Implicações políticas do estudo democracia e inovação na gestão local da saúde

EBAPE - Escola Brasileira de Administração Pública e de Empresas

Fragilidades dos mecanismos de controle das organizações sociais de saúde no município do Rio de Janeiro

Nosso problema de pesquisa neste trabalho é a avaliação do funcionamento dos principais mecanismos de controle das organizações sociais de saúde, no caso específico do Município do Rio de Janeiro. As reiteradas denúncias de irregularidades e ilegalidades pelo Tribunal de Contas do Município do Rio de Janeiro e pelo Ministério Público do Estado do Rio de Janeiro levantaram dúvidas acerca da adequação dos processos de monitoramento, fiscalização e controle dessas entidades. Disto decorre nosso objetivo central de pesquisa, que é identificar as fragilidades do novo modelo de gestão por organizações sociais de saúde, no caso da cidade do Rio de Janeiro. Para isso, foram analisados: o arcabouço jurídico-normativo do modelo local, a partir de análise comparativa da legislação municipal que regulamenta seu funcionamento (Lei 5.026/09) e sua contraparte federal (Lei 9.637/98); indicadores de saúde que mensurassem o desempenho das OSS; todas as inspeções realizadas pelo TCM-RJ até o fim de 2015; e o conjunto de recomendações enviado pelo MP-ERJ para a Prefeitura após deflagração da Operação Ilha Fiscal, que acarretou a desqualificação da OS BIOTECH e a prisão de seus dirigentes, acusados de desviar mais de R$48 milhões em recursos públicos. Ao final, constatouse que as fragilidades da legislação municipal e dos decretos executivos que regulamentam a atuação das OSS no MRJ não permitem o exercício efetivo do comando da parceria, em afronta, portanto, ao dispositivo constitucional que determina que a atuação de entidades privadas no âmbito do SUS pode se dar apenas de modo complementar. Ademais, verificou-se total inadequação da estrutura de controle pela Prefeitura, cuja principal consequência foi tornar o modelo de reforma gerencialista em um modelo que incentiva o comportamento patrimonialista no âmbito da saúde pública, uma vez que o controle de meios é absolutamente negligenciado.

Paradigms in health care and its relationship to the nursing theories: an analytical test

DANTAS, Rodrigo Assis Neves; NÓBREGA, Walkíria Gomes da; MORAIS FILHO, Luiz Alves; MACÊDO, Eurides Araújo Bezerra de ; FONSECA , Patrícia de Cássia Bezerra; ENDERS, Bertha Cruz; MENEZES, Rejane Maria Paiva de; TORRES , Gilson de Vasconcelos. Paradigms in health care and its relationship to the nursing theories: an analytical test . Revista de Enfermagem UFPE on line. v.4,n.2, p.16-24.abr/jun. 2010. Disponível em < http://www.ufpe.br/revistaenfermagem/index.php/revista>.

Militância, organização e mobilização antiproibicionista da maconha: coletivos, eventos e marchas em Natal (RN)

Based on the proposal entitled anti-prohibitionist, contrary to prohibition and illegality of cannabis and its use, the anti-prohibitionist Collectives proposes to discuss the topic of drugs, especially marijuana, aiming decriminalization and legalization of this psychoactive. With this idea was articulated anti-prohibitionist movement in Natal, by organizing collectives that discuss issues related to drug use and conduct activities directed to this issue, such as Marijuana Marches and Cycles of Debates anti-prohibitionist. In this study we sought to understand the positioning in social and cultural terms, the marijuana users participating of the collectives, on the situation of illegality of their actions, in front of social, legal and moral question involved in the illicit psychoactive, through initiatives conferences, events and demonstrations for this purpose

Ventilação e prescrições urbanísticas: uma aplicação simulada para a Orla da Praia do Meio em Natal/RN

