Conflicts between employee preferences and ergonomic recommendations in shift scheduling: regulation based on consent is not sufficient

OBJECTIVE: Contribution to the discussion of the role of participation/consent of employees in working hours regulation. METHODS: Exploratory analysis of conflicts between preferences of employees and ergonomic recommendations in shift scheduling by analysing a large number of participative shift scheduling projects. RESULTS: The analysis showed that very often the pursuit of higher income played the major role in the decision making process of employees and employees preferred working hours in conflict with health and safety principles. CONCLUSIONS: First, the consent of employees or the works council alone does not ensure ergonomically sound schedules. Besides consent, risk assessment procedures seem to be a promising but difficult approach. Secondly, more research is necessary to check the applicability of recommendations under various settings, to support the risk assessment processes and to improve regulatory approaches to working hours.

Guidelines for irrigation scheduling of banana crop in São Francisco Valley, Brazil. I - Root distribution and activity

In order to establish guidelines for irrigation water management of banana cv. Pacovan (AAB group, Prata sub-group) in Petrolina County, northeastern Brazil, the root distribution and activity were measured on an irrigated plantation, in a medium texture soil, with plants spaced in a 3 x 3 m grid. Root distribution was evaluated by the soil profile method aided by digital image analysis, while root activity was indirectly determined by the changing of soil water content and by the direction of soil water flux. Data were collected since planting in January 1999 to the 3rd harvest in September 2001. Effective rooting depth increased from 0.4 m at 91 days after planting (dap), to 0.6 m at 370, 510, and 903 dap, while water absorption by roots was predominantly in the top 0,6 m.

Guidelines for irrigation scheduling of banana crop in São Francisco Valley, Brazil. II - Water consumption, crop coefficient, and physiologycal behavior

The water consumption and the crop coefficient of the banana cv. Pacovan were estimated in Petrolina County, northeastern Brazil, in order to establish guidelines to irrigation water management. Evaluations were carried out since planting in January 1999 to the 3rd harvest in September 2001 on a microsprinkler irrigated orchard, with plants spaced in a 3 x 3 m grid. Average daily water consumption was 3.9, 4.0, and 3.3 mm in the 1st, 2nd and 3rd growing seasons, respectively. Crop coefficient values increased from 0.7 (vegetative growth) to 1.1 (flowering). Even with high soil water availability, transpiration was reduced due to high evaporative demand.

Estudo da adsorção/dessorção do ácido 2,4 diclorofenoxiacético (2,4d) em solo na ausência e presença de matéria orgânica

The herbicides are being used in huge quantities for various porpouses. Once the herbicide finds its way into the environment, a major part of it comes in contact with soil. Humic substances are major organic constituents of soil. These substances may interact with herbicides in different modes and adsorption is probably the most important one. Adsorption will control the quantity of herbicide in the soil solution, and determines its persistence, leaching, mobility and bioavailability. In this work we studied the interaction between the herbicide 2,4D and soil in the presence and absence of organic matter. The methodology utilized for the determination of 2,4D was gas chromatography with eletron capture detector. The behavior of 2,4D was evaluated through Freundlich isotherms. It was verified that the herbicide 2,4D has a large adsorption in the humic acid .

Harvesting and wood transport planning with SNAP III program (Scheduling and Network Analysis Program) in a pine plantation in Southeast Brazil

The objective of this study was to verify the potential of SNAP III (Scheduling and Network Analysis Program) as a support tool for harvesting and wood transport planning in Brazil harvesting subsystem definition and establishment of a compatible route were assessed. Initially, machine operational and production costs were determined in seven subsystems for the study area, and quality indexes, construction and maintenance costs of forest roads were obtained and used as SNAP III program input data. The results showed, that three categories of forest road occurrence were observed in the study area: main, secondary and tertiary which, based on quality index, allowed a medium vehicle speed of about 41, 30 and 24 km/hours and a construction cost of about US$ 5,084.30, US$ 2,275.28 and US$ 1,650.00/km, respectively. The SNAP III program used as a support tool for the planning, was found to have a high potential tool in the harvesting and wood transport planning. The program was capable of defining efficiently, the harvesting subsystem on technical and economical basis, the best wood transport route and the forest road to be used in each period of the horizon planning.

