Efetividade da doxiciclina na profilaxia contra letptospirose

Leptospirosis is a worldwide zoonosis of considerable medical and economical importance that affects humans in both urban and rural contexts, as well as domestic animals and wild fauna. Leptospira interrogans is the causative agent and is transmitted to humans by indirect contact with contaminated soil or water. The clinical syndromes include sub clinical infection, self-limited anicteric febrile illness, and severe and potentially fatal illness, known as Weil´s syndrome. In developed countries, leptospirosis is related to occupational or recreational activities while in developing countries, outbreaks occur during floods. In those regions, traditional strategies to prevent the transmission are difficulties to be implemented because of costs and lack of community acceptance. In addition, no efficient vaccine is available for human use. Several studies have suggested that chemoprophylaxis with doxycycline pre and post-exposure may be effective to prevent leptospirosis. Leptospirosis has been reported in rural areas of the State of Rio Grande do Norte, Brazil since 1985 in rice farmers who present the anicteric illness. The disease cause great social and economics impact. The study was conducted in São Miguel where an epidemic of leptospirosis in rice farmers was reported. The main objective was to determine the efficacy of doxycycline in preventing Leptospira exposure. A taxa de soroprevalência de leptospirose na população estudada antes e após a colheita foi de 14,2% (n=22) e de 16.6% (n=27) respectivamente. Anti-Leptospira serology was determined for 61 subjects in two instances, pre and post-exposure to potential contaminated water. There was an increased risk of 29.0 per cent in acquiring infection for individuals that did not use doxycycline. In addition, an increased risk of 30.0 % observed in farmers who did not use protection when exposed to Leptospira. The adhesion to preventive chemoprophylaxis was 55.7%. Therefore doxycycline, under specific circunstances appears to be an effective alternative to protect against leptosprirosis infection. A large sample composed of individuals to adhere to preventive therapy is needed to define time, dosage and length of use of doxycycline in this area

Acordos internacionais sobre a produção compartilhada de recursos naturais: a unitização interestatal na área do petróleo e gás sob o enfoque constitucional brasileiro

The apportionment of natural resources between sovereign States is a subject that relates many aspects of International law, as long as Constitutional Law, at the execution and application phases of international treaties that regulates the exploration of common goods. In this sense, because of their natural characteristics that creates an environment of constant migration and fixation in transboundary regions, terrestrial or maritime, the petroleum and the natural gas bound a complex juridical apparatus that can control the sovereign rights involved. This research is aim at accomplishing a study concerning the international agreements that enable the non-unilateral action, specifically the unitization treaties between sovereign States, as a manner to resolve situations related to the individualization of oil and/or gas reservoirs that go across their national borders. These agreements will be analyzed considering the international public law sources theory, bearing in mind yet the already existed experiences in this sense, not disregarding the way that this fact could affect Brazil. It will begin with an historical incursion over the unitization institute, covering its main characteristics and its formation and execution procedures, and finally it will address the Brazilian legal system and the comparative law threats the institute. The clauses of these relevant agreements will be analyzed in details, concerning its particularities and its contents. Because these agreements are international obligatory rules of law, it is indispensable that they are considered under the auspices of the international law system, focusing their nature and the subjects of international law and establishing them as sources of the international law, analyzing them, then, as international rules and the applicable law to these juridical relations, the conventional established, the consolidated international custom and the applicable International Law principles, appearing the State s responsibility as an important subject for the verification of the acts lawful practiced by States. The analysis of the apportionment of these natural resources ends with the individualization of possible exploitable marine oil fields located between the exclusive economic zone and the continental platform ends and the region administrated by the International Seabed Authority. At last, the Brazilian constitutional system appears as the mechanism of integration, application and execution of the international unitization agreements in Brazil, detaching the format and the proceedings that the international treaties take to acquire validity at the national legal system, passing through the treaties interpretation and the applicable constitutional principles, coming to its application in Brazil, considering the existing constitutional peculiarities and the role played by the National Agency of Petroleum, Natural Gas and bio-fuel ANP

