Adesão ao tratamento, acesso e qualidade da assistência em Aids no Brasil

A adesão à terapia antirretroviral (TARV) é crucial para a efetividade e o impacto do tratamento da Aids. Este artigo discute as relações entre adesão e qualidade dos serviços de assistência a pessoas vivendo com Aids (PVA), evidenciando a qualidade como elo central entre adesão e acesso. Está baseado nos resultados de pesquisas que conduzimos sobre a atenção a PVA no Brasil. Nossos estudos apontam que os grupos de pacientes acompanhados em serviços com número inferior a 100 pacientes apresentam risco estimado de não adesão maior do que os grupos acompanhados em serviços com mais de 500 pacientes. Apontam também que serviços com menos de 100 pacientes têm risco estimado maior de pertencer a grupos de má qualidade. Isto está relacionado à baixa complexidade observada nos serviços de menor porte caracterizada por: dificuldades em manter uma estrutura mínima de recursos humanos e materiais, simplificação da organização dos processos de trabalho, centramento no trabalho autônomo do profissional médico e gerenciamento sem projeto técnico. Há necessidade de pautar novos estudos sobre adesão e qualidade. As evidências existentes já apontam, porém, a necessidade de revisão na alocação dos serviços de assistência a PVA, bem como a de homogeneizar a qualificação destes serviços, condições necessárias para a manutenção de taxas aceitáveis de adesão à TARV no país.

Diagnostic de sécurité d’une entreprise brésilienne à partir de l’analyse des accidents du travail par la méthode de l’arbre des causes

We present here the results of a study of 21 work-related accidents that occurred in a Brazilian manufacturing company. The aim was to assess the safety level of the company to improve its work accident prevention policy. In the last 6 months of 1992 and 1993, all accidents resulting in 15 days' absence from work, reported for social security purposes, were analyzed using the INRS causal tree method (ADC) and a questionnaire completed on site. Potential risk factors for accidents were identified based on the specific factors highlighted by the ADC. More universal trees were also compiled for the safety assessment. Three hundred and thirty specific accident factors were recorded (mean of 15.71 per accident). This is consistent with there being multiple causes of accidents rather than the assertion of Brazilian business safety departments that accidents are due to dangerous or unsafe behavior. Introducing the idea of culpability into accidents prevents the implementation of an appropriate information feedback process, essential for effective prevention. However, the large number of accidents related to material (78%) and environment (70%) indicates that working conditions are poor. This shows that the technical risks, mostly due to unsafe machinery and equipment are not being dealt with. Seventy-five potential accident factors were identified. Of these, 35% were organizational, a high proportion for the company studied. Improvisation occurs at all levels, particularly at the organizational level. This is thus a major determinant for entire series of, if not most, accident situations. The poor condition of equipment also plays a major role in accidents. The effects of poor equipment on safety exacerbate the organizational shortcomings. The company's safety intervention policy should improve the management of human resources (rules designating particular workers for particular workstations; instructions for the safe operation of machines and equipment; training of operators, etc.) and introduce programs to detect risks and to improve the safety of machines and equipment. We also recommend the establishment of a program to follow the results of any preventive measures adopted.

Reflexão sobre o ensino farmacêutico

This paper aims to discuss the directions of pharmaceutical education based on the new curriculum guidelines from MEC (Ministry of Education - Brazil). In the recent past, Brazilian pharmaceutical faculties prioritized the formation of professional resources in specific modalities in detriment of pharmacist's private field: the prescription filling and delivery at the drugstore. In order to avoid repeating the same mistake it is necessary to develop new competence, allowing the graduates to develop skills to connect the scientific and technological knowledge to Brazilian social context. The new curriculum guidelines are about to finish a time when the undergraduate studies seemed to split the pharmacist into two different professionals: one for the clinical analysis and other for the pharmaceutical industry. The previous educational model, which supposedly allows for pharmaceutical care without providing a broad integral knowledge of health sciences, cannot be repeated in the new curriculum. However, teaching subjects in a superficial and segmented manner, replete of predictable and repetitive technical practices and without a skilled teaching staff, will give no improvement in pharmacists education care. It is clear that the return of the formation of specific human resources in the field won't happen in short time.

Diversity management: Challenges, benefits, and the role of human resource management in Brazilian organizations

Purpose The objective of this study was to analyze the major challenges and benefits of diversity management in Brazilian companies by assessing the role of human resources. Design/methodology/approach A total of 15 case studies were carried out on companies that operate in Brazil. Brazil is a country with considerable diversity and multiracial backgrounds. Findings It was found that diversity management in Brazilian companies is still an emerging issue, and the major challenges are related to discriminatory actions taken by coworkers. Among the 15 companies studied, only four had adopted a consistent set of diversity management and human resources practices. These four companies were the only companies to affirm that diversity management requires the strong support of top management and continuous organization to sustain efforts toward incorporating diversity. Originality/value Research studies on diversity management in Brazil are scarce. The findings of this study, however, can be useful to academic professionals and company directors in countries that exhibit similar characteristics to those of Brazil, or to those who are interested in learning more about Brazil. © 2011 Emerald Group Publishing Limited. All rights reserved.

