797 resultados para health state classification system
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This article starts by analysing healthcare litigation in Brazil by means of a literature review of articles that contribute with empirical findings on this phenomenon. Based on this review, I argue that health care litigation in Brazil makes the public health system less fair and rational. In the second part of this article, I discuss the three most overarching responses to control the level of litigation and its impact on the public health system: (i) the public hearing held by the Supreme Federal Court and the criteria the court established thereafter; (ii) the recommendations by the National Council of Justice aimed at building courts’ institutional capacity; and (iii) the enactment of the Federal Law 12.401/11, which created a new health technology assessment system. I argue that latter is the best response because it keeps the substantive decisions on the allocation of healthcare resources in the institution that is in the best position to make them. Moreover, this legislation will make the decisions about provision of health treatments more explicit, making easier for courts to control the procedure and the reasons for these decisions.
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This work proposes a method to examine variations in the cointegration relation between preferred and common stocks in the Brazilian stock market via Markovian regime switches. It aims on contributing for future works in "pairs trading" and, more specifically, to price discovery, given that, conditional on the state, the system is assumed stationary. This implies there exists a (conditional) moving average representation from which measures of "information share" (IS) could be extracted. For identification purposes, the Markov error correction model is estimated within a Bayesian MCMC framework. Inference and capability of detecting regime changes are shown using a Montecarlo experiment. I also highlight the necessity of modeling financial effects of high frequency data for reliable inference.
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Esta tese traz três exercícios empíricos sobre questões de recursos humanos em escolas públicas brasileiras, aproveitando-se de uma ampla política implantada na rede estadual de São Paulo. Esta política aumenta os salários para os professores que trabalham em escolas urbanas pobres e sua regra de alocação, baseada em um corte arbitrário em um índice socioeconômico, permite a identificação de impactos causais. Em resumo, os três artigos apontam que políticas de subsídios são capazes de, de fato, manter professores nas escolas mais pobres e este efeito, por sua vez, melhora o desempenho acadêmico dos alunos. Além disso, concluímos também que esta política também reduz o absenteísmo dos professores. No entanto, como consequência do desenho dessa política, não há evidências de que o subsídio melhora o perfil dos professores alocados nessas escolas. O primeiro artigo avalia os impactos dessa política sobre a rotatividade dos professores. Concluímos que a compensação salarial reduziu a taxa de rotatividade em 7,2 pontos percentuais, o que significa uma queda de 15% sobre a média pré-tratamento. Em um modelo em forma reduzida, encontramos também evidências de que esta política pode impactar positivamente o desempenho dos alunos. O segundo artigo analisa os impactos sobre a aprendizagem dos alunos, com foco em três possíveis mecanismos: i) a rotatividade; ii) a qualidade dos professores; iii) o aumento do salário. As estimativas mostram que o único canal através do qual esta política compensatória afeta o desempenho dos alunos é a redução da rotatividade dos professores. Ao reduzir taxa de volume de negócios em um desvio-padrão, a política reduziu a proporção de alunos de baixo desempenho em cerca de meio desvio-padrão. O terceiro artigo avalia como a diferenciação salarial criada por esta política afeta absenteísmo dos professores. Os resultados mostram que, após controlar efeitos fixos de professores e escolas, pagar um salário mais elevado (em média 26% a mais) provoca uma queda de 8-22% nas faltas dos professores. Ausências que não levam a desconto de salário, como por licenças médicas, não respondem à diferenciação salarial e o impacto é maior para os professores que recebem maior incentivo.
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Schistosomiasis is still an endemic disease in many regions, with 250 million people infected with Schistosoma and about 500,000 deaths per year. Praziquantel (PZQ) is the drug of choice for schistosomiasis treatment, however it is classified as Class II in the Biopharmaceutics Classification System, as its low solubility hinders its performance in biological systems. The use of cyclodextrins is a useful tool to increase the solubility and bioavailability of drugs. The aim of this work was to prepare an inclusion compound of PZQ and methyl-beta-cyclodextrin (MeCD), perform its physico-chemical characterization, and explore its in vitro cytotoxicity. SEM showed a change of the morphological characteristics of PZQ:MeCD crystals, and IR data supported this finding, with changes after interaction with MeCD including effects on the C-H of the aromatic ring, observed at 758 cm(-1). Differential scanning calorimetry measurements revealed that complexation occurred in a 1:1 molar ratio, as evidenced by the lack of a PZQ transition temperature after inclusion into the MeCD cavity. In solution, the PZQ UV spectrum profile in the presence of MeCD was comparable to the PZQ spectrum in a hydrophobic solvent. Phase solubility diagrams showed that there was a 5.5-fold increase in PZQ solubility, and were indicative of a type A(L) isotherm, that was used to determine an association constant (K(a)) of 140.8 M(-1). No cytotoxicity of the PZQ:MeCD inclusion compound was observed in tests using 3T3 cells. The results suggest that the association of PZQ with MeCD could be a good alternative for the treatment of schistosomiasis.
