A segurança viária e o fator humano : verificação da presença de álcool-direção no sistema de transporte rodoviário do RGS

Esta dissertação examina a situação geral dos Acidentes Viários, no contexto do transporte rodoviário, cujas evidências apontam o Fator Humano como o maior responsável por tais eventos. Entende-se que um maior conhecimento sobre ele possibilitará melhorar a segurança do tráfego e da produção transporte. O estudo pretende destacar a importância das análises relacionadas com a atividade transporte rodoviário, as variações da demanda do sistema de circulação e a tarefa do motorista, sob a ótica da ergonomia. Objetiva ele, também, mostrar importância desses estudos para melhor avaliar as interações dos fatores homemmáquina- ambiente viário e para o desenvolvimento de novas tecnologias e produtos de segurança viária. A revisão bibliográfica dos capítulos iniciais revelam o estado da arte e a importância da segurança de trânsito, em nível internacional. Também revelaram que todas nações sofrem do mesmo mal em suas redes viárias, que varia de acordo com a realidade de cada um. Embora o acidente de trânsito seja um fenômeno comum às nações, aqui eles atingiram a dimensão de flagelo social, em razão da sua severidade; e de calamidade econômica, face a elevação dos custos de produção na atividade do transporte rodoviário. São analisadas as características do fator humano, fundamentais na tarefa de condução, e o respectivo nexo causal das falhas com a gênese do acidente, num sistema multifatorial e interativo. O trabalho fundamenta-se em extensa revisão bibliográfica. O estudo de caso, desenvolvido a partir da revisão dos dados de uma pesquisa anterior, comprova a hipótese que o “álcool-direção”, considerado na literatura como o maior causador de acidentes viários, tem sua presença marcada por elevados índices nas rodovias do RS, contrariando a conclusão da pesquisa anterior. Ao final, também oferece recomendações para o desenvolvimento de ações objetivas para melhorar a segurança viária.

Processamento da informação : uma avaliação dos diferentes níveis de conhecimento no processo de decisão

Neste trabalho objetivou-se estudar como as diferenças no nível de conhecimento do decisor afetam a tomada de decisões, procurando aumentar o entendimento de diferentes resultados do processo decisório. Contemplou-se três grandes áreas: o processo decisório, a perspectiva cognitiva no processo decisório e a influência do nível de conhecimento sobre o objeto de decisão no processo de decisão. Utilizando uma tarefa decisória com múltiplas alternativas e múltiplos atributos realizou-se uma pesquisa do tipo experimental onde foram controladas as variáveis qualidade da informação, complexidade da tarefa decisória e tomadores de decisão especialistas e novatos. Após formuladas e testadas as hipóteses, chegou-se à conclusão de que decisores com menos conhecimento possuem menor autoconfiança excessiva e menor consistência no resultado da decisão do que decisores com mais conhecimento, sendo indiferente o consenso na comparação entre os mesmos. Quanto às estratégias decisórias, os decisores com menos conhecimento se utilizam mais de estratégias não compensatórias para chegar a escolha do que decisores com mais conhecimento. Tomadores de decisão com mais conhecimento cometem menor número de transgressões do método multicritério do que aqueles com menos conhecimento, porém há indicações de que os primeiros possuem mais motivos explícitos para as transgressões do que os últimos. Os dois grupos não diferem significativamente no tempo e número de passos para resolução das tarefas, mas durante o processo decisório para chegar a decisão final, os decisores com mais conhecimento são mais lineares do que aqueles com menos conhecimento, ou seja, se valem de menor número de passos e repetições para chegar à escolha final.

