Gewerbeaufsicht im 21. Jahrhundert.

Während zum Genehmigungsrecht zahlreiche Abhandlungen in der juristischen Literatur und eine große Zahl von Urteilen veröffentlicht sind, hält sich die Forschung und praktische Behandlung zum Aufsichtsrecht in Grenzen. Diese Arbeit vertieft das Verständnis, für die spezifische Verknüpfung und gegenseitige Abhängigkeit der Eröffnungskontrollen und der begleitenden Kontrollen im deutschen Arbeits-, Umwelt- und Verbraucherschutzrecht. Zentraler Punkt dieser Arbeit ist die Entwicklung von Grundlinien der begleitenden Aufsicht im Gewerbeaufsichtsrecht. Dazu ist es erforderlich die verschiedenen Randbedingungen gewerbeaufsichtlichen Handelns in den Blick zu nehmen. Es ist ein Blick auf die zu erwartende Ausbildung eines neuen Rationalitätstyps der gesellschaftlichen Entwicklung (2.), auf die Typisierung von Staats-, Gewerbe- und Wirtschaftsaufsicht und deren spezifischen Handlungsmustern, den festgestellten Defiziten des Aufsichtsrechts und des Aufsichtshandelns der begleitenden Kontrollen und den festgestellten tatsächlichen Wirkungen des Aufsichtssystems (3.) zu werfen. Weitere Einflüsse auf das Aufsichtsmodell der Zukunft kommen aus der erwarteten und wünschenswerten Entwicklung des Genehmigungsrechts (4.), der Art und Weise wie die begleitende Aufsicht gehandhabt werden kann und soll (5.) und den Privatisierungstypen und deren verfassungsrechtlichen Grenzen (6.). Die Arbeit schließt mit der Formulierung eines Zukunftsmodells, dass die Gewichte zwischen der Eröffnungs- und der begleitender Kontrolle, sowie das Verhältnis zwischen Staat, Privaten Dritten und Unternehmen, neu ordnet. Insgesamt wird in dieser Arbeit für ein Aufsichtsmodell plädiert, indem der Staat stärker in die Verantwortung für eine risikoorientierte begleitende Aufsicht genommen wird. Maßstäbe für die Risikoregelung sind künftig komplett vom Staat aufzustellen. Staatliche Aufsicht kann sich zukünftig auf Rahmenregelungen und Rahmenprüfungen bei den risikoreichsten Anlagen, Tätigkeiten und Produkten beschränken. Private Dritte können die Detailermittlungen und Freigaben bearbeiten. Private Sachverständige können künftig die Hauptlast detaillierter und zeitintensiver Kontrolltätigkeiten bei Anlagen, Tätigkeiten und Produkten mit mittlerem Risiko übernehmen. Anlagen, Tätigkeiten und Produkte mit geringem Risiko können der Eigenüberwachung überlassen werden. Im Gegenzug muss der Staat in deutlich stärkeren Maß die Aufsicht über die Kontrolleure anhand einheitlicher Maßstäbe organisieren und durchführen. Die Anforderungen an die Kontrolleure müssen künftig allgemein, sowohl für die externen Kontrollpersonen als auch für die internen Aufsichtspersonen, gelten und überprüft werden.

Caracterización de la exposición ocupacional a formaldehído en trabajadores del sector salud y educación en Colombia 2004-2013.

El Formaldehído es una sustancia química de amplio uso a nivel mundial con efectos documentados en personas expuestas entre los cuales se destacan irritación de la piel, mucosas, tracto respiratorio y ojos. Según la Agencia Internacional para la Investigación del Cáncer (IARC) el formaldehido se encuentra clasificado en el grupo 1 como agente cancerígeno con suficiente evidencia de producir neoplasias en humanos. Los sectores industriales en Colombia que utilizan de forma frecuente el formaldehído incluyen los fabricantes de maderas, los servicios funerarios, y los sectores de salud y educación. El presente estudio de corte transversal pretende, con base en mediciones históricas (2004-2013) construir un perfil de exposición a formaldehído en trabajadores vinculados al sector de salud y educación en Colombia, divididos y analizados según actividades de trabajo similares (Patólogos, Histotecnólogos, Auxiliares de laboratorio, Docentes y Estudiantes), con el fin de establecer una línea base de diagnóstico para la orientación acciones dirigidas al control del riesgo. Con base en los hallazgos y soportados en estimadores estadísticos aplicables a los grupos de exposición, en general existe un tendencia de no conformidad al comparar los resultados aplicables con valores de referencia de larga duración definidos para el agente por autoridades internacionales. De forma complementaria se encontraron brechas significativas respecto a la implementación de controles administrativos y técnicos que sugieren circunstancias de exposición no controladas en los colectivos de interés.

