O controle da tuberculose no contexto da atenção primária à saúde no Brasil

O Brasil é um dos países que concentram 80% da carga de tuberculose no mundo. No contexto da atenção primária brasileira, fatores interferem para que as equipes de saúde da família possam incorporar as atividades de controle da doença no processo de trabalho. O controle da doença depende da forma como os serviços de saúde estão organizados para garantir o acesso ao diagnóstico precoce e ao tratamento. Esse estudo tem como objetivo geral analisar o controle da tuberculose no contexto da atenção primária à saúde no Brasil. Os objetivos específicos são comparar o tratamento diretamente observado com o regime autoadministrado em pessoas com tuberculose; Verificar se o Programa Nacional de Controle da Tuberculose é avaliável e elaborar um modelo teórico e lógico para avaliação deste programa; avaliar a relação entre porte populacional dos municípios e as características de estrutura e processo de cuidado a pacientes de tuberculose na atenção primária no Brasil. Realizou-se uma revisão sistemática, seguida de um estudo de avaliabilidade e de um estudo transversal. Os achados da revisão sistemática revelam que não houve diferença significativa entre os grupos de tratamento (observado e não observado) para cura (OR 1,06. IC95% 0,75 - 1,50) e para conclusão do tratamento (OR 1,64, IC 95% 0,79 - 3,42). Menor abandono no grupo com tratamento supervisionado e não houve diferença estatisticamente significativa entre os grupos (OR 0,73, CI 95% 0,58-0,92). O risco de morte foi maior no regime de tratamento autoadministrado (OR 1,49 IC 95% 1,03 - 2,45). A hetorogeinadade entre os estudos analisados não permite afirmar que nao há diferença estatisticamente significativa para cura e tratamento concluído. A pré-avaliação do Programa de Controle de Tuberculose possibilitou a descrição do Programa, elaboração e pactuação do modelo lógico e a matriz de relevância dos indicadores. Caracterizou-se os seus elementos estruturantes, definição de indicadores de estrutura e processo, além das perguntas avaliativas. Uma avaliação somativa com enfoque na análise dos efeitos da intervenção de controle da tuberculose é recomendada. A avaliação das características de estrutura e processo de cuidado à pessoa com tuberculose revelou melhor desempenho para as equipes de atenção básica de municípios classificados como metrópole no acesso, coordenação do cuidado e qualidade técnica da atenção. Em relação ao acesso: 98,5% acolhimento a demanda espontânea; 95,8% programação de consultas. Na coordenação do cuidado, 93,2% existência de protocolo para tuberculose. Quanto a qualidade técnica da atenção à tuberculose verifica-se que 93,4% acompanhamento de tratamento diretamente observado, 95,8% com busca ativa de faltosos ao tratamento, 64,0% oferta de ações educativas, 91,3% busca ativa de sintomáticos respiratórios. Cabe destacar que metrópoles apresentaram maior tempo médio de espera para escuta/acolhimento (24,41 minutos); para consulta previamente agendada (23,52 dias); para consulta em pneumologia (87,12 dias). Percebem-se fragilidades na estrutura e processo da atenção à tuberculose, principalmente no controle especializado da doença e na qualidade técnica entre os municípios. Recomenda-se reforço, particularmente na qualidade técnica para aumentar a cobertura de acompanhamento do tratamento, busca de sintomáticos respiratórios e das ações educativas.

Vigilância eletrônica no trabalho bancário: do controle consentido ao totalitarismo corporativo

This dissertation addresses the electronic surveillance theme in the banking context. The research that originated it, which was held in an organization called for the fiction name Banco Total, started from the following driving question: How do workers at a bank perceive electronic surveillance at their process of work? The research s main objective was to comprehend how workers perceive electronic surveillance at their process of work. The study adopted an interdisciplinary perspective, having Management as the original field, establishing a dialogue with others disciplines, like Philosophy and Sociology. About its methodology, it s a qualitative research that addressed its object in oral (interviews with live history elements) way. . Ten individuals were interviewed. The analytical process utilized the hermeneutical-dialectics technique.. From the analyses (hermeneutics) of the data, the following themes have emerged: (i) Acquiescence ; (ii) Monitoring; (iii) Time and Motion; (iv) Fear; (v) Interdiction; and (vi) Resistance . From the discussion (dialectic) of the results, this work presents three synthetic propositions that culminate in the following dimensions (i) control; (ii) acquiescence; (iii) corporative totalitarianism. It can be concluded that electronic surveillance is one mechanism of control emerged from the apply of technology at Total Bank; that information technology has been improving the control mechanisms of management theories; and that the imbrications between management and material technology control mechanisms at a context where there is acquiescence by workers contribute for the emergency of corporative totalitarianism components

