738 resultados para Certificate
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Objective. To investigate mortality in which paracoccidioidomycosis appears on any line or part of the death certificate. Method. Mortality data for 1985-2005 were obtained from the multiple cause-of-death database maintained by the Sao Paulo State Data Analysis System (SEADE). Standardized mortality coefficients were calculated for paracoccidioidomycosis as the underlying cause-of-death and as an associated cause-of-death, as well as for the total number of times paracoccidioidomycosis was mentioned on the death certificates. Results. During this 21-year period, there were 1950 deaths related to paracoccidioidomycosis; the disease was the underlying cause-of-death in 1 164 cases (59.69%) and an associated cause-of-death in 786 (40.31%). Between 1985 and 2005 records show a 59.8% decline in the mortality coefficient due to paracoccidioidomycosis as the underlying cause and a 53.0% decline in the mortality as associated cause. The largest number of deaths occurred among men, in the older age groups, and among rural workers, with an upward trend in winter months. The main causes associated with paracoccidioidomycosis as the underlying cause-of-death were pulmonary fibrosis, chronic lower respiratory tract diseases, and pneumonias. Malignant neoplasms and AIDS were the main underlying causes when paracoccidioidomycosis was an associated cause-of-death. The decision tables had to be adapted for the automated processing of causes of death in death certificates where paracoccidioidomycosis was mentioned. Conclusions. Using the multiple cause-of-death method together with the traditional underlying cause-of-death approach provides a new angle on research aimed at broadening our understanding of the natural history of paracoccidioidomycosis.
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Detta examensarbete har utförts på SSAB- Tunnplåt i Borlänge under vårterminen 2004 och omfattar 10 veckors arbete.SSAB sköter idag sin kommunikation med distributionslagren via fax, telefon eller e-post. Eftersom detta är ett ganska tidskrävande kommunikationssätt, vill SSAB ha en smidigare och snabbare kommunikationslösning. Den lösning som SSAB vill ha är en extern Web-service-lösning för att upprätta en säker kommunikation med sina distributionslager.Parallellt med byggandet av Web-service-lösningen arbetades en förvaltningsmodell fram. Den beskriver hur förvaltningsorganisationen med dess rutiner kan se ut vid implementering av lösningen.För att skapa en säker förbindelse med Web-servicen skall en webbklient användas som i sin tur anropar en COM+ komponent. Detta för att kunna skicka med certifikatet ifrån webbklienten till webbservern där Web-servicen ligger. COM+ komponenten måste få tillgång till en användarprofil när den kommunicerar med Web-servicen. Detta för att kunna upprätta en SSL-förbindelse i det inledande skedet. SSL-förbindelsen skall läggas i den VPN-tunnel som mVPN tillhandahåller via WSSAL.
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Frieda Levine Miller was born to William and Sarah Ida Levine on March 26, 1896 and died August 24, 1990. The scrapbook contains family memories, death certificate, eulogies, newspaper clippings, family photographs, a high school graduation program, letters, and announcement of the marriage of her daughter Glenyce.
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This dissertation presents the result of a study accomplished on the degree of use of the certificate of hospital Accreditation as one of the criteria for the accreditation of hospitals by the health insurance companies. Should be emphasized that the Accreditation Certificate represents the main final product of Hospital Accreditation Brazilian Program, being the first emitted when the hospital assists to the quality patterns specified by the Program. In that way, the study focus was, in general terms, Hospital Accreditation Brazilian Program and, more strictly, the Accreditation Certificate and it use. To reach the objectives proposed by the study, interviews were accomplished with the professionals responsible for the accreditation of the hospitals in the main health insurance companies of Brazil. In the total, five companies were consulted among the ten larger health insurance companies of Brazil, considering the number of beneficiaries. To complement the research, additional information were collected in the National Agency of Supplemental Health. It was verified, through the research, that the health insurance companies don't use the Accreditation Certificate given by the Hospital Accreditation Brazilian Program to accredit hospitals.