BASS 4: a software system for ergonomic design and evaluation of working hours

OBJECTIVE: To extend an existing computer programme for the evaluation and design of shift schedules (BASS 3) by integrating workload as well as economic aspects. METHODS: The redesigned prototype BASS 4 includes a new module with a suitable and easily applicable screening method (EBA) for the assessment of the intensity of physical, emotional and cognitive workload components and their temporal patterns. Specified criterion functions based on these ratings allow for an adjustment of shift and rest duration according to the intensity of physical and mental workload. Furthermore, with regard to interactive effects both workload and temporal conditions, e.g. time of day, are taken into account. In a second new module, important economic aspects and criteria have been implemented. Different ergonomic solutions for scheduling problems can now also be evaluated with regard to their economic costs. RESULTS: The new version of the computer programme (BASS 4) can now simultaneously take into account numerous ergonomic, legal, agreed and economic criteria for the design and evaluation of working hours. CONCLUSIONS: BASS 4 can now be used as an instrument for the design and the evaluation of working hours with regard to legal, ergonomic and economic aspects at the shop floor as well as in administrative (e.g. health and safety inspection) and research problems.

Professional and community satisfaction with the Brazilian family health strategy

OBJECTIVE: To analyze the strengths and limitations of the Family Health Strategy from the perspective of health care professionals and the community. METHODS: Between June-August 2009, in the city of Vespasiano, Minas Gerais State, Southeastern Brazil, a questionnaire was used to evaluate the Family Health Strategy (ESF) with 77 healthcare professionals and 293 caregivers of children under five. Health care professional training, community access to health care, communication with patients and delivery of health education and pediatric care were the main points of interest in the evaluation. Logistic regression analysis was used to obtain odds ratios and 95% confidence intervals as well as to assess the statistical significance of the variables studied. RESULTS: The majority of health care professionals reported their program training was insufficient in quantity, content and method of delivery. Caregivers and professionals identified similar weaknesses (services not accessible to the community, lack of healthcare professionals, poor training for professionals) and strengths (community health worker-patient communications, provision of educational information, and pediatric care). Recommendations for improvement included: more doctors and specialists, more and better training, and scheduling improvements. Caregiver satisfaction with the ESF was found to be related to perceived benefits such as community health agent household visits (OR 5.8, 95%CI 2.8;12.1), good professional-patient relationships (OR 4.8, 95%CI 2.5;9.3), and family-focused health (OR 4.1, 95%CI 1.6;10.2); and perceived problems such as lack of personnel (OR 0.3, 95%CI 0.2;0.6), difficulty with access (OR 0.2, 95%CI 0.1;0.4), and poor quality of care (OR 0.3, 95%CI 0.1;0.6). Overall, 62% of caregivers reported being generally satisfied with the ESF services. CONCLUSIONS: Identifying the limitations and strengths of the Family Health Strategy from the healthcare professional and caregiver perspective may serve to advance primary community healthcare in Brazil.

Experience with the first Internet-based course at the Faculty of Medicine, University of São Paulo

PURPOSE: The Internet expands the range and flexibility of teaching options and enhances the ability to process the ever-increasing volume of medical knowledge. The aim of this study is to describe and discuss our experience with transforming a traditional medical training course into an Internet-based course. METHOD: Sixty-nine students were enrolled for a one-month course. They answered pre- and post-course questionnaires and took a multiple-choice test to evaluate the acquired knowledge. RESULTS: Students reported that the primary value for them of this Internet-based course was that they could choose the time of their class attendance (67%). The vast majority (94%) had a private computer and were used to visiting the Internet (75%) before the course. During the course, visits were mainly during the weekends (35%) and on the last week before the test (29%). Thirty-one percent reported that they could learn by reading only from the computer screen, without the necessity of printed material. Students were satisfied with this teaching method as evidenced by the 89% who reported enjoying the experience and the 88% who said they would enroll for another course via the Internet. The most positive aspect was freedom of scheduling, and the most negative was the lack of personal contact with the teacher. From the 80 multiple-choice questions, the mean of correct answers was 45.5, and of incorrect, 34.5. CONCLUSIONS: This study demonstrates that students can successfully learn with distance learning. It provides useful information for developing other Internet-based courses. The importance of this new tool for education in a large country like Brazil seems clear.

