Ações e percepções ambientais articuladas na sustentabilidade: estudos de múltiplos casos na indústria calçadista

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

Productivity, Leaf Nutrient Content and Soil Carbon Stocked in Agroforestry and Traditional Management of Maize (Zea mays L.)

The aim of the work was to evaluate the productivity, leaf nutrient content and soil nutrient concentration in maize (Zea mays L.) grown in sequence with black oats (Avena strigosa Schreb.) under Leucaena diversifolia alley cropping agroforestry system (AFS) and traditional management system/sole crop (without trees-TS), after two years of cultivation following a randomized block design. The experiment was carried out in the Brazilian Association of Biodynamic Agriculture, in Botucatu—S?o Paulo, Brazil. Treatments were: control (C), chemical fertilizer application (F), biomass of L. diversifolia alley cropping application (B), biomass of L. diversifolia alley cropping + chemical fertilizer application (B + F). In the second year of management it was observed that black oat yield was higher in treatments B + F and F with significant difference in relation to the others treatments in both systems, followed by treatment B. Between systems, only treatment B showed significant difference, with higher yield value corresponding to AFS, reflecting the efficiency of AFS to promote soil fertility. Maize production presented the second year of cultivation an increasing trend in all treatments in both production systems. This result may be due to the cumulative effect of mineralization and maize straw and oats, along the experiment. How productivity was higher in the AFS system, could also be occurring effect of biological nitrogen fixation, water retention and reduction of extreme microclimate through the rows of L. diversifolia. Comparing the AFS and TS, it was observed that the concentration of N in leaf tissue was higher in the AFS treatments, probably due to nitrogen fixation performed through the rows of L. diversifolia, that is a nitrogen fixing tree species. After two years, carbon stocked in soil show higher values in the treatments biomass + fertilizer and biomass application, in both systems, AFS and TS.

Análise do funcionamento e a evolução de um programa de sugestões de ideias e seus benefícios

The competition for markets have created extreme challenges for companies that need an efficient management system. The transformational system involve all the employees in the task of eliminating waste, add value to products, reduce variations in processes, increase reliability and discover customer needs. The collaborative management is one of the focuses of this research. It was based on the analysis of the Fleury's suggestion program called Central de Ideias, The Fleury Group is one of the most traditional organizations of medical and health in the country. We pointed out the evolution of the program and we also showed the results of the changed of the management tool ideas. An extensive theoretical study was conducted in order to enhance the benefits that a suggestion system provides to the organizations. The Programa Central de Ideias has saved millions for Fleury and it has been made processes more efficient. The increasing of employees participation, the improvement of the internal communication and the refinement of the quality services are one of the suggestion system benefits

Green supply chain management em uma indústria de bens do consumo do Vale do Paraíba - SP

The Green Supply Chain Management (GSCM) is gaining prominence in the academy and business, as an approach that aims to promote economic and environmental gains. The GSCM is operated through the Environmental Management System Tools and treated as an Environmental Management System (EMS), involving Reverse Logistics, Green Purchasing, Green Sourcing, Green Design, Green Packaging, Green Operation, Green Manufacturing, Green Innovation and Customer Awareness. The objective of this study is to map the GSCM tools and identify their practice in a consumer goods industry in the Vale do Paraiba. The approach and data collection were made in the company's database chosen as the object of study, as well as through on site visits and interviews. The results showed that the tools Green Operation, Green Manufacturing, Green Innovation and Green Sourcing are applied in the company and just Costumer Awareness tool showed no practice at all. To other tools was identified ideology or interest of the company in applying them

Estratégias de países sul-americanos na formação de recursos humanos para resposta ás emergências de saúde pública: exemplo dos programas de treinamento em epidemiologia de campo

Pós-graduação em Saúde Coletiva - FMB

Análise do funcionamento e a evolução de um programa de sugestões de ideias e seus benefícios

The competition for markets have created extreme challenges for companies that need an efficient management system. The transformational system involve all the employees in the task of eliminating waste, add value to products, reduce variations in processes, increase reliability and discover customer needs. The collaborative management is one of the focuses of this research. It was based on the analysis of the Fleury's suggestion program called Central de Ideias, The Fleury Group is one of the most traditional organizations of medical and health in the country. We pointed out the evolution of the program and we also showed the results of the changed of the management tool ideas. An extensive theoretical study was conducted in order to enhance the benefits that a suggestion system provides to the organizations. The Programa Central de Ideias has saved millions for Fleury and it has been made processes more efficient. The increasing of employees participation, the improvement of the internal communication and the refinement of the quality services are one of the suggestion system benefits

Green supply chain management em uma indústria de bens do consumo do Vale do Paraíba - SP

