Gestão do trabalho na Estratégia Saúde da Família em municípios do Estado do Rio de Janeiro com mais de 500 mil habitantes: o caso do Rio de Janeiro e Duque de Caxias

Não obstante ao aumento do número de equipes de Saúde da Família no território brasileiro há disparidade na implantação da Estratégia Saúde da Família (ESF) em municípios de grande porte. Outras dificuldades enfrentadas referem-se aos recursos humanos em saúde (RHS). Nesse sentido, esta pesquisa objetivou analisar o cenário atual da gestão do trabalho na ESF nos municípios do Rio de Janeiro e Duque de Caxias. Metodologia: Estudo exploratório, de investigação narrativa, bibliográfica e documental, de abordagem qualitativa. A coleta de dados se deu em duas fases: pesquisa de material bibliográfico nas bases: LILACS, PAHO e WHOLIS, e de editais de processos seletivos e concursos públicos dos anos 2000, com vistas à contratação de profissionais de saúde para a ESF e; entrevistas semiestruturadas com gestores da ESF. O período de coleta perdurou entre agosto de 2010 e dezembro de 2011. Os documentos foram analisados à luz da estatística descritiva e as entrevistas submetidas à análise de conteúdo. Resultados: Escassez de literatura sobre a ESF nos municípios de Duque de Caxias e Rio de Janeiro. As contratações no Rio de Janeiro obedeceram a dois momentos: prefeitura e Organizações Sociais (OS) como contratantes. Em Duque de Caxias a contratação foi exclusividade da Prefeitura. No Rio de Janeiro os salários dos profissionais variaram entre R$ 728,59 (Agentes Comunitários de Saúde - ACS) e R$ 7.773,69 (médicos), contrastando com a isonomia salarial adotada em Duque de Caxias, com vencimentos ao redor de R$ 700,00 para os ACS, R$ 800,00 para nível técnico e; aproximadamente R$ 5.000,00 aos profissionais de nível superior. Os gestores sugerem que a maior rotatividade entre os médicos é motivada por carga horária excessiva; más condições de trabalho e, localização da unidade em áreas de risco social. As estratégias para atração e fixação profissional incluem: processos seletivos; garantia dos direitos trabalhistas e; abonos salariais, no caso do Rio de Janeiro e; flexibilização de carga horária, melhorias em infraestrutura e estratégias de qualificação, em Duque de Caxias. Entrevistas revelaram as maiores dificuldades na gestão da ESF: alta rotatividade, formação médica destoante com o SUS e, infraestrutura precária. Acrescenta-se o baixo salário para médicos em Duque de Caxias e, vínculos e salários distintos entre profissionais que exercem mesma função no Rio de Janeiro. Conclusões: A expansão da ESF nos grandes centros urbanos encontra obstáculos relacionados à gestão do trabalho que fragilizam sua consolidação. O Rio de Janeiro mostra-se mais atraente para os profissionais da ESF. O único diferencial de Duque de Caxias, sobretudo para odontólogos e enfermeiros, refere-se à contratação direta pela Prefeitura com vinculação estatutária, ainda que, eventual aumento salarial esteja atrelado ao de todos os servidores municipais. No Rio de Janeiro, a contratação sob regime da Consolidação das Leis do Trabalho revela-se uma proteção, posto que diante da possibilidade de perda de profissionais as OS elevam seus salários. Dentre as recomendações para fixação profissional incluem-se: incentivos salariais para atuação em regiões vulneráveis, melhorias em infraestrutura e, acoplação entre Instituições de Ensino Superior e rede de saúde.