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O presente texto é resultado de uma pesquisa que visa a entender a atuação da Administração Tributária Federal brasileira no tocante ao estímulo ao pagamento de tributos. Trata-se de conhecer o processo de obtenção de certidões de regularidade fiscal junto à Receita Federal e à Procuradoria da Fazenda Nacional, bem como a possível política pública pretendida com a introdução daquelas no Sistema Tributário Nacional, a fim de se identificarem os pressupostos que determinam a atuação destes órgãos na indução do comportamento dos contribuintes, para, então, contrapô-los aos novos paradigmas de atuação das Administrações Fiscais, pensados por James Alm. Para tanto, o trabalho foi dividido em quatro partes. Na primeira, apresenta-se o referencial teórico que guiará todo o estudo. Inicia-se pela discussão do atual contexto dos países em desenvolvimento no tocante às formas de interação entre setor público e privado, o chamado Novo Estado Desenvolvimentista. Em seguida, após essa incursão nas modernas formas de Administração Pública para os países em desenvolvimento, ingressa-se no debate acerca das recentes teorias sobre atuação das Administrações Tributárias, em especial, sobre o paradigma do serviço e da confiança proposto por James Alm e sua adequação ao Novo Estado Desenvolvimentista. Nessa oportunidade, são fixados, então, os parâmetros pelos quais será avaliada a atuação da Administração Tributária Federal brasileira. Na segunda parte do trabalho, depois do mapeamento e classificação das normas que tratam sobre certidões de regularidade fiscal, são descritos o contexto histórico e debates legislativos referentes à produção dessas mesmas normas a fim de se identificarem os interesses e a possível política pública querida com a introdução daquelas certidões no Sistema Tributário Nacional. Na terceira parte, há o relato do processo de obtenção desses documentos de prova de regularidade fiscal. Pretende-se, com isso, descrever como Receita Federal e Procuradoria da Fazenda Nacional prestam o serviço de emissão deles. Diante das informações construídas no segundo e terceiro capítulos, bem como dos conceitos teóricos estabelecidos no primeiro tópico, avaliar-se-á, num quarto momento, a atuação da Administração Tributária Federal quanto aos métodos de que se vale para incentivar a obediência à legislação tributária. Após a elaboração desse diagnóstico, são apresentadas possíveis alternativas para que o relacionamento entre Fisco e contribuintes brasileiros esteja mais coerente com os padrões propostos pelo modelo teórico eleito.
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The coco de zambê is a dance of which origin is credited to old slaves who inhabited the coastalregion of Rio Grande do Norte. The zambê appears intensely in the narratives related to the past and present of Sibaúma, a quilombola community located in the southern coast of the state. It is conceived as a sign of ethnicity linked to a local black ancestry. The group is known as "remnant of Quilombo," and is demanding the process of territorial settlement, as guaranteed through the Brazilian federal constitution. The coco de zambê, presented as a kind of "certificate of ancestry to the group, besides, after a long period of abandonment, the dance is beeing "revitalized" and exploited by a part of the group alongside the demands for recognition. In this process there are several interlinked actors: NGOs, state agencies to promote the culture, representatives of public authorities and local leaders. Here, I'm interested in understanding how this process of revival occurs with the coco de zambê in Sibaúma: how a "brincadeira" (play) of the ancients comes to be a "cultural reference" and a means of political mobilization concerning their recognition
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The nurses in the hemodialysis has an important role in the nursing process implementation, in the context of a theoretical referential. Among the nursing theories, highlights the Roy´s adaptations model, who considers a person as an holistic adaptive system that aims to adapt customers to different living conditions. Thus, it is believed that the Roy´s nursing process will guide nursing care to patients on dialysis. Therefore, the study aimed to analyze the nursing diagnosis present in patients with chronic kidney disease on hemodialysis based on the theoretical model of Roy and NANDA-International. Descriptive and cros-sectional study, performed at a dialysis center in a city in northeastern Brazil. Sample of 178 patients and consecutive sampling by convenience. Data collection ocurred from October/2011 until February/2012, through interview and physical examination forms. Data analysis was initiated by clinical reasoning, diagnosis judgment and similarity relation. Then, the data were entered into SPSS program, 16.0 version, generating descriptive statistics. The project was approved by the Ethics Research Committee (protocol nº 115/11) with a Presentation Certificate for Ethics Appreciation (in 0139.0.051.000-111) and was funded by the Universal edict MCT / CNPq 14/2010. The results revealed that most patients were male (52.2%), married (62.9%) and residents in the Natal´s metropolitan region (54.5%). The mean age was 46.6 years and the years of study, 8,5. Regarding nursing diagnosis obtained an average of 6.6, especially: Risk of Infection (100%), excessive fluid volume (99.4%) and hypothermia (61.8%). On the other hand the adaptive problems average was 6.4, and the most common: intracellular fluid retention (99.4%); Hyperkalemia (64.6%); Hypothermia (61.8%) and edema (53.9%). Were established 20 similarity relations between the NANDA-International nursing diagnosis and adaptive problems of Roy, namely: risk of falls / injury risk and potential for injury, impaired physical mobility and walking mobility and / or restricted coordination, dressing self-care deficit and loss of self-care ability; hypothermia and hypothermia; impaired skin integrity and impaired skin integrity; excessive fluid volume and intracellular fluid retention / Hyperkalemia / Hypocalcemia / edema; imbalanced nutrition: less than body requirements and Nutrition less than the body's needs; constipation and constipation, acute pain and acute pain, chronic pain and chronic pain, sensorial perception disturbed: visual, tactile and auditory disabilities and a primary sense: sight, hearing and tactile; sleep deprivation and insomnia, fatigue and intolerance to activities; ineffective self health and fails in the role; sexual dysfunction and sexual dysfunction; situational low self-esteem and low self-esteem, and diarrhea and diarrhea. We conclude that there is similarity between the typologies and was required a model´s analysis, because they present different ways to establish the nursing diagnosis. Moreover, the nursing process use, under the context of a theory and a classification system, subsidizes the care and contributes to the strengthening of nursing science
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The venous ulcer is an epidemiological problem of high prevalence, causing disability and dependence. Assess the tissue impairment level of patients with venous lesions, within a nursing referential, is relevant for the implementation of a directed assistance to specific clientele. Thus, this work aims to characterize the health status regarding the integrity the lower limbs skin of patients with venous ulcers, according to the of tissue integrity outcome indicators from the Nursing Outcomes Classification. A cross-sectional study conducted in a university hospital in Natal - Rio Grande do Norte. The sample consisted of 50 participants, selected through consecutive sampling. Data collection occurred through a interview and physical examination form and a operational definitions tool for indicators of the nursing Tissue Integrity outcome directed to patients with venous ulcer, applied from February to June 2012. Data analysis was done by descriptive statistics and nonparametric tests (Spearman, Kruskal-Wallis and Mann-Whitney tests). The project was approved by the Research Ethics Committee with protocol 608/11 and Presentation Certificate to Ethical Consideration No. 0038.0.294.000-11. The results were presented using three scientific articles derivatives of research. It was found that the indicators show moderate impairment, light and not impaired, as the median. The respondents had an average of 59.72 years, 66% female, 50% were retired, 60% with a partner, 44% had arterial hypertension, 26% allergies, 20% diabetes mellitus, 96% were sedentary, 14% drank alcohol and 6% were smokers. There was a statistically significant correlation of low intensity between age and hydration (p=0.032; rs=-0.304) and skin desquamation (p=0.026; rs=-0.316), family income and necrosis (p=0.012; rs=-0.353); Ankle Brachial Index and tissue perfusion (p=0,044; rs=-0,329); Diabetes Mellitus and texture (p=0.015) and tissue perfusion (p=0.026); allergy and texture (p=0.034), physical activity and hydration (p=0.034), smoking and thickness (p=0.018), and alcohol consumption and exudate (p=0.045). We conclude that the patients had light to moderate impairment, indicating a good state of health on the integrity of the skin of the lower limbs, according to the indicators of the outcome of tissue integrity Classification Nursing Outcomes valued in the present study. It is believed that the evaluation of impairment tissue using a self-nursing system and its relation with socioeconomic, clinical and risk factors are unique tools in the care planning and in the wound healing
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The current study strives to address the interpersonal relationships of the nursing team from the perspective of the communicative action, by contributing to the health work process. It aims to analyze the interpersonal relationships of the nursing team in its work environment. This is a descriptive study with a qualitative approach. Data collection wal held from interviews, guided by a script with open questions. The study was conducted at a state hospital in the city of Natal/RN/Brazil. The research subjects were the workers of the nursing team, including nurses, nursing technicians and nursing assistants, totaling 16 subjects. The capture of information was performed in April 2012. The project was approved by the Ethics Research Committee, under CEP/UFRN protocol n. º 262/11 and Certificate of Presentation for Ethical Consideration n. º 0289.0.051.000-11. The analysis was performed from the categories that emerged from the research through a dialogue with the authors studied in the theoretical framework of the Theory of communicative action , by Jürgen Habermas, as well as The changing in the world of work, by Ricardo Antunes, and Characterization of the team , by Marina Peduzzi. The outocomes