Quality of life and Chronic Obstructive Pulmonary Disease

The Chronic Obstructive Pulmonary Disease (COPD) has a progressive and irreversible character and it’s associated to the triad of dyspnea, exercise limitation and the evident deterioration of quality of life. In the United States the prevalence of COPD in adult population is approximately of 6% in men, and 1 to 3% in women and it’s the fourth cause of mortality by no transmissible chronic diseases. In 1993, the National Health Interview Surgery considered that 12 millions of Americans suffer from chronic bronchitis and 2 million had emphysema. These two affections are responsible for more than 13% of the hospitalizations. As this affection progresses, patients experience a diminution in quality of life related to health (CVRS), their capacity to work get worse and their participation in physical and social activities reduces. Nevertheless, it has been confirmed that the isolated evaluation of COPD seriousness, defined by the reduction of the Forced Expiratory Volume in the First Second (FEV1), does not provide enough information to know the health state perceived by the patients. The fact that the CVRS is the result of the interaction of multiple physical, psychological and social factors, unique for each individual, can explain this finding. This paper is a general and updated approach to the integral handling of patients with COPD, and it discusses the concept of quality of life, related to health improvement.

Could the presumption of innocence protect the guilty?

At criminal trial, we demand that those accused of criminal wrongdoing be presumed innocent until proven guilty beyond any reasonable doubt. What are the moral and/or political grounds of this demand? One popular and natural answer to this question focuses on the moral badness or wrongness of convicting and punishing innocent persons, which I call the direct moral grounding. In this essay, I suggest that this direct moral grounding, if accepted, may well have important ramifications for other areas of the criminal justice process, and in particular those parts in which we (through our legislatures and judges) decide how much punishment to distribute to guilty persons. If, as the direct moral grounding suggests, we should prefer under-punishment to over-punishment under conditions of uncertainty, due to the moral seriousness of errors which inappropriately punish persons, then we should also prefer erring on the side of under-punishment when considering how much to punish those who may justly be punished. Some objections to this line of thinking are considered.

Picture this: how illustrations define dictionaries

Illustrations are an integral part of many dictionaries, but the selection, placing, and sizing of illustrations is often highly conservative, and can appear to reflect the editorial concerns and technological constraints of previous eras. We might start with the question ‘why not illustrate?’, especially when we consider the ability of an illustration to simplify the definition of technical terms. How do illustrations affect the reader’s view of a dictionary as objective, and how illustrations reinforce the pedagogic aims of the dictionary? By their graphic nature, illustrations stand out from the field of text against which they stand, and they can immediately indicate to the reader the level of seriousness or popularity of the book’s approach, or the age-range that it is intended for. And illustrations are expensive to create and can add to printing costs, so it is not surprising that there is much direct and indirect copying from dictionary to dictionary, and simple re-use. This article surveys developments in illustrating dictionaries, considering the difference between distributing individual illustrations through the text of the dictionary and grouping illustrations into larger synoptic illustrations; the graphic style of illustrations; and the role of illustrations in ‘feature-led’ dictionary marketing.

Levantamento de problemas em fundações correntes no estado do Rio Grande do Sul

Os resultados de um levantamento de 548 casos patológicos em fundações ocorridos no Estado do Rio Grande do Sul são apresentados com o objetivo de identificar as causas mais freqüentes de problemas, o tipo de fundação mais afetado e a gravidade dos danos. O mecanismo de formação de fissuras e a manifestação típica de fissuramentos causados por movimentação das fundações são descritos. Com o objetivo de auxiliar na prevenção de problemas, as causas patológicas mais freqüentes encontradas na literatura e no levantamento são descritas e separadas de acordo com a etapa da obra e da vida da edificação em que podem ocorrer. É feita uma revisão do comportamento dos solos voltada às fundações, tendo em vista a necessidade do seu conhecimento para o entendimento mais completo dos problemas. Procura-se neste trabalho esclarecer e alertar o meio técnico sobre as principais causas de problemas em fundações, devido ao grande número de edificações afetadas, mas principalmente devido à gravidade dos danos gerados.