Mecanismos federais de coordenação de políticas sociais e capacidades institucionais locais : o caso do Programa Bolsa Família

Este trabalho analisa o Programa Bolsa Família (PBF), tratando de sua evolução ao longo do governo Lula, tanto no que diz respeito ao seu escopo quanto a seu desenho institucional e as alterações que foi sofrendo em seus objetivos. Tendo em vista a natureza federativa do Estado brasileiro, o objetivo do trabalho é mostrar os desafios enfrentados pelo poder central para garantir a implementação homogênea de um programa nacional de transferência condicionada de renda a ser gerido pelos municípios. Para tanto, são analisados, de um lado, os recursos institucionais e as estratégias de que dispunha o governo federal para alcançar os seus objetivos para o PBF, e de outro, os resultados e a dinâmica da gestão municipal do programa em dois grandes centros urbanos, São Paulo e Salvador. São analisadas informações relativas ao desempenho nacional do programa e também referentes à implementação municipal do PBF nos casos escolhidos, por meio de dados de surveys realizados com a população de baixa renda e de entrevistas semi-estruturadas com gestores municipais do programa nessas duas cidades. A tese identifica os mecanismos que asseguram o crescente poder de coordenação do governo federal no sentido de fazer com que suas principais diretrizes para o programa sejam de fato implementadas no plano municipal. Mostra também que o processo de implementação do PBF é afetado não só por seu desenho institucional, definido no plano federal, mas também pelas diferentes capacidades institucionais disponíveis no plano local recursos humanos, capacidade de gestão e articulação entre diversos serviços e políticas, infra-estrutura disponível, entre outros aspectos e pelos diferentes interesses políticos na maior ou menor coordenação dos programas locais de transferência com o programa nacional. Finalmente, o trabalho examina ainda os limites e possibilidades para a articulação do PBF com uma política mais ampla de assistência social.

Invalidez por dor nas costas entre os contribuintes da Previdência Social, Brasil, 2007

O presente estudo teve por objetivo analisar a magnitude e a distribuição das aposentadorias por invalidez por dor nas costas no Brasil em 2007. Trata-se de estudo descritivo utilizando registros do Sistema Único de Informações de Benefícios e dos Anuários Estatísticos da Previdência Social de 2007. Foram concedidos 10.839 benefícios de aposentadoria por invalidez referentes a dor nas costas. As variáveis idade, sexo, estados e grandes regiões foram utilizadas para o cálculo das taxas de incidência de dor nas costas em aposentadorias por invalidez enquanto as variáveis faixa salarial, ramo de atividade, clientela e tipo de filiação, foram utilizadas para o cálculo das proporções. Para o cálculo das dez primeiras causas de aposentadoria por invalidez foram utilizados os dados de todas as causas deste benefício. Foram analisados ainda, os dias de trabalho perdidos por invalidez por atividade profissional. A dor nas costas idiopática foi a primeira causa de invalidez em 2007. A maioria dos beneficiários residia em área urbana, era composta por comerciários e recebia até três salários mínimos. A taxa de incidência de dor nas costas em aposentadorias por invalidez foi de 29,96 por 100.000 contribuintes. Este valor foi mais elevado no sexo masculino e apresentou crescimento à medida que se eleva a faixa etária. A taxa de Rondônia, estado com a maior proporção de trabalhadores rurais foi mais de quatro vezes o esperado (RT=4,05) enquanto a segunda maior taxa foi aproximadamente duas vezes o esperado (RT=2,07). A dor nas costas foi uma importante causa de invalidez em 2007. As diferenças observadas entre as incidências por estado apontam para a necessidade de melhor compreender os fatores associados a este importante problema de morbidade para a população trabalhadora brasileira.

A distributed process for the aerospace industry

In response to significant changes within the aerospace industry during recent years, a new approach is proposed for developing complex products in a globally distributed environment. Current approaches favour collocating project teams, but collocation is often not practical, nor economically justifiable. The Macro Concept is a process whereby products can be developed by globally distributed task teams, managed by a Core team. In the development of this concept, particular attention is paid to the human factors, the product decomposition and the infrastructure that supports the product introduction process in a globalized industry.

Alternative approaches to slum upgrading in Kibera, Nairobi

This paper discusses the sustainability of two different approaches to upgrade water and sanitation infrastructure in Kenya’s largest informal settlement, Kibera. A background to the urbanization of poverty is outlined along with approaches to urban slums. Two case-studies of completed interventions of infrastructure upgrading have been investigated. In one case-study, the upgrading method driven by an NGO uses an integrated livelihoods and partnership technique at community level to create an individual project. in the other case-study, the method is a collaboration between the government and a multi-lateral agency to deliver upgraded services as a part of a country-wide programme. The ‘bottom-up’ (project) and ‘top-down’ (programme) approaches each seek sustainability and aim to achieve this in the same context using different techniques. This paper investigates the sustainability of each approach. The merits and challenges of the approaches are discussed with the projected future of Kibera. The paper highlights the valuable opportunity for the role of appropriate engineering infrastructure for sustainable urban development, as well as the alleviation of poverty in a developing context.

