Readaptar ou reconstruir o trabalho no serviço público?: um estudo em um hospital universitário

O presente estudo tem como objeto de análise a readaptação funcional de servidores públicos enquanto uma expressão das condições objetivas de trabalho em um hospital universitário no Brasil e seus possíveis impactos na saúde dos trabalhadores; sendo ainda, momento potencial para análise das possibilidades de reconstrução do trabalho público. Os objetivos da investigação consistem em: identificar através do processo de readaptação funcional se o crescente adoecimento do servidor público seria uma expressão dos impactos do ajuste neoliberal no desmantelamento do Estado, via instituições públicas, precariedade das condições de trabalho e de suas formas de gestão; refletir sobre a intervenção interprofissional voltada para a reinserção do trabalhador ao processo produtivo em função da readaptação funcional e avaliar em que dimensões e processos as tendências de gestão pública, no campo analisado, interferem na saúde dos trabalhadores da área estudada e como poderiam contribuir para a mudança dos seus condicionantes. A metodologia de investigação baseou-se em pesquisa bibliográfica e documental e entrevistas individuais com técnicos da equipe interdisciplinar, gestores e representante sindical e entrevistas em grupo com auxiliares de enfermagem readaptados. O estudo confirmou a relevância da reconstrução do trabalho no serviço público por meio de uma gestão democrática com controle social, garantindo a participação da comunidade em todo o processo, para a definição de uma política institucional, norteada pelos pressupostos da saúde do trabalhador.

Rangia and Marsh Clams, Rangia cuneata, R. flexuosa, and Polymesoda caroliniana, in Eastern México: Distribution, Biology and Ecology, and Historical Fisheries

Rangia and marsh clams, Rangia cuneata, R. flexuosa, and Polymesoda caroliniana, occur in brackish waters along México’s eastern coast from the northern State of Tamaulipas to the southern State of Campeche. The clams were important to the prehispanic people in the southern part of the State of Veracruz, where they were used as food and as construction material. In modern times, they are harvested for food. The fishermen wade in shallow water and harvest the clams in soft sediments by hand. Annual landings of whole clams during a recent 5-yr period, 1998–2002, were 1,139–1,695 t. The only area with a substantial ongoing clam fishery is in the Lower Papaloapan River Basin, including Alvarado Lagoon, where as many as 450 fishermen are licensed harvesters. This fishery for the Rangia and marsh clams is the most important clam fishery along México’s Gulf Coast.

Quahogs in Eastern North America: Part I, Biology, Ecology, and Historical Uses

The northern quahog, Mercenaria mercenaria, ranges along the Atlantic Coast of North America from the Canadian Maritimes to Florida, while the southern quahog, M. campechiensis, ranges mostly from Florida to southern Mexico. The northern quahog was fished by native North Americans during prehistoric periods. They used the meats as food and the shells as scrapers and as utensils. The European colonists copied the Indians treading method, and they also used short rakes for harvesting quahogs. The Indians of southern New England made wampum from quahog shells, used it for ornaments and sold it to the colonists, who, in turn, traded it to other Indians for furs. During the late 1600’s, 1700’s, and 1800’s, wampum was made in small factories for eventual trading with Indians farther west for furs. The quahoging industry has provided people in many coastal communities with a means of earning a livelihood and has provided consumers with a tasty, wholesome food whether eaten raw, steamed, cooked in chowders, or as stuffed quahogs. More than a dozen methods and types of gear have been used in the last two centuries for harvesting quahogs. They include treading and using various types of rakes and dredges, both of which have undergone continuous improvements in design. Modern dredges are equipped with hydraulic jets and one type has an escalator to bring the quahogs continuously to the boats. In the early 1900’s, most provinces and states established regulations to conserve and maximize yields of their quahog stocks. They include a minimum size, now almost universally a 38-mm shell width, and can include gear limitations and daily quotas. The United States produces far more quahogs than either Canada or Mexico. The leading producer in Canada is Prince Edward Island. In the United States, New York, New Jersey, and Rhode Island lead in quahog production in the north, while Virginia and North Carolina lead in the south. Connecticut and Florida were large producers in the 1990’s. The State of Campeche leads in Mexican production. In the northeastern United States, the bays with large openings, and thus large exchanges of bay waters with ocean waters, have much larger stocks of quahogs and fisheries than bays with small openings and water exchanges. Quahog stocks in certifi ed beds have been enhanced by transplanting stocks to them from stocks in uncertified waters and by planting seed grown in hatcheries, which grew in number from Massachusetts to Florida in the 1980’s and 1990’s.

