Desafios da gestão de pessoas nos processos de contratualização : o caso do Hospital Municipal Infantil Menino Jesus

A estratégia de contratualização vem sendo adotada pela Prefeitura de São Paulo (Lei Municipal 14.132/2006) como em outros governos pelo país afora, com o intuito de melhorar a eficiência e a qualidade dos serviços de Saúde. Neste modelo, o Estado, por meio de um “Contrato de Gestão” firmado com uma Organização Social, transfere para esta entidade o gerenciamento de uma unidade do sistema público. Desse modo, o Hospital Municipal Infantil Menino Jesus (HMIMJ) está sob administração do Instituto de Responsabilidade Social Sírio-Libanês desde novembro de 2008. Esta experiência paulistana tem como especificidade, sobretudo em comparação ao governo estadual, a realização de um contrato de gestão com uma unidade já em funcionamento, o que cria uma situação em que funcionários do antigo modelo estatal convivem lado a lado com outros contratados pela Organização Social (OS). O presente trabalho tem como objetivo analisar e propor melhorias na gestão de pessoas do HMIMJ, visando alcançar ao mesmo tempo maior eficiência e maior engajamento de todos os funcionários. Para avaliar esta situação, à luz da referência teórica sobre Organizações Sociais, foi feito um diagnóstico aprofundado da convivência dos diferentes vínculos dos trabalhadores desta instituição, por meio de entrevistas e visitas de campo. Ao final, são apresentadas sugestões para o aperfeiçoamento do gerenciamento de pessoas levando-se em conta a existência de um modelo institucional híbrido.

Os efeitos do plasma não térmico à pressão atmosférica no desenvolvimento larval e anomalias morfológicas de Drosophila Melanogaster

O plasma não térmico nos cuidados de saúde é um campo emergente que tem as suas raízes na ciência de plasmas. Este tipo de investigação tem crescido rapidamente e é agora objeto de um amplo esforço de pesquisa interdisciplinar envolvendo a medicina, a biologia, a física, a química e a engenharia. Têm sido feitos vários trabalhos de modo a elucidar quais as interações das espécies produzidas pelo plasma com os sistemas vivos. É evidente que o mecanismo da interação do plasma com os sistemas vivos é complexo, em parte devido à complexidade do plasma mas principalmente devido à enorme complexidade da biologia. O principal objetivo desta dissertação foi observar os efeitos do plasma não térmico à pressão atmosférica (PNTPAs) no desenvolvimento larval e anomalias morfológicas de Drosophila melanogaster. Para o efeito, foram expostas e analisadas fenotipicamente 2.566 larvas após exposição, dos diferentes estádios (1.º, 2.º e 3.º) de desenvolvimento. Os testes foram realizados com aplicações de plasma com e sem ultra violeta, em duas linhas diferentes de Drosophila; uma linha selvagem preparada por nós e uma linha laboratorial. A análise fenotípica revelou que após exposição as larvas apresentavam alterações no fenótipo e no comportamento que não foram observadas no controlo, nomeadamente anomalias nas mudas, traqueias partidas, formação de massas melanóticas que podiam persistir até à fase adulta, excesso de gotículas lipídicas, atraso no desenvolvimento, comportamento de não alimentação e formação de pupa imatura que levava à formação de pupa precoce e morte pupal. Na fase pupal, as anomalias mais comuns estavam relacionadas com a forma do pupário (causadas pela pipação prematura), apresentando um desenvolvimento aberrante. Entre os vários fenótipos observados, o mais significativo foi o criptocefálico (alterações na eversão dos discos imaginais) levando à morte pupal. Nos adultos, as principais anomalias morfológicas foram registadas na formação e segmentação das patas, na forma e padrão das nervuras das asas e na formação do tórax. A similaridade destes resultados com trabalhos publicados relacionados com a hormona esteróide ecdisona indicam que provavelmente o PNTPA poderá ter influenciado a biossíntese e/ou a regulação da ecdisona, a principal hormona que regula o desenvolvimento e a metamorfose em Drosophila.

