A implementação de escritório da qualidade em hospital de pequeno porte

O tema qualidade na área da saúde vem sendo cada vez mais debatido em algumas regiões do Brasil e do mundo. Existe um significativo hiato entre a teoria discutida e a prática observada na maioria dos hospitais. No Brasil, alguns hospitais de grande porte das regiões Sul e Sudeste têm sido pioneiros na implantação de iniciativas voltadas à qualidade. Entretanto, mais de 60% dos hospitais brasileiros são de pequeno porte, reconhecidamente, em média, de pior desempenho que os maiores. O presente trabalho pretende analisar um caso de implantação de um novo serviço em organização hospitalar de pequeno porte, no estado de São Paulo, pertencente à uma cooperativa médica. O objetivo geral é aprofundar a compreensão de como se implementa um escritório de qualidade, com base nas percepções de atores envolvidos no processo, bem como as principais oportunidades e barreiras para seu funcionamento. A pesquisa foi exploratória, com metodologia qualitativa, composta por catorze entrevistas semiestruturadas aplicadas a uma amostra de todos os participantes do processo, bem como pela observação não participante de atividades desenvolvidas no local. Os principais impulsionadores identificados foram: envolvimento dos funcionários, treinamentos e alguma autonomia para o escritório de qualidade. As principais barreiras foram: falta de apoio da gestão, inexistência de cultura de qualidade, comunicação ineficiente.

Divergência entre prática e recomendações para modelos de atuação do PMO : o caso de uma empresa de grande porte do setor industrial

Neste trabalho, o objetivo é identificar, a partir da análise de um estudo de caso, quais são as principais divergências encontradas quando se compara o que a teoria preconiza como o escopo e a abordagem dos Project Management Offices - PMOs e o que acontece na prática, no que diz respeito à real atuação destas estruturas. O tema pode ser considerado relevante devido ao fato de fornecer uma melhor compreensão sobre como as estruturas de PMO realmente atuam, principalmente no que diz respeito ao escopo, isto é, se o PMO é um Programa-Projeto, um PMO Departamental ou um PMO Corporativo e relativamente a sua amplitude, ou seja, se sua atuação é operacional, tática ou estratégica. Para este estudo foi utilizada a metodologia qualitativa, por meio da abordagem de estudo de caso. Foi selecionada uma empresa de grande porte do setor de manufatura não estruturada por projeto para avaliação. A empresa do estudo de caso possui uma estrutura organizacional complexa que possibilita um estudo abrangente. A atuação dos PMOs do estudo de caso foi discutida à luz da revisão de literatura e levando-se em conta, também, as informações colhidas a partir da observação participante. Os resultados deste trabalho permitem concluir que o pressuposto defendido, que é a existência de divergências entre o que a teoria preconiza como escopo e abordagem do PMO e a real atuação dos PMOs, foi confirmado através do estudo de caso; além disso, não existe relação de causalidade clara entre o escopo de atuação dos PMOs e sua posição hierárquica dentro da empresa; e não existe uma atuação padrão destas estruturas, quando comparadas às funções que elas exercem. Por fim, são apresentadas recomendações relativas ao estudo de caso realizado, ou seja, é importante realizar um estudo multicasos entre ao menos uma empresa não estruturada por projeto e outra estruturada por projeto e comparar a atuação dos seus PMOs para melhor compreensão do tema, incluir mais stakeholders no grupo de entrevistados dentro do estudo de caso, realizar um survey com várias empresas de vários segmentos dentro do território nacional e um possível estudo onde seja verificado se tipologias diferentes de estruturas organizacionais podem afetar a atuação práticas dos PMOs.

Mapeamento acústico como ferramenta para predição de ruído urbano na área de influência do estádio Arena das Dunas, Natal/ RN

The Noise Pollution causes degradation in the quality of the environment and presents itself as one of the most common environmental problems in the big cities. An Urban environment present scenario and their complex acoustic study need to consider the contribution of various noise sources. Accordingly to computational models through mapping and prediction of acoustic scene become important, because they enable the realization of calculations, analyzes and reports, allowing the interpretation of satisfactory results. The study neighborhood is the neighborhood of Lagoa Nova, a central area of the city of Natal, which will undergo major changes in urban space due to urban mobility projects planned for the area around the stadium and the consequent changes of urban form and traffic. Thus, this study aims to evaluate the noise impact caused by road and morphological changes around the stadium Arena das Dunas in the neighborhood of Lagoa Nova, through on-site measurements and mapping using the computational model SoundPLAN year 2012 and the scenario evolution acoustic for the year 2017. For this analysis was the construction of the first acoustic mapping based on current diagnostic acoustic neighborhood, physical mapping, classified vehicle count and measurement of sound pressure level, and to build the prediction of noise were observed for the area study the modifications provided for traffic, urban form and mobility work. In this study, it is concluded that the sound pressure levels of the year in 2012 and 2017 extrapolate current legislation. For the prediction of noise were numerous changes in the acoustic scene, in which the works of urban mobility provided will improve traffic flow, thus reduce the sound pressure level where interventions are expected

