Reflexões sobre a política de descentralização em saúde: uma análise a partir do Hospital Monsenhor Walfredo Gurgel em Natal (RN)

The process of decentralization of health policy in Brazil has evolved throughout the second half of the twentieth century, advancing by leaps and bounds in the last two decades. The various public institutions have assumed the function of responding to a growing demand for medical care and hospital. Monsenhor Hospital Walfredo Gurgel - H.M.W.G. fits into this context as an institution par excellence-oriented service the demand for medium and high complexity. This paper presents some questions about the process of decentralization and devolution occurred in Brazil. To do so is a brief historical background and politics, showing the concepts of reform and counter-reform and how the processes mentioned in the Country Correlates develop local social development of the decentralization process and discusses the modifications in policies social intervention in recent decades and the state health policies. Presents the implementation of a Health System in Brazil and the state showing how the decentralization of health policy occurs in Rio Grande do Norte. Finally, it explores the role of H.M.W.G. in health policy in RN. For this, portrays the institution and is located within the decentralized structure of health policy in the state and capital. An analysis of the demand for hospital care and the budget situation is realized at the close of work, correlating the role of HMWG with the decentralization of health policy in Brazil and Rio Grande do Norte. The methodology used for the preparation of this work was based on documentary research, systematic nonparticipant observation, field diary and analysis of data, documents and content. This set shows a quantitative and qualitative methodology that strips the institution, enabling the understanding of their role, boundaries, threats and opportunities

JCML - Java Card Modeling Language: Definição e Implementação

Formal methods should be used to specify and verify on-card software in Java Card applications. Furthermore, Java Card programming style requires runtime verification of all input conditions for all on-card methods, where the main goal is to preserve the data in the card. Design by contract, and in particular, the JML language, are an option for this kind of development and verification, as runtime verification is part of the Design by contract method implemented by JML. However, JML and its currently available tools for runtime verification were not designed with Java Card limitations in mind and are not Java Card compliant. In this thesis, we analyze how much of this situation is really intrinsic of Java Card limitations and how much is just a matter of a complete re-design of JML and its tools. We propose the requirements for a new language which is Java Card compliant and indicate the lines on which a compiler for this language should be built. JCML strips from JML non-Java Card aspects such as concurrency and unsupported types. This would not be enough, however, without a great effort in optimization of the verification code generated by its compiler, as this verification code must run on the card. The JCML compiler, although being much more restricted than the one for JML, is able to generate Java Card compliant verification code for some lightweight specifications. As conclusion, we present a Java Card compliant variant of JML, JCML (Java Card Modeling Language), with a preliminary version of its compiler

Sistemas computacionais espaço-temporais para toma de decisão em questões ambientais relacionadas à indústria de petróleo e gás

The area between São Bento do Norte and Macau cities, located in the northern coast of the Rio Grande do Norte State is submitted to intense and constant processes of littoral and aeolian transport, causing erosion, alterations in the sediments balance and modifications in the shoreline. Beyond these natural factors, the human interference is huge in the surroundings, composed by sensitive places, due to the existence of the Guamaré Petroliferous Pole, RN, the greater terrestrial oil producing in Brazil, besides the activities of the salt companies and shrimp farms. This socioeconomic-environmental context justifies the elaboration of strategies of environmental monitoring of that coastal area. In the environmental monitoring of coastal strips, submitted to human impacts, the use of multi-sources and multitemporal data integrated through a Spatio- Temporal Database that allows the multiuser friendly access. The objective was to use the potential of the computational systems as important tools the managers of environmental monitoring. The stored data in the form of a virtual library aid in making decisions from the related results and presented in different formats. This procedure enlarges the use of the data in the preventive attendance, in the planning of future actions and in the definition of new lines of researches on the area, in a multiscale approach. Another activity of this Thesis consisted on the development of a computational system to automate the process to elaborate Oil-Spill Environmental Sensitivity Maps, based on the temporal variations that some coastal ecosystems present in the sensibility to the oil. The maps generated in this way, based on the methodology proposed by the Ministério do Meio Ambiente, supply more updated information about the behavior of the ecosystem, as a support to the operations in case of oil spill. Some parameters, such as the hydrodynamic data, the declivity of the beach face, types of resources in risk (environmental, economical, human or cultural) and use and occupation of the area are some of the essential basic information in the elaboration of the sensitivity maps, which suffer temporal alterations.In this way, the two computational systems developed are considered support systems to the decision, because they provide operational subsidies to the environmental monitoring of the coastal areas, considering the transformations in the behavior of coastal elements resulting from temporal changes related the human and/or natural interference of the environment