Avaliação da subluxação da articulação cricotireóidea no tratamento da paralisia unilateral de prega vocal

Resumo não disponível

Regionalização dos serviços de assistência à saúde: uma nova configuração estratégica da operadora Fesp

O segmento suplementar de saúde no Brasil apresenta hoje, substancial importância no cenário nacional, não só por sua abrangência e capilaridade, mas também por sua relevância econômica. Neste cenário, destaca-se o segmento de cooperativas médicas Unimed, que atendem hoje cerca de 8% da população brasileira e detém mais de 33% do marketshare do setor. Desde o advento do marco regulatório do setor no Brasil, a saúde suplementar vem sendo submetida a um rigoroso processo de reestruturação enquanto segmento econômico, que ano após ano, vem reduzindo a autonomia de livre negociação de preços e ampliando o rol de procedimentos obrigatórios para as operadoras. Diante deste cenário e sob a temática da estratégia empresarial, propôs-se um estudo exploratório da Federação das Unimeds do Estado de São Paulo (Fesp), avaliando criticamente o modelo de regionalização adotado em sua operadora, caracterizando-se como uma nova configuração estratégica, alinhada à realidade regulatória do setor e ao ambiente competitivo de mercado no qual está inserida.

PLANFOR: política compensatória para a inclusão na informalidade?

Study about the national politics on the professional education, under responsibility of the brazilian Work Department in 1990 years. Purposes to apprehend the results of the actions of the professional education in a basic level, offered by the National Plan of the worker qualification ( PLANFOR ), as well as the effects on the assisted exits, starting from the experience appreciated on the Plan of Qualification developed in the state of Maranhão between 1996 to 2000. It adopts a theoretical-methodological conception by an ontological nature, if being worth of categories as the one of totality and of mediation that together, makes possible the apprehension of a dialectical movement that happens among the analysis object, the professional education politics in a basic level, performed by PLANFOR and your context, the underdevelop and heterogeneous Brazilian capitalism and the consequent job market generalized precarious and informal, making possible that the reality investigated become to understood rationally. This paper uses the indirect documentation technique, instruments of the bibliographical research and documental research. This study is based on those that aren´t part of PLANFOR, qualified by professional education courses in basic level,they didn't get to be inserts at the formal job market, just occupying precarious occupations in the informal job market. Aims to presents and discusses the productive process and your restructuring globally in progress. It focuses at the impacts on the workers, the precariousness of the work that appears like a new phenomenon calls new informality. Talks about the particularity process of productive restructuring assumed in Brazil highlights, showing that the informality, was always a structural phenomenon in the country. Discusses about the professional qualification in the contemporary capitalism, specifying some of your theses. Shows in a historical view the process of appearance of the employment notions and competence, and the influence that it exercised on the reforms of the basic and professional education, as well as the implications of both in the politics of professional education in the country. Rescues the process of creation of PLANFOR, your official formulations and your organized bases, starting from the second half of the 1990 decade. Shows yet the continuos changes in the job market of Maranhão state, for after, starting from the reports expresses at the Plans of Qualification from the state, elaborated by the Group of Evaluation and Studies of the Poverty and the Politics addressed to the poverty from the Master degree Program in Public Politics, from the Federal University of Maranhão, analyzing the acting of PLANFOR in the State, your probable deficiencies, as results the changes verified in the conditions of occupation and the gains of the exits from the professional education courses in basic level

The Quasi-lattice of Indiscernible Elements

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

Best site for embryo transfer: the upper or lower half of endometrial cavity?

BACKGROUND: the objective of the present study was to determine the importance of the site of embryo transfer (upper or lower half endometrial cavity) on implantation and clinical pregnancy rates. METHODS: A total of 400 transfers guided by ultrasound were randomly assigned to two groups according to the distance between the uterine fundus and the catheter tip at the time of embryo placement. Group I (n=200) consisted of transfers corresponding to a distance of <50% of the endometrial cavity length (ECL), i.e. transfer in upper half of the cavity; and group II (n=200) consisted of transfers corresponding to a distance of greater than or equal to50%, of the ECL, i.e. transfer in lower half of cavity. The Student's t-test, Mann-Whitney test and Fisher's exact test were used where appropriate. RESULTS: the general characteristics of the study population and the main transfer cycle characteristics had an equal distribution (P>0.05) between groups I and II. No significant difference in implantation or pregnancy rates was observed between groups I and II. CONCLUSION: the implantation or pregnancy rates were similar whether the embryos were deposited in the upper or lower half of the endometrial cavity.