Inclusão social e atividades culturais: o Centro Cultural Banco do Brasil no Rio de Janeiro

The aim of this study is to look into the benefits provided to social inclusion by cultural activities carried out in a cultural place with great seriousness at Rio de Janeiro. To accomplish that, the author attempt to deepen into the social exclusion/inclusion in brazilian urban context, spotlighting the historic reality of the urban process of the city. Afterwards, by means of a quality research, document files from the cultural spot were consulted and looked into the view of customers, trustees and managers. For customers were applied questionnaires with open and close questions, with trustees and managers were made interviews, and also a documentary research with opinions available in mass media. This study fits into public politics, cultural and institutional marketing, for presenting examples of how cultural activities are essential tools for completely social inclusion of people in community, demonstrating that often marketing enterprises in culture area can result in benefits for society, even no being these their main purposes.

Análise da segurança no trabalho no setor de mármore e granito do Espírito Santo: proposição de ação para reunião do índice de acidentes no trabalho

O setor de mármore e granito do Espírito Santo constitui-se no maior pala industrial brasileiro do setor, sendo líder na comercialização dos produtos dele derivados, tanto no mercado interno como externo. Apesar do crescimento significativo observado nas exportações nos últimos anos, em peso e valor, bem como de estar comercializando a cada ano, produtos com maior valor agregado, convive com problemas de naturezas diversas, os quais se solucionados, proporcionarão maior participação nos mercados em que atua. Em termos sociais o reflexo será imediato, pois com os investimentos decorrentes, haverá geração de quantidade considerável de novos postos de trabalho, visto que trata-se de atividade altamente geradora de empregos. Por outro lado, os benefícios decorrentes do aumento de produção, proporcionarão a geração de renda e divisas para o país. Entre os problemas a serem solucionados encontra-se o alto índice de acidentes ocorridos no setor, conforme mostram as estatísticas apresentadas na presente dissertação. O estabelecimento de ações que visem a redução desses índices constitui o objetivo deste trabalho, tendo como meta principal, proporcionar a preservação da saú- de e segurança do trabalhador, e a implementação das mesmas, trarão como conseqüência natural, ganhos de produtividade e redução de custos, na medida que os acidentes implicam no surgimento de custos adicionais. A globalização da economia e a política econômica vigente no país, impuseram aos setores econô- micos uma competição cada vez mais acirrada, obrigando-os a buscarem alternativas que os viabilizem. A redução de custos por meio da prevenção de acidentes Vll no trabalho se constitui numa das alternativas. Esta dissertação, apresenta a partir de diagnóstico realizado nas diversas atividades do setor, ou seja, extração, serragem e beneficiamento, as tendências das ocorrências dos acidentes, caso não haja no futuro, nenhum tipo de intervenção. É estabelecida uma comparação com os demais setores da economia capixaba, através das respectivas curvas de tendências, na qual fica caracterizada a gravidade da situação e a importância da redução dos acidentes no setor de mármore e granito do Espírito Santo. Em fun- ção da dimensão com que o problema se apresenta, surge a necessidade de intervenções, as quais são classificadas como imediatas e de médio prazo. A observância à legislação vigente, representada pelas Normas Regulamentadoras, proporcionará maior segurança aos trabalhadores, possibilitando a esses, exercer suas atividades em ambiente onde os riscos referentes a lesões, com ou sem afastamentos, e morte, sejam minimizados, na medida que eles são inerentes ao setor e sempre existirão. Como metodologia é utilizado pesquisa de campo, através de entrevistas com empresários, trabalhadores, sindicatos patronal e dos trabalhadores, representantes da DRT e INSS, com as quais é possível o levantamento estatístico, consultas a revistas especializadas, jornais, Internet, disserta- ções e Normas Regulamentadoras. É ainda utilizado referencial teórico de diversos autores, na busca de dar sustentação conceitual ao tema abordado. Como resultado, é apresentado proposta que se constitui em uma série de ações a serem implementadas, para o atingimento do objetivo procurado.