Os programas de incentivo à cultura e o processo de fomento às organizações culturais no Rio Grande do Norte: o caso da Casa da Ribeira em Natal

Since the emergence of the first demands for actions that were intended to give greater attention to culture in Brazil, came the first discussions which concerned the way the Brazilian government could have a positive influence in encouraging the culture, as is its interaction with the actors interested and involved with the cause. During the military dictatorship, there were programs which relied on the direct participation of the State to ensure that right, from the viewpoint of its support and implementation of public resources in developing the "cultural product" to be brought to society in its various forms of expression - all this, funded by the government. It is an example of "EMBRAFILMES" and "Projeto Seis e Meia", continued until the present day in some regions of the country, though maintained by entities not directly connected with the administration or the government. However, it was from the period of democratization and the end of the dictatorship that the Brazilian government began to look at the different culture, under its guarantee to the society. Came the first incentive laws, led by "Lei Sarney" Nº 7.505/86, which was culture as a segment which could receive foreign assistance in order to assist the government in fulfilling its public duty. After Collor era and the end of the embargo through the encouragement of culture incentive laws, consolidated the incentive model proposed in advance of Culture "Lei Sarney" and the federal laws, state and local regimentares as close to this action. This applies to the Rouanet Law (Lei Rouanet), Câmara Cascudo Law (Lei Câmara Cascudo) and Djalma Maranhão Cultural Incentive Law (Lei de Incentivo à Cultura Djalma Maranhão), existing in Natal and Rio Grande do Norte. Since then, business entities could help groups and cultural organizations to keep their work from the political sponsorship under control and regiment through the Brazilian state in the form of their Cultural Incentive Law. This framework has contributed to the strengthening of NGOs and with the consolidation of these institutions as the linchpin of Republican guaranteeing the right to access to culture, but corporate social responsibility was the one who took off in the segment treated here, through the actions of Responsibility Cultural enterprises arising from the Cultural Organizations. Therefore, in the face of this discourse, this study ascertains the process of encouraging the Culture in Rio Grande do Norte from the Deviant Case Analysis at the Casa da Ribeira, the main Cultural Organization that operates, focused action in Natal in order to assess the relationships established between the same entity and the institutions which are entitled to maintain the process of encouraging treated in this study - Enterprise, from the viewpoint of corporate sponsorship and Cultural Responsibility and State in the form of the Laws Incentive Funds and Public Culture Incentive

Estudo paramétrico da recuperação de óleo no processo de drenagem gravitacional com injeção de CO2

The gas injection has become the most important IOR process in the United States. Furthermore, the year 2006 marks the first time the gas injection IOR production has surpassed that of steam injection. In Brazil, the installation of a petrochemical complex in the Northeast of Brazil (Bahia State) offers opportunities for the injection of gases in the fields located in the Recôncavo Basin. Field-scale gas injection applications have almost always been associated with design and operational difficulties. The mobility ratio, which controls the volumetric sweep, between the injected gas and displaced oil bank in gas processes, is typically unfavorable due to the relatively low viscosity of the injected gas. Furthermore, the difference between their densities results in severe gravity segregation of fluids in the reservoirs, consequently leading to poor control in the volumetric sweep. Nowadays, from the above applications of gas injection, the WAG process is most popular. However, in attempting to solve the mobility problems, the WAG process gives rise to other problems associated with increased water saturation in the reservoir including diminished gas injectivity and increased competition to the flow of oil. The low field performance of WAG floods with oil recoveries in the range of 5-10% is a clear indication of these problems. In order to find na effective alternative to WAG, the Gas Assisted Gravity Drainage (GAGD) was developed. This process is designed to take advantage of gravity force to allow vertical segregation between the injected CO2 and reservoir crude oil due to their density difference. This process consists of placing horizontal producers near the bottom of the pay zone and injecting gás through existing vertical wells in field. Homogeneous models were used in this work which can be extrapolated to commercial application for fields located in the Northeast of Brazil. The simulations were performed in a CMG simulator, the STARS 2007.11, where some parameters and their interactions were analyzed. The results have shown that the CO2 injection in GAGD process increased significantly the rate and the final recovery of oil