O desafio constitucional da distribuição dos royalties de petróleo da bacia pré-sal para promoção de políticas públicas

The administrative model of the Brazilian State, based on regulation, strives, with the application of the efficiency principle and assessment of economical costs, to give a greater effectiveness to fundamental rights by implementing public policies.The objective of this work is to analyze the role of Oil royalties in the context of the Brazilian State, considering that, being an income gap, they might work as a device that promotes intra/intergenerational justice. By means of a correct and efficient distribution and application in the national region, the royalties constitute financial resources available for implementing public policies that intend to guarantee the fundamental rights; above all, with the discovery of the Pre-salt basin and the indisputable rise in the tax revenues arising from Oil exploration. In the making of this work, the theoretical-descriptive methodology is observed, grounded in a critical-reflexive analysis about Constitutional Law and Oil Law. This work analyzes the administrative model of the Brazilian State, the theory of costs of fundamental rights and the theoretical aspects about royalties, such as: the ethical and economical fundamentals, the distribution and destination of revenues, considering the oil exploration scenario before and after the discovery of the pre-salt basin. it is verified, with the present work, the importance of the creation of a new regulatory framework, and consequently the creation of a sovereign wealth fund, which arises to re-evaluate the application of the current norms of Oil revenue distribution. Still, it is imperative that the mechanisms for controlling the application of royalties are defined in detail, so that those can fully admit the objectives of intra/intergenerational justice. Furthermore, it is emphasized that this process should develop from the efficiency principle viewpoint, as well as the principle of reducing social and regional differences, given that the Oil revenues might be used to ensure fundamental social rights, by implementing public policies that are aligned with the development recommended by the Federal Constitution

A Fruticultura Irrigada de pequenos produtores no Baixo-Açu: Uma análise da eficiência de custo

This work has as an objective analyze the efficiency of producers costs of the irrigation Project Baixo-Açu , and identify the determining factors of this efficiency. To achieve these targets it was estimated, in a first stage, a frontier of costs by the method, non parametric of Data Envelopment Analysis-DEA, and measured the stakes of efficiency producers. On the second stage, it was utilized the Tobit regression pattern, estimating an inefficiency function of costs, and were indentified the associated factors of resources waste. Among the results found it was noticed the existence of a high waste of resources, that represent more than 54% of effective cost. Among the factors with the highest wastes are: energy, herbicides, defensives and chemical fertilizers. In a general way, the producers presented low efficiency level and, only, two, of seventy-five researched, achieved the frontier of costs minimization. These results reveal, in a certain way, that the producers in irrigated fruit growing in the project Baixo-Açu don t seek to minimize the production costs. It was still noticed, that the reduction of resources waste, and this way the inefficiency of costs, is associated with the agriculturalist education, his experience in agriculture, his access to the technical assistance and credit

Fatores de decisão da adoção do gás natural na geração de energia elétrica em pequena escala em postos de combustíveis: um estudo de anális de decusão usando o processo de hierarquia analítica AHP

A modeling of criterias and alternatives is through and applied a questionnaire based on method AHP to proprietors of gas stations. The considered alternatives had been the maintenance of the current state with electric energy of the deliverer and the generation in small scale based on the natural gas. The used criteria had been Cost of the Investment, Final Cost of the Energy, Operational cost, Ambient Benefits, Risk and Variation of Costs. The study it was carried through in the city of Natal, RN in ranks that make use of the natural as for resale, where the generation alternative on the basis of the available gas is present. The main results evidence in a dimension the viability of use of method AHP with questionnaire by means of validation of the judgments with analysis of variance beyond proper the normal mechanisms of analysis of consistency to the method. The main results of the analysis help to show that in this in case that the profile of models of criteria and judgments of the actors is similar, with the final evidence of that it has a dominance of the maintenance of the energy of the deliverer. The main criterion to influence this decision was the risk

Gestão logística e comércio exterior: um estudo de caso em uma empresa exportadora do setor de alimentos