This work analyses a study on natural ventilation and its relation to the urban legislation versus the building types in an urban fraction of coastal area of Praia do Meio in the city of Natal/RN, approaching the type or types of land use most appropriate to this limited urban fraction. The objective of this study is to analyse the effects of the present legislation as well as the types of buildings in this area on the natural ventilation. This urban fraction was selected because it is one of the sites from where the wind flows into the city of Natal. This research is based on the hypothesis stating that the reduction on the porosity of the urban soil (decrease in the set back/boundary clearance), and an increase in the form (height of the buildings) rise the level of the ventilation gradient, consequently causing a reduction on the wind speed at the lowest part of the buildings. Three-dimensional computational models were used to produce the modes of occupation allowed in the urban fraction within the area under study. A Computational Fluid Dynamics (CFD) software was also used to analyse the modes of land occupation. Following simulation, a statistical assessment was carried out for validation of the hypothesis. It was concluded that the reduction in the soil porosity as a consequence of the rates that defined the minimum boundary clearance between the building and the boundary of the plot (and consequently the set back), as well as the increase in the building form (height of the buildings) caused a reduction in the wind speed, thus creating heat islands

Abundância e distribuição sazonal de espécies autóctones de camarões peneídeos no canal de abastecimento do sistema primar de aquicultura orgânica (Laguna de Guaraíras, Tibau do Sul, Rio Grande do Norte, Brasil)

Guaraíras lagoon, located in Tibau do Sul in the eastern littoral of Rio Grande do Norte (Brazil), presents a permanent connection to the sea, which guarantees the occurrence of a rich biodiversity, which includes the autochthonous shrimp species Litopenaeus schmitti, Farfantepenaeus subtilis and Farfantepenaeus brasiliensis. In spite of being subject to a strong human intervention in the last decade, mainly related to the installation of shrimp (Litopenaeus vannamei) farms, the lagoon is still scarcely studied. The present study aims at characterizing the populations of the three autochthonous penaeid shrimp species inhabiting Guaraíras, taking into consideration their abundance and seasonal distribution in the inflow channel of Primar System of Organic Aquaculture (Tibau do Sul, Rio Grande do Norte, Brazil). Twelve monthly samples were carried out from May 2005 to April 2006 with the aid of a circular cast net in the inflow channel, which is daily supplied with water from Guaraíras. Sampling months were grouped in trimesters according to the total pluviosity, thus comprising four trimesters. Water salinity was monitored twice a week and temperature values registered on a daily basis at noon, during the study period. The daily pluviosity data from the municipality of Tibau do Sul were supplied by Empresa de Pesquisa Agropecuária do Rio Grande do Norte (EMPARN). Collected shrimp were identified, weighted, measured and sexed. L. schmitti specimens (0.2 g to 17.8 g) were distributed in 1.3 g weight classes intervals. From the eighth sampling month (December 2005) onwards, males were classified into three categories, in accordance with the development of their petasm: (a) rudimentary petasm, (b) partially formed petasm, and (c) completely formed petasm. Among the ecological variables, rainfall showed the greatest dispersion (s.d.=187.74Rainfall and abundance of L. schmitti were negatively correlated (r = -0.85) whereas its abundance and water salinity were positively correlated (r = 0.63). Among 1,144 collected individuals, 1,127 were L. schmitti, 13 were F. subtilis and 4 were F. brasiliensis, which corresponded to 98.51%, 1.14% and 0.35% of the total of collected individuals. L. schmitti occurred in 100 % of all samples. Differently, the presence of F. subtilis and F. brasiliensis was restricted to 33% and 17% of the collected samples, respectively. The present study confirmed the occurrence of L. schmitti, F. brasiliensis and F. subtilis in Guaraíras. However, this lagoon seems to be primarily inhabited by juvenile Litopenaeus schmitti. The population of L. schmitti analysed showed a seasonal pattern of distribution. In general, in the months of high salinity and absence of rain, the number of individuals was higher than in the wet months. Further studies on the reproductive biology and ecology of L. schmitti, F. brasiliensis and F. subtilis may elucidate questions referring to the abundance, period, and phase of occurrence of these shrimp genera in Guaraíras. Finally, the risks associated to the establishment of L. vannamei in the lagoon provide a novel outlet for studies in this biotope