O controle no Departamento de Polícia Federal

O objetivo desse trabalho foi estudar as atividades de controle administrativo às quais o Departamento de Polícia Federal está submetido e identificar reflexos dessas atividades na gestão do órgão. As atividades de controle analisadas foram: os Controles Internos do próprio órgão, o Controle Interno exercido pela Controladoria Geral da União e o Controle Externo exercido pelo Tribunal de Contas da União. Os exercícios de 2010, 2011 e 2012 foram utilizados para o estudo. Para os Controles Internos, foram consolidados os questionários contidos nos Relatórios de Gestão de cada uma das Superintendências Regionais de Polícia Federal e no Relatório de Gestão das unidades centrais, perfazendo 84 formulários, sendo 28 por ano. Para o estudo do Controle Interno exercido pela CGU, foi analisado o Relatório de Auditoria Anual de Contas de cada um dos três exercícios, e para o Controle Externo exercido pelo TCU, foram examinados os 109 acórdãos publicados durante os três anos. Na análise dos dados, a estatística descritiva subsidiou a comparação anual, e o conteúdo dos documentos foi submetido a uma análise textual. As avaliações referentes aos Controles Internos foram ainda submetidas a uma análise de percepção compartilhada.

Ações dos agentes comunitários de saúde diante do usuário da estratégia saúde da família com estados depressivos no Município de Abaiara-CE-BR

Brazilian health public assistance is going through two Reforms, Sanitary and Psychiatric, and through these the assistance is guaranteed in the three levels: primary, secondary and tertiary. Thus, mental health assistance should be offered since preventive cares until the ones that demand larger technological apparatus. Programs like Health Community Agent's Program (HCAP) and Family Health Strategy (FHS), besides increasing the services coverage, have been making possible the system reorientation in the meaning of integrality, universalization and equity. Thus, united intervention of mental health team and FHS can offer several benefits to the population, providing assistance and follow-up to patients with mental disorder. It was aimed to assess health community agents facing the user of Family Health Strategy in depressive state. This quanti-qualitative study took place in the municipal district of Abaiara-CE. Semi-structured interview was applied with health community agents and Beck Depression Inventory with the users registered in Family Health Strategy. It was verified that among the 64 users interviewed, 12.5% didn't present symptoms of depression, 10.9% presented symptoms of light depression, 14.1% symptoms of moderate depression and 62.5% symptoms of serious depression. For the 22 health community agents interviewed, they all reported the existence of people with symptoms of depression in their personal micro-areas, being difficult to work with them, once the FHS team is not qualified to work with mental health problems. It was verified that the Municipal district doesn't have specialized professionals, making difficult the routing and treatment. Based on these results, it was concluded that in spite of the articulation of mental health with FHS is necessary and benefactor to the population, it still doesn't exist, worsening the situation, mainly in small Municipal districts, once they don't have mental health services. Thus, the population is exposed and without follow-up, which allows the identification of installed diseases and with gravity, like depression, because there are no prevention and control activities. It is recommended, due the extreme need, the elaboration and implantation of a mental health program in these municipal districts, articulated with FHS

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Validade da citologia cervicovaginal na detecção de lesões pré-neoplásicas e neoplásicas de colo de útero

Introdução: O exame colpocitológico ou teste de Papanicolaou permite o diagnóstico precoce do câncer de colo do útero. O êxito no rastreamento desta doença dependerá, além de outros fatores, da acuidade diagnóstica do exame colpocitológico. Objetivos: Avaliar a acurácia diagnóstica da citologia cervicovaginal na detecção de lesões cervicais através da comparação citoistopatológica. Material e métodos: Avaliou-se o grau de concordância entre os exames citológico e histopatológico de 373 pacientes atendidas em um hospital universitário no período de 1990 a 1997 e foram calculados os indicadores: sensibilidade, especificidade, valores preditivos positivos e negativos e as taxas de falsos positivos e falsos negativos do exame. Resultados: A taxa bruta de concordância citoistopatológica foi de 65,1%. A sensibilidade do exame foi alta (96,0%), no entanto sua especificidade foi baixa (51,5%), significando a inclusão de muitos resultados falsos positivos. A taxa de falsos positivos foi de 48,4%, enquanto a de falsos negativos foi de 4%. Discussão: Apesar de a sensibilidade do teste ser alta, sua especificidade é baixa, significando que muitas mulheres seriam falsamente diagnosticadas como doentes, levando a um número elevado de resultados falsos positivos e custos desnecessários, além do potencial caráter iatrogênico que esta ação poderia assumir. No entanto, um exame altamente sensível é o teste de escolha para programas de rastreamento de câncer cervical na população feminina. Conclusões: Para garantir a acuidade diagnóstica do teste de Papanicolaou são essenciais atividades de controle de qualidade nos laboratórios, tanto do procedimento colpocitológico quanto do histopatológico, permitindo, assim, o êxito na detecção precoce e no tratamento das lesões cervicais.