Associação entre as atividades desenvolvidas e os fatores de risco para doenças cardiovasculares de enfermeiros de um hospital universitário

Trata-se de um estudo de caráter descritivo, transversal com abordagem quantitativa. Este estudo transversal de base populacional possui como população de estudo enfermeiros trabalhadores de um hospital universitário do Estado do Rio de Janeiro. Possui como objetivo primário do estudo estimar a magnitude da associação entre as atividades profissionais dos enfermeiros e os fatores de risco para doenças cardiovasculares, e como objetivos secundários descrever o perfil demográfico e profissional dos enfermeiros do estudo; correlacionar a presença dos fatores de risco para doenças cardiovasculares com o tipo de atividade desenvolvida; e estabelecer a relação dos fatores de risco para doenças cardiovasculares com o nível de estresse dos enfermeiros. Selecionou-se para o estudo um total de 61 participantes. Os sujeitos foram acessados através de suas chefias imediatas e pela chefia geral de Enfermagem do hospital, que se dispusera a ajudar nesse contato. Listas com os nomes e setores foram disponibilizadas e os contatos assim foram realizados. As variáveis que foram analisadas no estudo são do tipo sociodemográficas, variáveis laborais e variáveis relacionadas aos fatores de risco para doenças cardiovasculares. Foi utilizado um questionário estruturado para a avaliação de variáveis socioeconômicas; variáveis sobre conhecimento da hipertensão, diabetes, dislipidemia, tabagismo, etilismo e atividade física; aferições sobre peso, altura e pressão arterial; informações sobre o trabalho. Para a avaliação de estresse no trabalho foi utilizada a Escala Bianchi de Estresse.. Após análises estatísticas secundárias, a mensuração do Escore Bianchi de Estresse e Escore de Risco Global para doenças cardiovasculares, foi identificado que as variáveis estatisticamente significativas associadas ao risco cardiovascular foram sexo, idade e o grupo de estresse (baixo e médio). Com a regressão logística foi possível identificar o tamanho da associação. O sexo masculino possui a chance de apresentar risco cardiovascular 5,66 vezes maior que o sexo feminino. A faixa etária entre 40 e 59 anos apresenta um risco cardiovascular 4,37 vezes maior que a faixa etária entre 20 e 39 anos. Os sujeitos com Escore de Bianchi de Estresse (EBS) classificados como Médio apresentam risco cardiovascular 6,63 vezes maior do que quem tem EBS baixo. A associação entre estresse e risco cardiovascular foi de 3,23. Concluiu-se que o existe uma nítida associação entre estresse, avaliado pelo Escore Bianchi de Estresse e aumento do risco cardiovascular global, através da ER Global. Os profissionais que trabalham em setores fechados apresentam um maior risco cardiovascular global. Os enfermeiros conhecem os fatores de risco para doenças cardiovasculares. Paradoxalmente encontramos que os enfermeiros que possuem apenas um emprego apresentam um risco global intermediário. Os profissionais homens, em nosso estudo, apresentam um risco cardiovascular global maior que as mulheres.

O processo de contratualização do hospital de Angra dos Reis no contexto do federalismo e das relações intergovernamentais.

Trata-se de estudo descritivo, de abordagem qualitativa, do tipo estudo de caso cujo objetivo é analisar o modelo de contratualização de uma unidade hospitalar pública. No contexto da evolução das relações intergovernamentais da saúde, verificaram-se o grau de correspondência entre as ações e serviços de natureza hospitalar ofertados no município e as necessidades de implementação desses na proposta de planejamento municipal, norteada pelo Plano Municipal de Saúde. Na busca do arcabouço teórico, foram aprofundados temas como: o processo contratual do Sistema Único de Saúde, o modelo de assistência hospitalar no Brasil, as redes de atenção à saúde e os mecanismos de gestão/relações interfederativas. São descritos os cenários municipais e regionais contextualizando a implantação da unidade hospitalar. Realizou-se estudo dos sistemas de informação da gestão pública, como: cadastro nacional de estabelecimentos de saúde/CNES, sistemas de informação hospitalar, sistema de informação morbimortalidade e o Plano de Saúde municipal e estadual. Ao final, apresentam-se os desafios da gestão na implantação do novo modelo de contrato diante da dificuldade de financiamento. Acredita-se que repensar o modelo de contratação dos serviços implica assegurar correspondência entre os serviços de saúde e os resultados da assistência à saúde da população usuária.

