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

A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em saúde bucal coletiva

RONCALLI, Angelo Giuseppe. A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em Saúde Bucal Coletiva. raçatuba, 2000. 238p. Tese (Doutorado em Odontologia Preventiva e Social). Faculdade de Odontologia, Universidade Estadual Paulista “Júlio de Mesquita Filho”

Previsão do índice bovespa por meio de redes neurais artificiais: uma análise comparada aos métodos tradicionais de séries de tempo

Forecast is the basis for making strategic, tactical and operational business decisions. In financial economics, several techniques have been used to predict the behavior of assets over the past decades.Thus, there are several methods to assist in the task of time series forecasting, however, conventional modeling techniques such as statistical models and those based on theoretical mathematical models have produced unsatisfactory predictions, increasing the number of studies in more advanced methods of prediction. Among these, the Artificial Neural Networks (ANN) are a relatively new and promising method for predicting business that shows a technique that has caused much interest in the financial environment and has been used successfully in a wide variety of financial modeling systems applications, in many cases proving its superiority over the statistical models ARIMA-GARCH. In this context, this study aimed to examine whether the ANNs are a more appropriate method for predicting the behavior of Indices in Capital Markets than the traditional methods of time series analysis. For this purpose we developed an quantitative study, from financial economic indices, and developed two models of RNA-type feedfoward supervised learning, whose structures consisted of 20 data in the input layer, 90 neurons in one hidden layer and one given as the output layer (Ibovespa). These models used backpropagation, an input activation function based on the tangent sigmoid and a linear output function. Since the aim of analyzing the adherence of the Method of Artificial Neural Networks to carry out predictions of the Ibovespa, we chose to perform this analysis by comparing results between this and Time Series Predictive Model GARCH, developing a GARCH model (1.1).Once applied both methods (ANN and GARCH) we conducted the results' analysis by comparing the results of the forecast with the historical data and by studying the forecast errors by the MSE, RMSE, MAE, Standard Deviation, the Theil's U and forecasting encompassing tests. It was found that the models developed by means of ANNs had lower MSE, RMSE and MAE than the GARCH (1,1) model and Theil U test indicated that the three models have smaller errors than those of a naïve forecast. Although the ANN based on returns have lower precision indicator values than those of ANN based on prices, the forecast encompassing test rejected the hypothesis that this model is better than that, indicating that the ANN models have a similar level of accuracy . It was concluded that for the data series studied the ANN models show a more appropriate Ibovespa forecasting than the traditional models of time series, represented by the GARCH model

Demanda química de oxigênio, clorofila a e comunidade fitoplanctônica como indicadores da qualidade da água no Canal do Pataxó/RN

The current study examined spatial-temporal modifications and water quality through chemical and biotic indicators during both dry (January, February and November 2006) and wet seasons (March to June 2006). This study was carried out in Armando Ribeiro Gonçalves Reservoir, RN, Canal do Pataxó and after the water station treatment (WST). The physical-chemical parameters were measured in situ and inorganic nutrients, chlorophyll a and Free Oxygen Demand (FOD) were analyzed in laboratory conditions. Quali quantitative analyses of phytoplankton were carried out utilizing Sedgwick-Rafter camera. Results indicate that DQO concentrations were low. FOD concentrations in the reservoir were comparatively higher in the dry season (5.21 mgL-1; 5.64 mgL-1 e 6.05 mgL-1) in relation to the wet season (4.52 mgL-1; 4.12 mgL-1 e 4.92 mgL-1), in surface, intermediate and bottom waters, respectively. FOD values were inferior to 1.0mgL-1in both Canal do Pataxó and after WST, which is considered adequate for public use reservoirs. Although FOD concentrations were low, Armando Ribeiro Gonçalves Reservoir, Canal do Pataxó and WST were classified as euthophizied, mesotrophic ad oligotrophic, respectively, considering the Index of Trophic State Criteria. Chlorophyll a concentrations in the study reservoir were higher in the surface (199.2 µgL-1) during the wet season, whereas in Canal do Pataxó concentrations decreased from 1.56 µgL-1 to 0.028 µgL-1, and after WST values were low (0.059 µgL-1). Dominance of cianobacterias, such as Planktotrhix agardhii (dry season) and Microcystis sp (wet season) was registered in all three areas. In the reservoir and Canal do Pataxó, density of cianobacterias, such as P. agardhii and Microcistys sp., was superior to the values allowed by the Health ministry (HM). However, after WST, density values of cianobacteria were inferior to values established by the HM