Mapeamento da zona costeria protegida por arenitos de praia (Beachrocks) em Nísia Floresta - RN

The goal of this work comprises the detailed mapping of the coastal zone of the south coast of the State of Rio Grande do Norte. The emphasis of the study is the units of beachrocks and the features of the physical environment associated. The mapping of the beachrocks and of the adjacent coastal features is justified, among other aspects, by the fact that the beachrocks constitute an important protection agent against the sea erosion. By one side, they dissipate the energy of the sea waves and make possible the imprisonment of sediments in the foreshore. The beachrocks in the studied area are constituted of discontinuous strips, parallel to the coast line presenting emerged in some places, even in the highest tides, entirely submerged or partially buried by coastal sediments. These sandstones compose the landscape of big part of the coast and they are responsible for the partial dissipation of the energy of the waves on the studied coast. The methodology used in this work consisted of different techniques were used, as the use of aerial pictures of small format (FAPEFs), acquisition of data of system of global positioning (GPS) and later elaboration of thematic maps and of digital models of soil (MDTs). The results obtained in the mapping of the use and occupation of the soil, demonstrate the existence of strong human pressure in the coastal area (built lots and no built), occupying about 54,74% of built areas. This problem has been taking to degradation risks due to the inconsequent expansion of divisions into lots and tourist enterprises. The MDT came as an excellent resource, as visual as functional, being possible to visualize several angles and to act in three dimensions the relief of the area in study, as well as to identify the present features in the coastal area. By the importance of the bodies of beachrocks as a protection agent against the coastal erosion, faces were delimited in the sandstones based in geometric criteria, classifying them in, central face, outside face, inside face, break and undermiming. These last two associates to the erosion and washout in the base of these bodies. Field data indicate clearly that the most important process in the fracturing of the bodies is associated with mechanisms related to the gravity, being the joints formed by processes of gravitational sliding. Finally, the mapping of the coastal zone starting from aerial pictures of small format it made possible the identification of the elements that compose the beach strip, for accomplishing with larger detailed level and by presenting a better monitoring of the dynamics of the coastal zone

Faixas de proteção ambiental do Rio Pitimbu/RN: uma análise como subsídio ao planejamento e ordenamento do território

The Environmental Protection area sof Pitimbu river are important tools for planning and territorial land management. The Pitimbu river protection is aided in laws, so much of Federal stamp, as the Brazilian s Forest Code (Law No. 4771/1965), and in State s and City s Resolutions. So, this research begins in the State s Law No. 8426/2003interpretations, for being the most restrictive in the river's margin occupation and management. The objective is to analyze the applicability of the Environmental Protection areas of Pitimbu river, localized at the State of Rio Grande do Norte, considering environmental legislation and how to use this space by the man. Having specific goals for the discussion of the legislation s scope to this river; the identification of the types of soil s covering and evaluation the effectiveness of Law Nº.8426/2003, as protection instrument and land management. The river is characterized by its ecological importance and for feeding the Jiqui pond, an important reservoir that supplies 30% of drinking water to the east, west and south population sof the capital of the State. Pitimbu river is passing by a process of environmental degradation, originating from actions as deforestations of its ciliary forests by intensive agricultural practices; introduction of urban and industrial effluents leading to its contamination; increase of the pluvial drainage; erosion, sedimentation and discharge of urban waste , along with pressure for urban settlements along its banks. Under the methodological point of view is part of theoretical planning and land management research, and from a vision of social and environmental spaces. It was produced a survey map of the soil s covering, with 16 classes. Divided into coverage and disturbed natural covering. Using the 300 meters spatial limits of the Environmental Protection Strip, according to the State Law. The survey highlighted a higher percentage of classes disturbed, indicating man s interference in the balance of that system, as well as the lack of environmental actions. Leading to the degradation of riparian areas, and lack of conservation of water resources. Finally, it was considered that the strips of environmental protection are not effective as the preservation and territorial ordination

