Gestão de estoques: uma proposta de reposição contínua para material médico hospitalar e medicamentos em um hospital universitário federal do estado do Rio Grande do Norte

The inventory management in hospitals is of paramount importance, since the supply materials and drugs interruption can cause irreparable damage to human lives while excess inventories involves immobilization of capital. Hospitals should use techniques of inventory management to perform replenishment in shorter and shorter intervals, in order to reduce inventories and fixed assets and meet citizens requirements properly. The inventory management can be an even bigger problem for public hospitals, which have restrictions on the use of resources and decisionmaking structure more bureaucratized. Currently the University Hospital Onofre Lopes (HUOL) uses a periodic replacement policy for hospital medical supplies and medicines, which involves one moment surplus stock replenishment, the next out of stock items. This study aims to propose a system for continuous replenishment through order point for inventory of medical supplies and medicines to the hospital HUOL. Therefore, a literature review of Federal University Hospitals Management, Logistics, Inventory Management and Replenishment System in Hospitals was performed, emphasizing the demand forecast, classification or ABC curve and order point system. And also, policies of inventory management and the current proposal were described, dealing with profile of the mentioned institution, the current policy of inventory management and simulation for continuous replenishment order point. For the simulation, the sample consisted of 102 and 44 items of medical and hospital drugs, respectively, selected using the ABC classification of inventory, prioritizing items of Class A, which contains the most relevant items in added value, representing 80 % of the financial value in 2012 fiscal year. Considering that it is a public organization, subject to the laws, we performed two simulations: the first, following the signs for inventory management of Instruction No. 205 (IN 205 ), from Secretary of Public Administration of the Presidency ( SEDAP / PR ), and the second, based on the literature specializing in inventory management hospital. The results of two simulations were compared to the current policy of replenishment system. Among these results are: an indication that the system for continuous replenishment reorder point based on IN 205 provides lower levels of safety stock and maximum stock, enables a 17% reduction in the amount spent for the full replenishment of inventories, in other words, decreasing capital assets, as well as reduction in stock quantity, also the simulation made from the literature has indicated parameters that prevent the application of this technique to all items of the sample. Hence, a change in inventory management of HUOL, with the application of the continuous replenishment according to IN 205, provides a significant reduction in acquisition costs of medical and hospital medicine

Um estudo algorítmico de problemas logísticos na indústria de petróleo e gás natural

This work consists on the study of two important problems arising from the operations of petroleum and natural gas industries. The first problem the pipe dimensioning problem on constrained gas distribution networks consists in finding the least cost combination of diameters from a discrete set of commercially available ones for the pipes of a given gas network, such that it respects minimum pressure requirements at each demand node and upstream pipe conditions. On its turn, the second problem the piston pump unit routing problem comes from the need of defining the piston pump unit routes for visiting a number of non-emergent wells in on-shore fields, i.e., wells which don t have enough pressure to make the oil emerge to surface. The periodic version of this problem takes into account the wells re-filling equation to provide a more accurate planning in the long term. Besides the mathematical formulation of both problems, an exact algorithm and a taboo search were developed for the solution of the first problem and a theoretical limit and a ProtoGene transgenetic algorithm were developed for the solution of the second problem. The main concepts of the metaheuristics are presented along with the details of their application to the cited problems. The obtained results for both applications are promising when compared to theoretical limits and alternate solutions, either relative to the quality of the solutions or to associated running time

Protozoários de vida livre em ambientes aquáticos do RN: ocorrência, caracterização e importância para a educação básica