Modelagem e previsão da perda de injetividade em poços canhoneados

Waterflooding is a technique largely applied in the oil industry. The injected water displaces oil to the producer wells and avoid reservoir pressure decline. However, suspended particles in the injected water may cause plugging of pore throats causing formation damage (permeability reduction) and injectivity decline during waterflooding. When injectivity decline occurs it is necessary to increase the injection pressure in order to maintain water flow injection. Therefore, a reliable prediction of injectivity decline is essential in waterflooding projects. In this dissertation, a simulator based on the traditional porous medium filtration model (including deep bed filtration and external filter cake formation) was developed and applied to predict injectivity decline in perforated wells (this prediction was made from history data). Experimental modeling and injectivity decline in open-hole wells is also discussed. The injectivity of modeling showed good agreement with field data, which can be used to support plan stimulation injection wells

Um Modelo híbrido para previsão de curvas de produção de petróleo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

O direito coletivo prestacional à saúde e o poder judiciário: a concretização do art. 196 da Constituição de 1988 pela via jurisdicional

During the ninth century, owing to the process of industrialization, new social conflicts were showed, forcing the Government not to remain inert. The necessity of answer to these new demands requires from the State some actions that assure the new economic, cultural and social rights, able to exceed the formal equality, according to the principles of redistributive equality and well-being. Among the social rights, the right to health is showed up, which is placed at the Universal Declaration of Human Rights and the International Treaty for the Economic, Social and Cultural Rights, as a necessary term to promote the dignity and the free development of the human personality. Under the Constitutional Law, it is clear that the implementation of the right to health, placed at the 6th article of the Brazilian Constitution, demands a government activity, which usually requires a provision of material goods, depending on budgetary resources. The Legislative and Executive Branches have a very important role in compliance with the constitutional regulations about the satisfactory offer of health care services, besides the correct use of the resources at this area. The adoption of public policies is the way of Government action to the planning and realization of this right. Though, some public policies are usually made apart from the social compromises, to the detriment of the basic social rights. The government has a discretionary competence to manage the health services. That is the reason it is necessary the control of the political choices, through the popular control, the extrajudicial control by the Account Courts, or the judicial review. Owed to the constitutionalization of social rights, the constitutional justice has a very relevant role, concerning to the constitutional jurisdiction, in a way the Judiciary Branch assume your position as a player that transforms the society. On the control of the public health policies, there is a cast of official instruments, judicial or not, to the guarantee of the collective right to the public health services, and to allow the citizens to reach the real implementation of the right to health

Estimação da demanda de instalações elétricas de edificações com múltiplas unidades de consumo

This work aims to predict the total maximum demand of a transformer that will be used in power systems to attend a Multiple Unit Consumption (MUC) in design. In 1987, COSERN noted that calculation of maximum total demand for a building should be different from that which defines the scaling of the input protection extension in order to not overestimate the power of the transformer. Since then there have been many changes, both in consumption habits of the population, as in electrical appliances, so that this work will endeavor to improve the estimation of peak demand. For the survey, data were collected for identification and electrical projects in different MUCs located in Natal. In some of them, measurements were made of demand for 7 consecutive days and adjusted for an integration interval of 30 minutes. The estimation of the maximum demand was made through mathematical models that calculate the desired response from a set of information previously known of MUCs. The models tested were simple linear regressions, multiple linear regressions and artificial neural networks. The various calculated results over the study were compared, and ultimately, the best answer found was put into comparison with the previously proposed model

Extração e Representação de Conhecimento de Séries Temporais de Demanda de Energia Elétrica Usando TSKR

The opening of the Brazilian market of electricity and competitiveness between companies in the energy sector make the search for useful information and tools that will assist in decision making activities, increase by the concessionaires. An important source of knowledge for these utilities is the time series of energy demand. The identification of behavior patterns and description of events become important for the planning execution, seeking improvements in service quality and financial benefits. This dissertation presents a methodology based on mining and representation tools of time series, in order to extract knowledge that relate series of electricity demand in various substations connected of a electric utility. The method exploits the relationship of duration, coincidence and partial order of events in multi-dimensionals time series. To represent the knowledge is used the language proposed by Mörchen (2005) called Time Series Knowledge Representation (TSKR). We conducted a case study using time series of energy demand of 8 substations interconnected by a ring system, which feeds the metropolitan area of Goiânia-GO, provided by CELG (Companhia Energética de Goiás), responsible for the service of power distribution in the state of Goiás (Brazil). Using the proposed methodology were extracted three levels of knowledge that describe the behavior of the system studied, representing clearly the system dynamics, becoming a tool to assist planning activities