Food habits and consumption rates of common dolphinfish (Coryphaena hippurus) in the eastern Pacific Ocean

An ecosystem approach to fisheries management requires an understanding of the impact of predatory fishes on the underlying prey resources. Defining trophic connections and measuring rates of food consumption by apex predators lays the groundwork for gaining insight into the role of predators and commercial fisheries in influencing food web structure and ecosystem dynamics.We analyzed the stomach contents of 545 common dolphinfish (Coryphaena hippurus) sampled from 74 sets of tuna purse-seine vessels fishing in the eastern Pacific Ocean (EPO) over a 22-month period. Stomach fullness of these dolphinfish and digestion state of the prey indicated that diel feeding periodicity varied by area and may be related to the digestibility and energy content of the prey. Common dolphinfish in the EPO appear to feed at night, as well as during the daytime. We analyzed prey importance by weight, numbers, and frequency of occurrence for five regions of the EPO. Prey importance varied by area. Flyingfishes, epipelagic cephalopods, tetraodontiform fishes, several mesopelagic fishes, Auxis spp., and gempylid fishes predominated in the diet. Ratios of prey length to predator length ranged from 0.014 to 0.720. Consumption-rate estimates averaged 5.6% of body weight per day. Stratified by sex, area, and length class, daily rations ranged up to 9.6% for large males and up to 19.8% for small dolphinfish in the east area (0–15°N, 111°W–coastline). Because common dolphinfish exert substantial predation pressure on several important prey groups, we concluded that their feeding ecology provides important clues to the pelagic food web and ecosystem structure in the EPO.

Coastal development and pollution impact on the distribution of macrobenthic communities along the eastern coast of the Gulf of Suez (Egypt)

The configuration for the eastern side of the Gulf of Suez was studied over 241 km from Ras Mohammed to Ras Sudr including 35 station. Litters, tar balls and aged oil patches aggregated in considerable amounts on the beach and shore line of the middle part due to the oil spills from off-shore oil wells. A large reef flat in the shallow intertidal waters exists at stations 1 and 2 (Ras Mohammed, Protected area) and spars coral patches are less frequent at the Stations from 7 to 13. Density and diversity of marine benthos were higher on hard and cobble bottoms compared to muddy sand and sandy substrates. The assemblages of the benthic fauna are dominated by the gastropod Courmya (Thericium) vulgata; the bivalve Brachiodontes variabilis, and the barnacles Chthamalus stellatus, Balanus amphitrite and Tetraclita rubescens. The distribution of the algal cover in the intertidal region shows high abundance of the brown algae, Sargassum latifolium; padina pavonica and Cystoseira trinodis rather than the green and red algae. These species are found in both polluted and unpolluted areas. The changes in benthic structures in the study area depend not only on the state of pollution but also on the type of substrates.

COASTAL SEA-LEVEL AND THE LARGE-SCALE CLIMATE STATE - A DOWNSCALING EXERCISE FOR THE JAPANESE ISLANDS

A major problem which is envisaged in the course of man-made climate change is sea-level rise. The global aspect of the thermal expansion of the sea water likely is reasonably well simulated by present day climate models; the variation of sea level, due to variations of the regional atmospheric forcing and of the large-scale oceanic circulation, is not adequately simulated by a global climate model because of insufficient spatial resolution. A method to infer the coastal aspects of sea level change is to use a statistical ''downscaling'' strategy: a linear statistical model is built upon a multi-year data set of local sea level data and of large-scale oceanic and/or atmospheric data such as sea-surface temperature or sea-level air-pressure. We apply this idea to sea level along the Japanese coast. The sea level is related to regional and North Pacific sea-surface temperature and sea-level air pressure. Two relevant processes are identified. One process is the local wind set-up of water due to regional low-frequency wind anomalies; the other is a planetary scale atmosphere-ocean interaction which takes place in the eastern North Pacific.