As contas públicas do Estado do Rio de Janeiro face à legislação de responsabilidade fiscal e previdenciária: 2000 a 2007

Com o advento do Plano Real, que procedeu à estabilização da moeda em meados da década de noventa, ficou patente a gravidade da situação fiscal das unidades subnacionais. De um lado figuravam as dificuldades na condução da gestão financeira por meio da ausência do processo inflacionário que anteriormente possibilitava a indexação das receitas tributárias enquanto as despesas correntes tinham a sua liquidação e pagamento postergados. Por outro lado, a dívida consolidada, majoritariamente mobiliária, disparava em função da política monetária restritiva. Esta situação financeira precária tornou urgente a realização do ajuste fiscal dos estados que teve como condutor a União que instituiu medidas primordiais para atingir este fim, destacando-se três leis federais: a Lei de Renegociação das Dívidas Estaduais, a Lei de Responsabilidade Previdenciária e a Lei de Responsabilidade Fiscal. O trabalho em tela estuda a condução das contas públicas do Estado do Rio de Janeiro no período de 2000 a 2007, objetivando verificar a existência de esforços de ajuste fiscal e em que medida estes esforços trouxeram resultados satisfatórios, demonstrando a eficácia do arcabouço legal instituído pela União. Conclui-se neste trabalho que, no período de 2000 a 2006, não ocorreu avanço significativo em direção da melhoria das contas públicas estaduais e que os superávits primários alcançados no período foram impulsionados pelo aumento de receitas de caráter instável, extraordinário e finito. Destacou-se quanto aos riscos inerentes à excessiva e crescente dependência que as finanças estaduais apresentam, relativamente às receitas supracitadas, tendo em vista que estas têm sido utilizadas para pagamento de despesas públicas correntes de caráter continuado. O presente trabalho conclui também que, a partir do ano de 2007, foi dado o pontapé inicial para o alcance do ajuste fiscal, tendo em vista a mudança de patamar do superávit primário, com ênfase na redução das despesas primárias e não no aumento das receitas extraordinárias.

Análise das condições ergonômicas da situação de trabalho dos auxiliares de enfermagem em uma unidade de interação hospitalar

O objetivo do presente estudo foi investigar as condições ergonômicas da situação de trabalho dos Auxiliares de Enfermagem em uma unidade de clínica geral de um hospital privado na cidade de Curitiba, Paraná, bem como sugerir melhorias a partir da situação caracterizada. Com a aplicação do método da Análise Ergonômica do Trabalho (AET), pôde-se verificar a realidade desses profissionais, caracterizando suas tarefas, registrando a existência de distanciamento entre tarefa prescrita e real. Os resultados obtidos evidenciaram problemas no âmbito organizacional como a montagem inadequada da escala de divisão de pacientes, o quadro de pessoal abaixo da exigência mínima estabelecida pelo Conselho Federal de Enfermagem (COFEN), a falta e a má conservação de materiais e equipamentos e, em relação ao posto de trabalho, o dimensionamento inadequado dos espaços para trânsito de pessoas e equipamentos. Concluiu-se que os problemas de maior relevância são de origem organizacional e que os mesmos favorecem e, até mesmo, intensificam os relativos ao posto de trabalho, contribuindo para o elevado índice de atestados e insatisfação entre os Auxiliares de Enfermagem. O estudo é finalizado com sugestões de melhorias, entre elas, o redimensionamento do número de leitos nas enfermarias e quadro de pessoal, promoção de rodízio dos Auxiliares de Enfermagem entre postos de diferentes níveis de exigência, escalonamento apropriado na distribuição de pacientes de acordo com a gravidade do quadro clínico, formação de comitês com reuniões periódicas para discussão de problemas existentes e outras possíveis soluções.