point out that the interpersonal relationship of the nursing team is very troubled, with no interaction among the individuals involved in this process, among themselves and with other health professionals. We have developed a particular concept about team, which is comprised of three essential elements: multiplicity of individuals, common objective and heterogeneity. In the studied environment, it was realized the existence of grouping teams. The interpersonal relationship of the nursing can be a facilitator or an obstacle in the workplace in such a way that causes positive or negative consequences, both to the health workers, and to the sicks. In this context, the interviewees have intensified their viewpoints with regard to the weaknesses that permeate the nursing relationship, by pointing them more frequently than the strengths. The work conditions have signaled a failing situation, which is evidenced by the constant improvisation process before the lack of human and material resources, low wages, deficit in recognizing the nursing worker, and physical and emotional wear, by creating a professional exhaustion. The devaluation of the worker also became a strong factor for this study, because it was characterized a reason of job dissatisfaction, due to the lack of valuation policies, which should be prepared by the institution or, even, they are unknown by the worker itself. The worker participation in the design of these policies has emerged as a relevant factor. The poor work conditions lead the worker to a process of professional demotivation and dissatisfaction, by causing the feeling of devaluation within its work environment. Hence, it was found in this research that the lack of communication leads to situations of inadequate interpersonal relationships, which are creators of an unsuitable environment for the performance of the nursing team
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This study aimed to identify and describe the factors related to Patient Safety in a medication system according to the nurses analysis in a teaching hospital from the photographic analysis method. This was a cross-sectional, descriptive study with mixed approach in a teaching hospital in Rio Grande do Norte. The population consisted of 42 nurses from inpatient units, of which 34 composed the study sample. As eligibility criteria, we defined nurses from public service and nurses who agreed to participate. Ethical determinations were observed, the study was submitted to the Ethics and Research of the University Hospital Onofre Lopes, obtaining the assent with ethical assessment certificate (CAAE 0098.0.051.294-11). For data collection, we used the photographic method (Photographic Analysis Technique) by Patricia Marck (Canada). It was developed in two phases: at first, we randomly captured photos from the medication system, resulting in 282 images; then we selected/processed the photographs, which were reduced to 10 images in Microsoft Excel 2010; in the second phase, the nurses answered the questionnaire divided into socio-professional profile and Digital Photography Scoring Tool (questions a and b ). For analysis of the question a , we used the content analysis technique, and for b , we used the Statistical Package for the Social Sciences 20.0 (temporary license). The socio-professional profile revealed the predominance of females; age group 34-43 years; professionals with specialization; 10-18 years of length of service; and nurses working exclusively in the hospital and who know the Patient Safety. The photographic analysis in relation to Patient Safety resulted in specific categories for each stage of the medication system. Regarding disposal, we identified Proper verification ; Improper verification ; Correct identification ; Disposal in single doses ; and Improper Environment , with predominance of that last category. As for storage: Proper storage ; Improper storage ; Risk of exchange/disappearance ; and Poor hygiene , with special reference to improper storage. In preparation: Risk of exchanging medication/patient ; Inappropriate physical space ; and Inadequate 9 preparation of controlled drugs , highlighting the first category. In drug administration: Lack of Personal Protective Equipment ; Use of Personal Protective Equipment ; Improper administration technique ; Proper administration technique ; Correct drug identification ; Incorrect drug identification ; and Peripheral venous access without identification . From the safety assessment of 10 photographs, by adapting the scores (1-10) to the Likert Scale, we identified three Totally Unsafe (Level 1), three Unsafe (Level 2), three Partially Safe (Level 3), one Safe (Level 4), and no photograph considered Totally Safe. This study identified the prevalence of unsafety in the medication system in the nurses opinion. We were also able to understand that, although nurses identify safety aspects, the most prevalent categories characterize an unsafe assessment. Nursing needs to reflect on its practice, identifying gaps in the medication system in order to achieve a proper and safe care