Comparison of the psychological evaluation test and classical psychoanalysis in infertile women

This study aims to compare a psychological evaluation test to classical psychoanalysis in infertile women. Two hundred women were submitted to the Psychological Evaluation Test (PET). The sum of the scores for the responses ranged from 15 to 60 points, with scores 30 points being defined as 'psycho-emotional maladjustment' (cut-off point: median + 25%). For comparison, the patients were simultaneously submitted to a psychological examination by a psychologist, who was unaware of the PET results. of the 200 patients, 66 (33%) presented a test with greater than or equal to30 points ('psycho-emotional maladjustment') and 134 (67%) a test with <30 points (normal). Upon psychological examination, 105 (52.5%) presented an abnormal evaluation and 95 (47.5%) a normal evaluation. For the PET, statistical analysis showed 82% efficiency, 62% sensitivity, 98% positive predictive value, 99% specificity, 70% negative predictive value, likelihood ratio for a positive test result 62, and likelihood ratio for negative test result 0.38. The PET proved to be a useful clinical instrument, being of help in the selection of patients with psychological needs induced by infertility.

Ultrasound guidance is not necessary during easy embryo transfers

Purpose: To determine whether the use of ultrasound (US) to guide embryo transfer (ET) in a population previously defined as likely to have easy transfer would change the implantation and pregnancy rates in an ICSI program.Methods: A total of 100 patients identified as likely to have easy transfer after mock transfer were divided into two groups: Group I, US-guided ET (N = 50) and Group II, ET without the aid of US (N = 50).Results: Implantation and pregnancy rates were similar (p = 0.51, p = 0.29) for Group I (19.6%,42%) and Group II (16.3%,30%), as also was the abortion rate (p = 0.55) (Group I: 1/21; Group II: 2/15).Conclusion: As long as previous mock transfers are routinely performed during a cycle preceding assisted reproduction and the clinician considers transfer to be easy, ultrasound does not benefit the process of embryo transfer.

Recombinant luteinizing hormone supplementation to recombinant follicle-stimulation hormone during induced ovarian stimulation in the GnRH-agonist protocol: A meta-analysis

Purpose: to compare the efficacy of recombinant LH supplementation for controlled ovarian stimulation in recombinant FSH and GnRH-agonist protocol.Methods: Search strategies included on-line surveys of databases. The fixed effects model was used for odds ratio and effect size (weighted mean difference). Four trials fulfilled the inclusion criteria.Results: a fewer days of stimulation (p < 0.0001), a fewer total amount of r-FSH administered (p < 0.0001) and a higher serum estradiol levels on the day of hCG administration (p < 0.0001) were observed for the r-LH supplementation protocol. However, differences were not observed in number of oocyte retrieved, number of mature oocytes, clinical pregnancy per oocyte retrieval, implantation and miscarriage rates.Conclusions: more randomized controlled trials are necessary before evidence-based recommendations regarding exogenous LH supplementation in ovarian stimulation protocols with FSH and GnRH-agonist for assisted reproduction treatment can be provided.

Zona thinning with a noncontact diode laser in ICSI embryos from women of advanced age