Quantificação da dilatação ventricular esquerda na cintilografia miocárdica perfusional

FUNDAMENTO: O índice de dilatação transitória pode ser determinado através de teste ergométrico ou estresse farmacológico. Desconhece-se se o tipo de estresse tem impacto sobre os valores médios do índice de dilatação transitória. OBJETIVO: Comparar os valores médios do índice de dilatação transitória na cintilografia com 99mTc-sestamibi, em pacientes submetidos a teste ergométrico em esteira, versus estresse com dipiridamol. O objetivo secundário foi avaliar o impacto sobre o valor médio do índice exercido pelas características demográficas, pelos fatores de risco para doença arterial coronariana e a gravidade da isquemia. MÉTODOS: O estudo transversal incluiu 200 pacientes, entre 40 e 70 anos, portadores ou não de fatores de risco para cardiopatia isquêmica, com ou sem diagnóstico prévio de cardiopatia isquêmica. A separação entre grupos foi sequencial. O software 4D-MSPECT calculou o índice de dilatação transitória e forneceu um sistema de escores para análise da perfusão. RESULTADOS: O valor do índice de dilatação transitória médio do grupo submetido a teste ergométrico foi de 1,06 (±0,23). O do grupo submetido ao estresse com dipiridamol foi de 1,10 (±0,22);(p = 0,200). Não houve associação entre o tipo de estresse e os valores médios do índice de dilatação transitória. Encontrou-se associação entre os valores médios do índice e a faixa etária somente para os pacientes do grupo do teste ergométrico (p = 0,009). CONCLUSÃO: Os resultados do nosso estudo demonstram que o índice de dilatação transitória não difere quando os pacientes são submetidos a estresse pelo teste ergométrico em esteira ou estresse farmacológico pelo dipiridamol.

Opportunistic screening actions for breast cancer performed by nurses working in primary health care

Abstract OBJECTIVE To identify opportunistic screening actions for breast cancer performed by nurses working in primary health care units in Ribeirão Preto, São Paulo. METHOD Cross-sectional study with 60 nurses from 28 units, who had been working for at least one year in the public municipal health care network. Data were collected between December 2013 and March 2014, by means of a questionnaire, using descriptive analysis and the software IBM SPSS version 20 and Microsoft Excel 2010. RESULTS The results showed that 71.7% of the participants questioned their female patients as for risk factors for breast cancer, mainly during nursing consultation; 70.0% oriented users about the age to perform clinical breast exam, whereas 30.0% did not due to lack of knowledge and time; 60.0% explained about the age to perform mammogram; 73.3% did not refer patients with suspicious breast exam results to the referral department, citing scheduling as the main obstacle to referral. Educational activities were not performed by 78.3% of participants. CONCLUSION Investment is needed in professional training and management of breast cancer screening.