Water is considered an essential right to life, besides being a determinant of economic development and social welfare, represented by both the quantity available, and the quality. In semi-arid Northeast, droughts occurring on a regular basis combined with human activities, aggravate the situation regarding the conservation of water resources in this area. To alleviate this condition is common to construction of artificial reservoirs, such as reservoirs and dams. As in natural aquatic environments, these reservoirs are potential sites for the proliferation, growth and development of diverse biological communities, whether of animals, plants and microorganisms. Research on the composition and ecology of these communities, especially microbial, are still restricted. One of the least studied groups in these environments are free-living protozoa, which over time have been neglected and after discoveries about its various functions in the aquatic ecosystem are beginning to receive more attention from scholars. They are, in quantitative terms, the most important consumers of microorganisms (mainly bacteria and algae) in aquatic environments, and therefore control the abundance of these. They may therefore influence the structure of the aquatic food chain in terms of species composition, abundance, biomass and biodiversity. Despite the recognition of the importance of protozoa in the final of the trophic transfer in aquatic environments, there are few data and, in general, are still precarious knowledge of them. Given the importance of protozoa in aquatic environments and the paucity of research on this group, especially in the state of Rio Grande do Norte, the present study aimed at identifying the genus and species of free-living protozoa that are present in the Armando Ribeiro Gonçalves Dam as well as to relate the occurrence and dynamics of the trophic conditions in the environment in which they are inserted, in order to support the hypothesis that species that are in these environments can serve to indicate the water quality. We observed the presence of 65 taxa of free-living protozoa, of which 29 were identified at the species level. There was a similarity space in taxonomic composition of protozoa, suggesting a possible regulation of this type of community for limnological variables other than those studied in this work (chlorophyll a, pH, temperature). Although it was aimed to analyze the conceptions of teachers and students from nearby towns Dam Armando Ribeiro Gonçalves, on issues relating to water quality and the role of protozoa. For this, we applied questionnaires with teachers and pupils of public schools of San Rafael and Itajá. It was concluded that teachers and students recognize the multi-dam Armando Ribeiro Gonçalves, although unaware of important aspects of the dynamics and ecology of this environment. Conceptions of teachers and students are matched at various times, especially with regard to waterborne diseases. In an attempt to identify possible misconceptions about the knowledge of the protozoa, assuming that these organisms have neglected their ecological role, and are seen as only, disease, a study was done with teachers and students, following a particular methodology that allowed look so clear and precise results. It was clear that knowledge about the free-living protozoa is still quite limited. The alternative conceptions that were found show a direct relation of protozoans and diseases. From the data obtained by these studies, we planned a series of science communication activities, environmental education and health education in schools close to study environments in order to promote a didactic transposition of accumulated knowledge about these organisms, favoring continuing education of teachers and the increase of information to the local community through the knowledge of biodiversity and ecology of these organisms. Moreover, the results found in this study and reflections on it that led to propose the elaboration of a book Readers with an emphasis on the group of freeliving protozoa in the populations for use in public schools in the region where it was developed the semiarid work

Avaliação da atenção humanizada ao abortamento em maternidade-escola, em Natal, Rio Grande do Norte

Unplanned pregnancy is experienced by millions of women worldwide. Such fact increases the risk of abortion-related morbimortality, which represents a serious public health problem. This study aims to evaluate the advances and challenges of the implementation of Humanized Abortion Care at the Maternity-School in Natal, state of Rio Grande do Norte. The research was evaluative, was preceded by an Evaluative Study, and resulted in a Case Study. The intentional sample totaled 102 subjects (60 users, 39 professionals and 3 managers). The collection techniques included documental analysis, semi-structured interview and observation with a field diary. The documental analysis was descriptive, while the Content Analysis by Bardin was used for semi-structured interviews and field diary. The Evaluative Study observed that Humanized Abortion Care is an evaluative program with preparation and pact of the logical model, of the matrix of indicators and evaluative questions. The Case Study showed that users were satisfied with the problem-solving capacity and access to the service; however, is also showed that they pointed out inadequacy in terms of environment, qualified hearing and reproductive planning. Professionals reported that the inefficiency of service consists of infrastructure and environment, which are considered inefficient and inadequate to humanized care, especially regarding patient accommodation, the lack of hospital beds, the reduced number of rooms in the surgical center and the lack of laboratory inside the maternity. Moreover, reproductive planning does not consist of an institutionalized practice in the service, and integrality with other services or partnership with the community is not in place. The Maternity Board emphasizes that the excessive demand of patients is one of the reasons that hinders the appropriate implementation of the technical standard. We then conclude that although satisfied regarding problem-solving capacity in terms of service and ease of access, there is room for improvement in qualified hearing systems, in the creation of a system to promote team work, implementation of ombudsman and satisfaction surveys. The right of shared choice did not prevail among users and health professionals with regard to the option of uterine evacuation procedure. Environment was the most mentioned category as that requiring more changes, seeing as a limited factor for the development of humanized and welcoming practices. Health professionals do not establish a periodic routine of planning practices, and such practices are not aligned with the Technical Standard. Incorporation of guidelines and availability of a plurality of methods and possibilities of choices for family planning are required. There is no institutionalization of reference and counter-reference, or partnerships with the community, which makes integrality of care not viable. The Standard needs to be included in the action plans of managers as one of the priorities in the construction of care strategies for women's health, in order to enable, allied to other initiatives, the real integration among safe conduct service, primary care network and social organizations. As a result, respect for human rights and adequate humanized care, as a way of attention and prevention of abortion, can be secured.

