Programa de Gestão em Farmácia Pública módulo Saúde Mental: ferramenta gerencial para a assistência farmacêutica em um Centro de Atenção Psicossocial Álcool e Drogas

Este trabalho tem por objetivo geral apresentar uma ferramenta computacional auxiliar na gestão dos serviços farmacêuticos bem como alguns resultados alcançados com a sua aplicação na sistematização do atendimento aos usuários do Centro de Atenção Psicossocial álcool e drogas (CAPS ad) do município de Vitória-ES, conhecido como Centro de Prevenção e Tratamento de Toxicômanos (CPTT). O Programa de Gestão em Farmácia Pública (PGFP) Módulo Saúde Mental possui um formato de banco de dados relacional, desenvolvido sob a plataforma Access e possui interface com o gerador de planilhas e gráficos do tipo Excel , aplicáveis a outras farmácias de unidades do tipo CAPS ad. Desde 2004 vem sendo utilizado e aperfeiçoado com uma proposta de informatizar a administração da farmácia, possibilitando a instrumentalização do farmacêutico via emissão de relatórios para a gestão técnica, operacional e estratégica, além de propiciar a avaliação do serviço baseando-se em indicadores sócio demográficos, de morbidade e específicos da Assistência Farmacêutica voltados para o campo da toxicodependência. Para ilustrar o uso do PGFP são apresentados dados pertencentes a 489 prontuários de usuários cadastrados na farmácia no período de janeiro de 2007 a dezembro de 2008, além de 50 prescrições médicas sistematicamente selecionadas para cada ano, coletadas a partir do sistema. Com isso, foi possível elaborar o perfil demográfico, sóciosanitário dos usuários além de aspectos relacionados a Assistência Farmacêutica local. Foi utilizado o programa computacional SPSS 11.5 for Windows para a análise estatística exploratória descritiva (distribuição de freqüências) e inferencial (teste qui-quadrado) dos dados contidos nos prontuários. Dentre algumas dessas análises, observou-se a prevalência do Crack (44%) como substância psicoativa. Revelou que a maioria dos usuários cadastrados são homens (82,4%), com faixa etária prevalente entre 25 e 34 anos (31,7%) e com grau de escolaridade equivalente ao 1 Grau Incompleto (41,3%). Com relação aos aspectos relacionados a Assistência Farmacêutica pode-se observar um No. médio de medicamentos prescritos por receita entre 1,6 1,7 itens/receita; um percentual mínimo de 96% das receitas atendidas na farmácia; e o Clonazepam como o medicamento mais prescrito no período. São citadas algumas limitações do PGFP e dos dados apresentados. Conclui-se o presente estudo fazendo-se alusão a relevância do Programa de Gestão em Farmácia Pública (PGFP), em relação não somente ao seu potencial de uso na gestão estratégica e operacional da Assistência Farmacêutica em Saúde Mental (álcool e drogas), mas fundamentalmente, como importante ferramenta de informação que propicia a elucidação do perfil da drogadição, despertando a percepção para os aspectos ligados à saúde pública e as implicações sócio-econômicas sobre a população em estudo.

Understanding function and function-to-form evolution

This is a report on a workshop held at Cambridge University Engineering Design Centre, 17-10 June 1992. This workshop was held to discuss the issue of 'function' and 'function-to-form' evolution in mechanical design. The authors organised this workshop as they felt that their understanding of these topics was incomplete and that discussions between researchers might help to clarify some key issues.

The topic chosen for the workshop proved to be a stimulating one. The term 'function' is part of a designer's daily vocabulary, however there is poor agreement about its definition. In order to develop computer systems to support product evolution, a precise definition is required. Further the value of 'function' and 'function-to-form' evolution as a good choice of workshop topic is evident from the lack of firm conclusions that resulted from the sessions. This lack of consensus made for lively discussion and left participants questioning many of their preconceived ideas.

Attendance at the workshop was by invitation only. A list of the participants (not all those invited could attend due to time and financial constraints) is given in Appendix 1.

A Biogeographic assessment off North/Central California: In support of the National Marine Sanctuaries of Cordell Bank, Gulf of the Farallones and Monterey Bay. Phase II - Environmental setting and update to marine birds and animals

