66 resultados para Small-sized hospitals

em Scielo Saúde Pública - SP


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We studied life history traits of females of the lizard Eurolophosaurus nanuzae (Rodrigues, 1981), an endemic species of rock outcrop habitats in southeastern Brazil. During October 2002 and 2003 we sampled three populations in sites that encompass the meridional portion of the geographic range of the species. Clutch size varied from one to three eggs, with most females carrying two eggs. Clutch size did not vary among populations, but was correlated to female body size. Only larger females produced clutches of three eggs. Females of the small-sized E. nanuzae produce eggs as large as those of medium-sized tropidurids, thus investing a considerable amount of energy to produce clutches resulting in high values of relative clutch mass.

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OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System.METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction.RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed.CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

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Recent studies have demonstrated that the use of paramagnetic hepatobiliary contrast agents in the acquisition of magnetic resonance images remarkably improves the detection and differentiation of focal liver lesions, as compared with extracellular contrast agents. Paramagnetic hepatobiliary contrast agents initially show the perfusion of the lesions, as do extracellular agents, but delayed contrast-enhanced images can demonstrate contrast uptake by functional hepatocytes, providing further information for a better characterization of the lesions. Additionally, this intrinsic characteristic increases the accuracy in the detection of hepatocellular carcinomas and metastases, particularly the small-sized ones. Recently, a hepatobiliary contrast agent called gadolinium ethoxybenzyl dimeglumine, that is simply known as gadoxetic acid, was approved by the National Health Surveillance Agency for use in humans. The authors present a literature review and a practical approach of magnetic resonance imaging utilizing gadoxetic acid as contrast agent, based on patients' images acquired during their initial experiment.

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The chemical role of iron-bearing compounds on the dynamics of phosphorus in selected Brazilian latosols was investigated. The iron oxides were characterized in an attempt to assess their main chemical-mineralogical properties influencing the ion sorption mechanisms in those pedosystems. It was found that increasing total iron contents tend to increase the phosphorus adsorption capacity in the selected soils. 110 K-Mössbauer data reveal that the dominant iron oxides are hematite and goethite. Particularly for the yellower soil samples some prominent doublets, more certainly due to superparamagnetic relaxation, may be assigned to corresponding fractions of relatively small-sized particles.

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Bauhinia variegata and B. variegata var. candida, commonly known as orchid trees, are small sized trees widely used for urban forestry and landscaping. Adult plants grow under full sun; in Brazil, however, seedlings are generally cultivated in commercial nurseries under natural half-shading. The objective of this study was to evaluate the influence of different colored shade nets and light conditions on the initial growth of B. variegata and B. variegata var. candida. The influence of six light conditions (red net with 50% shading; blue net with 50% shading; black net with 70% shading; black net with 50% shading; black net with 30% shading; and full sun) on the initial growth of B. variegata and B. variegata var. candida were evaluated along 160 days, and growth relationships were calculated. Seedlings showed more efficiency on the use of photoassimilated compounds when grown under full sun. Such condition is the most appropriate for seedling production of B. variegata and B. variegata var. candida, contradicting what has been performed in practice.

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The effects of strenuous exercise before and during pregnancy on the renal function and morphological alterations of the progeny were determined in a study on female Wistar rats. This research was done based on a previous study carried out in our laboratory, which showed morphological alterations in rats submitted to this kind of exercise. As the form is related to the function, the physiological relevance of submitting a pregnant female to a high-intensity exercise training regimen could be explained by the fact that morphological alterations can influence kidney function. The animals were assigned to one of two groups: control animals that did not exercise during pregnancy and trained animals that swam for 120 min 5 days a week for 8 weeks before pregnancy and daily for 60 min over a period of 8 weeks starting on the second day of pregnancy. Seven rats of each group were analyzed for morphological alterations and for renal function. The progeny of the rats used for morphological evaluation were born by cesarean section and the progeny of the animals used to evaluate renal function were born normally. The progeny were two months old when renal function was evaluated. Fertility and morbidity were the same for both groups. Strenuous maternal exercise had no significant influence on glomerular filtration rate (GFR) but renal plasma flow was lower in the progeny of the trained group (mean ± SD, 16.65 ± 3.77 ml min-1 kg-1) compared to the progeny of the control group (33.42 ± 2.56 ml min-1 kg-1). Antidiuretic and antinatriuretic effects on the progeny of the trained group were observed, since urine flow as percentage of GFR and the fraction of urinary sodium excretion were lower in this group (1.38 ± 0.10 and 0.60 ± 0.04%, respectively) compared to the progeny of the control group (2.36 ± 0.11 and 1.55 ± 0.20%, respectively). Moreover, in this exercise program, fetuses from trained animals were small-sized (2.45 ± 0.19 vs 4.66 ± 2.45 g for control animals) and showed lower differentiation compared to fetuses from the control group. These effects were probably caused by caloric restriction, hypoxia and reduction of umbilical cord length.