Uma análise de jogos de empresas na área de planejamento da produção e uso integrado de sistemas de informações

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação do nível de suscetibilidade de linhagens de Aedes aegypti (Díptera: Culicidae) aos inseticidas utilizados para seu controle

Pós-graduação em Saúde Coletiva - FMB

A Method to Estimate the Population Level of Aceria litchii (Prostigmata: Eriophyidae) and a Study of the Population Dynamics of This Species and Its Predators on Litchi Trees in Southern Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

FROM FACTORY-FLOOR TO UNIVERSITY

The interaction between industry and university is often discussed. Industry participants feel they do not have enough time to spend with academics because of tight deadlines to achieve your goals. The other hand, professors and his students do not have availability and resources for responding quickly to industry activities. Both sides recognize the associated problems and feel the consequences of various forms. One way to reduce the distance between them is to provide industrial labs that resemble the factory floor at the university. Thus not only students may work on a real technological base, but also the industry's problems can be brought to the university laboratory. To ensure that relevant industrial problems will be studied, the industry needs help in the formulation of the problem being researched. The graduate program of Automation and Control Engineering from UNESP Sorocaba is aimed at training human resources with skills in automation and control activities related to the development of automatic control processes, integrating electronic commands, intelligent manufacturing and industrial robotics. In order to achieve its objectives, one of the pillars of the university consists of a wide range of modern equipments and software for industrial automation, which allows the circuit assembly from most primitive until configuration and programming of a complex system of integrated manufacturing. This paper describes industrial automation equipments and laboratory structure offered to students of Control and Automation Engineering graduate program at UNESP Sorocaba as alternative to close technologies and real problems on the job until academic world. The strategic is to do students understand theory and operations in robotic and industrial automation by means to manipulating real production systems locate at university

Evaluation of Blood Assays for Detection of Mycobacterium bovis in White-Tailed Deer (Odocoileus virginianus) in Michigan

Surveillance and control activities related to bovine tuberculosis (TB) in free-ranging, Michigan white-tailed deer (Odocoileus virginianus) have been underway for over a decade, with significant progress. However, foci of higher TB prevalence on private lands and limited agency ability to eliminate them using broad control strategies have led to development and trial of new control strategies, such as live trapping, testing, and culling or release. Such strategies require a prompt, accurate live animal test, which has thus far been lacking. We report here the ability of seven candidate blood assays to determine the TB infection status of Michigan deer. Our aims were twofold: to characterize the accuracy of the tests using field-collected samples and to evaluate the feasibility of the tests for use in a test-and-cull strategy. Samples were collected from 760 deer obtained via five different surveys conducted between 2004 and 2007. Blood samples were subjected to one or more of the candidate blood assays and evaluated against the results of mycobacterial culture of the cranial lymph nodes. Sensitivities of the tests ranged from 46% to 68%, whereas specificities and negative predictive values were all .92%. Positive predictive values were highly variable. An exploratory analysis of associations among several host and sampling-related factors and the agreement between blood assay and culture results suggested these assays were minimally affected. This study demonstrated the capabilities and limitations of several available blood tests for Mycobacterium bovis on specimens obtained through a variety of field surveillance methods. Although these blood assays cannot replace mass culling, information on their performance may prove useful as wildlife disease managers develop innovative methods of detecting infected animals where mass culling is publicly unacceptable and cannot be used as a control strategy.

Taking an Endemically Infected Bovine Tb Area Through to Livestock Clearance. A Case Study of West Taupo, New Zealand

The Pest Management Strategy for Bovine Tuberculosis (Tb) in New Zealand aims to achieve efficient freedom from Tb by 2013 and to eradicate the disease from livestock and wildlife. The West Taupo area, in the central North Island of New Zealand, was chronically infected with Tb in both domestic livestock herds (cattle and deer) and within wildlife populations (brushtail possum, ferret, feral deer and pigs). Through the development and implementation of a technically innovative management plan, this area is now approaching Tb free status. The case study / management plan reported here discusses the operational techniques and strategies that were implemented to achieve Tb clearance in the livestock herds and the possibilities of eradication from wildlife species. It particularly identifies the variations in control strategies that are required as population densities reduce and the challenges of maintaining strong effective control at low densities of some wildlife species, whilst not needing to control other species that were initially clinically diagnosed with Tb control. Use of diagnostic tools and education as an area moves through the cycle towards Tb freedom are as essential as the physical control activities. The use of intensive monitoring of both livestock and wildlife species as trend and performance indicators and the need to educate farmers, hunters and other land use groups become increasingly important.