Purpose: the objective of this study was to determine if the zona thinning (ZT) technique improved the rates of implantation and clinical pregnancy for patients aged, greater than or equal to38 years submitted to an ICSI program.Methods: A total of 100 patients submitted to ICSI and aged, greater than or equal to38 years were divided in a prospective and randomized manner into two groups: Group I - patients submitted to ZT (n = 50); a laser diode with 1.48 mum wavelength (Fertilaser) was used for the ZT procedure with 1-2 irradiations of 10 ms applied to four different positions on the zona pellucida (ZP) of each embryo to thin 60-90% of the ZP (each point with a 15-20 mum length of ZT). Group II - patients with no ZT (n = 50). In both groups, embryo transfer was performed on the second or third day.Results: the age of Group I patients (39.8 +/- 1.3) did not differ (p = 0.67) from that of Group II patients (40 +/- 1.9). The number of oocytes retrieved at metaphase II from Group I (6.4 +/- 4.2) and Group II (6.8 +/- 5) was similar (p = 0.94). Normal fertilization rates and cleavage rates were similar (p = 0.78 and p = 0.63, respectively) for Group I (71.5 +/- 22% and 96.7 +/- 11%) and Group II (73.5 +/- 19.7% and 96 +/- 11%, respectively). The number of embryos transferred was similar (p = 0.53) for the two groups (Group I = 3.1 +/- 1.3; Group II = 2.9 +/- 1.1). The thickness of the ZP of Group I embryos (16.9 +/- 2.4 mum) did not differ (p = 0.97) from that of Group II embryos (16.9 +/- 2.3 mum). The rates of embryo implantation and clinical pregnancy per embryo transfer were similar (p = 0.67, p = 0.61) for Group I (7 and 16%, respectively) and for Group II (8.2 and 22%, respectively).Conclusions: These results suggest that ZT in the population aged, 38 years may have no impact on ICSI success rates. However, this conclusion is limited to a situation in which length of the laser ZT was less than or equal to 20 mum and the laser was applied to four different positions.

Administration of beta(2)-adrenergic agonists during the peri-implantation period does not improve implantation or pregnancy rates in intracytoplasmic sperm injection (ICSI) cycles

Purpose: the objective of the present investigation was to determine implantation and pregnancy rates in patients undergoing ICSI and treated with beta(2)-adrenergic agonists, considering the uterine-relaxing action of these agents.Methods: A total of 225 women undergoing ICSI at the Center for Human Reproduction, Sinha Junqueira Maternity Foundation, entered the study. Patient participation in each group was random, by drawing lots, using a randomization table previously elaborated for the study (2:2:1). The group I (90 women) received 10 mg of terbutaline daily for 15 days starting on the day of oocyte retrieval; group II (90 women) received 20 mg of ritodrine daily during the same period of time as group I; group III (45 patients) received no treatment and was used as control. The evaluation was interrupted in 3 patients of group I and in 30 patients of group II because of a high incidence of side effects.Results: Pregnancy, implantation, and miscarriage rates were not significantly different (p>0.05) between the three groups: 29.88%, 13.25%, and 26.9% for group I; 33.33%, 17.5%, and 10.0% for group II; 28.88%, 15.07%, and 15.38% for group III, respectively.Conclusions: the results of this study do not support the routine use of beta(2)-adrenergic agonists during the peri-implantation period in assisted reproductive technology cycles.

Motile sperm organelle morphology examination is stricter than Tygerberg criteria

The present study aimed to evaluate the correlation between the motile sperm organelle morphology examination (MSOME) and a well-known sperm morphology classification (Tygerberg criteria). For MSOME, spermatozoa were analysed at x8400 magnification by inverted microscope equipped with Nomarski differential interference contrast optics, Uplan Apo x 100 oil/1.35 objective lens and variable zoom lens. By Tygerberg criteria, the semen underwent morphological evaluation as described in the literature. Regression analysis demonstrated significant positive correlation between percentage of normal sperm forms by Tygerberg criteria and by MSOME (r = 0.83, P < 0.0001). However, the incidence of normal spermatozoa by Tygerberg criteria (9.4%) was significantly higher (P < 0.0001) than under MSOME (3.3%). Despite the highly positive correlation, MSOME is a much stricter criterion of sperm morphology classification, since it identifies vacuoles and chromatin abnormalities that are not evaluated with the same precision by the analysis of Tygerberg criteria. MSOME should be included among the routine criteria for semen analysis. In addition, MSOME should be used for selection of spermatozoa for intracytoplasmic sperm injection based on the already published literature, as this is a good selection tool.