Avaliação de produtos naturais no controle de biofilmes formados em sistema dinâmico

The biofilms microbial forms of association are responsible for generating, accelerating and / or induce the process of corrosion. The damage generated in the petroleum industry for this type of corrosion is significatives, representing major investment for your control. The aim of this study was to evaluate such tests antibiograms the effects of extracts of Jatropha curcas and essential oil of Lippia gracilis Schauer on microrganisms isolated from water samples and, thereafter, select the most effective natural product for further evaluation of biofilms formed in dynamic system. Extracts of J. curcas were not efficient on the complete inhibition of microbial growth in tests type antibiogram, and essential oil of L. gracilis Schauer most effective and determined for the other tests. A standard concentration of essential oil of 20 μL was chosen and established for the evaluation of the biofilms and the rate of corrosion. The biocide effect was determined by microbial counts of five types of microorganisms: aerobic bacteria, precipitating iron, total anaerobic, sulphate reducers (BRS) and fungi. The rate of corrosion was measured by loss of mass. Molecular identification and scanning electron microscopy (SEM) were performed. The data showed reduction to zero of the most probable number (MPN) of bacteria precipitating iron and BRS from 115 and 113 minutes of contact, respectively. There was also inhibited in fungi, reducing to zero the rate of colony-forming units (CFU) from 74 minutes of exposure. However, for aerobic and anaerobic bacteria there was no significant difference in the time of exposure to the essential oil, remaining constant. The rate of corrosion was also influenced by the presence of oil. The essential oil of L. gracilis was shown to be potentially effective

Potencial larvicida de extratos de plantas regionais no controle de larvas de Aedes Aegypti (Diptera:Culicidae)

Dengue, amongst the virus illnesses one can get by vectorial transmission, is the one that causes more impact in the morbidity and mortality of world s population. The resistance to the insecticides has caused difficulties to control of vector insect (Aedes aegypti) and has stimulated a search for vegetables with larvicidal activity. The biodiversity of Caatinga is barely known and it is potential of use even less. Some plants of this biome are commercialized in free fairs northeast of Brazil, because of its phytotherapics properties. The vegetables in this study had been selected by means of a questionnaire applied between grass salesmen and natives of the Serido region from Rio Grande do Norte state; culicids eggs had been acquired with traps and placed in container with water for the larva birth. Thirty larvae had been used in each group (a group control and five experimental groups), with four repetitions four times. The vegetables had been submitted to the processes of decoction, infusion and maceration in the standard concentration of 100g of the vegetable of study in 1l of H2O and analyzed after ½, 1, 2, 4, 8, 12, 24 and 48 hours for verification of the average lethal dose (LD50) from the groups with thirty larva. The LD50 was analyzed in different concentrations (50g/l, 100g/l, 150g/l, 200g/l e 300g/l) of Aspidosperma pyrifolium Mart. 48 extracts of rind, leaf and stem of the seven vegetal species: Aspidosperma pyrifolium Mart., Mimosa verrucosa Benth, Mimosa hostilis (Mart.) Benth., Myracrodruon urundeuva Allemão, Ximenia americana L, Bumelia sartorum Mart Zizyphus joazeiro Mart, had been analyzed. The extracts proceeding from the three methods were submitted to the freezedrying, to evaluate and to quantify substances extracted in each process. The results had shown that Aspidosperma pyrifolium Mart. and Myracrodruon urundeuva Allemão are the species that are more distinguished as larvicidal after 24 hours of experiment, in all used processes of extraction in the assays. The Zizyphus joazeiro Mart species has not shown larvicidal activity in none of the assays. In relation to the extraction method, the decoction was the most efficient method in the mortality tax of the A. aegypti larvae