The flow of steel into the construction sector

Half of the world's annual production of steel is used in constructing buildings and infrastructure. Producing this steel causes significant amounts of carbon dioxide to be released into the atmosphere. Climate change experts recommend this amount be halved by 2050; however steel demand is predicted to have doubled by this date. As process efficiency improvements will not reach the required 75% reduction in emissions per unit steel output, new methods must be examined to deliver service using less steel production. To apply such methods successfully to construction, it must first be known where steel is used currently within the industry. This information is not available so a methodology is proposed to estimate it from known data. Results are presented for steel flows by product for ten construction sectors for both the UK and the world in 2006. An estimate for steel use within a 'typical' building is also published for the first time. Industrial buildings and utility infrastructure are identified as the largest end-uses of steel, while superstructure is confirmed as the main use of steel in a building. The results highlight discrepancies in previous steel estimates and life-cycle assessments, and will inform future research on lowering demand for steel, hence reducing carbon emissions. © 2012 Elsevier B.V. All rights reserved.

Application of gel-casting to the fabrication of 1-3 piezoelectric ceramic-polymer composites for high-frequency ultrasound devices

A modified gel-casting technique was used to fabricate a 1-3 piezoelectric ceramic/polymer composite substrate formed by irregular-shaped pillar arrays of small dimensions and kerfs. This technique involves the polymerization of aqueous piezoelectric (PZT) suspensions with added water-soluble epoxy resin and polyamine-based hardener that lead to high strength, high density and resilient ceramic bodies. Soft micromoulding was used to shape the ceramic segments, and micropillars with lateral features down to 4 m and height-to-width aspect ratios of ∼10 were achieved. The composite exhibited a clear thickness resonance mode at approximately 70 MHz and a k eff ∼ 0.51, demonstrating that the ceramic micropillars possess good electrical properties. Furthermore, gel-casting allows the fabrication of ceramic structures with non-conventional shapes; hence, device design is not limited by the standard fabrication methods. This is of particular benefit for high-frequency transducers where the critical design dimensions are reduced. © 2012 IOP Publishing Ltd.

EEFIT mission to Haiti following the 12th January 2010 earthquake

The Mw= 7.2 Haiti earthquake of 12th January 2010 caused extensive damage to buildings and other infrastructure in the epicentral region in and around Port-au-Prince. The Earthquake Engineering Field Investigation Team (EEFIT), which is based in the United Kingdom, organised a field mission to Haiti with the authors as the team members. The paper presents the geotechnical findings of the team including those relating to soil liquefaction and lateral spreading and discusses the performance of buildings, including historic buildings, and bridges. Unprecedented use was made of damage assessments made from remote images (i. e. images taken from satellites and aircraft) when planning the post-earthquake relief effort in Haiti and a principal objective of the team was to evaluate the accuracy of such assessments. Accordingly, 142 buildings in Port-au-Prince were inspected in the field by the EEFIT team; damage assessments had previously been made using remote images for all these buildings. On the basis of this survey, the tendency of remote assessments to underestimate damage was confirmed; it was found that the underestimate applied to assessments based on oblique images using the relatively new technique of Pictometry, as well as those based on vertical images, although to a lesser degree. The paper also discusses the distribution of damage in Port-au-Prince, which was found to be strongly clustered in ways that appear not to have been completely explained. © 2012 Springer Science+Business Media B.V.