NOAA’s National Centers for Coastal Ocean Science (NCCOS) conducts and supports research, monitoring, assessments, and technical assistance to meet NOAA’s coastal stewardship and management responsibilities. In 2001 the Biogeography Branch of NCCOS partnered with NOAA’s National Marine Sanctuary Program (NMSP) to conduct biogeographic assessments to support the management plan updates for the sanctuaries. The first biogeographic assessment conducted in this partnership focused on three sanctuaries off north/ central California: Cordell Bank, Gulf of the Farallones and Monterey Bay. Phase I of this assessment was conducted from 2001 to 2004, with the primary goal to identify and gather the best available data and information to characterize and identify important biological areas and time periods within the study area. The study area encompasses the three sanctuaries and extends along the coastal ocean off California from Pt. Arena to Pt. Sal (35°-39°N). This partnership project was lead by the NCCOS Biogeography Branch, but included over 90 contributors and 25 collaborating institutions. Phase I results include: 1) a report on the overall assessment that includes hundreds of maps, tables and analyses; 2) an ecological linkage report on the marine and estuarine ecosystems along the coast of north/central California, and 3) related geographic information system (GIS) data and other summary data files, which are available for viewing and download in several formats at the following website: http://ccma.nos.noaa.gov/products/biogeography/canms_cd/welcome.html Phase II (this report) was initiated in the Fall of 2004 to complete the analyses of marine mammals and update the marine bird colony information. Phase II resulted in significant updates to the bird and mammal chapters, as well as adding an environmental settings chapter, which contains new and existing data and maps on the study area. Specifically, the following Phase II topics and items were either revised or developed new for Phase II: •environmental, ecological settings – new maps on marine physiographic features, sea surface temperature and fronts, chlorophyll and productivity •all bird colony or roost maps, including a summary of marine bird colonies •updated at-sea data CDAS data set (1980-2003) •all mammal maps and descriptions •new overall density maps for eight mammal species •new summary pinniped rookery/haulout map •new maps on at-sea richness for cetaceans and pinnipeds •most text in the mammal chapter •new summary tables for mammals on population status and spatial and temporal patterns

Baseline assessment of Guánica Bay, Puerto Rico in support of watershed restoration

Guánica Bay is a major estuary on the southwest coast of Puerto Rico. Significant coral reef ecosystems are present outside the bay. These valuable habitats may be impacted by transport of sediments, nutrients and contaminants from the watershed, through the bay and into the offshore waters. The National Oceanic and Atmospheric Administration’s (NOAA) National Centers for Coastal Ocean Science (NCCOS), in consultation with local and regional experts, conducted an interdisciplinary assessment of coral reef ecosystems, contaminants, sedimentation rates and nutrient distribution patterns in and around Guánica Bay. This work was conducted using many of the same protocols as ongoing monitoring work underway elsewhere in the U.S. Caribbean and has enabled comparisons among coral reef ecosystems between this study and other locations in the region. This characterization of Guánica marine ecosystems establishes benchmark conditions that can be used for comparative documentation of future change, including possible negative outcomes due to future land use change, or improvement in environmental conditions arising from management actions. This report is organized into six chapters that represent a suite of interrelated studies. Chapter 1 provides a short introduction to the study area. Chapter 2 is focused on biogeographic assessments and benthic mapping of the study area, including new surveys of fish, marine debris and reef communities on hardbottom habitats in the study area. Chapter 3 quantifies the distribution and magnitude of a suite of contaminants (e.g., heavy metals, PAHs, PCBs, pesticides) in both surface sediments and coral tissues. Chapter 4 presents results of sedimentation measurements in and outside of the bay. Chapter 5 examines the distribution of nutrients in in the bay, offshore from the bay and in the watershed. Chapter 6 is a brief summary discussion that highlights key findings of the entire suite of studies.

Support for integrated ecosystem assessments of NOAA’s National Estuarine Research Reserve System (NERRS): assessment of ecological condition and stressor impacts in subtidal waters of the Sapelo Island National Estuarine Research Reserve

A study was conducted in June 2009 to assess the current status of ecological condition and potential human-health risks throughout subtidal estuarine waters of the Sapelo Island National Estuarine Research Reserve (SINERR) along the coast of Georgia. Samples were collected for multiple indicators of ecosystem condition, including water quality (dissolved oxygen, salinity, temperature, pH, nutrients and chlorophyll, suspended solids, fecal coliform bacteria and coliphages), sediment quality (granulometry, organic matter content, chemical contaminant concentrations), biological condition (diversity and abundance of benthic fauna, fish tissue contaminant levels and pathologies), and human dimensions (fish-tissue contaminant levels relative to human-health consumption limits, various aesthetic properties). Use of a probabilistic sampling design facilitated the calculation of statistics to estimate the spatial extent of the Reserve classified according to various categories (i.e., Good, Fair, Poor) of ecological condition relative to established thresholds of these indicators, where available. Overall, the majority of subtidal habitat in the SINERR appeared to be healthy, with over half (56.7 %) of the Reserve area having water quality, sediment quality, and benthic biological condition indicators rated in the healthy to intermediate range of corresponding guideline thresholds. None of the stations sampled had one or more indicators in all three categories rated as poor/degraded. While these results are encouraging, it should be noted that one or more indicators were rated as poor/degraded in at least one of the three categories over 40% of the Reserve study area, represented by 12 of the 30 stations sampled. Although measures of fish tissue chemical contamination were not included in any of the above estimates, a number of trace metals, pesticides, polybrominated diphenyl ethers (PBDEs), and polychlorinated biphenyls (PCBs) were found at low yet detectable levels in some fish at stations where fish were caught. Levels of mercury and total PCBs in some fish specimens fell within EPA guideline values considered safe, given a consumption rate of no more than four fish meals per month. Moreover, PCB congener profiles in sediments and fish in the SINERR exhibit a relative abundance of higher-chlorinated homologs which are uniquely characteristic of Aroclor 1268. It has been well-documented that sediments and fish in the creeks and marshes near the LCP Chemicals Superfund site, near Brunswick, Georgia, also display this congener pattern associated with Aroclor 1268, a highly chlorinated mixture of PCBs used extensively at a chlor-alkali plant that was in operation at the LCP site from 1955-1994. This report provides results suggesting that the protected habitats lying within the boundaries of the SINERR may be experiencing the effects of a legacy of chemical contamination at a site over 40km away. These effects, as well as other potential stressors associated with increased development of nearby coastal areas, underscore the importance of establishing baseline ecological conditions that can be used to track potential changes in the future and to guide management and stewardship of the otherwise relatively unspoiled ecosystems of the SINERR.

