Impact of worksite health-promotion programs in hospital admission costs and medical leaves in a sample of brazilian companies

Programas de saúde e bem-estar têm sido adotados por empresas como forma de melhorar a saúde de empregados, e muitos estudos descrevem retornos econômicos positivos sobre os investimentos envolvidos. Entretanto, estudos mais recentes com metodologia melhor têm demonstrado retornos menores. O objetivo deste estudo foi investigar se características de programas de saúde e bem-estar agem como preditores de custos de internação hospitalar (em Reais correntes) e da proporção de funcionários que têm licença médica, entre Abril de 2014 e Maio de 2015, em uma amostra não-aleatória de empresas no Brasil, através de parceria com uma empresa gestora de ‘big data’ para saúde. Um questionário sobre características de programas de saúde no ambiente de trabalho foi respondida por seis grandes empresas brasileiras. Dados retirados destes seis questionários (presença e idade de programa de saúde, suas características – inclusão de atividades de screening, educação sobre saúde, ligação com outros programas da empresa, integração do programa à estrutura da empresa, e ambientes de trabalho voltado para a saúde – e a adoção de incentivos financeiros para aderência de funcionários ao programa), bem como dados individuais de idade, gênero e categoria de plano de saúde de cada empregado , foram usados para construir um banco de dados com mais de 76.000 indivíduos. Através de um modelo de regressão múltipla e seleção ‘stepwise’ de variáveis, a idade do empregado foi positivamente associada e a idade do programa de saúde e a categoria ‘premium’ de plano de saúde do funcionário foram negativamente associadas aos custos de internação hospitalar (como esperado). Inesperadamente, a inclusão de programas de screening e iniciativas de educação de saúde nos programas de saúde e bem-estar nas empresas foram identificados como preditores positivos significativos para custos de admissão hospitalar. Para evitar a inclusão errônea de licenças-maternidade, apenas os dados de licença médica de pacientes do sexo masculino foram analisados (dados disponíveis apenas para duas entre as companhias incluídas, com um total de 18.957 pacientes do sexo masculino). Analisando estes dados através de um teste Z para comparação de proporções, a empresa com programa de saúde que inclui atividades voltadas a cessação de hábitos ruins (como tabagismo e etilismo), controle de diabetes e hipertensão, e que adota incentivos financeiros para a aderência de funcionários ao programa tem menor proporção de empregados com licençca médica no período analisado, quando comparada com a outra empresa que não tem estas características (também conforme esperado). Entretanto, a companhia com menor proporção de funcionários com licença médica também foi aquela que adota programa de screening entre as atividades de seu programa de saúde. Potenciais fontes de ameaça à validade interna e externa destes resultados são discutidas, bem como possíveis explicações para a associação entre programas de screening e educação médica a piores indicadores de saúde nesta amostra de companhias são discutidas. Novos estudos com melhor desenho, com amostras maiores e randômicas são necessários para validar estes resultados e possivelmente melhorar a validade interna e externa destes resultados.

O tratamento ortodôntico em uma perspectiva a longo prazo: avaliação da estabilidade oclusal e do grau de satisfação dos pacientes

This study aimed to evaluate factors associated to orthodontic treatment stability and patient satisfaction in the long-term. A total of 209 patients (88 class I and 121 class II) treated with straight wire fixed appliance were selected at least 5 years post treatment. Six hundred twenty seven dental casts were examined with the PAR Index at pretreatment (T1), end of treatment (T2), and at long-term follow up (T3, mean 8.5 years post treatment). At T3, a Dental Impact on Daily Living questionnaire was used to assess patient satisfaction with the dentition in the long-term. Friedman test and multiple regression analysis were used to evaluate changes among the time points and factors associated with stability and patient satisfaction. Predictive factors used to exam the occlusion were: PAR Index at T1 and T2, age at T1, the amount of time without retainer, length of Hawley retainer wear, length of follow-up, sex, extraction and third molar status. To assess patient satisfaction were considered: changes produced by the orthodontic treatment (PAR T2-T1), post treatment stability (PAR T3), age at the start of treatment (T1), length of treatment (T2-T1), gender, and extraction. Orthodontic treatment produced a significant improvement of 94.2% in the PAR Index (T2-T1), but this change was not associated with the level of satisfaction when the patient was questioned at T3. No significant change was observed between T2 and T3. However, when the sample was divided according to the level of finalization (PAR T2), it was observed that well-finished patients experienced some deterioration (P<.001), whereas the less well-finished ones showed some improvement (P<.05). Even with the deterioration, the well-finished patients still had a better PAR Index at T3 compared to the less well-finished ones (PAR T2- T3). Regression analysis showed that PAR Index at T1 and T2, age at T1, and length of retainer wear had a slight association with occlusal stability (R2 = 0.27). Patient satisfaction was significantly associated only with PAR Index at T3 (r2=0.125, P<.0001). We can conclude that, even thought orthodontic treatment is quite stable, not so well-finished treatments tend to show some improvement and well-finished ones deteriorate some in the long-term. Despite of that, well-finished patients still have better occlusal characteristics. Patient satisfaction is not related to the result of orthodontic treatment; nevertheless, there is a slight association with dentition in the long-term