Produção de enzimas quitosanolíticas utilizando Paenibacillus ehimensis e Paenibacillus chitinolyticus para obtenção de quitoologossacarídeos

The acquisition of oligosaccharides from chitosan has been the subject of several studies in the pharmaceutical, biochemical, food and medical due to functional properties of these compounds. This study aimed to boost its production of chitooligosaccharides (COS) through the optimization of production and characterization of chitosanolytic enzymes secreted by microorganisms Paenibacillus chitinolyticus and Paenibacillus ehimensis, and evaluating the antioxidant potential of the products obtained. In the process of optimizing the production of chitosanase were employed strategies Fractional Factorial Experimental Design and Central Composite Rotatable Design. The results identified the chitosan, peptone and yeast extract as the components that influenced the production of chitosanase by these microorganisms. With the optimization of the culture media was possible to obtain an increase of approximately 8.1 times (from 0.043 to 0.35 U.mL U.mL-1) and 7.6 times (from 0.08 U.mL-1 to 0.61 U.mL-1) in the enzymatic activity of chitosanase produced by P. chitinolyticus and P. ehimensis respectively. Enzyme complexes showed high stability in temperature ranges between 30º and 55º C and pH between 5.0 and 9.0. Has seen the share of organic solvents, divalent ions and other chemical agents on the activity of these enzymes, demonstrating high stability of these crude complexes and dependence of Mn2+. The COS generated showed the ability of DPPH radical scavenging activity, reaching a maximum rate of scavenging of 61% and 39% when they were produced with enzymes of P. ehimensis and P. chitinolyticus respectively. The use of these enzymes in raw form might facilitate its use for industrial applications

Produção e caracterização de quitooligossacarídeos produzidos pelo fungo Metarhizium anisopliae e avaliação da citotoxicidade em células tumorais

Chitosan is a natural polymer, biodegradable, nontoxic, high molecular weight derived from marine animals, insects and microorganisms. Oligomers of glucosamine (GlcN) and N-acetylglucosamine (GlcNAc) have interesting biological activities, including antitumor effects, antimicrobial activity, antioxidant and others. The alternative proposed by this work was to study the viability of producing chitooligosaccharides using a crude enzymes extract produced by the fungus Metarhizium anisopliae. Hydrolysis of chitosan was carried out at different times, from 10 to 60 minutes to produce chitooligosaccharides with detection and quantification performed by High Performace Liquid Chromatography (HPLC). The evaluation of cytotoxicity of chitosan oligomers was carried out in tumor cells (HepG2 and HeLa) and non-tumor (3T3). The cells were treated for 72 hours with the oligomers and cell viability investigated using the method of MTT. The production of chitosan oligomers was higher for 10 minutes of hydrolysis, with pentamers concentration of 0.15 mg/mL, but the hexamers, the molecules showing greater interest in biological properties, were observed only with 30 minutes of hydrolysis with a concentration of 0.004 mg/mL. A study to evaluate the biological activities of COS including cytotoxicity in tumor and normal cells and various tests in vitro antioxidant activity of pure chitosan oligomers and the mixture of oligomers produced by the crude enzyme was performed. Moreover, the compound with the highest cytotoxicity among the oligomers was pure glucosamine, with IC50 values of 0.30; 0.49; 0.44 mg/mL for HepG2 cells, HeLa and 3T3, respectively. Superoxide anion scavenging was the mainly antioxidant activity showed by the COS and oligomers. This activity was also depending on the oligomer composition in the chitosan hydrolysates. The oligomers produced by hydrolysis for 20 minutes was analyzed for the ability to inhibit tumor cells showing inhibition of proliferation only in HeLa cells, did not show any effect in HepG2 cells and fibroblast cells (3T3)