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Peripheral glial cells consist of satellite, enteric glial, and Schwann cells. In dorsal root ganglia, besides pseudo-unipolar neurons, myelinated and nonmyelinated fibers, macrophages, and fibroblasts, satellite cells also constitute the resident components. Information on satellite cells is not abundant; however, they appear to provide mechanical and metabolic support for neurons by forming an envelope surrounding their cell bodies. Although there is a heterogeneous population of neurons in the dorsal root ganglia, satellite cells have been described to be a homogeneous group of perineuronal cells. Our objective was to characterize the ultrastructure, immunohistochemistry, and histochemistry of the satellite cells of the dorsal root ganglia of 17 adult 3-4-month-old Wistar rats of both genders. Ultrastructurally, the nuclei of some satellite cells are heterochromatic, whereas others are euchromatic, which may result from different amounts of nuclear activity. We observed positive immunoreactivity for S-100 and vimentin in the cytoplasm of satellite cells. The intensity of S-100 protein varied according to the size of the enveloped neuron. We also noted that vimentin expression assumed a ring-like pattern and was preferentially located in the cytoplasm around the areas stained for S-100. In addition, we observed nitric oxide synthase-positive small-sized neurons and negative large-sized neurons equal to that described in the literature. Satellite cells were also positive for NADPH-diaphorase, particularly those associated with small-sized neurons. We conclude that all satellite cells are not identical as previously thought because they have different patterns of glial marker expression and these differences may be correlated with the size and function of the neuron they envelope.

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The artisanal production of cachaça, a beverage obtained by the fermentation of sugar cane juice after distillation, especially by small-sized producers, has traditionally used natural ferment ("fermento caipira") which consists of sugar cane juice with crushed corn, powdered rice, or citrus fruits. In despite of the difficulties in quality control due to the high level of contaminants and longer periods of preparation, the sensorial quality of the beverage may be attributed to the physiological activities of wild yeasts and even bacteria present during fermentation when this ferment is used. In this context, the aim here was to evaluate the microbiological (yeasts) and physicochemical characteristics of sugar cane juice extracted from different parts of three different varieties (RB72454, RB835486, and RB867515) of the cane stalk (lower, medium, and upper sections) in three harvesting periods (from May to December 2007) in an area under organic management. The juice from the upper section (from the eleventh internode to the top) of the sugar cane stalk could be indicated for the preparation of the natural ferment since it is as a source of yeasts and reducing sugars, especially the variety RB867515. Due to the seasonality, the best period for using this part of the sugar cane stalk is at the beginning of harvesting when the phenolic compounds are at low concentration, but there are higher number of Saccharomyces population and other yeast species. The high acidity in this section of the plant could result in a better control of bacterial contamination. These findings explain the traditional instructions of adding the upper sections for the preparation of natural ferment and can help its management in order to get a better performance with respect to organic cachaça production.