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Trasnversal study, with the objective of evaluating the accuracy of clinical indicators of nursing diagnosis excessive fluid volume in patients undergoing hemodialysis. The study occurred in two stages, the first consisted of the evaluation of the diagnostic indicators in study; and the second, the diagnostic inference conducted by nurse diagnosticians. The first stage occurred from december 2012 to april 2013, in a University Hospital and a Hemodialysis Clinic in Northeastern of Brazil, with a sample of 100 chronic renal failure patients on hemodialysis. The data were selected through an interview form and a physical examination, organized into spreadsheets and analyzed as to the presence or absence of the indicators of diagnosis excessive fluid volume. In the second step, the spreadsheets were sent to three nurses diagnosticians, who judged the presence or absence of diagnosis in the clientele searched. This step was conducted from july to september 2013. For analysis of the data, we used descriptive and inferential statistics. In the descriptive analysis, we used measures of central tendency and dispersion. In inferential analysis, we used the tests Chi- square, Fisher and prevalence ratios. The accuracy of the clinical indicators pertaining to the diagnosis were measured as to the specificity, sensitivity, predictive values, likelihood ratios and Diagnostic Odds Ratio. Also developed a logistic regression. The results were organized in tables and discussed with literature. This study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, with Presentation Certificate for Ethics Appreciation nº 08696212.7.0000.5537. The results revealed that the diagnosis studied was present in 82% of patients. The characteristics with prevalence above 50 % that stood out were: azotemia, decreased hematocrit, electrolyte imbalance, intake exceeds output, anxiety, edema, decreased hemoglobin, oliguria and blood pressure changes. Eight defining characteristics were presented statistically significant association with the nursing diagnosis investigated: pulmonary congestion, intake exceeds output, electrolytes imbalance, jugular vein distension, edema, weight gain over short period of time, agitation and adventitious breath sounds. Among these, the 10 characteristics which showed higher prevalence ratios were: edema and weight gain over short period of time. The features with the highest sensitivity were edema, electrolytes imbalance and intake exceeds output and the standing out with greater specificity were: anasarca, weight gain over short period of time, change in respiratory pattern, adventitious breath sounds, pulmonary congestion, agitation and jugular vein distension. The indicators jugular vein distension, electrolytes imbalance, intake exceeds output, increased central venous pressure and edema, together, were identified in the logistic regression model as the most significant predictors. It is concluded that the identification of accurate clinical indicators allow a good prediction of the nursing diagnosis of excessive fluid volume in patients undergoing hemodialysis in order to assist the nurse in the inference process, which will contribute to the success of patient care. In addition, nurses will consider for diagnostic inference not only his clinical experience, but also scientific evidence of the occurrence of excessive fluid volume, contributing to the control of volemia in these patients
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Popular practices correspond to the resources used by households, lay people and popular therapists, whose perception of knowledge is constructed in the everyday. In this context, the sick child can become vulnerable to be dependent on a family caregiver, who often decide to employ popular practices. Thus, the child care should be shared between carer and health professional. However, they know little about the resources that the family uses to detect a grievance in infant. Therefore, the present research aimed to analyse the use of popular practices by caregivers of children with zero to five years old. We conducted an exploratory and descriptive study with a qualitative approach, together with 15 caregivers of children who were treated at the Joint Unit Felipe Shrimp, located in Natal, Rio Grande do Norte, Brazil. To select the participants, they should be age and above 18 years; be caregivers of children up to five years of age; and reside in the area ascribed the Joint Unit Felipe Shrimp. The data collection took place between September and October 2013, through in depth interview. This step was preceded by the approval of the Health Department of the city of Natal; the direction of the Joint Unit Felipe Shrimp; as well as, the Committee on Ethics in Research from the Federal University of Rio Grande do Norte with Certificate of Presentation and Consideration Ethics, No 15467013.8.0000.5537. Furthermore, the interviewees formally authorized their participation in the research by signing the consent form. The data were treated according to the technique of content analysis in the form of thematic analysis according to Bardin. This process, four categories emerged: "Types of popular practices used in the care of the child"; "Source of information of popular practices"; "Results obtained with popular practices"; "Factors that hinder the adoption of common practices." The results showed the use of popular practices by caregivers in the case of illness to children such as the homemade preparations with medicinal plants and folk healers. The family environment was referenced as the main learning space and spread of popular practices, which are influenced by cultural relations present in this context. As to the results obtained with popular features, the caregivers said to be satisfactory, and this triggers a feeling of confidence and acceptability of such measures. It is concluded that the use of popular practices in child care persists in everyday most of the participants, despite the hegemony of allopathic therapy. The caregivers stated that such practices are effective and easy to obtain, being secured in context by popular culture. In addition, health professionals, especially nurses, were seldom mentioned by the caregivers as to the information concerning popular resources used by them, which suggests the weakness in dialogic process of negotiating practices between both of them
