempty and it may be strictly bigger than the set of dual solutions and strictly smaller than the core. The present paper defines a general concept of stability and shows that this concept is a natural solution concept, stronger than the core concept, for a much more general coalitional game than a matching game. Instead of mutual agreements inside partnerships, the players are allowed to make collective agreements inside coalitions of any size and to distribute his labor among them. A collective agreement determines the level of labor at which the coalition operates and the division, among its members, of the income generated by the coalition. An allocation specifies a set of collective agreements for each player.