The Green Supply Chain Management (GSCM) is gaining prominence in the academy and business, as an approach that aims to promote economic and environmental gains. The GSCM is operated through the Environmental Management System Tools and treated as an Environmental Management System (EMS), involving Reverse Logistics, Green Purchasing, Green Sourcing, Green Design, Green Packaging, Green Operation, Green Manufacturing, Green Innovation and Customer Awareness. The objective of this study is to map the GSCM tools and identify their practice in a consumer goods industry in the Vale do Paraiba. The approach and data collection were made in the company's database chosen as the object of study, as well as through on site visits and interviews. The results showed that the tools Green Operation, Green Manufacturing, Green Innovation and Green Sourcing are applied in the company and just Costumer Awareness tool showed no practice at all. To other tools was identified ideology or interest of the company in applying them

Estratégias de países sul-americanos na formação de recursos humanos para resposta ás emergências de saúde pública: exemplo dos programas de treinamento em epidemiologia de campo

Pós-graduação em Saúde Coletiva - FMB

Metropolitan and regional health planning: dilemmas of the Pact for Health in the Baixada Santista Metropolitan Area, Sao Paulo State, Brazil

This paper focuses on the relationship between metropolitan and regional health planning based on the processes of regionalization and the Pact for Health in the Baixada Santista Metropolitan Area, Sao Paulo State, Brazil. The method used was a case study in two stages, namely during initial implementation of the Pact for Health (2007) and the Regional Administration Committees (CGR) and in 2010. Municipal and regional health systems managers and the director of the Metropolitan Agency were interviewed, and records were analyzed from ten years of meetings of the Regional Inter-Administration Committee and the Regional Development Council. Four issues emerged: financing and infrastructure; health services utilization; inefficiency of the Regional Health Administration's instruments and decision-making levels; and the relationship between different levels in the Administration. Metropolitan health management remained as an underlying issue, appearing only incidentally or tangentially to regional management. Despite some limitations, the CGR has been legitimized as a space for regional health management.

Framing the difficulties resulting from implementing a Participatory Management Model in a public hospital

Objective: This study aims to address difficulties reported by the nursing team during the process of changing the management model in a public hospital in Brazil. Methods: This qualitative study used thematic content analysis as proposed by Bardin, and data were analyzed using the theoretical framework of Bolman and Deal. Results: The vertical implementation of Participatory Management contradicted its underlying philosophy and thereby negatively influenced employee acceptance of the change. The decentralized structure of the Participatory Management Model was implemented but shared decision-making was only partially utilized. Despite facilitation of the communication process within the unit, more significant difficulties arose from lack of communication inter-unit. Values and principals need to be shared by teams, however, that will happens only if managers restructure accountabilities changing job descriptions of all team members. Conclusion: Innovative management models that depart from the premise of decentralized decision-making and increased communication encourage accountability, increased motivation and satisfaction, and contribute to improving the quality of care. The contribution of the study is that it describes the complexity of implementing an innovative management model, examines dissent and intentionally acknowledges the difficulties faced by employees in the organization.

Family Health Support Centers: challenges and opportunities from the perspective of primary care professionals in the city of Sao Paulo, Brazil

Family Health Support Centers (NASF) were created in Brazil to increase the case-resolution capacity of primary healthcare. Prior to their implementation in the West Side of the city of Sao Paulo, Brazil, a series of workshops were held for primary healthcare professionals to prepare a proposal for such centers. Hermeneutic analysis was used to study the transcribed material. The thematic categories were: role, constitution, and functioning of the NASF, relationship with family health teams, and interdisciplinarity. The participants' expected the NASF to be an empowering device for comprehensiveness of care, intervening in an existing culture of unnecessary referrals while fostering linkage with other levels of care. The participants also expected the NASF to contribute to the discussion on health professionals' training and stimulating reflection with policy-makers on health indicators based exclusively on the number of consultations. These indicators fail to reflect the impact on the services' activities and the quality of care offered to the population in the coverage area.

Computational framework to support integration of biomolecular and clinical data within a translational approach