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Contextualization: Several studies have examined the mobility of this group of children, however little is known about the impact of motor function in activities of daily living, considering the seriousness of their neuromotor damage. Objective: Identify the functional differences of children with Cerebral Palsy with different levels of motor dysfunction and correlate these differences with the areas of mobility, self-care and social function in functional ability and caregiver´s assistance of these children. Methods: An l analytical cross-section search was developed, which were part 70 children / families aged from 4 to 7.5 years, in the Rehabilitation Center for Children. As tools were used the Pediatric Evaluation Disability Inventory (PEDI) and the Gross Motor Function Classification System (GMFCS). Data analysis was performed by ANOVA and Pearson's correlation tests. Results: The results show the functional variability of children CP in different severity levels of motor disfunction This variation was observed in the areas of mobility, self-care and social function. The results also showed a strong correlation between the domains mobility and self-care, mobility and social function. Conclusions: The variability shown by the children with CP, suggests the use of PEDI and GMFCS as this association appears to increase the understanding of how the gross motor functions are related to activities of daily living, describing the best commitments and their degree of impact on functional activities. This correlation demonstrates how mobility is crucial to evaluate the performance and guide the therapeutic practice, to develop the children´s potencial, and guide the caregiver in stimulation
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The lipid profile is a group of lab tests that include triglycerides, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). However, serum non-HDL-C, Apo A-I and Apo B levels, as well as the lipids ratios (TC/HDL-C, LDL-C/HDL-C and Apo B/Apo A-I), have been described as better predictors of cardiovascular diseases. Reference intervals are tools often used to help the evaluation of the people s health state. These days, Brazilian studies still use the reference intervals of lipids and lipoproteins from other countries, ignoring differences between the populations. Therefore, this study aimed to establish reference intervals for lipids, lipoproteins and apolipoproteins in adults of Rio Grande do Norte/Brazil. Healthy individuals (96 men and 283 women) between 18 and 59years old formed the reference sample group. The samples were collected after fasting 12 to 14 hours. Information on lifestyle and dietary habits of the participants were obtained through questionnaire. The serum glucose level and renal and liver activity were evaluated by laboratory testing. The results of lipid profile were analyzed according to sex, age and mesoregion of Rio Grande do Norte, with significance level of 5% (p < 0,05). The lower and upper reference limits were identified by the 2.5 percentile and 97.5 percentile, respectively, and assurance intervals of 90% was calculated for each of these limits. Among the determinants of lipid profile analyzed, only a few significant differences were observed according to sex, but in terms of age, the groups of smaller and older ages were most likely different. When evaluated by region, the means of West region shown the most significant variations. Not many studies were useful to compare the reference intervals determined in this study. Thus, it becomes necessary to carry out similar studies in other regions of Brazil and of the world given the clinical importance of reference intervals
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The present paper analyses matters about the assessment in the context of the school organization in cycles. The complexity that involves the assessment turns it into a difficult subject, since the evidence that the model supported by the traditional approach contributes to foil the fulfillment of new continuous and wide-ranging assessment practices, that are coherent with a view of learning as a process established in the student-teacher-knowledge interaction. This paper has as guidance the following questions: How did the introduction of the teaching organization in cycles happen in Fortaleza/ CE? How far are the teachers prepared to the introduction of the cycles system, specially in the way of thinking and practicing the assessment? What are the teacher s involvements with this project and with the continuous assessment in the cycles? What meanings do the teachers give to the assessment in this project? Therefore, were determined as objectives: to comprehend the meanings attributed to the learning assessment by the teachers in contact with the cycles in Fortaleza/CE; to identify assessment practices that are closer to a less qualifying perspective, more related to the students learning and to the educational intervention in order to improve this process. The methodological orientation chosen was based on the presuppositions of the comprehensible interview, with reference to the studies of the French sociologist Jean Claude Kaufmann, developed with 15 (fifteen) teachers of 15 (fifteen) schools of the state teaching system of Fortaleza/CE. It was considered, in the methodology, the word as a central fact in the consolidation of the object of study, what allows to conceive the teachers as active participants of this research and of the discussions about assessment. The analysis about the speeches in the interviews made possible to glimpse the meanings attributed to the learning assessment that are not related to the traditional paragon, in spite of the dilemma in which the participants of the research faced at the time of the introduction of the cycles in Fortaleza/CE. These meanings were created between the presence and the absence of the teachers knowledge that, in their way, interact with the changes caused by the obligation of the teaching organization in cycles, seeking a strategy of self-organization as a consequence of the search for new knowledge connected with the teaching