Tamanho de amostra e estimativa de custo em levantamento epidemiológico de cárie dentária

This study aimed to analyze how the prevalence and the distribution of dental caries influence the sample size in epidemiological surveys, and how much are the costs. Secondary data of oral health surveys in 12-year-old schoolchildren from Bauru in 1976, 1984, 1990, 1994, and 2001, and from Piracicaba in 2001 and 2005 were studied. Sample sizes were estimated taking into account the mean DMFT and standard deviation of each survey, establishing sampling errors of 1%, 2%, 5%, and 10%. Costs were estimated considering permanent material, consumption material and human resources. The sample size in both towns needed to be increased, ranging from 119 in 1976 to 1,118 in 2001 in Bauru, and from 954 in 2001 to 1,252 in 2005 in Piracicaba, when a sampling error of 10% was considered. The cost of dental caries surveys was verified considering different sampling errors. This cost depends on how acceptable is the margin of difference between the true mean and the one found in the survey. In conclusion, the reduction in the prevalence of dental caries has determined the need for increase in sample size and in costs for conducting the surveys.

Environmental development in Brazilian companies: The role of human resource management

Specialized literature states that proper environmental management at companies requires support from human resource management. This occurs because the more efficient and effective human resource management is, the more it tends to contribute towards the organization's objectives. Considering that environmental management is an emerging organizational objective, human resource practices, when efficient and effective, tend to incorporate environmental goal and to become greener. In order to contribute to this emerging field of research, this paper reports on an empirical study about the relationship between human resources and environmental management at 75 Brazilian companies. The data collected were analyzed statistically using Structural Equation Modeling. The main results indicated that human resource management practices tend to statistically significant relate to environmental management at analyzed companies, through validation of H 1, but his relationship can be considered weak. © 2012 Elsevier B.V.

Building sustainable values in organizations with the support of human resource management: Evidence from one firm considered as the 'best place to work' in Brazil

Researchers and other professionals unanimously agree that companies should become more sustainable, but this will not happen without the support of human resource management. Paradoxically, there is a lack of information on the support human resource management offers to organizational sustainability applied to real cases. Therefore, this research presents a case study on this topic that was carried out in a leading Brazilian company, which is considered as a model and has been selected as 'the best place to work in the country'. The results provide practical examples of how this family company has been working to guarantee an increasingly sustainable performance with the support of human resources, highlighting the achievements and challenges the company has faced. One of the main results indicates that companies seeking to achieve sustainability need the assistance of the human resource field in order to design a communication system which bridges the gap between practices and sustainable values. © 2012 Management Centre for Human Values.

Chlamydophila psittaci infections in hyacinth macaws (anodorhynchus hyacinthinus) confiscated in Brazil

The hyacinth macaw (Anodorhynchus hyacinthinus) is the largest species of psittacine birds. It is considered endangered and illegal trade is one of the main factors involved in its decline. In this study, 26 hyacinth macaws maintained under poor husbandry conditions and destined for the illegal trade were confiscated in São Paulo State, Brazil. These birds were evaluated for the presence of antibodies against Chlamydophila psittaci by complement fixation test and C. psittaci DNA by seminested polymerase chain reaction. Results showed that 65.4% of the macaws were positive for at least one test. Birds with subclinical infections can shed chlamydiae intermittently over long periods, contributing to the dissemination of the agent. Global trade is one of the most important drivers of disease emergence. The high percentage of positive samples in this study emphasizes the potential risk that the illegal trade of wild birds represents for both human and animal health. Copyright 2013 by American Association of Zoo Veterinarians.

Environmental management and operational performance in automotive companies in Brazil: The role of human resource management and lean manufacturing

The main objective of this study is to verify the influence of Environmental Management (EM) on Operational Performance (OP) in Brazilian automotive companies, analyzing whether Lean Manufacturing (LM) and Human Resources (HR) interfere in the greening of these companies. Therefore, a conceptual framework listing these concepts was proposed, and three research hypotheses were presented. A questionnaire was elaborated based on this theoretical background and sent to respondents occupying the highest positions in the production/operations areas of Brazilian automotive companies. The data, collected from 75 companies, were analyzed using structural equation modeling. The main results are as follows: (a) the model tested revealed an adequate goodness of fit, showing that overall, the relations proposed between EM and OP and between HR, LM and EM tend to be statistically valid; (b) EM tends to influence OP in a positive and statistically weak manner; (c) LM has a greater influence on EM when compared to the influence HR has over EM; (d) HR has a positive relationship over EM, but the statistical significance of this relationship is less than that of the other evaluated relationships. The originality of this paper lies in its gathering the concepts of EM, LM, HR and OP in a single study, as they generally tend not to be treated jointly. This paper also provided valid empirical evidence for a littlestudied context: the Brazilian automotive sector. © 2012 Elsevier Ltd. All rights reserved.

O significado para o enfermeiro do processo de trabalho na UTIS de um hospital universitário do estado de São Paulo

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Psicologia e rede básica de saúde: tendências curriculares e características de atuação profissional

Pós-graduação em Educação - FFC

Implantação de sistemas de segurança e saúde no trabalho em empresas fabricantes de baterias automotivas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Perfil, ações e relações dos agentes comunitários de saúde integrantes do Programa de Saúde da Família do município de Araçatuba-SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Percepção da humanização das condições de trabalho por trabalhadores de enfermagem da unidade de terapia intensiva adulto

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Caracterização da educação em saúde dos cuidadores formais em institutições de longa permanência para idosos de Botucatu-SP

Pós-graduação em Enfermagem (mestrado profissional) - FMB