Globalização e estratégias competitivas na indústria automobilística: uma abordagem a partir das principais montadoras instaladas no Brasil

O presente artigo primeiramente trata do processo de globalização da indústria automobilística internacional. da mesma forma, o importante papel desempenhado pela introdução de novas tecnologias nessa indústria é também considerado. As mudanças recentes e principais tendências das estratégias competitivas - em particular no tocante à globalização e aos produtos - implementadas por algumas das principais montadoras da indústria automobilística mundial (GM, Ford, Toyota, VW, Fiat) são também examinadas. Por fim, são considerados os planos internacionais e o mercado interno brasileiro.

Consenso brasileiro para a abordagem clínica e tratamento do hipotireoidismo subclínico em adultos: recomendações do Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia

INTRODUÇÃO: O hipotireoidismo subclínico (HSC), definido por concentrações elevadas do TSH em face de níveis normais dos hormônios tireoidianos, tem elevada prevalência no Brasil, particularmente entre mulheres e idosos. Embora um número crescente de estudos venha associando o HSC com maior risco de doença arterial coronariana e de mortalidade, não há ensaio clínico randomizado sobre o benefício do tratamento com levotiroxina na redução dos riscos e o tratamento permanece controverso. OBJETIVO: Este consenso, patrocinado pelo Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia e desenvolvido por especialistas brasileiros com vasta experiência clínica em tireoide, apresenta recomendações baseadas em evidências para uma abordagem clínica do paciente com HSC no Brasil. MATERIAIS E MÉTODOS: Após estruturação das questões clínicas, a busca das evidências disponíveis na literatura foi realizada inicialmente na base de dados do MedLine-PubMed e posteriormente nas bases Embase e SciELO - Lilacs. A força da evidência, avaliada pelo sistema de classificação de Oxford, foi estabelecida a partir do desenho de estudo utilizado, considerando-se a melhor evidência disponível para cada questão e a experiência brasileira. RESULTADOS: Os temas abordados foram definição e diagnóstico, história natural, significado clínico, tratamento e gestação, que resultaram em 29 recomendações para a abordagem clínica do paciente adulto com HSC. CONCLUSÃO: O tratamento com levotiroxina foi recomendado para todos os pacientes com HSC persistente com níveis séricos do TSH > 10 mU/L e para alguns subgrupos especiais de pacientes.

O grupo psicoterapêutico e a interpretação na abordagem lacaniana: reflexão e redefinição de possibilidades e modos de atendimento na Saúde Coletiva

Cet article propose, à travers une expérience pratique, présenter et discuter le groupe psychothérapeutique dans le référentiel psychanalytique théorique et éthique de Jacques Lacan en mettant l'accent sur la question de l'interprétation. Nous proposons une réflexion et la redéfinition des possibilités et des modes d'accueil dans le contexte de la Santé Collective. Le groupe psychothérapeutique proposé ici, qui applique la psychanalyse, correspond à une possibilité parmi les dispositifs de production de sens pour les impasses de subjectivation de la clinique contemporaine, surtout dans la Santé Publique. La pratique présentée et analysée dans cet article est une petite contribution à une proposition de psychothérapie de groupe fondée sur la théorie de Jacques Lacan, dont le but est de repenser et redéfinir les formes d'accueil de groupe en Santé Collective.

Abordagem quantitativa na avaliacao do deposito de carvao de cerquilho - SP

This paper deals with an integrated study concerning the evaluation of the coal deposit at Cerquilho (Sao Paulo State) in the upper part of the Tubarao Group. Palaeogeographical studies from other authors describe the genesis of these deposits as a deltaic system overlapped by a marine transgressive sequence. The study applied four methods for ore reserve estimation (isolines, blocks, polygones and triangles), besides statistical and geostatistical methodology. The technological characterization assays suggest the application for the coal in cement and ceramics industries. The applied methodology showed reserves estimated around 1 400 000 ton. The isolines method tend to underestimate the amount of coal, on the other hand, the kriging method shows a tendency to overestimate the results. The data from the polygonal method are closest to mean values. For the thickness estimation the results close to the mean values are those from the isolines. -after English summary

A abordagem fractal em Geociencias

This is a synthesis of the use of fractal approaches in geosciences. It presents references and a list of publications, taking into account sectors of many fields, including geophysics, petrology, mineralogy, sedimentology, tectonics, meteorology, climatology, geomorphology, hydrogeology, oceanography, geomechanics, geochemistry and soil studies. -English summary

Abordagem diagnóstica dos pacientes com suspeita de trombose venosa profunda dos membros inferiores