Distribuição do amônio, nitrato, potássio e fósforo em colunas de latossolos fertirrigadas

Na fertirrigação, é conveniente aplicar os nutrientes de forma a conseguir sua localização na profundidade mais adequada para absorção por parte das culturas: em maior profundidadepara a cultura perene e, mais superficialmente, nas culturas de ciclo curto. Com os objetivos de estabelecer em que fração da lâmina de irrigação devem ser aplicada as doses de N (NH4+ e NO3-); K+ e H2PO4-, de investigar qual o melhor fracionamento de suas doses, de modo a localizá-los na profundidade adequada, e de determinar a distribuição na coluna de NH4+, NO3-, K+ e H2PO4- aplicados por fertirrigação, foi realizado um experimento em laboratório, utilizando colunas de percolação. Os tratamentos corresponderam a um fatorial 4 (1 + 7), sendo quatro Latossolos de Minas Gerais [dois Latossolos Vermelho-Amarelos distróficos (LVAd1 e LVAd2), um Latossolo Vermelho distroférrico (LVdf) e um Latossolo Vermelho distrófico (LVd)], uma testemunha (aplicação de água deionizada) e sete formas de aplicação de 1 mmol dm-3 de NH4+, 1 mmol dm-3 de NO3-, 2 mmol dm-3 de K+ e 0,667 mmol dm-3 de H2PO4-. A lâmina de água foi dividida em cinco frações iguais (F1 a F5) e a dose dos nutrientes aplicada integralmente (D), ou fracionada em duas (D1/2) ou em três vezes (D1/3). Assim, a aplicação dos nutrientes foi feita segundo o esquema: F2D, F3D, F4D, F2D1/2F3D1/2 , F3D1/2F4D 1/2, F2D1/2F4D1/2 ou F2D1/3F3D1/3 F4D1/3. Subamostras foram utilizadas na análise de NH4+; NO3-; K+ e H2PO4-, determinando-se a distribuição desses nutrientes na coluna de solo. A mobilidade apresentou a seguinte ordem nos solos LVAd1, LVAd2 e LVd: NO3- > NH4+ > K+ > H2PO4-. Já para o solo LVdf, a ordem foi NH4+ > NO3- > K+ > H2PO4-. A ordem de risco de contaminação de águas subterrâneas por NO3- foi a seguinte: LVAd1 > LVAd2 > LVdf > LVd. A quantidade de água acrescentada a cada coluna, inferior a meio volume de poros, não foi suficiente para deslocar o H2PO4- além do primeiro anel. Para os outros íons em estudo, a localização em maior profundidade, quando aplicados como pulso único, foi verificada com a maior concentração no pulso (D > D1/2 > D 1/3) e com a maior lâmina de água posterior à sua aplicação (F2D > F3D > F 4D e F2D1/2F3D1/2 > F3D1/2F4D1/2 ). Os resultados evidenciam que a mobilidade diferencial de N (NH4+ e NO3-) e K+ exigiria escolha cuidadosa das doses desses nutrientes na solução, a fim de evitar perdas de N (NH4+ e NO3-) por lixiviação, ou localização excessivamente superficial do K+. A baixa mobilidade do H2PO4- mostra que a fertirrigação não seria uma técnica apropriada para sua incorporação no perfil do solo, visando à fertilização das culturas.

Estimation of water retention and availability in soils of Rio Grande do Sul

Dispersed information on water retention and availability in soils may be compiled in databases to generate pedotransfer functions. The objectives of this study were: to generate pedotransfer functions to estimate soil water retention based on easily measurable soil properties; to evaluate the efficiency of existing pedotransfer functions for different geographical regions for the estimation of water retention in soils of Rio Grande do Sul (RS); and to estimate plant-available water capacity based on soil particle-size distribution. Two databases were set up for soil properties, including water retention: one based on literature data (725 entries) and the other with soil data from an irrigation scheduling and management system (239 entries). From the literature database, pedotransfer functions were generated, nine pedofunctions available in the literature were evaluated and the plant-available water capacity was calculated. The coefficient of determination of some pedotransfer functions ranged from 0.56 to 0.66. Pedotransfer functions generated based on soils from other regions were not appropriate for estimating the water retention for RS soils. The plant-available water content varied with soil texture classes, from 0.089 kg kg-1 for the sand class to 0.191 kg kg-1 for the silty clay class. These variations were more related to sand and silt than to clay content. The soils with a greater silt/clay ratio, which were less weathered and with a greater quantity of smectite clay minerals, had high water retention and plant-available water capacity.