Sinterização de aço inoxidável reforçado com partículas nanométricas dispersas de carbeto de nióbio - NbC

Metal powder sintering appears to be promising option to achieve new physical and mechanical properties combining raw material with new processing improvements. It interest over many years and continue to gain wide industrial application. Stainless steel is a widely accepted material because high corrosion resistance. However stainless steels have poor sinterability and poor wear resistance due to their low hardness. Metal matrix composite (MMC) combining soft metallic matrix reinforced with carbides or oxides has attracted considerable attention for researchers to improve density and hardness in the bulk material. This thesis focuses on processing 316L stainless steel by addition of 3% wt niobium carbide to control grain growth and improve densification and hardness. The starting powder were water atomized stainless steel manufactured for Höganäs (D 50 = 95.0 μm) and NbC produced in the UFRN and supplied by Aesar Alpha Johnson Matthey Company with medium crystallite size 16.39 nm and 80.35 nm respectively. Samples with addition up to 3% of each NbC were mixed and mechanically milled by 3 routes. The route1 (R1) milled in planetary by 2 hours. The routes 2 (R2) and 3 (R3) milled in a conventional mill by 24 and 48 hours. Each milled samples and pure sample were cold compacted uniaxially in a cylindrical steel die (Ø 5 .0 mm) at 700 MPa, carried out in a vacuum furnace, heated at 1290°C, heating rate 20°C stand by 30 and 60 minutes. The samples containing NbC present higher densities and hardness than those without reinforcement. The results show that nanosized NbC particles precipitate on grain boundary. Thus, promote densification eliminating pores, control grain growth and increase the hardness values

Síntese e caracterização de ferrita ni-zn pelo método dos precursores poliméricos calcinada por energia de microondas

Magnetic ceramics have been widely investigated, especially with respect to intrinsic and extrinsic characteristics of these materials. Among the magnetic ceramic materials of technological interest, there are the ferrites. On the other hand, the thermal treatment of ceramic materials by microwave energy has offered various advantages such as: optimization of production processes, high heat control, low consumption of time and energy among others. In this work were synthesized powders of Ni-Zn ferrite with compositions Ni1- xZnxFe2O4 (0.25 ≤ x ≤ 0.75 mols) by the polymeric precursor route in two heat treatment conditions, conventional oven and microwave energy at 500, 650, 800 and 950°C and its structural, and morphological imaging. The materials were characterized by thermal analysis (TG/ DSC), X-ray diffraction (XRD), absorption spectroscopy in the infrared (FTIR), scanning electron microscopy (SEM), X-ray spectroscopy and energy dispersive (EDS) and vibrating sample magnetometry (VSM). The results of X-ray diffraction confirmed the formation of ferrite with spinel-type cubic structure. The extrinsic characteristics of the powders obtained by microwave calcination and influence significantly the magnetic behavior of ferrites, showing particles ferrimagnéticas characterized as soft magnetic materials (soft), is of great technological interest. The results obtained led the potential application of microwave energy for calcining powders of Ni-Zn ferrite