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ABSTRACT This study aims at presenting the process of machine design and agricultural implements by means of a reference model, formulated with the purpose of explaining the development activities of new products, serving as a guideline to coach human resources and to assist in formalizing the process in small and medium-sized businesses (SMB), i.e. up to 500 employees. The methodology used included the process modeling, carried out from case studies in the SMB, and the study of reference models in literature. The modeling formalism used was based on the IDEF0 standard, which identifies the dimensions required for the model detailing: input information; activities; tasks; knowledge domains; mechanisms; controls and information produced. These dimensions were organized in spreadsheets and graphs. As a result, a reference model with 27 activities and 71 tasks was obtained, distributed over four phases of the design process. The evaluation of the model was carried out by the companies participating in the case studies and by experts, who concluded that the model explains the actions needed to develop new products in SMB.

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Soil characteristics related to the genesis, land use and management are important factors in water dynamics in watersheds. This study evaluated physical, morphological and pedogenetic attributes related to water yield potential in small watersheds in Guarapari, ES, Brazil. The following representative profiles were selected, morphologically described and sampled in area of Atlantic Forest domain: Lithic Udifolists, Oxyaquic Udifluventes, Typic Paleudults, Typic Hapludults, Typic Hapludox, Oxic Dystrudepts and Typic Endoaquents. Samples were collected in the soil profiles for physical analysis. Measurements of field-saturated hydraulic conductivity and soil penetration resistance were perfomed in some profiles, which were under different uses. The Endoaquents of Limão Creek can be considered efficient as temporary water reservoirs. However, the use of artificial drainage tends to reduce this effect. Differential erosion was detected by the sand texture on the surface of the Typic Paleudults due to the low degree of clay flocculation, slope, high resistance to the penetration and low hydraulic conductivity of the Bt horizon, making it necessary to adopt soil management practices to increase the water infiltration. Under pasture, mainly in the cattle trails where the trampling is more intense, there was high resistance to penetration in the superficial layers of the Typic Hapludults. The Typic Hapludox have the greatest potential for water yield in the small watersheds because of its greater extent in the headwaters and their morphological and physical characteristics, which can result in increased aquifer recharge.

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Category management (CM) is an important tool to strengthen the relationship between manufacturers and retailers. This process has been associated with large corporate retailers; however, some recent researches show that CM is open to companies of any type or size. This possibility is important in emerging markets, where neighborhood supermarkets are still representative and are often considered an alternative for manufacturers to achieve higher margins compared to big chains. In this context, the aim of this research was to analyze the results of a CM initiative in small neighborhood supermarkets from a manufacturer perspective. Data for the study comes from a food manufacturer in Brazil that implemented a CM process with 180 small retailers. A quantitative analysis was conducted in order to analyze the effect of the program on the food manufacturer' s sales and market share. Our analysis suggests an overall positive effect of the program on both, sales and market share.

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This study demonstrates and applies a social network methodology for studying the dynamics of hierarchies in organizations. Social network (blockmodel) analysis of verbal networks in four hospitals contrasted hierarchical and structurally equivalent partitions of the sociomatrices of frequent ties and perceptions of organizational culture. It was found that the verbal networks in these organizations follow a center periphery pattern rather than a hierarchical logic and that perceptions of culture vary more by verbal network than by formal hierarchy. The perceptions of culture of central groups in one organization are much like those of peripheral groups in another. In all four hospitals, structurally equivalent social networks are more important in predicting subcultures than are hierarchical groupings and hierarchy has a limited impact on the development of verbal networks. These findings suggest the value of an amoeba rather than a pyramid metaphor in interpreting the cultures and relational structures of organizations.

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Nutritional surveys (food consumption, clinical and biochemichal) were conducted in a small institution for homeless children. Results showed that only 30% of the children presented adequate calorie intake. Most of the children presented adequate protein intake, but almost half consumed less than 2/3 of the calcium RDA considered necessary. Food handling, processing, and distribution also proved inadequate and wastage, high. Skinfold measurement showed up one case of obesity. Furthermore, most of the children presented clinical signs of vitamin A deficiency, mostly skin lesions; while about half presented clinical signs of riboflavin deficiency. Biochemical data showed that 63.6% had deficient plasma levels of vitamin A, none showed abnormal results for riboflavin excretion, four showed packed blood cell volume below normal, and all had normal hemoglobin levels. Stool examinations revealed a high rate of pathogenic protozoa (Hymenolepis nana), in fact, one of the highest in Brazilian literature.