Deep venous thrombosis is a relatively common disease, which can present pulmonary embolism as a complication in its acute phase, and later the post-thrombotic syndrome. Thus, diagnosis should be made as soon as possible, in order to prevent or minimize such complications. Several studies have shown that the symptoms and the clinical signs are inaccurate for the deep venous thrombosis diagnosis and that complementary exams are necessary. As an attempt to simplify the patients' assessment, Well et al., in 1997, developed a clinical prediction index that combines symptoms, signs and risk factors for deep venous thrombosis and managed to make a simpler approach through an association of this index with the complementary exams. Phlebography has been considered the gold standard of complementary exams. However, since it is an invasive exam and thus subject to complications, other diagnostic methods were introduced aiming at making the diagnostic approach simpler and less invasive. Doppler ultrasound, duplex scan, impedance plethysmography, computed tomography, and blood tests such as the D-dimer are some of the available methods for assessing the patient with suspicion of deep venous thrombosis. Among them, duplex scan has shown excellent accuracy and it is currently widely accepted as the first choice test for approaching the patient with deep venous thrombosis. Several authors have suggested an association of diagnostic methods to simplify and make the assessment of such patients more cost-effective, leading to the introduction of a wide range of diagnostic strategies. The different diagnostic methods used for assessing deep venous thrombosis are discussed, as well as a review of the literature on the accuracy, advantages and disadvantages of these methods. Copyright © 2005 by Sociedade Brasileira de Angiologia e Cirurgia Vascular.

Inibidores da HIV-integrase: Potencial abordagem farmacológica para tratamento da AIDS

AIDS has the HIV as its etiological agent. Researches has been done to find new pharmacological agents to be used in therapy, because of problems of resistance and side effects. The HIV-integrase inhibitors are some of those new agents that are being studied. This updating focusses on the fundamental information about HIV and HIV-integrase and the main methods being used to develop these new drugs, with examples for each case.

Caracterização geométrica de um sistema fluvial, formação Ttaquaquecetuba, Terciário da Bacia de São Paulo

The objective of this study is the geometric characterization of a fluvial system, exemplified by the Itaquaquecetuba Formation. The studied area is a quarry located in Itaquaquecetuba, distant 35 km from the city of São Paulo, which is inserted in the context of São Paulo Basin. Fluvial systems are important hydrocarbon reservoirs, and this study may contribute with an analogue for ancient reservoirs. It was elaborated ten facies logs along a distance of 200 m (log spacing of 20 m), with a vertical column (thickness) of 40 m for each log. Eight facies cycles, and its lateral chrono-correlation allowed to map the potential reservoir and non-reservoir facies within each cycle. Regarding the depositional model for the studied section, it is assumed an alluvial fan system composed of meandering and ribbon-type fluvial channels.

Segmentação de dados de perfilamento a laser em áreas urbanas utilizando uma abordagem Bayesiana

In this paper is presented a region-based methodology for Digital Elevation Model segmentation obtained from laser scanning data. The methodology is based on two sequential techniques, i.e., a recursive splitting technique using the quad tree structure followed by a region merging technique using the Markov Random Field model. The recursive splitting technique starts splitting the Digital Elevation Model into homogeneous regions. However, due to slight height differences in the Digital Elevation Model, region fragmentation can be relatively high. In order to minimize the fragmentation, a region merging technique based on the Markov Random Field model is applied to the previously segmented data. The resulting regions are firstly structured by using the so-called Region Adjacency Graph. Each node of the Region Adjacency Graph represents a region of the Digital Elevation Model segmented and two nodes have connectivity between them if corresponding regions share a common boundary. Next it is assumed that the random variable related to each node, follows the Markov Random Field model. This hypothesis allows the derivation of the posteriori probability distribution function whose solution is obtained by the Maximum a Posteriori estimation. Regions presenting high probability of similarity are merged. Experiments carried out with laser scanning data showed that the methodology allows to separate the objects in the Digital Elevation Model with a low amount of fragmentation.

Abordagem initial do paciente com mielopatia aguda não compressiva

Acute myelopathy are characterized by spinal cord dysfunction, developing sensitive, motor and autonomic signs and symptons. Since they are relatively rare, there are some difficulties to early diagnosis and to the beginning of the treatment. So, literature was reviewed to describe the main aetiologies of acute non compressive myelopathy: 1) demyelinating diseases; 2) systemic disease; 3) parainfectious; 4) delayed radiation myelopathy; 5) vascular myelopathy; 6) idiopatic and 7) vitamin B12 deficiency. Besides, we suggest an algorithm to initial approach of these patients and further aethiologic investigation. © Copyright Morelra Jr. Editora.

A identidade do agente comunitário de saúde: Uma abordagem fenomenológica

The structure of Brazil's National Health System (SUS) is being firmed up through programs adding a new element to its multi-professional healthcare teams: Community Healthcare Agents. This study examines psycho-social factors that are significant for the construction of this identity, from the standpoint of these Community Healthcare Agents, using the hermeneutic phenomenology of Paul Ricoeur as its reference methodology. The subjects of this survey were seven Community Healthcare Agents who were asked during interviews (with informed consent and after approval by the Research Ethics Committee) to: 'Tell me about your experience as Community Healthcare Agent'. The analysis of their replies indicated the following topics: previous experience; capacity-building for the job; bonding; building up expertise; gratifying experience; feelings of power(lessness); communications; daily work routines, personal growth; criticisms of the institution; user-agent experiences; and insertion into the social reality. The overall analysis disclosed the phenomenon through the convergence and divergence of the grouping of these topics, viewed from the standpoint of these Community Healthcare Agents and the psycho-social aspects constructing their identity.