Diagnóstico de enfermagem risco de quedas em pacientes com angina instável

O risco de quedas pode ser reconhecido como fenômeno ou diagnóstico de enfermagem. Pesquisas relacionam diretamente isquemias miocárdicas, como a angina instável e o risco de cair. Objetivou-se analisar o diagnóstico de enfermagem Risco de quedas na ocorrência de angina instável por um estudo transversal realizado em 57 indivíduos internados em um hospitalescola, mediante exame físico e formulário. Para o tratamento estatístico foram utilizados teste qui-quadrado, teste exato de Fisher, Mann-Whitney, teste-t e Coefi ciente Phi (p<0,05). O Risco de quedas foi o diagnóstico de enfermagem mais prevalente (87,71%), sobretudo em homens, mais velhos, com menos anos de estudo e renda inferior. Presença da angina instável, hipertensão arterial, medicação anti-hipertensiva, doença vascular, difi culdades visuais e insônia apresentaram associação com o diagnóstico de enfermagem Risco de quedas. Conclui-se que é imprescindível o desenvolvimento de parâmetros claros e objetivos à mensuração mais acurada do risco de quedas no âmbito hospitalar

Repercussões psico-sociais da síndrome dos ovários policísticos: estudo quali-quantitativo

BACKGROUND: Polycystic ovary syndrame (PCOS) has been shown to cause a reduction in quality of life. Little is known on the psychosocial aspects associated with PCOS, especially on women s own experiences regarding the syndrome. Therefore, the aim of this study was to analyze the psychosocial impact of PCOS by measuring the health-related quality of life and exploring the women s own experiences of PCOS. METHODS: A two-phase model of combination of quantitative and qualitative research approaches was conducted, a crass-sectional survey to pravide quantitative data on the quality of life and a qualitative approach to understand the women s experience in relation to the PC OS sympt?ms. For the first phase, 109 women with PC OS and 104 healthy contrais were evaluated with the 36-item short-form health survey (SF-36). Additionally, semi-structured interviews (n=30) were conducted to facilitate in-depth exploration of PC OS women s experience. RESUL TS: PCOS patients showed significant reductions in almost ali SF-36 domains of quality of life when compared with healthy contrais (physical function 76.5:!:20.5 and 84.6:!:15.9, respectively; physical rale function 56.4:!:43.3 and 72.6:!:33.3; general health 55.2:!:21.0 and 62.5:!:17.2; vitality 49.6:!:21.3 and 55.3:!:21.3; social function 55.3:!:32.4 and 66.2:!:26.7; emotional rale function 34.2:!:39.7 and 52.9:!:38.2; mental health 50.6:!:22.8 and 59.2:!:20.2). Thematic analysis revealed reports of feeling abnormal , sadness, afraid and anxiety. These feelings were related to four symptoms commonly experienced by women with PCOS: excess hair grawth; irregular or absent menstruation, infertility and obesity. CONCLUSIONS: Polycystic ovary syndrame impacts women both physically and psychosocially. Owing to this, women with PCOS need not only medical treatment for. the reproductive, esthetic and metabolic repercussions, but also the care of a multidisciplinary team, since PCOS is not just a physical condition, but also an important psychosocial problem that affects various aspects of a woman s life

O estágio supervisionado como contexto de formação docente específica para educação infantil: o que dizem os formandos sobre suas aprendizagens?