The thesis argues the importance of the logistic management for the performance of the companies and for the foreign trade. The study is endorsed in construction of one analyses that brings in its essential the underlyng elements for the understanding of the subject. The analyse made from the data of an exporters company of Rio Grande of the Norte, with performance in the branch of candies, allowed to evaluate an efficient of the logistic management, that involving operacional and financial questions, is unavoidable for reduction of costs of the companies and has significant impact is its profitability

Controle por modos deslizantes com compensação difusa aplicado a sistemas com descontinuidade

The development of non-linear controllers gained space in the theoretical ambit and of practical applications on the moment that the arising of digital computers enabled the implementation of these methodologies. In comparison with the linear controllers more utilized, the non -linear controllers present the advantage of not requiring the linearity of the system to determine the parameters of control, which permits a more efficient control especially when the system presents a high level of non-linearity. Another additional advantage is the reduction of costs, since to obtain the efficient control through linear controllers it is necessary the utilization of sensors and more refined actuators than when it is utilized a non-linear controller. Among the non-linear theories of control, the method of control by gliding ways is detached for being a method that presents more robustness, before uncertainties. It is already confirmed that the adoption of compensation on the region of residual error permits to improve better the performance of these controllers. So, in this work it is described the development of a non-linear controller that looks for an association of strategy of control by gliding ways, with the fuzzy compensation technique. Through the implementation of some strategies of fuzzy compensation, it was searched the one which provided the biggest efficiency before a system with high level of nonlinearities and uncertainties. The electrohydraulic actuator was utilized as an example of research, and the results appoint to two configurations of compensation that permit a bigger reduction of the residual error

Desenvolvimento e avaliação de padrão de torque para calibração de torquímetros em três faixas de medição

The continuous development of instruments and equipment used as tools or torque measurement in the industry is demanding more accurate techniques in the use of this kind instrumentation, including development of metrological characteristics in torque measurement. The same happens with the needs in calibration services. There is a diversity of methods of hand torque tools in the market with different measuring range but without complaining with technical standards in terms of requirements of quality and reliability. However, actually there is no choice of a torque measuring standard that fulfils, with low cost, the needs for the calibration of hand torque tools in a large number of ranges. The objective of this thesis is to show the development and evaluation of a torque measuring standard device with a conception to allow the calibration of hand torque tools with three levels of torque with an single instrument, promoting reduction of costs and time in the calibration, also offering reliability for the evaluation of torque measuring instrument. To attend the demand in the calibration of hand torque tools it is necessary that the calibration laboratories have a big collection of torque measuring standards, to fulfills the needs of the costumer, what is very costly. The development of this type of torque measuring standard revealed a viable technique and economically making possible the calibration of hand torque tools in different nominal ranges through a single measurement system versatile, efficient and of easy operation

Aplicação da água residuária das salinas no tratamento de efluente têxtil

The treatment of colored and alkaline effluent has been a challenge to the textile industry. An alternative to remove the colors of those effluents is applying magnesium chloride as a coagulant agent. The magnesium ion, in high pH, hydrolyzes itself, forming the magnesium hydroxide which has a large adsorptive area and positive electrostatic charges able to act as an efficient coagulant. The bittern wastewater from the salt industries has been studied as a potential font of this magnesium ion. Nowadays, this bittern wastewater is evicted into the sea, without any treatment or other use. This thesis has evaluated the potential of applying the wastewater from the salt industries in the treatment of dyeing effluent containing indigo dye and alkaline pH. All the experiments were made in jar tests simulating the chemical coagulation, flocculation and decantation steps ranging the pH and the concentration of magnesium ion. Were obtained removals between 96% and 76% for turbidity, apparent color, and true color, respectively, using 200mg/L Mg2+. The reduction of costs with acid, when were used the salt industries wastewater, comparing with Al2(SO4)3, was 62%. For the degradation of organic matter remaining in the clarified, around 900 mg/L, was applyed the advanced process of oxidation: photo-Fenton. The preliminary results showed 57% reduction in DOC. According to the results obtained, the salt industries wastewater can be applied, as coagulant, in the physical-chemical treatment of the denim dyeing wastewater, so it is not necessary a previous adjust of pH, efficiently and economically