Alternative approaches to slum upgrading in Kibera, Nairobi

This paper discusses the sustainability of two different approaches to upgrade water and sanitation infrastructure in Kenya's largest informal settlement, Kibera. A background to the urbanisation of poverty is outlined along with approaches to urban slums. Two case studies of completed interventions of infrastructure upgrading have been investigated. In one case study, the upgrading method driven by a non-government organisation uses an integrated livelihoods and partnership technique at community level to create an individual project. In the other case study, the method is a collaboration between the government and a multi-lateral agency to deliver upgraded services as part of a country-wide programme. The 'bottom-up' (project) and 'top-down' (programme) approaches both seek sustainability and aim to achieve this in the same context using different techniques. This paper investigates the sustainability of each approach. The merits and challenges of the approaches are discussed with the projected future of Kibera. The paper highlights the valuable opportunity for the role of appropriate engineering infrastructure for sustainable urban development, as well as the alleviation of poverty in a developing context.

小麦—偏凸山羊草6Mv/6B代换系的研究

小麦条锈病（Puccinia striiformis f. sp. tritici）是世界性小麦病害，可导致受害小麦减产30%以上，甚至绝收。小麦条锈病在我国西南、华北麦区危害严重，四川麦区是小麦条锈病发病最重的地区之一，每年因条锈病流行造成小麦产量损失巨大。利用抗条锈病品种是控制该病害最安全、经济的有效途径，因此挖掘利用抗病新基因，开展抗病遗传基础研究是当前育种工作中面临的重要任务。 偏凸山羊草（Aegilops ventricosa，DDMvMv，2n=28）是一年生草本植物，起源于地中海西部沿岸地区，具有对小麦白粉病、锈病等高抗或免疫、耐盐、抗寒、蛋白质含量高等优良性状，是小麦遗传育种很好的种质资源。本研究以高抗条锈病的小麦—偏凸山羊草6Mv/6B代换系（Moisson 6Mv/6B）为材料，对其含有的带条锈病抗性基因的偏凸山羊草6Mv染色体在四川小麦背景中的传递情况、与小麦—簇毛麦双端体附加系所具有的白粉病抗性的聚合以及对Moisson 6Mv/6B进行电离辐射诱变筛选抗条锈病的小麦—偏凸山羊草易位系三个方面进行了研究。取得的主要研究结果如下： 1. Moisson 6Mv/6B与高感条锈病的四川地区普通小麦品种绵阳26、绵阳93-124和SW3243的杂种F1与其普通小麦亲本分别作为父、母本回交，通过对其BC1和F2的结实率、根尖细胞有丝分裂中期染色体的观察以及对条锈病抗性的鉴定，发现含6Mv染色体的F1植株作母本时的回交结实率（83.10%）普遍高于含6Mv染色体的F1植株作父本（48.61%），结实率与普通小麦基因型密切相关（χ2=34.15>>χ20.05=5.99（df=2））；6Mv染色体在三种四川小麦中通过雌、雄配子传递的传递方式与其传递率间没有显著相关性，其传递率与普通小麦基因型呈显著相关性（χ2=6.42>χ20.05=5.99（df=2））。 2. Moisson 6Mv/6B与高抗白粉病的小麦—簇毛麦双端体附加系Pana（2n=42+2t）正反杂交，希望在聚合两者抗性的同时观察不同受体背景下的抗性反应。对Moisson 6Mv/6B和Pana正反杂交的结实率、杂交后代的农艺性状进行观察，并对杂交后代进行基因组荧光原位杂交（GISH）分析及条锈病和白粉病的抗性鉴定。结果表明Moisson 6Mv/6B作母本时杂交结实率（80.56%）高于Pana作母本时（58.33%），结实率与杂交方式间紧密相关（χ2=4.96>χ20.05=3.84（df=1））；Moisson 6Mv/6B和Pana杂交后代株高比最高亲本高约10cm，成熟期也较两亲本提前两个星期左右；正反杂交后代中具有偏凸山羊草6Mv染色体的植株具有条锈病抗性，具有簇毛麦端体的植株具有白粉病抗性，同时筛选到4株含有偏凸山羊草和簇毛麦遗传物质并对条锈病和白粉病兼抗的材料，证明来自偏凸山羊草6Mv染色体的条锈病抗性与来自簇毛麦端体的白粉病抗性已经聚合在一起，且没有产生相互抑制的作用，暗示通过这两个抗性基因的聚合是完全能获得兼抗条锈病和白粉病的小麦新种质。 3. 对Moisson 6Mv/6B在减数分裂时期的成株进行总剂量为6Gy、辐射频率为120rad/min的60Co-γ射线辐射，对辐射植株自交后代进行农艺性状及根尖细胞有丝分裂中期染色体形态观察和条锈病抗性鉴定。结果为辐射植株自交结实率为2.22%，根尖细胞有丝分裂中期的染色体存在明显碎片，辐射自交后代植株对条锈病具有成株期抗性。 小麦—偏凸山羊草6Mv/6B代换系对条锈病抗性稳定，是培育条锈病抗性品种的良好供体。本研究证明在四川小麦背景中要利用该品种抗性，在结实数满足需要时，可将其作父本，亦可作母本，但关键是要选择好一个优良的受体基因型；同时其条锈病抗性与来自簇毛麦的白粉病抗性没有相互抑制作用，可将两者抗性有效聚合用于小麦育种中。 Wheat stripe rust (Puccinia striiformis f. sp. Tritici) is a worldwide disease of wheat, and could lead to victims of 30 percent or even total destruction of wheat production. Wheat stripe rust harms badly in China's southwest and North China. Sichuan province is one of the regions damaged by wheat stripe rust heavily. The use of resistant varieties is the most secure and economical way to control the wheat stripe rust. Therefore, it is essential to identify new disease-resistant genes and genetically research of disease resistance. Aegilops ventricosa (DDMvMv, 2n = 28) is an annual herbaceous plant, originating in the coastal areas of the western Mediterranean, with good characters such as resistance of wheat powdery, rust, salt, cold and high protein content. It is a good germplasm resource. In this study, the wheat- Aegilops ventricosa 6Mv/6B substitution line Moisson 6Mv/6B (highly resistant to the wheat stripe rust) was used to study on the