Kindergarten teachers training gains the spotlight with the passing of Law number 9.394/96 (Guidelines and Basis Law) that defines this segment as the initial step of basic education, with pedagogical function. In this spectrum, the discussion about teacher training unravels to ensure social quality to education as well as the teacher s specificities towards child singularities. Adding to that, the growing propagation of Pedagogy in an undergraduate level, given that such course has been continually transformed by the National Curriculum Guidelines for Pedagogy (2006), highlighting the addition of curriculum components that are specific to upbringing. The complex debate circa kindergarten teachers training has advancements and hardships that need to be unveiled in order to improve both formation and social quality of education in the 0- 5 years old range. This investigation inserts itself in said context and aims to analyze which knowledge, specific to kindergarten teaching are constructed, according to undergraduate trainees, in Pedagogy s supervised internship. The study was conducted alongside the discipline: Supervised Internship in Child Education ministered by the Advanced Campus of Rio Grande do Norte s State University s in the municipality of Patu-RN (CAP-UERN-Patu) and was conducted through 2012 by accompanying four undergraduate interns. We first assumed that the development of teaching knowledge is a complex process of appropriation of cultural-social practices and is symbolically mediated by interactions that occur in the formation context, and the supervised internship can be understood as a space for the articulation and enlargement of theoretical and practical knowledge, directly related to the specificities of child education. The theoretical-methodological foundation was based upon the historiccultural approach of L. S. Vygotsky and M. Bakhtin s dialogism on human sciences research, as well as his postulates on learning and developmental processes, conceived as both essentially social and discursive. The investigation approached the principles of the qualitative perspective and to the construction and analysis of data, involved documental analysis and, specially, semi-structured interviews, both individual and collective, whose fundamental premise was the production-comprehension of meanings in a dialogical perspective. The participants texts/speeches produced a synthesis that points to the occurrence, within the supervised internship at CAP/UERN, of internalization/appropriation processes and, as such, of formulation of meanings that are pertinent to child education: child, childhood, kindergarten and teacher signification and this stage s specific teaching knowledge. It stood out that the internship, alongside other curriculum components, is, in fact, one of the primeval formation environment for the teachers, in which the interns interact with their colleagues, supervisor professor, collaborator professor, and of course, the children to construct their erudition. Such interactions allow the undergraduate interns to develop attitudes and procedures to reflect on what they know, what they ve done and what they can achieve. We have concluded that the undergraduate internship can constitute itself as an articulatorconsolidator environment in the future teacher s formation process and, since well oriented, can provide the effective initiation, not only to the practice, but to the praxis as a movement of non dissociability between theory and practice

Sistema de gestão ambiental na produção de água mineral

It s more and more evident the subject of the shortage of water, worsened by the accelerated urbanization, growth of the population, increase of the demand and of the costs of its treatment, factors that are also tied up to the increase of the consumption of mineral waters, whose chemical composition or physical-chemistries characteristics do with that are considered beneficial to the health. The growth accelerated all over the world in its consumption aims the concern with the waters quality, the health and the incentive to the consumption of natural products. However, in spite of quite valuable, that resource is explored, most of the time, without optimization of production or actions that avoid wastefulness. This research is justified for the need of minimizing the negative environmental impacts caused by the mineral water s production, mainly in what it say about the generation of effluents and wastes in the productive process, through the study, development and application of cleaner production tools for the environmental management, pertinent for that section. The applicability of Environmental Management System was determined by means of the characterization of the environmental aspects of productive process in a company of the section, in the state of Rio Grande do Norte and of the discussion of the panoramas that demonstrate the tendency for a sustainable development. Actions as a reforestation, optimization of energy and water uses, recycle of solid residues and water reuse were applied during the research, resulting in the considerable reduction of wastes of raw materials and inputs and consequent environmental and economic won. A specific methodology was proposed with concepts of Environmental Management, integrating with Quality Management. As foundations for the elaboration of the methodology, it was realized a similarity analysis among the systems and, mainly, an analysis of the experiences observed in the case study, including specificities, needs and difficulties of the company. With these results, the implantation of a EMS as a company strategy has environmental, economic and social benefits, and this research can be applied and adequate to others companies and sectors

Medição de satisfação e fidelidade do cliente :um estudo com pacientes de clínica particular

This Thesis deals with a study on customer satisfaction and loyalty measurement focusing on a model of factors antecedents of customer satisfaction and loyalty. The model is based on a Satisfaction Index model adopted in Norway developed by Johnson et al.(2001) and the service quality drivers from the literature. It is surveyed a sample of 130 patients of a gynecology clinical. It is used a multiple regression analysis as the main statistical method in order to verify the factors affecting satisfaction and loyalty. The main findings are that the quality model explain 54% of the satisfaction but the whole model explain only 31% of the loyalty. Although the results are consistent with the literature in term of quality as the main driver of the satisfaction and that the satisfaction is not only one factor to explain loyalty, both the quality model to satisfaction and the factors model affecting loyalty should be improved to explain better the satisfaction and loyalty in health care service

Caracterização numérica de antenas para aplicações RFID utilizando o método das ondas - WCIP