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It aims to consider the possible relationship between formal school education and work, from the experience of the State School House of the Minor Worker CMT of Natal-RN in this first decade of the 21st century. In this institution, children and adolescents are enrolled in the Fundamental Teaching sponsored by the State Public System studying the regular curriculum contents defined for this level of teaching, and in the opposite shift they take part in career workshops which are kept by members of a religious congregation. CMT has had as its object, since its foundation, to take children and adolescents from the streets and to provide them with a full time education associating basic education and training/qualification for the job market. In our research, we tried to learn a little bit of the expectations, concerns and knowledge of the young participants of two workshops: carpentry and bakery, so that we could gain sufficient understanding of the learning process of these youths, while still keeping an approximation with the reality of the aforementioned subjects. It was possible for us to conduct a description of the contexts and of characteristics of the subjects which make up CMT, capturing concrete aspects and aspects of the thoughts of students, teachers, instructors and coordinators. The main point of our research was: how does the approximation between formal school education and work take place in the House of the Minor Worker? To search for possible answers we have made use of basic techniques for the data construction - questionnaire, observation, conversation groups, assessment drills which allowed an approximation and a good dialogue with the participants. We also discussed the job world in the context of the capitalist exploration, from the contributions of Mèszáros (2005), Frigotto (1989); (1993); (1999); (2002); Ferretti (1994); (2004); Kuenzer (1989); (1997), in order to understand the skills demanded of the worker and the necessity of an education which allows the professional qualification of youths eager to enter the job market, through the first job. In this perspective, the study that we have systematized here aims to show the relevance of an education which manages to take a firm and conscientious stand in connection with the hegemonic capitalist project and to provide for a humane, ethical, responsible, critical and civic background
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The human voice is an important communication tool and any disorder of the voice can have profound implications for social and professional life of an individual. Techniques of digital signal processing have been used by acoustic analysis of vocal disorders caused by pathologies in the larynx, due to its simplicity and noninvasive nature. This work deals with the acoustic analysis of voice signals affected by pathologies in the larynx, specifically, edema, and nodules on the vocal folds. The purpose of this work is to develop a classification system of voices to help pre-diagnosis of pathologies in the larynx, as well as monitoring pharmacological treatments and after surgery. Linear Prediction Coefficients (LPC), Mel Frequency cepstral coefficients (MFCC) and the coefficients obtained through the Wavelet Packet Transform (WPT) are applied to extract relevant characteristics of the voice signal. For the classification task is used the Support Vector Machine (SVM), which aims to build optimal hyperplanes that maximize the margin of separation between the classes involved. The hyperplane generated is determined by the support vectors, which are subsets of points in these classes. According to the database used in this work, the results showed a good performance, with a hit rate of 98.46% for classification of normal and pathological voices in general, and 98.75% in the classification of diseases together: edema and nodules
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The evolution of automation in recent years made possible the continuous monitoring of the processes of industrial plants. With this advance, the amount of information that automation systems are subjected to increased significantly. The alarms generated by the monitoring equipment are a major contributor to this increase, and the equipments are usually deployed in industrial plants without a formal methodology, which entails an increase in the number of alarms generated, thus overloading the alarm system and therefore the operators of such plants. In this context, the works of alarm management comes up with the objective of defining a formal methodology for installation of new equipment and detect problems in existing settings. This thesis aims to propose a set of metrics for the evaluation of alarm systems already deployed, so that you can identify the health of this system by analyzing the proposed indices and comparing them with parameters defined in the technical norms of alarm management. In addition, the metrics will track the work of alarm management, verifying if it is improving the quality of the alarm system. To validate the proposed metrics, data from actual process plants of the petrochemical industry were used
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Crude oil is a complex liquid mixture of organic and inorganic compounds that are dominated by hydrocarbons. It is a mixture of alkanes from the simplest to more complex aromatic compounds that are present derivatives such as gasoline, diesel, alcohol, kerosene, naphtha, etc.. These derivatives are extracted from any oil, however, only with a very high quality, in other words, when the content of hydrocarbons of low molecular weight is high means that production of these compounds is feasible. The American Petroleum Institute (API) developed a classification system for the various types of oil. In Brazil, the quality of most of the oil taken from wells is very low, so it is necessary to generate new technology to develop best practices for refining in order to produce petroleum products of higher commercial value. Therefore, it is necessary to study the thermodynamic equilibrium properties of its derivative compounds of interest. This dissertation aims to determine vapor-liquid equilibrium (VLE) data for the systems Phenilcyclohexane - CO2, and Cyclohexane - Phenilcyclohexane - CO2 at high pressure and temperatures between 30 to 70oC. Furthermore, comparisons between measured VLE experimental data from this work and from the literature in relation to the Peng- Robinson molecular thermodynamic model, using a simulation program SPECS IVCSEP v5.60 and two adjustable interaction parameters, have been performed for modeling and simulation purposes. Finally, the developed apparatus for determination of phase equilibrium data at high pressures is presented
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Land cover mappings represent important tools for the regional planning. However, the current mappings are related to very specific purposes and, consequently, they are limited in their capacity to define the wide variety of existing types of land cover. In that context, this paper aims at developing a wide and including hierarchical classification system for land cover mapping in regional scale, which should contribute for a future standardization of classes. Besides, it is intended to test that system for a study case that contemplates the use of a classification method based on fuzzy approach, which has shown to be more appropriate than conventional approaches. Therefore, it was proposed a hierarchical classification system with three detailing levels and a study case was defined with the specification of the test area and of the classification project. Then, the georreferencing of a TM/Landsat-5 image that comprises the test area was carried out. Later, it was applied a fuzzy classification approach in the TM/Landsat-5 image, starting from images of probability for the mapped classes and an uncertainty image were generated. Finally, it was produced a conventional output that represents the thematic mapping of the test area.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)