Effects of muscarinic receptor antagonists on acetylcholine-induced contractions of jejunal smooth muscle in horses

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Composite surfaces after finishing and polishing techniques

Purpose: To evaluate the effect of finishing and polishing techniques on surface roughness of resin-based composites (RBCs). Materials and Methods: Forty specimens of each material were cured under Mylar strips and immersed in artificial saliva for 1 wk. Samples were tested with a profilometer to obtain baseline average surface roughness (Ra). Specimens of both RBCs were then finished and polished according to four techniques: (1) Sof-Lex disks; (2) Sof-Lex disks followed by Prisma Gloss; (3) Enhance points; (4) Enhance points followed by Prisma Gloss application. New readings of the roughness pattern were carried out and the difference of post-polishing and baseline values were analyzed. Results: ANOVA test (alpha= 0.05) did not show differences between materials (P= 0.9393) nor interaction effects (P= 0.3094), but significant difference among the finishing/polishing techniques were detected (P= 0.0157). Tukey's test showed that the smoothest surface was obtained when the specimens were treated by Sof-Lex followed by Prosma Gloss polishing paste; and the worst results were obtained after using Enhance points alone.

Evalution of methods for the detection of MRSA in patients of Botucatu Medical School Hospital, São Paulo, Brazil

Oxacillin is the main drug of choice for the treatment of S. aureus infections. However, S. aureus resistance to oxacillin has become a major problem in the recent decades. The study aimed assess the rates of oxacillin resistance in S. aureus samples obtained at the Botucatu Medical School Hospital, UNESP, and to compare phenotypic techniques for the detection of MRSA against the gold standard method (mecA gene detection) in these samples. A total of 102 samples, previously isolated between 2002 and 2006, and kept at the Culture Collection of the Department of Microbiology and Immunology, in the Botucatu Biosciences Institute, UNESP, were included. Oxacillin resistance was assessed by oxacillin and cefoxitin disk diffusion and agar dilution tests, screening tests using Mueller-Hinton agar with 6 mu g/mL of oxacillin and 4% NaCl, E-test, and mecA gene detection. of the samples analyzed, 46 (45.1%) were mecA-positive. Oxacillin disk sensitivity and specificity were 86.9% and 91.1%, respectively. Cefoxitin disk sensitivity and specificity were respectively 91.3% and 91.1%. The screening test with the cefoxitin disk showed almost the same level of sensitivity (91.3%) and specificity (91.1%). With E-test strips, sensitivity was higher (97.8%) and specificity was comparable to that found with the other methods (91.1%). Ninety-three percent of the samples produced beta-lactamase and five of them were mecA-negative. There was a gradual increase in the number of oxacillin-resistant S. aureus samples between 2002 and 2004. However, from 2004 to 2006, the number of resistant samples dropped from 55% of MRSA in 2004, to 45% in 2005 and 34.6% in 2006. The data obtained reveal that, among phenotypic methods, the E-test yielded the best results, with higher sensitivity levels when compared to the other methods. The decreased resistance rate observed over the most recent years may be explained by the rational use of antimicrobial agents associated with good practices in the control of hospital infection, or may be related to the diminished use of oxacillin as a treatment option.

Ultrastructure of last larval instar fat body cells of Pachycondyla (= Neoponera) villosa (Formicidae : Ponerinae): cytochemical and chemical analysis

The ultrastructure of the fat body cells (trophocytes) of the last larval instar of Pachycondyla (= Neoponera) villosa is presented. The cytoplasm is restricted to the cell periphery and to the smaller strips among the vacuoles, protein granules, lipid droplets, and around the nucleus. Cytochemically, the presence of basic amino acids in the protein granules and in the nuclei was observed by using the ethanolic phosphotungstic acid technique (EPTA). The lipid droplets stained for unsaturated lipids. This result was further confirmed by gas chromatography and mass spectrometry, where the unsaturated fatty acids were identified as oleic and linoleic acids together with saturated fatty acids such as palmitic and stearic acid. Carbohydrates (glycogen) were also detected in the fat body. The glycogen is present as beta particles distributed among the lipid droplets and sometimes attached to them.