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The aim of this present research is to investigate about aplication of the supply chain management in Civil Construction, through perception of brasilian building companies directors. Research purpose includes potential benefits and main dificults analysis in supply chain management, beyond to identify decision criterions for suppliers and sales chain (commission agent and real state agency) choice and reduction, to facilility management in companies. The methodology used in this work considers the application of a questionnaire with scales of the type Likert being constituted of variables that compose the aspects of evaluation and of behaviors, beyond questions to identify the market profile of the respondents. For analysis statistics is used the descriptive, clusters and variance, ANOVA, analysis last two to verify the connections between variables. The results show more perception as for long terms contracts with suppliers for purchase of materials and services being decisive for companies nowadays (40%) than as for exclusive contracts with commission agents (30%). There is a positive appraisal about viability of hipotetic situations showed, but more caution as for disposition to apply them too. Another results aim for biggers dificults in management of chain links formed by commission agents and real state agencies, than chain links formed by anothers suppliers of materials and services. The companies for study were chosen among to those with ISO 9000 certificate until november 2001, considering that these companies have the best management systems, probably
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Demand for organic foods in the Brazil are growing year last, characterizing itself for if constituting in a new strategical segment of commercialization. In this context, the objective of this research was to investigate the factor that influence the interest of the consumers in the purchase decision of organic products, aiming to characterize the level of competitiveness of these products, assisting in the creation of environmental strategies for the development of the activity and contributing in the increment of the knowledge about the subject, that can assist it in the increase of the commercialization and the consumption of these foods. From data collected in the city of Manaus/AM, it was used a survey research, of exploratory and descriptive character. The sample was obtained using 421 questionnaires, in which was realized the descriptive analysis, analysis of groupings and association analysis among variables using the test qui-square. The results found in this study indicate that the majority the of consumers of supermarkets of the Manaus/AM never to purchase organic foods. Generally the consumers to have few or some knowledge about these foods, however, the level of the interest in to obtain information about the subject is high.The barriers mains in the purchase of organic products are the label fault in the product and the quality no certificate in the product. Among the profile characteristics, the variables income and level scholar are associate to interest level in the obtain information about the subject
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Taking competitive advantage or satisfy the client are the reasons why companies have been implementing a Quality Management System (QMS). It brings benefits such as the improvement in the processes, products and services; an enhancement in the image of the company (marketing) and satisfaction of the clients. As a whole, this paper aims to evaluate the results obtained from the implementation of the QMS in the certified companies in the ISO 9001 standard, contained in the database of INMETRO, of the Rio Grande do Norte State (RN). In order to achieve the goals, a bibliographical research about the theme quality management system was made and, subsequently a survey was made with the managers of the certified companies in RN, using the online questionnaire. Out of 27 companies that have the certificate in Rio Grande do Norte, 21 responded the data collection instrument. The data analysis was made through techniques of descriptive and multivariate statistics: cluster analysis. The research instrument used contained 20 questions that address the main theme of this dissertation. Using the cluster analysis, four groupings that possessed similarities concerning the survey answers were found. This analysis allowed us to conclude that the QMS boosts significant improvements in the organizations, such as: quality in the reputation of the company and sales increase. On the other hand, it allowed us to identify as main difficulties: the dissemination of the quality culture, lack of commitment of the whole organization and the resistance of the workers