Infrared thermometry to schedule irrigation of common bean

The objective of this work was to determine the critical irrigation time for common bean (Phaseolus vulgaris L. cv. Carioca) using infrared thermometry. Five treatments were analyzed. Canopy temperature differences between plants and a well-watered control about 1, 2, 3, 4, and 5±0.5ºC were tested. Physiological variables and plant growth were analyzed to establish the best time to irrigate. There was a significant linear correlation between the index and stomatal resistance, transpiration rate, and leaf water potential. Although significant linear correlation between the index and mean values of total dry matter, absolute growth rate, and leaf area index was found, no correlation was found with other growth index like relative growth rate, net assimilation rate, and leaf area ratio. Plants irrigated when their canopy temperature was 3±0.5ºC above the control had their relative growth rate mean value increased up to 59.7%, yielding 2,260.2 kg ha-1, with a reduction of 38.0% in the amount of water used. Plants irrigated when their canopy temperature was 4±0.5ºC yielded 1,907.6 kg ha-1, although their relative growth rate mean value was 4.0% below the control. These results show that the best moment to irrigate common bean is when their canopy temperature is between 3ºC and 4±0.5ºC above the control.

Malformações do sistema nervoso central e malformações associadas diagnosticadas pela ultrassonografia obstétrica

OBJETIVO: Identificar a prevalência de malformações congênitas do sistema nervoso central (SNC) e malformações associadas diagnosticadas pela ultrassonografia obstétrica. MATERIAIS E MÉTODOS: Estudo observacional, transversal, descritivo, em instituição de referência para gestações de alto risco. RESULTADOS: Malformações congênitas do SNC estiveram presentes sem outras malformações associadas em 65,78%, com a distribuição: hidrocefalia (37,5%), mielomeningocele (15%), encefalocele (12,5%), agenesia de corpo caloso (12,5%), anencefalia (12,5%), holoprosencefalia (7,5%), Dandy-Walker (7,5%), Arnold-Chiari (5,0%), hidranencefalia (5,0%), meningocele (5,0%), cisto aracnoideo (2,5%). Malformações congênitas de outros sistemas estiveram associadas às do SNC: craniofacial (73,9%), ortopédica (65,2%), cardiovascular (34,8%), geniturinária (30,4%), gastrintestinal (30,4%), respiratória (8,7%), sindrômica (8,7), oftalmológica (4,3%). A sensibilidade ultrassonográfica no estudo de malformações fetais do SNC foi 79,4%. A taxa de falso-negativos foi 20,5%. Dentre as limitações quantificáveis destaca-se o oligodrâmnio, presente em 25% dos falso-negativos. CONCLUSÃO: A ultrassonografia obstétrica possui boa sensibilidade no rastreio de malformações fetais do SNC, em especial com o aperfeiçoamento constante e domínio na utilização de métodos especializados, como o Doppler e a ultrassonografia volumétrica (3D/4D), contribuindo para firmar-se como modalidade de escolha nesta rotina. Complementar ao método, a ressonância magnética pode vir a fornecer subsídios para uma ainda melhor assistência perinatal.

Solutions in radiology services management: a literature review

AbstractObjective:The present study was aimed at reviewing the literature to identify solutions for problems observed in radiology services.Materials and Methods:Basic, qualitative, exploratory literature review at Scopus and SciELO databases, utilizing the Mendeley and Illustrator CC Adobe softwares.Results:In the databases, 565 papers – 120 out of them, pdf free – were identified. Problems observed in the radiology sector are related to procedures scheduling, humanization, lack of training, poor knowledge and use of management techniques, and interaction with users. The design management provides the services with interesting solutions such as Benchmarking, CRM, Lean Approach, ServiceBlueprinting, continued education, among others.Conclusion:Literature review is an important tool to identify problems and respective solutions. However, considering the small number of studies approaching management of radiology services, this is a great field of research for the development of deeper studies.