Avaliação citológica em base líquida de fármacos moduladores estrogênicos

Hormone therapy is an important tool in the treatment of breast cancer and tamoxifen represents one of the most important drugs used in this type of treatment. Recently other drugs based on the inhibition of aromatase had been developed, this enzyme is responsible for the synthesis of estrogenic esteroids from the androgenic ones. The objective of this study would be the development of a quantitative cytological model of murine estral analysis that allowed the characterization of different hormone drugs effect over vaginal epithelium. The technique of monochromatic staining with Evans blue (C.I. 23860) showed to be efficient in the qualitative and quantitative classification of the cycle. It had been observed differences in the cytological standard of animals submitted to the studied drugs; tamoxifen presented a widening of phases of lesser maturation (diestrais), while anastrozole and exemestane increased the duration of the phases of larger maturation (estrais). The data were analysed through a cubical non linear regression (spline) which allowed a better characterization of the drugs, suggesting a proper cytological profile to the antagonism of the estrogen receptor (tamoxifen), aromatase competition (anastrozole) and inhibition of the enzyme (exemestane)

Emprego formal na região nordeste brasileira: seus efeitos na inclusão social

This work aims to study the problem of the formal job in the Brazilian Northeast region and its effect in the social inclusion, taking for base the analysis of variables defined in the Atlas of Social Exclusion, which is based on the 2000 Brazilian Census, choosing the county as unit of analysis. As methodological options, an exploratory data analysis was performed, followed by multivariate statistical techniques, such as weighted multiple regression analysis, cluster analysis and exploratory analysis of spatial data. The results pointed out to low rates of formal job for the active age population as well as low indexes of social inclusion in the Northeast region of Brazil. A strong association of the formal job with the indicators of social inclusion under investigation, was evidenced (schooling, inequality, poverty, youth and income form government transfers), as well as a strong association of the formal job with the new index of social inclusion (IIS), modified from the IES. At the Federative Units, in which better levels of formal job had been found, good indexes of social inclusion are also observed. Highlights for the state of the Rio Grande do Norte, with the best conditions of life, and for the states of the Maranhão and Piauí, with the worst conditions. The situation of the Northeast region, facing the indicators under study, is very precarious, claiming for the necessity of emphasizing programs and governmental actions, specially directed to the raise of formal job levels of the region, reflecting, thus, in improvements on the income inequality, as well as in the social inclusion of the population of Northeastern natives.

Guilherme de La Penha: uma história do seu itinerário intelectual em três dimensões

This study focuses on the central Brazilian historiography of science, focusing specifically on the life and work of a contemporaneous mathematician-physicist, and becomes part of the set of research results that investigate, organize and describe personal, intellectual and professional itineraries of Brazilian scientists and educators. The theme chosen for the study ran from seminars on Mathematics in Pará and is up to organize and describe the life history, education, professional experience and scientific production of William Mauricio Souza Marcos de La Penha (Guilherme de La Penha), considering their academic, professional and intellectual life history, so that their academic and intellectual production be spread over the Brazilian scientific and academic community. We adopted the historical research as theoretical and methodological base for the development of this study, rising arguments about the profile of Guilherme de La Penha to characterize him as a multiskill intellectual and to reveal that his thoughts about science, technology, training scientists and educators were in accordance with their writings and their professional practice in order to build a first story about the life and work of William de La Penha. In this sense, we took the theoretical aspects related to historical research, biographies, intellectual itineraries, files and inventories as sources and historical construction vehicles in order to point out the essential elements to form a profile of the transdisciplinary intellectual historians, ie a profile scientist who carries out the research, management and administration, as well as a committed educator to the on-going training and forming process. The results pointed in different directions, among which we highlight the creation of Seção Guilherme de La Penha at Universidade da Amazonia, producing several articles about the life and work of William de La Penha presented at national and international conferences and the proposal for documentary displays which could contribute to understanding the implementation of a scientific area in Pará State, an area that would not only be restricted to the production of knowledge, but more than that, it would include the spreading, which provides various means, primarily through education. Thus it was possible to ensure that La Penha has an intellectual profile that can be considered a multi-and transdisciplinary intellectual who defends the possibility of forming a scientist one and multiple, non-linear attitudes and dialogues with all other areas in order to be understood under a model scientist for the twenty-first century based on the model clearly inspired by the scientist authors with which he identified throughout their training and professional activities, like the three that stood out in their relationship science: Archimedes, Leonhard Euler and Cliford Ambrose Truesdell