Protótipo de um microgerador termoelétrico de estado sólido: cogeração a gás

The thermoelectric energy conversion can be performed directly on generators without moving parts, using the principle of SEEBECK effect, obtained in junctions of drivers' thermocouples and most recently in semiconductor junctions type p-n which have increased efficiency of conversion. When termogenerators are exposed to the temperature difference (thermal gradient) eletromotriz a force is generated inducing the appearance of an electric current in the circuit. Thus, it is possible to convert the heat of combustion of a gas through a burner in power, being a thermoelectric generator. The development of infrared burners, using porous ceramic plate, is possible to improve the efficiency of heating, and reduce harmful emissions such as CO, CO2, NOx, etc.. In recent years the meliorate of thermoelectric modules semiconductor (TEG's) has stimulated the development of devices generating and recovery of thermal irreversibility of thermal machines and processes, improving energy efficiency and exergy these systems, especially processes that enable the cogeneration of energy. This work is based on the construction and evaluation of a prototype in a pilot scale, for energy generation to specific applications. The unit uses a fuel gas (LPG) as a primary energy source. The prototype consists of a porous plate burner infrared, an adapter to the module generator, a set of semiconductor modules purchased from Hi-Z Inc. and a heat exchanger to be used as cold source. The prototype was mounted on a test bench, using a system of acquisition of temperature, a system of application of load and instrumentation to assess its functioning and performance. The prototype had an efficiency of chemical conversion of 0.31% for electrical and heat recovery for cogeneration of about 33.2%, resulting in an overall efficiency of 33.51%. The efficiency of energy exergy next shows that the use of primary energy to useful fuel was satisfactory, although the proposed mechanism has also has a low performance due to underuse of the area heated by the small number of modules, as well as a thermal gradient below the ideal informed by the manufacturer, and other factors. The test methodology adopted proved to be suitable for evaluating the prototype

Análise do desempenho de um queimador infravermelho funcionando com gás liquefeito de petróleo e glicerina

The use of infrared burners in industrial applications has many advantages in terms of technical-operational, for example, uniformity in the heat supply in the form of radiation and convection, with greater control of emissions due to the passage of exhaust gases through a macro-porous ceramic bed. This paper presents an infrared burner commercial, which was adapted an experimental ejector, capable of promoting a mixture of liquefied petroleum gas (LPG) and glycerin. By varying the percentage of dual-fuel, it was evaluated the performance of the infrared burner by performing an energy balance and atmospheric emissions. It was introduced a temperature controller with thermocouple modulating two-stage (low heat / high heat), using solenoid valves for each fuel. The infrared burner has been tested and tests by varying the amount of glycerin inserted by a gravity feed system. The method of thermodynamic analysis to estimate the load was used an aluminum plate located at the exit of combustion gases and the distribution of temperatures measured by a data acquisition system which recorded real-time measurements of the thermocouples attached. The burner had a stable combustion at levels of 15, 20 and 25% of adding glycerin in mass ratio of LPG gas, increasing the supply of heat to the plate. According to data obtained showed that there was an improvement in the efficiency of the 1st Law of infrared burner with increasing addition of glycerin. The emission levels of greenhouse gases produced by combustion (CO, NOx, SO2 and HC) met the environmental limits set by resolution No. 382/2006 of CONAMA

Estudo de adsorvente obtido de terras diatomáceas para remoção de metais pesados em águas produzidas: processamento, caracterização e dinâmica em leito fixo

The acceleration of industrial growth in recent decades on all continents aroused the interest of the companies to counter the impacts produced on the environment, spurred primarily by major disasters in the petroleum industry. In this context, the water produced is responsible for the largest volume of effluent from the production and extraction of oil and natural gas. This effluent has in its composition some critical components such as inorganic salts, heavy metals (Fe, Cu, Zn, Pb, Cd, ), presence of oil and chemicals added in the various production processes. In response to impact, have been triggered by research alternative adsorbent materials for water treatment and water produced, in order to removing oils and acids and heavy metals. Many surveys of diatomaceous earth (diatomite) in Brazil involve studies on the physico-chemical, mineral deposits, extraction, processing and applications. The official estimated Jazi are around 2.5 million tonnes, the main located in the states of Bahia (44%) and Rio Grande do Norte (37,4%). Moreover, these two states appear as large offshore producers, earning a prominent role in research of adsorbents such as diatomite for treatment of water produced. Its main applications are as an agent of filtration, adsorption of oils and greases, industrial load and thermal insulator. The objective of this work was the processing and characterization of diatomite diatomaceous earth obtained from the municipality of Macaíba-RN (known locally as tabatinga) as a low cost regenerative adsorbent for removal of heavy metals in the application of water produced treatment. In this work we adopted a methodology for batch processing, practiced by small businesses located in producing regions of Brazil. The characterization was made by X-ray diffraction (XRD), scanning electron microscopy (SEM) and specific surface area (BET). Research conducted showed that the improvement process used was effective for small volume production of diatomite concentrated. The diatomite obtained was treated by calcination at temperature of 900 oC for 2 hours, with and without fluxing Na2CO3 (4%), according to optimal results in the literature. Column adsorption experiments were conducted to percolation of the in nature, calcined and calcined fluxing diatomites. Effluent was used as a saline solution containing ions of Cu, Zn, Na, Ca and Mg simulating the composition of produced waters in the state of Rio Grande do Norte, Brazil. The breakthrough curves for simultaneous removal of copper ions and zinc as a result, 84.3% for calcined diatomite and diatomite with 97.3 % for fluxing. The calcined fluxing diatomite was more efficient permeability through the bed and removal of copper and zinc ions. The fresh diatomite had trouble with the permeability through the bed under the conditions tested, compared with the other obtained diatomite. The results are presented as promising for application in the petroleum industry