transmission of chromosome 6Mv of Aegilops ventricosa in different genetic background of Sichuan wheat varieties, hybridization with wheat- Haynaldia villosa ditelosomic addition line Pana (highly resistant to the powdery mildew) and screening of wheat- Aegilops ventricosa translocation line by exposuring Moisson 6Mv/6B under ionizing radiation. The main results are as following: 1. Moisson 6Mv/6B was crossed with Sichuan wheat varieties mianyang26, mianyang93-124 and SW3243 (highly susceptible to stripe rust), respectively. Their F1 hybrids were further backcrossed as male and female to corresponding wheat varieties. The seed-setting rate, chromosomes confirmation in the mitotic metaphase of root tip cells, and resistance to stripe rust of the subsequent BC1 and F2 plants were investigated. The average seed-setting rate of backcross via 6Mv as female donor (83.10%) was higher than that of backcross via 6Mv as male donor (48.61%), suggesting that the seed-setting rate was associated with the wheat genotypes（χ2=34.15>>χ20.05=5.99（df=2））. In all analyzed populations, transmission frequencies of chromosome 6Mv were not correlated with the ways of 6Mv through male or through female. However, transmission frequencies of chromosome 6Mv were significantly correlated with Sichuan wheat genotypes（χ2=6.42>χ20.05=5.99（df=2））. 2. To aggregating the resistances to stripe rust and powdery mildew, as well as research on the resistance reactions in different genetic background, Moisson 6Mv/6B was reciprocally hybrided with the wheat- Haynaldia villosa ditelosomic addition line Pana (highly resistant to the powdery mildew). The seed-setting rate, agronomic characters, genomic in situ hybridization (GISH) of hybrid progenies，and resistances to stripe rust and powdery mildew were investigated. The results showed that the seed-setting rate of hybridization via Moisson 6Mv/6B as female donor (80.56%) was significant higher than that via Pana as female donor (58.33%). The seed-setting rate was associated with the hybrid methods (χ2 = 4.96> χ20.05 = 3.84 (df = 1)). The plant height of hybrid progenies was about 10 cm higher than Pana, the parent with maximum height. And the maturity of hybrid progenies was about two weeks earlier than that of the parents. In the hybrid progenies, the plants with the 6Mv chromosome have the resistance to stripe rust and the plants with the telosome from Haynaldia villosa have the resistance to powdery mildew. It was found that four plants with both the 6Mv chromosome and the telosome from Haynaldia villosa were resistant to stripe rust and powdery mildew. It indicated that the resistance to stripe rust and powdery mildew aggregated, and no mutual inhibition was found. It implied that the aggregation of the two resistance genes was able to provide the new wheat germplasm with the resistances to stripe rust and powdery mildew. 3. Moisson 6Mv/6B was irradiated with 60Co-γ rays of 6Gy (120rad/min) during meiosis. The agronomic characters and chromosomes confirmation in the mitotic metaphase of root tip cells，as well as resistance to stripe rust were investigated. The seed-setting rate of irradiated plants was only 2.22%. The chromosomes in mitotic metaphase had clear fragments. The resistance to stripe rust of progeny of irradiated plants was the adult-plant resistance. The wheat- Aegilops ventricosa 6Mv/6B substitution line is a good stripe rust resistance donor for its stabile resistance. Our study demonstrated that the key for use the resistance is to choose a good receptor. There is no difference between Moisson 6Mv/6B be the female and be the male if the seed number meets the requirement. At the same time, the stripe rust resistance of Moisson 6Mv/6B did not have the mutual inhibition with the powdery mildew resistance from Haynaldia villosa. It is able to aggregate the two resistances for wheat breeding.