"Em cada esquina um poeta, em cada rua um jornal": a vida intelectual natalense (1889-1930)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Características psicológicas do paciente obeso grave e suas implicações pós-operatórias na cirurgia bariátrica

Obesity is a chronic disease that has multi-factorial aetiology, characterized by high degree of body fat; the degree of obesity will vary according to the Body Mass Index (BMI=m2 /kg). The severe degree of obesity is characterized by BMI>40 and it is regularly associated to endocrine-metabolic or mechanic clinical alterations, and to psychological disorders. Binge Eating (BE) results were overly high for this population. The Bariatric Surgery has been the treatment chosen by those diagnosed with severe obesity as this intervention provides prompt outcomes for loss of weight and clinical improvement conditions. However, recent research has acquiesced that after two years between 20% and 30% of people subject to this intervention gained weight. The main objective of this research is to assess the psychological and behavioral characteristics of those diagnosed with severe obesity that have been subject to Gastric Bypass Surgery in the past 24 months. Specific aspects were investigated: (1) characteristics of different personalities and diagnose of clinic and personality disorders; (2) BE and its relation with loss of weight; (2) the difference between the groups regarding post-surgery care, e.g. physical activity, psychological and dietician input. Method: 40 adults (women and men) aged 23 and 60 year-old who went through a bariatric surgery in the past 24 months, in the city of Natal-RN (Brazil); they were assembled in two groups n=20, Gain group displaying loss of < 50% of their initial surplus of weight, and the Loss group displaying loss of >50%. The research protocol is made of a socio-demographic questionnaire and 3 psychometric instruments: Rorschach – Comprehensive System; Millon Personality Inventory (MCMI-III); and the Binge Eating Scale (Escala de Compulsão Alimentar Periódica (ECAP). Through Rorschach significant differences between these groups were verified according to the kind of personality (EB) - more EB Extratensivo in Gain group and Intratensivo in Loss group – and the lack of control to express affect, increasing the answer for Color Pure at Group I. Concerning the people standardization, the sample as a whole tends to show psychic pain, denigrated selfperception, high levels of self-criticism, distorted perceptions, vulnerability to develop mood disorders and high scores regarding Suicide. MCMI-III results showed more clinic and personality disorders in Group I: Depressive Disorder and Schizotypal, Anxiety, Dysthymia, Major Depressive Disorder; Thought Disorder, Bipolar- Manic and Posttraumatic Stress Disorder. In relation to ECAP, the results indicated significant differences, showing increased BE results in Gain group. There were found significant differences between BE severity and the presence of clinic and personality disorders. Concerning the post-surgery care, the observed differences are statistically significant regarding physical activities with median-increased differences in Loss group. There is a difference between the initial weight and the time post-surgery, indicating that the higher the initial weight and the time after the surgery the higher the re-gain of weight post-surgery. Finally, the results show that the participants with more than 3 years of surgery will have Clinic and Major Depressive Disorders; Somatoform Disorder; Dysthymia. These results confirm prior studies related to BE post-surgery and re-gain of weight as well as the proneness of clinic disorders in severe obesity people. That means the results reinforce that the surgery process is a facet of the severe obesity treatment. The post-surgery process needs to be the main focus of attention and have a long-term input to sustain the care of the surgery results and the quality of life of the patients.