A biogeographic asssessment of seabirds, deep sea corals and ocean habitats of the New York Bight: science to support offshore spatial planning

This report provides a compilation of new maps and spatial assessments for seabirds, bathymetry, surficial sediments, deep sea corals, and oceanographic habitats in support of offshore spatial planning led by the New York Department of State Ocean and Great Lakes Program. These diverse ecological themes represent priority information gaps left by past assessments and were requested by New York to better understand and balance ocean uses and environmental conservation in the Atlantic. The main goal of this report is to translate raw ecological, geomorphological and oceanographic data into maps and assessments that can be easily used and understood by coastal managers involved in offshore spatial planning. New York plans to integrate information in this report with other ecological, geophysical and human use data to obtain a broad perspective on the ocean environment, human uses and their interactions. New York will then use this information in an ecosystem-based framework to coordinate and support decisions balancing competing demands in their offshore environment, and ultimately develop a series of amendments to New York’s federally approved Coastal Management Program. The targeted users of this report and the compiled spatial information are New York coastal managers, but other State and federal decision-makers, offshore renewable energy development interests and environmental advocates will also find the information useful. In addition, the data and approaches will be useful to regional spatial planning initiatives set up by the Mid-Atlantic Regional Council on the Ocean (MARCO) and federal regional planning bodies for coastal and marine spatial planning.

Baseline assessment of Fish and Coral bays, St. John, U.S. Virgin Islands in support of watershed restoration activities, part I: fish, coral and benthic habitats

This report provides baseline biological data on fishes, corals and habitats in Coral and Fish Bays, St. John, USVI. A similar report with data on nutrients and contaminants in the same bays is planned to be completed in 2013. Data from NOAA’s long-term Caribbean Coral Reef Ecosystem Monitoring program was compiled to provide a baseline assessment of corals, fishes and habitats from 2001 to 2010, data needed to assess the impacts of erosion control projects installed from 2010 to 2011. The baseline data supplement other information collected as part of the USVI Watershed Stabilization Project, a project funded by the American Recovery and Reinvestment Act of 2009 and distributed through the NOAA Restoration Center, but uses data which is not within the scope of ARRA funded work. We present data on 16 ecological indicators of fishes, corals and habitats. These indicators were chosen because of their sensitivity to changes in water quality noted in the scientific literature (e.g., Rogers 1990, Larsen and Webb 2009). We report long-term averages and corresponding standard errors, plot annual averages, map indicator values and list inventories of coral and fish species identified among surveys. Similar data will be needed in the future to make rigorous comparisons and determine the magnitude of any impacts from watershed stabilization.

A geo-referenced benthic habitat survey in support of natural resource management: Port Graham Bay, Alaska

The impact of recent changes in climate on the arctic environment and its ecosystems appear to have a dramatic affect on natural populations (National Research Council Committee on the Bering Sea Ecosystem 1996) and pose a serious threat to the continuity of indigenous arctic cultures that are dependent on natural resources for subsistence (Peterson D. L., Johnson 1995). In the northeast Pacific, winter storms have intensified and shifted southward causing fundamental changes in sea surface temperature patterns (Beamish 1993, Francis et al. 1998). Since the mid 1970’s surface waters of the central basin of the Gulf of Alaska (GOA) have warmed and freshened with a consequent increase in stratification and reduced winter entrainment of nutrients (Stabeno et al. 2004). Such physical changes in the structure of the ocean can rapidly affect lower trophic levels and indirectly affect fish and marine mammal populations through impacts on their prey (Benson and Trites 2002). Alaskan natives expect continued and perhaps accelerating changes in resources due to global warming (DFO 2006).and want to develop strategies to cope with their changing environment.