Sistema inteligente para estimar a porosidade em sedimentos a partir da análise de sinais GPR

This Thesis presents the elaboration of a methodological propose for the development of an intelligent system, able to automatically achieve the effective porosity, in sedimentary layers, from a data bank built with information from the Ground Penetrating Radar GPR. The intelligent system was built to model the relation between the porosity (response variable) and the electromagnetic attribute from the GPR (explicative variables). Using it, the porosity was estimated using the artificial neural network (Multilayer Perceptron MLP) and the multiple linear regression. The data from the response variable and from the explicative variables were achieved in laboratory and in GPR surveys outlined in controlled sites, on site and in laboratory. The proposed intelligent system has the capacity of estimating the porosity from any available data bank, which has the same variables used in this Thesis. The architecture of the neural network used can be modified according to the existing necessity, adapting to the available data bank. The use of the multiple linear regression model allowed the identification and quantification of the influence (level of effect) from each explicative variable in the estimation of the porosity. The proposed methodology can revolutionize the use of the GPR, not only for the imaging of the sedimentary geometry and faces, but mainly for the automatically achievement of the porosity one of the most important parameters for the characterization of reservoir rocks (from petroleum or water)

PROEJA FIC/Fundamental no IFRN-Campus Mossoró: das intenções declaradas ao funcionamento de um curso em espaço prisional

This research aims to analyze the FIC Course of Assistant Technician in Service Management and Quality, integrated to elementary education / EJA form developed by IFRN MO Campus between 2011 and 2013 in the form of a PROEJA FIC / AT ELEMENTARY SCHOOL LEVEL. We seek to understand the adhesion between the national guidelines postulated for the Program, established in PPC and mediations with the process conceived in the run of the course. Guiding by the socio-critical approach and the dialogical paradigm, the theoretical-epistemological mark is especially buoyed by the theoretical contributions of Ciavatta (2005) , Rock (2011) , Haddad and Di Pierro (2000), Freire (2005), Marx (1982), Ramos (2005), Frigotto; Ciavatta; Ramos (2005), Moura (2012), and also on education in prisons by Onofre (2007, 2011), Bueno (2007), Julião (2011) and Foucault (2001). We assume that an action that enables professional qualification as FIC courses articulated to the EJA in the context of education in prisons have conceptual, methodological, political and pedagogical implications for it focuses challenges, weaknesses and opportunities on the same area of education., We have developed four techniques of data collection based on procedures and tools of qualitative research, such as document analysis, a student survey, the conduction of focus groups with teachers and administrators of the course and on-site observation. Mediated by the investigated context, results showed that the consolidation of PROEJA FIC / AT ELEMENTARY SCHOOL LEVEL goes beyond the intentions officially declared. It is inferred that after seven years of its creation, even though it keeps some potential, this program is not being satisfactorily developed and it shows weaknesses national and locally, it is set at low capillarity, it has a limited scope, and dissolved essential public commitments to the course development. The effectiveness of PROEJA FIC / AT ELEMENTARY SCHOOL LEVEL as part of an emancipatory inclusion social policy, according to official statement, entails approximating the legal logic with social logic, so as not only to propagate discourses and enforce worship to specific and successful experiences that reach only a minority, but to provide actual and necessary conditions to promote the breadth and social quality of the offered deals in this program format