Wildlife Risk Management at Vancouver International Airport

The Vancouver International Airport (YVR) is the second busiest airport in Canada. YVR is located on Sea Island in the Fraser River Estuary - a world-class wintering and staging area for hundreds of thousands of migratory birds. The Fraser Delta supports Canada’s largest wintering populations of waterfowl, shorebirds, and raptors. The large number of aircraft movements and the presence of many birds near YVR pose a wide range of considerable aviation safety hazards. Until the late 1980s when a full-time Wildlife Control Program (WCP) was initiated, YVR had the highest number of bird strikes of any Canadian commercial airport. Although the risks of bird strikes associated with the operation of YVR are generally well known by airport managers, and a number of risk assessments have been conducted associated with the Sea Island Conservation Area, no quantitative assessment of risks of bird strikes has been conducted for airport operations at YVR. Because the goal of all airports is to operate safely, an airport wildlife management program strives to reduce the risk of bird strikes. A risk assessment establishes the current risk of strikes, which can be used as a benchmark to focus wildlife control activities and to assess the effectiveness of the program in reducing bird strike risks. A quantitative risk assessment also documents the process and information used in assessing risk and allows the assessment to be repeated in the future in order to measure the change in risk over time in an objective and comparative manner. This study was undertaken to comply with new Canadian legislation expected to take effect in 2006 requiring airports in Canada to conduct a risk assessment and develop a wildlife management plan. Although YVR has had a management plan for many years, it took this opportunity to update the plan and conduct a risk assessment.

Epidemiological aspects of tuberculosis in children and adolescents in Rio de Janeiro

Objective: To describe the epidemiological aspects of childhood tuberculosis (TB) in a Brazilian reference hospital. Methods: This was a retrospective study (1999-2008) of 473 subjects (0-14 year olds) with confirmed TB, or with clinical improvement by the fourth month of treatment under the unit's care, including the review of medical records, monitoring reports and notifications by the TB unit. Results: Among 473 TB cases included in the study, positive tuberculin skin test was observed in 52%, history of contact with a patient with pulmonary tuberculosis in 66%, mostly intra-household, and with the father/stepfather most commonly involved; and disseminated TB in 22%. The result of HIV testing was obtained in 265 (56%) cases, being positive in 45 (17%). The diagnosis of TB was confirmed in 31% of cases, most frequently in children older than 5 years, with negative tuberculin skin test, and in disseminated forms. Of the 65 cultures positive for TB performed in the study, drug sensitivity testing to anti-TB drugs was done in 30 (46%) clinical samples, among which 10 (33%) were resistant to one or more anti-TB drugs, and 2 (0.8%) were multi-drug-resistant. Among patients with confirmed pulmonary TB, 31% did not meet the criteria for starting anti-TB treatment according to the scores of the Ministry of Health (<= 25 points). Conclusion: The high proportion of drug-resistant TB and co-infection with HIV identified in this study highlight the necessity to carry out additional studies in order to evaluate the impact of TB control activities on childhood TB.

Visceral leishmaniasis in Brazil: trends and challenges

The urbanization of visceral leishmaniasis in Brazil has been related to environmental changes, migration, interaction and spread of sylvatic reservoirs and infected dogs to areas with no transmission, and adaptation of the vector Lutzomyia longipalpis to the peridomiciliary environment. From 1980 to 2005, Brazil recorded 59,129 cases of visceral leishmaniasis, 82.5% of which in the Northeast region. Visceral leishmaniasis gradually spread to other regions of the country: in 1998 these other regions reported 15% of all cases, but by 2005 this proportion had increased to 44%. From 1998 to 2005, indigenous cases were reported in 1,904 different municipalities of the country (34.2%). Reservoir and vector control pose major challenges for disease control, since there is a need for better knowledge of vector behavior in urban areas, and control activities involve high operational costs. In recent years the Brazilian Ministry of Health has supported research on the laboratory diagnosis of infection and disease in humans and dogs, treatment of patients, evaluation of the effectiveness of control strategies, and development of new technologies that could contribute to the surveillance and control of visceral leishmaniasis in the country.