Previsão do módulo de elasticidade transversal de compósitos unidirecionais através de redes neurais mistas

The aim of this study is to create an artificial neural network (ANN) capable of modeling the transverse elasticity modulus (E2) of unidirectional composites. To that end, we used a dataset divided into two parts, one for training and the other for ANN testing. Three types of architectures from different networks were developed, one with only two inputs, one with three inputs and the third with mixed architecture combining an ANN with a model developed by Halpin-Tsai. After algorithm training, the results demonstrate that the use of ANNs is quite promising, given that when they were compared with those of the Halpín-Tsai mathematical model, higher correlation coefficient values and lower root mean square values were observed

Estudo do equilíbrio líquido-vapor do sistema água+etanol+líquido iônico visando a separação do álcool anidro

Anhydrous ethanol is used in chemical, pharmaceutical and fuel industries. However, current processes for obtaining it involve high cost, high energy demand and use of toxic and pollutant solvents. This problem occurs due to the formation of an azeotropic mixture of ethanol + water, which does not allow the complete separation by conventional methods such as simple distillation. As an alternative to currently used processes, this study proposes the use of ionic liquids as solvents in extractive distillation. These are organic salts which are liquids at low temperatures (under 373,15 K). They exhibit characteristics such as low volatility (almost zero/ low vapor ), thermal stability and low corrosiveness, which make them interesting for applications such as catalysts and as entrainers. In this work, experimental data for the vapor pressure of pure ethanol and water in the pressure range of 20 to 101 kPa were obtained as well as for vapor-liquid equilibrium (VLE) of the system ethanol + water at atmospheric pressure; and equilibrium data of ethanol + water + 2-HDEAA (2- hydroxydiethanolamine acetate) at strategic points in the diagram. The device used for these experiments was the Fischer ebulliometer, together with density measurements to determine phase compositions. The experimental data were consistent with literature data and presented thermodynamic consistency, thus the methodology was properly validated. The results were favorable, with the increase of ethanol concentration in the vapor phase, but the increase was not shown to be pronounced. The predictive model COSMO-SAC (COnductor-like Screening MOdels Segment Activity Coefficient) proposed by Lin & Sandler (2002) was studied for calculations to predict vapor-liquid equilibrium of systems ethanol + water + ionic liquids at atmospheric pressure. This is an alternative for predicting phase equilibrium, especially for substances of recent interest, such as ionic liquids. This is so because no experimental data nor any parameters of functional groups (as in the UNIFAC method) are needed

Avaliação da disponibilidade hídrica e da demanda hídrica no trecho do Rio Piranhas-Açu entre os açudes Coremas-mãe D´água e Armando Ribeiro Gonçalves

Piranhas-Açu basin is a Federal watershed with a drainage area of 43.681,5 km2, sited at Brazilian northeast semi arid, with 60% of your area in Paraiba State and 40% in Rio Grande do Norte State. The main river, Piranhas-Açu, has strategic importance for development of these states, because it s an essential source for many socio-economics activities developed along watercourse. The river s reach between Coremas-Mãe D`água Dam and Armando Ribeiro Gonçalves Dam has many irrigation projects, and supply many riverside cities. All this activities practiced in this river s reach consumes high water volumes. Due the importance of this stream and the necessity of an adequate management, this work aims for an impartial and detailed evaluation of real water supply conditions in this river s reach, by the application of hydrological modeling, including the arrangement of main dams in tributaries, and storage reservoir water balance. The rainfall-discharge model s applied in each sub-basins it was selected the model MODHISA- Hydrological Model of Semi Arid, that is a concentrated model with easy application. The simulation produced 50 years of inflows into the reservoirs, for which, were constructed the guaranties curves; and produced 50 years of synthetic discharge data in relevant points on the river and on its affluents; so it was constructed the permanence curves. Confronting the available discharge with the current and futures volumes of raw water captured in this river s reach, it was verified that de demands have high guaranties. This work concluded that the MODHISA Model is suitable to reproduce the hydrologic characteristics of Piranhas-Açu sub-basins, and showing good results