O balanço social como estratégia de fortalecimento das práticas de responsabilidade socioambiental

A sociedade de hoje, não se contenta mais em cobrar das Organizações apenas o triângulo consagrado que trata especificamente da qualidade, custo e prazo. Consciente de seu papel no mundo globalizado, ela exige o envolvimento e o comprometimento dessas Organizações com as questões sociais e ambientais. Neste contexto, faz-se necessário investir na preservação da natureza, na sua relação com a sociedade e no estreito relacionamento com os envolvidos direta e indiretamente nesta difícil empreitada. Em respostas a essas demandas, a ciência contábil, frente às exigências deste mercado globalizado e em lugar do modelo gestão corporativa utilizado até recentemente, que tratava apenas dos resultados econômicos, criou o Balanço Social. Como instrumento estratégico de desenvolvimento corporativo, o Balanço Social permite que a sociedade visualize os resultados de seu comprometimento com o futuro da humanidade. Quem não procura se adaptar às novas exigências da sociedade global, tende ao fracasso. Esta pesquisa tem como agente principal apresentar se as empresas no Brasil aplicam o conceito de Responsabilidade Social em suas atividades, propondo a cidadania de forma séria e responsável. Foram observados os dados divulgados pela Petrobras, - Petróleo Brasileiro SA, Vale e Gerdau S.A,, descrevendo informações entre seus demonstrativos e relatórios com a aplicação a partir dos propostos pelo Instituto ETHOS. Foi investigado o quanto estas empresas atendem aos quesitos propostos e, com base nos resultados obtidos, indicar, o nível de seriedade que estas companhias praticam a questão. A preferência pelas empresas supracitadas como objeto de pesquisa se dá pela posição de destaque no cenário econômico nacional e mundial; por sua atuação em setores considerados de alto nível de degradação e consumo de recursos naturais; e pelo alto impacto social gerado pela organização no local onde está introduzida. Os resultados mostram que as empresas começam a visualizar as questões socioambientais, verifica-se esta informação devido aos montantes absolutos investidos, todavia esta preocupação não atingiu a idéia principal deste conceito de responsabilidade social, ao atender interesses estratégicos superficiais de promoção e auto-imagem.

Social media crises in the organization: exploring management strategies through cases from France and Brazil

The aim of this Master’s thesis has been to shed light on the response strategies that organizations are implementing when facing a crisis created on or amplified by social media. Since the development of social media in the late 1990s, the interplay between the online and the offline spheres has become more complex, and characterized by dynamics of a new magnitude, as exemplified by the wave of “Twitter” Revolutions or the Wikileaks scandal in the mid 2000s, where online behaviors deeply affected an offline reality. The corporate world does not escape to this worldwide phenomenon, and there are more and more examples of organizational reputations destroyed by social media “fireballs”. As such, this research aims to investigate, through the analysis of six recent cases of corporate crises (2013-2015) from France and Brazil, different strategies currently in use in order to identify examples of good and bad practices for companies to adopt or avoid when facing a social media crisis. The first part of this research is dedicated to a review of the literature on crisis management and social media. From that review, we were able to design a matrix model, the Social Media Crisis Management Matrix, with which we analyzed the response strategies of the six companies we selected. This model allows the conceptualization of social media crises in a multidimensional matrix built to allow the choice, according to four parameters, of the most efficient (that is: which will limit the reputational damage) response strategy. Attribution of responsibility for the crisis to the company by stakeholders, the origin of the crisis (internal or external), the degree of reputational threat, and the emotions conveyed online by stakeholders help companies determining whether to adopt a defensive response, or an accommodative response. The results of the analysis suggest that social media crises are rather manichean objects for they are, unlike their traditional offline counterparts, characterized by emotional involvement and irrationality, and cannot be dealt with traditionally. Thus analyzing the emotions of stakeholders proved to be, in these cases, an accurate thermometer of the seriousness of the crisis, and as such, a better rudder to follow when selecting a response strategy. Consequently, in the cases, companies minimized their reputational damage when responding to their stakeholders in an accommodative way, regardless of the “objective” situation, which might be a change of paradigm in crisis management.