Handicrafts from Jalapao (TO), Brazil, and their relationship to plant anatomy

EICHEMBERG, M. T. and V. L. SCATENA (Universidade Estadual Paulista, Departamento de Botanica, Rio Claro, São Paulo, Brazil). J. Torrey Bot. Soc. 138:34-40. 2011.-Handicrafts from Jalapao (TO), Brazil, and their Relationship to Plant Anatomy. In the state of Tocantins, midwestern Brazil, communities from the region of Jalapao use scapes of "capim dourado" (golden grass - Syngonanthus nitens- Eriocaulaceae) and leaves of "buriti" (Mauritia flexuosa - Arecaceae) to make handicrafts (baskets and ornaments). The predominant biome of this area is cerrado (savanna), with a notable presence of buriti in the "veredas" (swampy forest-like vegetation), and of golden grass, which is one of the most common plants in humid grasslands. These traditional handicrafts represent a significant source of income for local communities. The whole scapes of Syngonanthus nitens are used due to their golden color, which is a reflection of such internal structures as thick walled cells and lignin in the epidermis and cortex. The strips called "seda" (silk) used to sew the scapes in the making of handicrafts come from young leaves of Mauritia,flexuosa. They are constituted by the adaxial epidermis and bundles of subepidermic fibers, both showing thick-walled cells. Since the cells of the bundles of sclerenchymatic fibers from the abaxial surface of buriti leaves present stegmata containing silica bodies, their mechanical properties are less adapted to the production of "silk", justifying the use of the leaf adaxial surface. Anatomical characteristics such as the thickening and composition of the cell walls of both species together with sociocultural factors, allow a better knowledge of the use of plant structures in the making of handicrafts.

High-fat diet associated with obesity induces impairment of mouse corpus cavernosum responses

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Oral manifestations of diabetes mellitus in complete denture wearers

Statement of problem. The oral mucosa has been reported to show a variety of changes in subjects with diabetes mellitus.Purpose. The purpose of this study was to compare diabetic and nondiabetic subjects wearing complete dentures with regard to salivary flow, salivary buffering capacity, denture retention, and oral mucosal lesions.Material and methods. Sixty subjects, 30 with and 30 without a diagnosis of diabetes, were matched for gender, race, and age. Salivary flow, salivary buffering capacity, glycemia, blood pressure, presence of mucosal lesions, denture retention, use of medications, and behavioral factors (controlled or uncontrolled diet, alcohol consumption, and smoking) reported by the subjects, were evaluated. For the salivary buffering capacity test, 1 mL of saliva was pipetted into a test tube containing 3 mL 0.005 N of hydrochloric acid, and the pH was measured with indicator strips. Group differences were statistically analyzed using the Student t test and the Mann-Whitney test for quantitative variables and the chi-square test for qualitative variables (alpha = .05).Results. Mean (SD) salivary flow was 1.14 (0.87) mL/min in the nondiabetic subjects and 0.95 (0.61) mL/min in the diabetic subjects. Evaluation of self-reported denture retention revealed no significant difference between groups. Denture retention was observed in 66.7% (20/30) of the control group and in 50% (15/30) of the diabetic group. The prevalence of mucosal lesions was 90% (27/30) in the control group and 83.3% (25/30) in the diabetic group. Salivary buffering capacity was 5.80 (0.85) in the control group and 5.26 (0.83) in the diabetic group (P = .017).Conclusions. Within the limitations of this study, no significant differences were observed in salivary flow, denture retention, or oral lesions in diabetic and nondiabetic subjects.

Streptococcus mutans Biofilm Adhesion on Composite Resin Surfaces After Different Finishing and Polishing Techniques

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Metabolite fingerprint of "capim dourado" (Syngonanthus nitens), a basis of Brazilian handcrafts

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Soil loss risk and habitat quality in streams of a meso-scale river basin

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)