In recent years, the radio frequency identification technology (RFID) has gained great interest both industrial communities as scientific communities. Its ability to locate and monitor objects, animals and persons with active or passive tags allows easy development, with good cost-benefice and still presents undeniable benefits in applications ranging from logistics to healthcare, robotics, security, among others. Within this aspect what else comes excelling are RFID tags and the antennas used in RFID readers. Most tags have antennas omnidirectional and are usually manufactured as dipoles modified printed. The primary purpose of a project of antenna for tag is to achieve the required input impedance to perform a good marriage impedance with the load impedance of the chip. Already the objective principal in project of antennas for readers is to achieve reduced sizes and structures with good data transmission capacity. This work brings the numerical characterization of antennas for RFID applications, being these divided into tags RFID and antennas for RFID readers. Three tags RFID and two antennas for RFID readers, found in literature, are analyzed. The analysis of these structures is made using the Method of Waves - WCIP. Initial results found in the literature are compared with those obtained through simulations in WCIP with objective to show that the Method of Waves is able to analyze such structures. To illustrate the results obtained in simulations is presented the behavior of electric and magnetic fields. It also performed a literature review on the characteristics and principles of RFID technology. Suggestions for continuity to this work are presented

Análise das emissões atmosféricas por veículos automotores em Natal-RN

The fast urban occupation of Brazil, mainly from the last decade of 50, a sensible degradation of the quality of the air generated mainly for the activities was verified human beings associates to industrialization. From the past years, the situation has gotten worst in function of the increment of the fleet of vehicles in circulation in the great cities. Being these, in the city of Natal-RN, the ones that offer the biggest contributions to the atmospheric pollution. For atmospheric air to be a finite natural resources, indispensable and essential to the maintenance of the life in the land, is necessary to the implementation of action to improve its quality and to protect the health of the population. With the objective to study relative aspects to the characteristics of vehicles in use, the present study it searchs to analyze the levels of emissions of gases generated for vehicles converted bi-fuels into the modalities: natural gas (GNV), gasoline and alcohol, inspected for ends of register and together licensing to the State Department of Transit. One used the data gotten from inspections carried through for the company System Specialized in Inspection To propagate, in the city of the Natal-RN, capital of the State of Rio Grande do Norte, between 14 of November of 2003 and 30 of December of 2004. The analyzed parameters are established in the resolution nº 07/93 CONAMA. Of a total of 1.517 inspected vehicles, a average of 15,2% of failed was gotten, or either, that they emit levels of pollution above of the limits established for the legislation, below of the national average that is of 20,0%. The analysis of the data discloses that 7.3% of the fleet are converted the GNV; the growth of vehicles converted the GNV into the city is gradual, with a average of increment in last the 4 years of 23,3%; it has a vehicle predominance that has as combustible original to the gasoline (88,2%); the inspected fleet has average age of 8 years of use, considered young for the Brazilian standards, except for the moved one to the alcohol (average of use of 15 years). Moreover, the type of fuel is not the main parameter to define the indices of emissions; the age of the fleet is the parameter most important when emission is analyzed to propagate; the gas that more generates failed in the inspections is the corrected carbon monoxide; the vehicles generate higher indices of emissions in idling for all the fuels; the presence of the catalyser was not reflected, as it expected, in the reduction of emissions of gases toxic, however when analyzed according to year of manufacture, it was observed that for the vehicles manufactured between 1997 and 2004, reduction of 46,0% in the failed of the vehicles equipped with catalyser was gotten. In conclusion, the fleet of the studied sample, in average terms, takes care of to the requirements of Resolution CONAMA nº 07/93. The results gotten for the present study can subsidize action of public administrations that aim at to the improvement and the maintenance of the quality of air in the city of Natal-RN, as, for example, to implant a net of monitoramento of the quality of air

Caracterização farmacognóstica do jambolão (Syzypiam cumini (L.) Skeels)