Hemiparesia congênita e adquirida na criança: interrelação entre presença de crises epilépticas, os achados eletrencefalográficos e de neuroimagem por ressonância nuclear magnética

The purpose of this paper was to study patients with congenital and acquired hemiparesis, their clinical aspects, the presence or not of epileptic seizures, and electroencephalographic (EEG) and Magnetic Resonance Imaging (MRI) findings. We analyzed the interrelation between etiology, the presence and seriousness of epileptic seizures (ES) and the possible causes of refractoriness. This is a prospective study using the clinical diagnosis of a child neurologist, who attested to the presence of unilateral motor lesions. We compared the electroencephalographic findings in patients with or without epileptic seizures, and investigated if among the former, these seizures were controlled or not, their likely etiology and risks of refractoriness. EEG background activity on the lesion and contralateral side was analyzed, in addition to the presence of concomitant epileptiform activity. Encephalon MRIs of all the patients were studied to correlate etiology and the control or not of epileptic seizures. The disorganization of bilateral EEG activity correlated with the difficult-to-control epileptic seizures. Suitably organized background activity contralateral to the lesion is a good prognosis in relation to epileptic seizures. Focal epileptogenic activity does not necessarily predispose to epileptic manifestation. The MRI is more important in determining etiology than in prognosing epileptic seizures. This study used a multidisciplinary approach involving child neurologists, a physical therapist and a neuroradiologist. This meets the criteria of multidisciplinarity of the Postgraduate Program in Health Sciences

Avaliação do desempenho funcional de crianças com paralisia cerebral de acordo com níveis de comprometimento motor

Contextualization: Several studies have examined the mobility of this group of children, however little is known about the impact of motor function in activities of daily living, considering the seriousness of their neuromotor damage. Objective: Identify the functional differences of children with Cerebral Palsy with different levels of motor dysfunction and correlate these differences with the areas of mobility, self-care and social function in functional ability and caregiver´s assistance of these children. Methods: An l analytical cross-section search was developed, which were part 70 children / families aged from 4 to 7.5 years, in the Rehabilitation Center for Children. As tools were used the Pediatric Evaluation Disability Inventory (PEDI) and the Gross Motor Function Classification System (GMFCS). Data analysis was performed by ANOVA and Pearson's correlation tests. Results: The results show the functional variability of children CP in different severity levels of motor disfunction This variation was observed in the areas of mobility, self-care and social function. The results also showed a strong correlation between the domains mobility and self-care, mobility and social function. Conclusions: The variability shown by the children with CP, suggests the use of PEDI and GMFCS as this association appears to increase the understanding of how the gross motor functions are related to activities of daily living, describing the best commitments and their degree of impact on functional activities. This correlation demonstrates how mobility is crucial to evaluate the performance and guide the therapeutic practice, to develop the children´s potencial, and guide the caregiver in stimulation

Os programas de governo no horário gratuito de propaganda eleitoral:um estudo das eleições governamentais no Rio Grande do Norte em 2006

In Brazil, the Free Political advertising time (HGPE) represents one of the main venues for the contest between political parties, revealing a tool that streamlines the electoral dispute and enables all sectors and social classes of important information about dispute over candidates. In HGPE, political groups have the opportunity to present their programs of government and discuss issues that relate to the demands of the population. This research sought to examine the role played by so-called "government programs" in the electoral race for governor of Rio Grande do Norte in 2006, which had as main candidates, two traditional characters of the political landscape in Natal: Wilma de Faria (PSB) and Garibaldi Alves Filho (PMDB). According to our analysis, discussion of government programs such candidates in HGPE had not meant to enlighten the voters about the political projects designed, not just the desire to build an image of seriousness and competence of candidates, but appeared as a means to meet the schedule imposed by the opponent and as a strategic resource to select a specific segment of the electorate.

O Probásica e a formação de professores no Pólo de Parnamirim: política de formação profissional no Rio Grande do Norte?