Análise do processo de avaliação de desempenho ambiental face às diretrizes da ISO 14031: um estudo de caso

The present dissertation aims to analyze the evaluation process of environmental performance inside an organization from the building construction section of civil construction based on the NBR ISO 14031 guidelines, which provide orientation regarding the implementation of this project towards the internal organizational management. The theoretical research has addressed concepts and historical development of environmental management inside organizations, from the emergence of the first models to the strengthening of environmental management through the standardization of the Environmental Management System caused by the publication of ISO 14001. It has also addressed the evaluation of environmental performance, the NBR ISO 14031 (concepts, types of indicators of evaluation of environmental performance, the elaboration process of such indicators, as well as its use and evaluation by the high administration). The research has an applied character, with exploratory and descriptive goals, and a qualitative approach based on case study. The data collection will be made through questionnaires, interviews, and documental analysis. Through the present research project, one expects to learn the elements taken into consideration by the organization for the elaboration and selection of indicators; to identify which interested parties contribute in the aforementioned process; to discover which sources are taken into consideration by the organization while establishing its environmental performance goals; to learn how the different kinds of environmental indicators are handled by organizations on daily basis, considering the existence of interferences on the decision making process, whether or not the interested parties are integrated, and if there is an periodical evaluation of environmental performance and how it is handled. One also expects to identify the opportunities for improvement regarding the organization that is object of study.

Frases magnéticas, polaritons magnéticos e modos magnetostáticos em filmes e cristais magnônicos de terras-raras

Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq

Frases magnéticas, polaritons magnéticos e modos magnetostáticos em filmes e cristais magnônicos de terras-raras

Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq

Estudo da sinterização e oxidação anódica na produção de um capacitor eletrolítico de nióbio

It seeks to find an alternative to the current tantalum electrolytic capacitors in the market due to its high cost. Niobium is a potential replacement for be lighter and cheaper than tantalum. They belong to the same table group periodically and thus exhibit several physical and chemical properties similar. Niobium is used in many technologically important applications, and Brazil has the largest reserves, around 96%. These electrolytic capacitors have high specific capacitance, so they can store high energy in small volumes compared to other types of capacitors. This is the main attraction of this type of capacitor because is growing demand in the production of capacitors with capacitance specifies increasingly high, this because of the miniaturization of various devices such as GPS devices, televisions, computers, phones and many others. The production route of the capacitor was made by powder metallurgy. The initial niobium poder was first characterized by XRD, SEM and laser particle size to then be sieved into particle size 400mesh. The powder was then compacted at pressure of 150MPa and sintered at 1400, 1450 and 1500°C using two sintering time 30 and 60min. Sintering is an important part of the process as it affects properties as porosity and surface cleaning of the samples, which greatly affected the quality of the capacitor. After sintering the samples were underwent a process of anodic oxidation (anodizing), which created a thin film of niobium pentoxide over the whole surface of the sample, this film is the dielectric capacitor. The anodizing process variables influenced a lot in film formation and consequently the capacitor. The samples were characterized by electrical measurements of capacitance, loss factor and ESR (equivalent series resistance). The sintering has affected the porosity and in turn the specific area of the samples. The capacitor area is directly related to the capacitance, that is, the higher the specific area is the capacitance. Higher sintering temperatures decrease the surface area but eliminate as many impurities. The best results were obtained at a temperature of 1400°C with 60 minutes. The most interesting results were compared with the specific capacitance and ESR for all samples.

Estudo da sinterização e oxidação anódica na produção de um capacitor eletrolítico de nióbio

It seeks to find an alternative to the current tantalum electrolytic capacitors in the market due to its high cost. Niobium is a potential replacement for be lighter and cheaper than tantalum. They belong to the same table group periodically and thus exhibit several physical and chemical properties similar. Niobium is used in many technologically important applications, and Brazil has the largest reserves, around 96%. These electrolytic capacitors have high specific capacitance, so they can store high energy in small volumes compared to other types of capacitors. This is the main attraction of this type of capacitor because is growing demand in the production of capacitors with capacitance specifies increasingly high, this because of the miniaturization of various devices such as GPS devices, televisions, computers, phones and many others. The production route of the capacitor was made by powder metallurgy. The initial niobium poder was first characterized by XRD, SEM and laser particle size to then be sieved into particle size 400mesh. The powder was then compacted at pressure of 150MPa and sintered at 1400, 1450 and 1500°C using two sintering time 30 and 60min. Sintering is an important part of the process as it affects properties as porosity and surface cleaning of the samples, which greatly affected the quality of the capacitor. After sintering the samples were underwent a process of anodic oxidation (anodizing), which created a thin film of niobium pentoxide over the whole surface of the sample, this film is the dielectric capacitor. The anodizing process variables influenced a lot in film formation and consequently the capacitor. The samples were characterized by electrical measurements of capacitance, loss factor and ESR (equivalent series resistance). The sintering has affected the porosity and in turn the specific area of the samples. The capacitor area is directly related to the capacitance, that is, the higher the specific area is the capacitance. Higher sintering temperatures decrease the surface area but eliminate as many impurities. The best results were obtained at a temperature of 1400°C with 60 minutes. The most interesting results were compared with the specific capacitance and ESR for all samples.