A padronização de um fitoterápico é etapa imprescindível para garantia da qualidade de medicamentos contendo plantas medicinais. Objetivou-se padronizar Syzygiam cumini (L.) Skeels e para tanto se estabeleceram parametros tais como, avaliação morfoanatômica das folhas, morfológica das flores e dos frutos, avaliação granulométrica da droga rasurada (frutos), determinação da umidade, avaliação dos processos de secagem, determinação do teor de extrativos e do teor de taninos (monômeros e polimeros). O estudo anatômico das folhas revelou a inexistência de pêlos no sistema dérmico, assim como a ocorrência de glândulas secretoras, drusas, colênquima e esclerênquima. As flores são hermafroditas, com androceu polistêmone e gineceu com ovário ínfero, gamocarpelar, bilocular com placentação axial. Observou-se elevado teor extrativo (38,57%). O diâmetro médio de partícula dos frutos secos moídos ficou em 0,630 mm. O processo de secagem dos frutos influenciou o teor de taninos totais. O teor de taninos determinado ficou em 5,10% para monômeros e 11,30% para os polimeros.

Custos e benefícios de um programa de exercício aeróbios na doença pulmonar obstrutica crônica: ensaio cliníco aleatório controlado

Pulmonary Rehabilitation, especially due to aerobic exercise, positive impact in reducing morbidity/mortality of patients with COPD, however the economic impact with costs of implementing simple programs of aerobic exercise are scarce. This is a blind randomized clinical trials, which aimed to evaluate the costs and benefits of a simple program of aerobic exercise in individuals with COPD, considering the financial costs of the Public Health System and its secondary endpoints. We evaluated lung function, the distance walked during six minutes of walking, the respiratory and peripheral muscle strength, quality of life related to health (QLRH), body composition and level of activity of daily living (ADL) before and after eight weeks of an aerobic exercise program consisting of educational guidance for both groups, control and intervention and supervised walks to the intervention group. The health costs generated in both groups were calculated following table Brazilian Public Health System. The sample consisted of forty patients, two being excluded in the initial phase of desaturation during the walk test six minutes. Were randomized into control and intervention group thirty-eight patients, three were excluded from the control group and one was excluded from the intervention group. At the end, thirty-four COPD comprised the sample, 16 in the control group and 18 in the intervention group (FEV1: 50.9 ± 14% pred and FEV1: 56 ± 0.5% pred, respectively). After for intervention, the intervention group showed improvement in meters walked, the sensation of dyspnea and fatigue at work, BODE index (p <0.01) in QLRH, ADL level (p <0.001) as well as increased strength lower limbs (p <0.05). The final cost of the program for the intervention group was R $ 148.75, including: assessments, hiking supervised by a physiotherapist and reassessments. No patient had exacerbation of IG, while 2 patients in the CG exacerbated, generating an average individual cost of R $ 689.15. The aerobic exercises in the form of walking showed significant clinical benefits and economic feasibility of its implementation, due to low cost and easy accessibility for patients, allowing them to add their daily practice of aerobic exercises

Programa de odontologia para bebês: uma avaliação quantitativa e qualitativa

The objective of this study was to evaluate a baby dentistry program which has been in the city of Natal for five years. The research was based on two analysis: a quantitative one, which tried to check caries prevalence in 52 children supported by the program and a qualitative one, which, through interviews carried out with the mothers, using the focus group technique, tried to realize the effect of the program their attitudes related to the care of their children´s oral health. For the quantitative analyses of caries prevalence there was the use of def-s and knutson rates and the values obtained were shown in a descritive and analytical way.The results showed that 4.2% of babies ranging 24 to 36 months old presented carie disease. Children from 36 to 48 months old and above 48 months old presented 18.2% and 16.7% carie prevalence respectively.The def-s averages found in ages 24 to 36, 36 to 48 and 48 to 60 months old were 0.08; 0.40 and 1.16 respectively, considered as being equally low, going along with Knutson rates. The qualitative analyses showed a high level of the mothers` satisfaction, considering the access,practitioner-patient relationship and opportunity to keep the oral health. Children supported by the program showed a low carie prevalence and the program turned out to be effective under the mothers` point of view

Elaboração e avaliação de indicadores comportamentais de aderência ao tratamento hemodialítico