What's happening in European supply-chains?

Many multinational companies are supposedly viewing Europe as one region and re-shaping their approach to the supply of products to customers. Several factors are thought to be driving this trend, notably the degree of merger and acquisitions activity; the need for improved financial performance; the pressure to reduce inventories and costs, facilitated by improvements in communication and information technology systems. All of this is in the context of European market and monetary harmonisation. This paper investigates the extent and effect of the amanegement of supply chains on a pan-European baisis by multinational business. A survey was used to examine changes, both made and anticipated. to operational strategies, processes, organisational structures and physical infrastructure across a range of businesses and industry sectors. Cost reducation, driven by the need for profit and shreholder return, was found to be the priority for developments in supply chains.Many businesses reported consolidation of manufacturing and distribution activities whilst retaining discrete country-by-country organisational structures for managing customers and markets.Logistics Service Providers were seen in a traditional role as suppliers of commodity warehousing and transport services and lacked true pan-European capability. Despite the often-vaunted concept of a pan-European business model, individual businesses wwere seen to be negotiating their own path to balancing economies of scale with customers' service needs and expectations.

Estudo do processo de difusão de gases em carvões com base em isotérmicas de Langmuir

Tese de Doutoramento apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Doutror em Ciências da Terra.

Estudo da prevalência da utilização de protetores bucais em praticantes da arte marcial Muay Thai

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

As barreiras urbanas no tecido da cidade

Dissertação apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Arquitetura e Urbanismo

Cost savings from relaxation of operational constraints on a power system with high wind penetration

Wind energy is predominantly a nonsynchronous generation source. Large-scale integration of wind generation with existing electricity systems, therefore, presents challenges in maintaining system frequency stability and local voltage stability. Transmission system operators have implemented system operational constraints (SOCs) in order to maintain stability with high wind generation, but imposition of these constraints results in higher operating costs. A mixed integer programming tool was used to simulate generator dispatch in order to assess the impact of various SOCs on generation costs. Interleaved day-ahead scheduling and real-time dispatch models were developed to allow accurate representation of forced outages and wind forecast errors, and were applied to the proposed Irish power system of 2020 with a wind penetration of 32%. Savings of at least 7.8% in generation costs and reductions in wind curtailment of 50% were identified when the most influential SOCs were relaxed. The results also illustrate the need to relax local SOCs together with the system-wide nonsynchronous penetration limit SOC, as savings from increasing the nonsynchronous limit beyond 70% were restricted without relaxation of local SOCs. The methodology and results allow for quantification of the costs of SOCs, allowing the optimal upgrade path for generation and transmission infrastructure to be determined.