Uma avaliação do serviço de atenção domiciliar/programa melhor em casa: o caso do hospital Monsenhor Walfredo Gurgel

This dissertation try to understand how management actions implemented by Monsenhor Walfredo Gurgel Hospital in the city of Natal promote effectively the benefits of Home Care Services / Programa Melhor em Casa . The research is exploratory and descriptive, qualitative approach. Data were collected through document analysis and the interviews with the managers of the Program in Health Department and Hospital beyond the questionnaires with the home care teams and technical management unit of Hospital Jobs. The information were treatment trough categories that analyzed to implemented actions and program objectives. The results show that: the practices carried out by the host teams produce the humanization of care by seeking to ensure access to health services and solving human form; networks of health care are not yet finalized hindering the referral of patients to other units, the networks allow support from other institutions to minimize the problems encountered, the management unit vacancies allows the reduction of costs, mainly by regulating beds and record of health initiatives in home care assists in the monitoring and evaluation process of the Services Home Care / Programa Melhor em Casa primarily the epidemiological profile and patients individual treatment plan. Concludes that most of the actions implemented by the Hospital contribute to the effectiveness of the goals of Programa Melhor em Casa

O problema biobjetivo da árvore geradora quadrática em adjacência de arestas

The Quadratic Minimum Spanning Tree Problem (QMST) is a version of the Minimum Spanning Tree Problem in which, besides the traditional linear costs, there is a quadratic structure of costs. This quadratic structure models interaction effects between pairs of edges. Linear and quadratic costs are added up to constitute the total cost of the spanning tree, which must be minimized. When these interactions are restricted to adjacent edges, the problem is named Adjacent Only Quadratic Minimum Spanning Tree (AQMST). AQMST and QMST are NP-hard problems that model several problems of transport and distribution networks design. In general, AQMST arises as a more suitable model for real problems. Although, in literature, linear and quadratic costs are added, in real applications, they may be conflicting. In this case, it may be interesting to consider these costs separately. In this sense, Multiobjective Optimization provides a more realistic model for QMST and AQMST. A review of the state-of-the-art, so far, was not able to find papers regarding these problems under a biobjective point of view. Thus, the objective of this Thesis is the development of exact and heuristic algorithms for the Biobjective Adjacent Only Quadratic Spanning Tree Problem (bi-AQST). In order to do so, as theoretical foundation, other NP-hard problems directly related to bi-AQST are discussed: the QMST and AQMST problems. Bracktracking and branch-and-bound exact algorithms are proposed to the target problem of this investigation. The heuristic algorithms developed are: Pareto Local Search, Tabu Search with ejection chain, Transgenetic Algorithm, NSGA-II and a hybridization of the two last-mentioned proposals called NSTA. The proposed algorithms are compared to each other through performance analysis regarding computational experiments with instances adapted from the QMST literature. With regard to exact algorithms, the analysis considers, in particular, the execution time. In case of the heuristic algorithms, besides execution time, the quality of the generated approximation sets is evaluated. Quality indicators are used to assess such information. Appropriate statistical tools are used to measure the performance of exact and heuristic algorithms. Considering the set of instances adopted as well as the criteria of execution time and quality of the generated approximation set, the experiments showed that the Tabu Search with ejection chain approach obtained the best results and the transgenetic algorithm ranked second. The PLS algorithm obtained good quality solutions, but at a very high computational time compared to the other (meta)heuristics, getting the third place. NSTA and NSGA-II algorithms got the last positions