Background The use of the knowledge produced by sciences to promote human health is the main goal of translational medicine. To make it feasible we need computational methods to handle the large amount of information that arises from bench to bedside and to deal with its heterogeneity. A computational challenge that must be faced is to promote the integration of clinical, socio-demographic and biological data. In this effort, ontologies play an essential role as a powerful artifact for knowledge representation. Chado is a modular ontology-oriented database model that gained popularity due to its robustness and flexibility as a generic platform to store biological data; however it lacks supporting representation of clinical and socio-demographic information. Results We have implemented an extension of Chado – the Clinical Module - to allow the representation of this kind of information. Our approach consists of a framework for data integration through the use of a common reference ontology. The design of this framework has four levels: data level, to store the data; semantic level, to integrate and standardize the data by the use of ontologies; application level, to manage clinical databases, ontologies and data integration process; and web interface level, to allow interaction between the user and the system. The clinical module was built based on the Entity-Attribute-Value (EAV) model. We also proposed a methodology to migrate data from legacy clinical databases to the integrative framework. A Chado instance was initialized using a relational database management system. The Clinical Module was implemented and the framework was loaded using data from a factual clinical research database. Clinical and demographic data as well as biomaterial data were obtained from patients with tumors of head and neck. We implemented the IPTrans tool that is a complete environment for data migration, which comprises: the construction of a model to describe the legacy clinical data, based on an ontology; the Extraction, Transformation and Load (ETL) process to extract the data from the source clinical database and load it in the Clinical Module of Chado; the development of a web tool and a Bridge Layer to adapt the web tool to Chado, as well as other applications. Conclusions Open-source computational solutions currently available for translational science does not have a model to represent biomolecular information and also are not integrated with the existing bioinformatics tools. On the other hand, existing genomic data models do not represent clinical patient data. A framework was developed to support translational research by integrating biomolecular information coming from different “omics” technologies with patient’s clinical and socio-demographic data. This framework should present some features: flexibility, compression and robustness. The experiments accomplished from a use case demonstrated that the proposed system meets requirements of flexibility and robustness, leading to the desired integration. The Clinical Module can be accessed in http://dcm.ffclrp.usp.br/caib/pg=iptrans webcite.

A rigorous approach to facilitate and guarantee the correctness of the genetic testing management in human genome information systems

Abstract Background Recent medical and biological technology advances have stimulated the development of new testing systems that have been providing huge, varied amounts of molecular and clinical data. Growing data volumes pose significant challenges for information processing systems in research centers. Additionally, the routines of genomics laboratory are typically characterized by high parallelism in testing and constant procedure changes. Results This paper describes a formal approach to address this challenge through the implementation of a genetic testing management system applied to human genome laboratory. We introduced the Human Genome Research Center Information System (CEGH) in Brazil, a system that is able to support constant changes in human genome testing and can provide patients updated results based on the most recent and validated genetic knowledge. Our approach uses a common repository for process planning to ensure reusability, specification, instantiation, monitoring, and execution of processes, which are defined using a relational database and rigorous control flow specifications based on process algebra (ACP). The main difference between our approach and related works is that we were able to join two important aspects: 1) process scalability achieved through relational database implementation, and 2) correctness of processes using process algebra. Furthermore, the software allows end users to define genetic testing without requiring any knowledge about business process notation or process algebra. Conclusions This paper presents the CEGH information system that is a Laboratory Information Management System (LIMS) based on a formal framework to support genetic testing management for Mendelian disorder studies. We have proved the feasibility and showed usability benefits of a rigorous approach that is able to specify, validate, and perform genetic testing using easy end user interfaces.

Conceitos de regulação em saúde no Brasil

São revisados os conceitos de regulação em saúde empregados em publicações científicas nacionais sobre gestão em saúde. Elaborou-se uma tipologia para os conceitos de regulação a partir das ideias mais correntes em cinco disciplinas: ciências da vida, direito, economia, sociologia e ciência política. Quatro ideias destacaram-se: controle, equilíbrio, adaptação e direção, com maior ênfase para a natureza técnica da regulação. A natureza política da regulação ficou em segundo plano. Considera-se que a discussão do conceito de regulação em saúde relacionou-se com a compreensão do papel que o Estado exerce nesse setor. A definição das formas de intervenção do Estado é o ponto fundamental de convergência entre as distintas formas de se conceituar regulação em saúde.

O enfermeiro e a avaliação na gestão de Sistemas de Saúde

Este artigo teve como objetivo refletir criticamente acerca da avaliação, enquanto ferramenta gerencial que favorece a inserção do enfermeiro no processo de gestão de sistemas de saúde. Em decorrência de sua formação, que engloba conhecimentos da área assistencial e gerencial, tendo como centralidade o cuidado, o enfermeiro tem potencial para assumir postura diferenciada na gestão e condições de tomar posições decisórias e de proposição de políticas de saúde. Entretanto, ainda há que se construir e consolidar inserção expressiva em níveis decisórios nos espaços de gestão. A avaliação é um componente da gestão, cujos resultados podem contribuir para tomada de decisão mais objetiva que possibilite a melhoria das intervenções de saúde e a reorganização das práticas de saúde, dentro de um contexto político, econômico, social e profissional; é também uma área de aplicação de conhecimentos que tem potência para mudar o panorama atual da inserção do enfermeiro na gestão.