Atendimento Pré-hospitalar Móvel. Mapeando Riscos e Prevenindo Erros

The attention with safety of the patients is important in the quality of the nursing and health care. In the pre-hospital care, such care is essential on site with the purpose of avoiding possible consequences to the individual, ensuring a fast and appropriate care, with improvement of the morbidity and reduction of the mortality. This medical attention is equally associated with the significant risks of adverse events and serious mistakes, which can be reduced with the awareness of the professionals, organization and quality management. It is a descriptive, transversal research, of quantitative approach, with the objective of identifying the risks for the safety of the patient during the mobile pre-hospital care under the view of the nurses, in a city of the Brazilian Northeast. The sample was formed by 23 nurses. The inclusion criteria: to have at least two years of experience and accept to participate on the research. The data collection was done in two steps, first photo collection, through the adapted method of photographic analysis, and the second with the application of questionnaire, divide in two parts: socio-professional data and digital photo punctuation instrument of the patient s safety. The majority of the nurses had an average working time in the mobile pre-hospital care of six years and six months, in the age group of 38 to 53 years old (69,56%) and with Lato sensu specialization (73,91%), being (29,41%) emergency and (29,41%) in intensive care. The (74%) have the Advance Cardiac Life Support (ACLS) and (100%) have the Pre-Hospital Trauma Life Support (PHTLS); (91, 30%) know the thematic safety of the patient. On the pictures it was observed a bigger variability of the categories (risks) where 44% of variance emerged on the first picture of the research. The pictures 4 and 9 with the average below 5 were classified as very insecure, while pictures 7 and 3 with an average above 7, very secure. On the results of risks observed for the patient s safety in the mobile pre-hospital care five categories emerged: organization and packaging of the equipment and materials, routines and specificities in the mobile pre-hospital care, risks on the management of medications, for traumas and infections. Starting from the analysis of these risks, it was proposed ten steps for the safety in the mobile pre-hospital care: 1- Identify the patient; 2- Safety related to prevention of infection; 3- Safety in the management of medications; 4- Safety and standardization of the packaging of equipment and materials; 5- Attention to the specificities of the mobile pre-hospital care; 6- Incentive and value the participation of the patient and family; 7- Promote the communication with the central of regulation; 8- Prevention of traumas and falls; 9- Protect the skin from additional injuries; 10- Understand the benefit of all the equipment in the ambulance. The multiple risks and their emerged combinations on the research indicate a variety of actions to be developed and stimulated, like the use of steps for the patient s safety in the mobile pre-hospital care which contributes with the aid and management of risks, reduction of mistakes, disabilities and death

Argamassas do grupo escolar Augusto Severo/RN: caracterização e incidência de manifestações patológicas

The search for cultural heritage preservation should be a constant, in order to minimize the lost of historical and cultural identity of a country. As part of this cultural heritage, highlights the importance of historical buildings. For the principles of restoration are met its important to know the state of conservation and the existing materials. Given the above, this work aims to study the pathological manifestations of the mortar coating from the Grupo Escolar Augusto Severo. For this, was conducted historical survey of the building, on-site visits with visual observation, collecting samples of mortar coating and characterization through visual and laboratory analysis, XRF, XRD, TG/DTG, OM and SEM-EDS. From the observations, pathological manifestations were found as: cracks, detachment of the coating, dirt, use of inappropriate material basis of cement, efflorescence, mold and mildew and also incompatible material base of cement. It was found that the pathological manifestations were intensified due to lack of coverage in some spots and especially the abandonment of the building, that many years does not have restoration or any other type of preventive and corrective maintenance. The results of laboratory tests indicated that the mortars studied are based on lime, with calcitic nature, and siliceous aggregate, with the presence of clay in two samples. From the samples collected, two are composed of lime, sand and clay and two by lime and sand. In this regard, it is important to conduct periodic inspections and maintenance, as well as carrying out restoration with use of material compatible with the original

Automação da detecção de fraudes em sistemas de medição de energia elétrica utilizando lógica fuzzy em ambiente SCADA

This works presents a proposal to make automatic the identification of energy thefts in the meter systems through Fuzzy Logic and supervisory like SCADA. The solution we find by to collect datas from meters at customers units: voltage, current, power demand, angles conditions of phasors diagrams of voltages and currents, and taking these datas by fuzzy logic with expert knowledge into a fuzzy system. The parameters collected are computed by fuzzy logic, in engineering alghorithm, and the output shows to user if the customer researched may be consuming electrical energy without to pay for it, and these feedbacks have its own membership grades. The value of this solution is a need for reduce the losses that already sets more than twenty per cent. In such a way that it is an expert system that looks for decision make with assertivity, and it looks forward to find which problems there are on site and then it wont happen problems of relationship among the utility and the customer unit. The database of an electrical company was utilized and the datas from it were worked by the fuzzy proposal and algorithm developed and the result was confirmed