Introduction: This work intents to characterize behavioral indicators of tack to the hemodialysis treatment in a sample of carrying patients of chronic kidney failure (CKF) in the great Natal/RN. The therapeutical adherence represents the agreement degree between the patient behavior and the health team lapsings. The CKF is the gradual and irreversible loss of the renal function, being the hemodialysis treatment an important alternative to assist or to substitute the kidneys. Method: The sample consisted in 80 chronic kidney patients in hemodialysis treatment in two located clinical centers in the region of the great Natal, RN. It was used as instruments (a) a protocol of clinical data collection, (b) the Millon Index of Personality Styles (MIPS) and (c) a script of halfstructuralized interview. Results: The results show a balance between the genders (51% of female and 48.8% of the male sex), average age and equal average time of dialysis respectively to the 43,4 years (±13,25 years) and 22,04 years (±4,24 years). The marital status of half of the sample is married, predominating basic education (43.6%) and a familiar income until a minimum wage (43.8%). It had been defined six physicianlaboratorial indicators to evaluate the therapeutical adherence, further the use of the evaluation of the health team and the patient themselves. Thus, there was an average adherence around 55.97% of the sample ±18.37%). However only between selfassessment of the patients about the adherence and the assessment made by blood pressure post-dialysis indicated a significant association (p=0,029, qui-square test). On the other hand, there was a significant association (p <0.05, chi-square test) among the criteria for treatment adherence and issues investigated in the interview - the perception on the quality of the health services provided to patients, the difficulties following the prescribed diet, the characterization of the days between dialysis sessions and the perception of patients about the dialysis sessions. It was also noted a significant association (p <0.05, Levene test) between adherence to therapy and scales that constitute the MIPS. The health team characterized the patients more adherent behavior as an attitude of acceptance of the treatment, looking actively for their implementation, for more information and knowledge, and establishing a positive communication with the team and with other patients. Similar results were confirmed by the MIPS evaluation. According to that assessment the more compliant patients adopt a more optimistic attitude, trying to act or adapt themselves to their environment, processing cognitively both concrete and objective information, such as more speculative and symbolic information. In addition they establish a gregarious, cooperative, submissive and flexibly pattern of interpersonal relationships to social demands. These characteristics managed to explain 55.7% of the adherence variation according the health team and 23.3% of the variation according the CaxP laboratory indicator. Conclusions: The MIPS shown to be able to identify the most and least adherent to therapy patients. The use of different adherence indicators is important for an evaluation covering the different facets of this process. The adhesion levels are observed within registered by the relevant literature. There is need for further studies with a larger sample to deepen the data findings in this work

A Psicologia do trabalho e das organizações na formação do psicólogo no Brasil

This research has aimed to analyze the presence of the Work and Organizational Psychology (WOP) at the psychologist s undergraduate education after 2004 s National Curricular Guidelines in Brazil. It has investigated in 43 Brazilian undergraduate courses of Psychology how their Course Pedagogical Projects (CPPs) approach the WOP issues. For that investigation, the CPPs, the subjects programmes related to the WOP and the curriculum grid have been accurately read and analyzed. Categories created by similar studies have also been used. The studied knowledge field has been cited by 41 courses, mainly on the definition of the egress s professional profile, on the expected competences and on the psychologist s formation process lines. Moreover, 28 courses have disposed curricular emphasis on the WOP and 12 have provided professional practices on that Psychology s field. All the courses have displayed, at least, one subject related to the WOP and in 29 cases there have been found between two and six subjects concerned to that field of Psychology, occupying nearby 10% of the whole courses credit hours. It has been verified that the Work and Organizational Psychology is allied to discussions about Quality of Life and Health of the Worker, bonded to work prescriptions at the Personnel Management departments and in other places such as syndicates. Additionally, 37% (147) of the WOP s subjects concerns to the contents of the Work Psychology, 21% (81) relates to the Organizational Psychology, 18% (71) are about Industrial Psychology s topics and 14% (55) debates the field generically. The most often issues are: Recruitment and Selection (25 courses); Training, Development, Learning and Education (24); and Work and Mental Health (24). Those topics have assumed three functions: providing principles for the acting at the WOP field; tutoring psychologists to analyze their own workplaces; and offering a comprehension of the human being mediated by the Work. It has been concluded that the WOP is incorporated on the psychologist s undergraduate education by considering the increasing of its presence and the occurrence of its traditional and emergent topics