Gasto com a internação de idosos em unidades de terapia intensiva

Introduction: Population aging in Brazil underscores the need to discuss the proper management of the budget allocated in health field, especially in the sectors of high complexity, where coexist costly procedures, limited resources and the need for cost containment. In the other hand, demand is growing in a way directly proportional to the increase in the number of elderly in country. Objective: In this way, this research had as main objective to analyze the costs resulting from the admission of elderly in intensive care units (ICU) and its associated factors. Methods: This is a cross-sectional study with a quantitative approach and featured as a descriptive and exploratory research. Data were collected from medical records of elderly hospitalized in ICU from a brazilian city called Natal-RN, between november first, 2013 and january, 31 of 2014. The variables collected relate to the socio demographic profile, morbidity framework and characterization of hospitalization. The dependent variable was categorized by quartile 75 in high and low expense of hospitalization and submitted to chi-square test with the independent variables of the survey. Associations with p value <0.20 in the bivariate analysis were submitted to the technique of multiple logistic regression. We opted for the construction of three regression models from the above algorithm: general regression model, composed by all 493 hospitalizations in the study, other made with 181 individuals admitted in health public system (SUS) and a third one related to 312 cases from private service in health area. Results: In the general regression model, the variables respiratory diseases, hospitalizations in the private system, disoriented patient and previous stroke were associated with greater probability of high spending in the ICU. In the other hand, in SUS kind of hospitalizations, this probability was associated with disoriented patient, 80 years old or more, sepsis and admission for clinical reason. In the cases from the private network health, the high expenditure was associated with respiratory disease, mechanical ventilation, hospitalization for clinical reason and disoriented patients. Conclusion: The increased expenditure on hospitalization of elderly in intensive care depends on the clinical conditions of individuals. This highlights the importance of avoiding hospitalizations due to diseases sensitive to primary care by health preventive actions and providing comprehensive care to the elderly. In addition, obtaining different explanatory models, according to kind hospital funding, demonstrates the importance of the organization in health services related to composition of costs of hospitalization among the elderly. Another question founded was the need that to improve the funding, we must use rationally the available resources by avoiding unnecessary hospitalizations of elderly people in the extremes of severity. On this kind of precarious funding, ICU hospitalization of elderly non-critical or in a terminal state can compromise the quality of services provided to those who really need intensive care.

Efetividade da doxiciclina na profilaxia contra letptospirose

Leptospirosis is a worldwide zoonosis of considerable medical and economical importance that affects humans in both urban and rural contexts, as well as domestic animals and wild fauna. Leptospira interrogans is the causative agent and is transmitted to humans by indirect contact with contaminated soil or water. The clinical syndromes include sub clinical infection, self-limited anicteric febrile illness, and severe and potentially fatal illness, known as Weil´s syndrome. In developed countries, leptospirosis is related to occupational or recreational activities while in developing countries, outbreaks occur during floods. In those regions, traditional strategies to prevent the transmission are difficulties to be implemented because of costs and lack of community acceptance. In addition, no efficient vaccine is available for human use. Several studies have suggested that chemoprophylaxis with doxycycline pre and post-exposure may be effective to prevent leptospirosis. Leptospirosis has been reported in rural areas of the State of Rio Grande do Norte, Brazil since 1985 in rice farmers who present the anicteric illness. The disease cause great social and economics impact. The study was conducted in São Miguel where an epidemic of leptospirosis in rice farmers was reported. The main objective was to determine the efficacy of doxycycline in preventing Leptospira exposure. A taxa de soroprevalência de leptospirose na população estudada antes e após a colheita foi de 14,2% (n=22) e de 16.6% (n=27) respectivamente. Anti-Leptospira serology was determined for 61 subjects in two instances, pre and post-exposure to potential contaminated water. There was an increased risk of 29.0 per cent in acquiring infection for individuals that did not use doxycycline. In addition, an increased risk of 30.0 % observed in farmers who did not use protection when exposed to Leptospira. The adhesion to preventive chemoprophylaxis was 55.7%. Therefore doxycycline, under specific circunstances appears to be an effective alternative to protect against leptosprirosis infection. A large sample composed of individuals to adhere to preventive therapy is needed to define time, dosage and length of use of doxycycline in this area