Reciclagem de material asfáltico fresado utilizando solventes e microemulsões

With the increase of asphalt milling services was also a significant increase in recycling services pavements. The techniques used today are basically physical processes in which the milled material is incorporated into new asphalt mixtures or executed on site, with the addition of virgin asphalt and rejuvenating agent. In this paper seeks to analyze the efficiency of extraction of CAP (Petroleum Asphalt Cement) mixtures from asphalt milling, using commercial solvents and microemulsions. The solvents were evaluated for their ability to solubilize asphalt using an extractor reflux-type apparatus. Pseudoternary diagrams were developed for the preparation of microemulsion O/W surfactant using a low-cost coconut oil saponified (OCS). Microemulsions were used to extract the CAP of asphalt through physicochemical process cold. Analysis was performed concentration of CAP in solution by spectroscopy. The data provided in the analysis of concentration by the absorbance of the solution as the basis for calculating the percentage of extraction and the mass flow of the CAP in the solution. The results showed that microemulsions prepared with low concentration of kerosene and butanol/OCS binary has high extraction power of CAP and its efficiency was higher than pure kerosene, reaching 95% rate of extraction

Kondo-attractive-Hubbard model for the ordering of local magnetic moments in superconductors

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

Gestão da segurança e saúde no trabalho em empresas produtoras de baterias automotivas: um estudo para identificar boas práticas

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

Administrative rationality and coping strategies in shift work

Shift work (SW) can affect worker health and productivity. Working at night, workers often accumulate fatigue and are less productive. In Brazil, laws have been drafted aiming to reduce night work and rotating shift hours. In order to slash costs, companies have been looking for new arrangements to improve productivity under these conditions. The purpose of this study was to examine management changes and their outcomes in a large glass factory located in an industrial region of Brazil. The results show that the management, seeking equal productivity among shifts, focused its efforts mainly on distributing employee expertise. The arrangement resulted in 12 different groups that combine to serve three fixed shifts. A same shift can be served by more than one group, and the members of a same group share days off on different days. There was no statistically significant productivity difference among the three shifts. The on-site examination showed that part of the production was held by the workers and transferred to the next shift in order for them to be able to meet the management's performance rate requirements. The finding shows how a Brazilian cultural trait (resistance without conflict) is used to drive coping in SW.

Phospholipase A(2) myotoxins from Bothrops snake venoms: Structure-function relationship

Phospholipases A(2) constitute the major components from Bothrops snake venoms and have been extensively investigated not only because they are relatively very abundant in these venoms but mainly because they display a range of many relevant biological effects, including: myotoxic, cytotoxic, edema-inducing, artificial membrane disrupting, anticoagulant, neuromuscular, platelet aggregation inhibiting, hypotensive, bactericidal, anti-HIV, anti-tumoural, anti-malarial and anti-parasitic. The primary structures of several PLA(2)s have been elucidated through direct amino acid sequencing or, inderectly, through the corresponding nucleotide sequencing. Two main subgroups were thus described: (i) Asp49 PLA(2)s, showing low (basic, highly myotoxic) to relatively high (acidic, less or non myotoxic) Ca++-dependent hydrolytic activity upon artificial substrates; (ii) Lys49 PLA(2)s (basic, highly myotoxic) , showing no detectable hydrolytic activity on artificial substrates. Several crystal structures of Lys49 PLAs from genus Bothrops have already been solved, revealing very similar fold patterns. Lack of catalytic activity of myotoxic Lys49-PLA(2)s, first related solely with the fact that Lys49 occupies the position of the calcium ion in the catalyticly active site of Asp49 PLA(2)s, is now also attributed to Lys122 which interacts with the carbonyl of Cys29 hyperpolarising the peptide bond between Cys29 and Gly30 and trapping the fatty acid product in the active site, thus interrupting the catalytic cycle. This hypothesis, supported for three recent structures, is also discussed here. All Asp49 myotoxins showed to be pharmacologically more potent when compared with the Lys49 variants, but phospholipid hydrolysis is not an indispensable condition for the myotoxic, cytotoxic, bactericidal, anti-HIV, anti-parasitic, liposome disrupting or edema-inducing activities. Recent studies on site directed mutagenesis of the recombinant Lys49 myotoxin from Bothrops jararacussu revealed the participation of important amino acid residues in the membrane damaging and myotoxic activities.

Quantitative comparisons and models of time-averaging in bivalve and brachiopod shell accumulations

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

Using a one-dimensional lattice applied to the thermodynamic study of DNA

In this work it is analyzed a one-dimensional lattice which is composed by mass-spring systems with one additional Rosen-Morse potential on site. This kind of lattice is used to study thermodynamic properties of DNA, especially its thermal denaturation. on the context of this work, the Rosen-Morse potential simulates hydrogen bonds between double strands of the molecule. From the graphic of the average stretching of base pairs versus temperature it is possible to observe the thermal denaturation of the system. This result shows that it is possible to obtain phase transition with an asymmetric potential without an infinite barrier.