This work studies the thematic of the politics of formation of teachers in the Program of Professional Qualification for Basic Education (PROBÁSICA) developed in the City of Parnamirim, Rio Grande do Norte. It has as its main objective to identify and to analyze the contribution of this politics of initial formation for the professional formation of teachers. To install the work, we will use the procedures of bibliographical research, documentary analysis, comment, structuralized interview, questionnaire-script and virtual research. In the analysis of the data, we trace a general view on PROBÁSICA while initial formation along with the continued formation, pedagogical research, collaborative research and the exercise of the teaching profession, identifying the possibilities and limits of the Program in the direction to reach the objective considered in this work. From the inquiry, we construct the institutional land scope of the program in question, also focusing, the organizational aspects of its functioning. We have to take care about the results, we evidence that PROBÁSICA is making the possible to access of the teachers in the educational service to the University, what the main aspect that consists, trying to prove eminent weak points in its systematic due to give to the organizational structure of this educational politics that does not count with curricular, institutional and financial the necessary conditions for the success of the professional formation of the teachers. The research will try to understand that the operationalization of the politics of formation in Parnamirim will be belong with it the main idea of the Educational Reformation in years of 1990, articulated to the neoliberal interests, that the responsibility for the problems of the public system of education attributed to the teachers, and that are not answered completely through the purpose of the professional formation, and ti seems that it does not define one global national politics that deals with seriousness to the questions the initial formation, permanent formation, pedagogical research, , career and conditions of work for the teachers

Educação - Corporeidade - Lazer: saber da experiência cultural em prelúdio

In the passage of life, the labyrinth of songs and corners are propitious ways for a better comprehension, perception and incorporation of learnings that emerge from our subjectiveness in a magic caught by senses. Eyesight, taste, hearing, touch and smell in communication with the world, put us in front of cultural diversities. The ludicity accumulated by experiences promote the flow of hilarious and concrete discoveries that express themselves in work and leisure demonstrations. Such reflections emerge indicators to the problematic construction centralized in the incorporation of cultural experience knowledge to the formation process and professional interventions in this rule and area. From this significant problematic, aiming to deepen studies, we favored leisure as field of investigative production in full expansion. This, for sure, was an exercise of qualification that guided us through meander of education and made us dip into studies about the corporeity. A research in which the scenery was painted and constructed with the complicity of the culture lived with shine, colors, rhythm and drummings of one of the most present cultural cycles: carnival. Recognized as a stimulant for beauty, participation, socialization, and helped us to enter in the essence of gestures and expressions of corporeity, to think, elaborate and socialize a critic-scientific knowledge which, appropriating from the rhythm of colors, of sounds, of tonalities, of senses and of meanings impregnated in the web of life. All these things seduced the researcher, making imagination flow amid ludic-creative dialogues with the imaginary of researchers creation and production in the rule and area of leisure, education and corporeity. Option that made us outline as objective to investigate and interpret how leisure teachers-researchers, from their studies, researches and interventions, locate and incorporate the knowledge from cultural experience to the formation process and intervention of professionals in this rule and in this area, emphasizing the contributions from this knowledge to fence and qualify this praxis. So, as living each cultural scenery, each epistemological contribution was feeding the production with images of the different versions of the Brazilian breedings, creating and raising expectations and new discoveries and newcomers. With the seriousness of a scientific study, we lived an xxiii academic experience with complex intensity, rigor and coherence, eliminating, step by step, the risks and limitations always present in a work of this magnitude. However, we weren t, even for one moment, alone. Our epistemic regard always maintained mediated by the principles of a methodological approach - the Etnomethodology, that while central guide provided us clues to unveil the lived world by our people-playful , in a universe of 15 members, that allowed themselves to comprehend, comment, analyze. This way, grasping the object in interactions arised and provoked by narrative interview, it was systematically dialected by (re) interpretation of images and formulations of people-playful, enriched by their beliefs, myths, conceptions and rituals inherent to knowledge from cultural experience, which each one attuned with Brazilian and international history, in a mixture of senses echoed from songs and tales. Inspired in drummings and percussions, clothing and choreographies of gestures and expressions, in mixtures produced in unit interactions in the multiplicity shown as necessary requests to the totality of life, with ludicity the rescue of the past, the conquest of present and the construction of future was the axle guide. This rich process of scientific creation made us realize that is possible qualify and empower the praxis in the rule and area of leisure incorporating the knowledge from cultural experience. What also becomes possible is the recuperation of objective revolutionaries and changing conditions of praxis itself with the view of strengthening and triggerment of vital elements in the rule and area of leisure. We also reaffirm that from this praxis emerge elements necessary to human formation in plenitude, by the appropriation of knowledge that guide the facing of challenges of a complex and plural world that valorize education, corporeity and leisure