Análise de um queimador infravermelho funcionando com combustível híbrido : GLP/Bio-óleo

Biomass is considered the largest renewable energy source that can be used in an environmentally sustainable. From the pyrolysis of biomass is possible to obtain products with higher energy density and better use properties. The liquid resultant of this process is traditionally called bio-oil. The use of infrared burners in industrial applications has many advantages in terms of technical-operational, for example, uniformity in the heat supply in the form of radiation and convection, with a greater control of emissions due to the passage of exhaust gases through a macroporous ceramic bed. This paper presents a commercial infrared burner adapted with an ejector proposed able to burn a hybrid configuration of liquefied petroleum gas (LPG) and bio-oil diluted. The dilution of bio-oil with absolute ethanol aimed to decrease the viscosity of the fluid, and improving the stability and atomization. It was introduced a temperature controller with thermocouple modulating two stages (low heat / high heat), and solenoid valves for fuels supply. The infrared burner has been tested, being the diluted bio-oil atomized, and evaluated its performance by conducting energy balance. The method of thermodynamic analysis to estimate the load was used an aluminum plate located at the exit of combustion gases and the distribution of temperatures measured by thermocouples. The dilution reduced the viscosity of the bio-oil in 75.4% and increased by 11% the lower heating value (LHV) of the same, providing a stable combustion to the burner through the atomizing with compressed air and burns combined with LPG. Injecting the hybrid fuel there was increase in the heat transfer from the plate to the environment in 21.6% and gain useful benefit of 26.7%, due to the improved in the efficiency of the 1st Law of Thermodynamics of infrared burner

Análise das emissões gasosas de um veículo flex funcionando com diferentes combustíveis

Efforts in research and development of new technologies to reduce emission levels of pollutant gases in the atmosphere has intensified in the last decades. In this context, it can be highlighted the modern systems of electronic engine management, new automotive catalysts and the use of renewable fuels which contributes to reduce the environmental impact. The purpose of this study was a comparative analysis of gas emissions from a automotive vehicle, operating with different fuels: natural gas, AEHC or gasoline. To execute the experimental tests, a flex vehicle was installed on a chassis dynamometer equipped with a gas analyzer and other complementary accessories according to the standard guidelines of emission and security procedures. Tests were performed according to NBR 6601 and NBR 7024, which define the urban and road driving cycle, respectively. Besides the analysis of exhaust gases in the discharge tube, before and after the catalyst, using the suction probe of the gas analyzer to simulate the vehicle in urban and road traffic, were performed tests of fuel characterization. Final results were conclusive in indicating leaded gasoline as the fuel which most contributed with pollutant emissions in atmosphere and the usual gasoline being the fuel which less contributed with pollutant emissions in atmosphere