Estudo e desenvolvimento de um capacitor eletrolítico de nióbio

It seeks to find an alternative to the current tantalum electrolytic capacitors in the market due to its high cost. Niobium is a potential substitute, since both belong to the same group of the periodic table and because of this have many similar physical and chemical properties. Niobium has several technologically important applications, and Brazil has the largest reserves, around 96%. There are including niobium in reserves of tantalite and columbite in Rio Grande do Norte. These electrolytic capacitors have high capacitance specifies, ie they can store high energy in small volumes compared to other types of capacitors. This is the main attraction of this type of capacitor because is growing demand in the production of capacitors with capacitance specifies increasingly high, this because of the miniaturization of various devices such as GPS devices, televisions, computers, phones and many others. The production route of the capacitor was made by powder metallurgy. The initial niobium powder supplied by EEL-USP was first characterized by XRD, SEM, XRF and laser particle size, to then be sieved into three particle size, 200, 400 e 635mesh. The powders were then compacted and sintered at 1350, 1450 and 1550°C using two sintering time 30 and 60min. Sintering is one of the most important parts of the process as it affects properties as porosity and surface cleaning of the samples, which greatly affected the quality of the capacitor. The sintered samples then underwent a process of anodic oxidation, which created a thin film of niobium pentóxido over the whole porous surface of the sample, this film is the dielectric capacitor. The oxidation process variables influence the performance of the film and therefore the capacitor. The samples were characterized by electrical measurements of capacitance, loss factor, ESR, relative density, porosity and surface area. After the characterizations was made an annealing in air ate 260ºC for 60min. After this treatment were made again the electrical measurements. The particle size of powders and sintering affected the porosity and in turn the specific area of the samples. The larger de area of the capacitor, greater is the capacitance. The powder showed the highest capacitance was with the smallest particle size. Higher temperatures and times of sintering caused samples with smaller surface area, but on the other hand the cleaning surface impurities was higher for this cases. So a balance must be made between the gain that is achieved with the cleaning of impurities and the loss with the decreased in specific area. The best results were obtained for the temperature of 1450ºC/60min. The influence of annealing on the loss factor and ESR did not follow a well-defined pattern, because their values increased in some cases and decreased in others. The most interesting results due to heat treatment were with respect to capacitance, which showed an increase for all samples after treatment

Síntese e caracterização de catalisadores de LaNiO3 não suportados e suportados em Al2O3 e ZrO2 para a reforma a vapor do metano

Ionic oxides with ABO3 structure, where A represents a rare earth element or an alkaline metal and B is a transition metal from group VIII of the periodic table are potential catalysts for oxidation and good candidates for steam reforming reaction. Different methods have been considered for the synthesis of the oxide materials with perovskite structure to produce a high homogeneous material with low amount of impurities and low calcination temperatures. In the current work, oxides with the LaNiO3 formula had been synthesized using the method of the polymeric precursors. The thermal treatment of the materials took place at 300 ºC for 2h. The material supported in alumina and/or zirconia was calcined at 800 ºC temperature for 4h. The samples had been characterized by the following techniques: thermogravimetry; infrared spectroscopy; X-ray diffraction; specific surface area; distribution of particle size; scanning electron microscopy and thermo-programmed reduction. The steam reforming reaction was carried out in a pilot plant using reducing atmosphere in the reactor with a mixture of 10% H2-Argon, a mass about 5g of catalyst, flowing at 50 mL.min-1. The temperature range used was 50 - 1000 oC with a heating rate of 10 oC.min-1. A thermal conductivity detector was used to analyze the gas after the water trapping, in order to permit to quantify the consumption of hydrogen for the lanthanum nickelates (LaNiO3). The results showed that lanthanum nickelate were more efficient when supported in alumina than when supported in zirconia. It was observed that the methane conversion was approximately 100% and the selectivity to hydrogen was about 70%. In all cases were verified low selectivity to CO and CO2