The changing face and role of CACSD

Computer Aided Control Engineering involves three parallel streams: Simulation and modelling, Control system design (off-line), and Controller implementation. In industry the bottleneck problem has always been modelling, and this remains the case - that is where control (and other) engineers put most of their technical effort. Although great advances in software tools have been made, the cost of modelling remains very high - too high for some sectors. Object-oriented modelling, enabling truly re-usable models, seems to be the key enabling technology here. Software tools to support control systems design have two aspects to them: aiding and managing the work-flow in particular projects (whether of a single engineer or of a team), and provision of numerical algorithms to support control-theoretic and systems-theoretic analysis and design. The numerical problems associated with linear systems have been largely overcome, so that most problems can be tackled routinely without difficulty - though problems remain with (some) systems of extremely large dimensions. Recent emphasis on control of hybrid and/or constrained systems is leading to the emerging importance of geometric algorithms (ellipsoidal approximation, polytope projection, etc). Constantly increasing computational power is leading to renewed interest in design by optimisation, an example of which is MPC. The explosion of embedded control systems has highlighted the importance of autocode generation, directly from modelling/simulation products to target processors. This is the 'new kid on the block', and again much of the focus of commercial tools is on this part of the control engineer's job. Here the control engineer can no longer ignore computer science (at least, for the time being). © 2006 IEEE.

The changing face and role of CACSD

Computer Aided Control Engineering involves three parallel streams: Simulation and modelling, Control system design (off-line), and Controller implementation. In industry the bottleneck problem has always been modelling, and this remains the case - that is where control (and other) engineers put most of their technical effort. Although great advances in software tools have been made, the cost of modelling remains very high - too high for some sectors. Object-oriented modelling, enabling truly re-usable models, seems to be the key enabling technology here. Software tools to support control systems design have two aspects to them: aiding and managing the work-flow in particular projects (whether of a single engineer or of a team), and provision of numerical algorithms to support control-theoretic and systems-theoretic analysis and design. The numerical problems associated with linear systems have been largely overcome, so that most problems can be tackled routinely without difficulty - though problems remain with (some) systems of extremely large dimensions. Recent emphasis on control of hybrid and/or constrained systems is leading to the emerging importance of geometric algorithms (ellipsoidal approximation, polytope projection, etc). Constantly increasing computational power is leading to renewed interest in design by optimisation, an example of which is MPC. The explosion of embedded control systems has highlighted the importance of autocode generation, directly from modelling/simulation products to target processors. This is the 'new kid on the block', and again much of the focus of commercial tools is on this part of the control engineer's job. Here the control engineer can no longer ignore computer science (at least, for the time being). ©2006 IEEE.

Institutional support for freshwater aquaculture development: a study of Mirzapur district of Uttar Pradesh, India

The aquaculture sector has been playing an increasingly dominating role in Indian fisheries scenario since the last two and half decades. Introduction of induced breeding and composite fish culture (CFC) technologies has changed the freshwater aquaculture sector in India. Institutional support has been one of the most crucial aspects in all fisheries development programs, more so in the Indian context where most of fish farmers are socially and economically weak. The innovation of CFC technology in freshwater aquaculture sector in the early seventies generated the need for adequate and effective institutional support to farmers. Under the freshwater aquaculture development program, the Fish Farmers Development Agencies (FFDA) have been established at district level to provide technical and extension support to the farming community besides arranging ponds on lease and supply of seeds. In addition to above, FFDAs are also expected to arrange loans from banks and provide subsidies. Thus, FFDAs are meant to provide institutional support to fish farming community in the country. In view of the above, an effort was made to study the adequacy and effectiveness of institutional support provided by the FFDA, Mirzapur for the development of aquaculture in Mirzapur district of Uttar Pradesh {U.P.), India. Study reveals that leasing of ponds for fish farming has been favourable to economically weaker sections of societies while bank loan accessibility is more for those having relatively higher economic status. Though the FFDA, Mirzapur performed well in providing training to potential fish farmers and creating awareness about fish farming, its effectiveness could not be equally seen in seed supply.

Computer-based selection of joining processes

The assembly of any manufactured product involves joining. This paper describes ways of selecting processes for joining. The method allows discrimination of the joint geometry, joint loading, material, and other attributes of the joint itself, identifying the subset of available processes capable of meeting a given set of design constraints. A relational database containing data-tables for joining processes, materials to be joined, and joint geometry and mode of loading, allows the attributes of each of these to be stored in an appropriate format, and permits links to be created between those that are related. A search engine isolates the processes that meet design requirements on material, joint geometry and loading. The method is illustrated in Part 2 by case studies, utilising software that embodies the method.