Continuity and Change in the European Union’s Approach to Enlargement::Turkey and Central and Eastern Europe compared

Existing studies of European Union (EU) enlargement provide few answers to questions concerning continuity and change in the dynamics of the process. This article identifies a number of conditioning factors that have shaped the EU’s approach to eastern enlargement and traces elements of continuity and change in the EU’s handling of Turkey’s membership aspirations. The article focuses on three established factors – member state preferences, supranational activism and EU capacity – and two less prominent factors – public opinion and narrative frame

Accounting, Regulation and Profitability: The Case of PFI Hospital Refinancing

The refinancing of PFI (Private Finance Initiative) projects represents one of the most contentious aspects of Public Private Partnerships (PPPs) in the UK. The negative publicity associated with UK PFI refinancing deals is associated with several factors, including, evidence of massive private sector profit making, the failure of private sector financiers to share refinancing profits and, lastly, private sector frustration of adequate regulatory intervention in this area. Utilising a dynamic model of capital market and state interaction, this paper explains these outcomes as a function of effective private sector lobbying of bureaucratic state agencies to alter the structure of accounting, accountability and regulation with the goal of securing favourable profit and risk outcomes. These dynamics are illustrated with reference to the history of UK PFI refinancing and a case study of one of the projects where these gains reached extreme levels.

'"These schemes will win for themselves the confidence of the people": Irish independence, poor law reform and hospital provision'

This article examines hospital provision in Ireland during the early twentieth century. It examines attempts by the newly independent Irish Free State to reform and de-stigmatise medical relief in former workhouse infirmaries. Such reforms were designed to move away from nineteenth century welfare regimes which were underpinned by principles of deterrence. The reform initiated in independent Ireland - the first attempted break-up of the New Poor Law in Great Britain or Ireland - was partly successful. Many of the newly named County and District Hospitals provided solely for medical cases and managed to dissociate such health care provision from the relief of poverty. However, some hospitals continued to act as multifunctional institutions and provided for various categories including the sick, the aged and infirm, 'unmarried mothers' and 'harmless lunatics'. Such institutions often remained associated with the relief of poverty. This article also examines patient fee-payment and outlines how fresh terms of entitlement and means-testing were established. Such developments were even more pronounced in voluntary hospitals where the majority of patients made a financial contribution to their treatment. The article argues that the ability to pay at times determined the type of provision, either voluntary or rate-aided, available to the sick. However, it concludes that the clinical condition of patients often determined whether they entered a more prestigious voluntary hospital or the former workhouse. Although this article concentrates on two Irish case studies, County Kerry and Cork City; it is conceptualised within wider developments with particular reference to the British context.

Alcohol gel ingestion amongst homeless Eastern and Central Europeans in London: assessing the effects on cognitive functioning and psychological health

Background: Intentional consumption of alcohol based hand gels has been reported especially amongst non-UK national, alcohol dependent, homeless individuals in London. Whilst alcohol misuse is known to be associated with impaired cognitive functioning and mental health problems, the effects of additional ingestion of alcohol gel are unknown. Objectives: To explore cognitive and psychological functioning in users who intentionally ingest alcohol gel compared with ethyl-alcohol only misusers and controls. Methods: Male, Central and Eastern European alcohol only misusers, (n=14; mean age 39 years), alcohol gel users (n=14; mean age 43 years) and controls (n=12; mean age 31 years) were recruited from a London Homeless Service during 2013/14. Alcohol misusers, alcohol gel users and controls were compared on the Forwards and Backwards Digit Span Test; Block Design test; Retrospective and Prospective Memory Questionnaire (PRMQ) and the Hospital and Anxiety Depression Scale (HADS). Results: Alcohol gel users performed significantly worse on the Block Design task (p<0.01) and PRMQ (p<0.01) relative to both alcohol only and control groups, and significantly worse on the digit span relative to controls (p=0.01). Both alcohol misusing groups scored comparatively on digit span backwards (p<0.01), with both groups performing significantly worse than controls. The alcohol gel group reported significantly higher levels of anxiety relative to controls (p=0.02). Conclusions: Whilst there could be constitutional differences between alcohol misusers who additionally abuse alcohol gel, the findings suggest that alcohol gel ingestion may have a greater impact on psychological functioning than traditional alcohol misuse.

Application of DPSIR framework integrated with multiple regression model to simulate Guadiana catchment - estuary continuum, south eastern Iberia

Dissertação de Mestrado, Gestão da Água e da Costa, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2010