Avaliação da capacidade para o trabalho do servidor público: um estudo de caso em uma instituição federal de ensino superior

The ability to work, considered as resulting from a dynamic process between the individual resources in relation to their work, influenced from various factors such as sociodemographic, lifestyle, aging process and requirements of work. Aiming analyze the ability to work in a population of public servants, the study analyzed 132 public servants volunteers of the infrastructure sector, in a Federal Institution of Higher Education of the state of Rio Grande do Norte, Northeast, Brazil. Data were collected through a questionnaire called the Index of Capacity for Work - ICT. The variable analysis was done by using descriptive statistics of means, standard deviations, median minimum and maximum values of the scores of quantitative variables. The joint analysis of the variables was performed by multiple linear regression. The server had low capacity to work 11 (8.33%), moderate 31 (23.48%), good 54 (40.91), and Great 28 (21.21). Multiple regression analysis, adjusted for age, sex, education, age started to work, length of service, current capacity and full of disease, showed that best explained the variation of the CTI were age, current capacity and full of disease. The survey showed that 75% of the servers showed ICT below 43, so capacity low, moderate or good and only 25% of respondents had the CTI servers over 43 points, so great capacity for work. According to the recommendations of FIOH - Finnish Institute of Occupational Health, for servers that have these scores be implemented whose objective is to restore the ability to work which is low, improving the capacity for moderate work, support the capacity for the good work and maintain the ability to work great. Therefore, we recommend that the ICT is implemented in other units of the IFES survey in the perspective of achieving a real situation of all its servers, enabling the implementation of these measures as necessary to promote recovery and health of its employees.

Fatores que afetam a satisfação e a fidelidade do consumidor: um estudo com usuários de calçado esportivo (tênis), na Região Sul da cidade de Natal

This paper aims to investigate the factors that influence the satisfaction and fidelity of tennis´s users with the region southern city of Natal, capital of Rio Grande do Norte as the area of analyzing , using the national satisfaction index models as a tool to study. In this study was used the questionnaire as a tool for collecting data based on the new Norwegian customer satisfaction barometer model proposed by Johnson et. al. (2001). The data collection took place during the months of May and June 2008, when 450 tennis´s users were interviewed. The main results obtained by multiple regression analysis and logistic regression showed that the users' satisfaction with the tennis´s brand is influenced by the quality, comfort, material used in the manufacture and price, while fidelity is potentized by the image of the brand and the satisfaction degree with the user's tennis and with the brand of tennis. In relation to user satisfaction with the tennis, that satisfaction is influenced by the quality, comfort, weight and the material used, while fidelity is potentized by the satisfaction with the tennis´s brand, with the possibility of paying the same amount again and the emotional commitment. As the processing of claims there was no direct influence on satisfaction and consumers fidelity due to the low number complaints

Trends of the genetic connectedness measures among Nelore beef cattle herds

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Utilização de modelos de programação não-linear para sistematização de terras para irrigação em áreas regulares

Objetivou-se com este trabalho, desenvolver modelos de programação não-linear para sistematização de terras, aplicáveis para áreas com formato regular e que minimizem a movimentação de terra, utilizando o software GAMS para o cálculo. Esses modelos foram comparados com o Método dos Quadrados Mínimos Generalizado, desenvolvido por Scaloppi & Willardson (1986), sendo o parâmetro de avaliação o volume de terra movimentado. Concluiu-se que, ambos os modelos de programação não-linear desenvolvidos nesta pesquisa mostraram-se adequados para aplicação em áreas regulares e forneceram menores valores de movimentação de terra quando comparados com o método dos quadrados mínimos.

Modelagem linear e identificação do modelo dinâmico de um robô móvel com acionamento diferencial

This work presents a modelling and identification method for a wheeled mobile robot, including the actuator dynamics. Instead of the classic modelling approach, where the robot position coordinates (x,y) are utilized as state variables (resulting in a non linear model), the proposed discrete model is based on the travelled distance increment Delta_l. Thus, the resulting model is linear and time invariant and it can be identified through classical methods such as Recursive Least Mean Squares. This approach has a problem: Delta_l can not be directly measured. In this paper, this problem is solved using an estimate of Delta_l based on a second order polynomial approximation. Experimental data were colected and the proposed method was used to identify the model of a real robot

Controlador preditivo não linear aplicado ao controle de golfadas em processos de produção de petróleo

Slugging is a well-known slugging phenomenon in multiphase flow, which may cause problems such as vibration in pipeline and high liquid level in the separator. It can be classified according to the place of its occurrence. The most severe, known as slugging in the riser, occurs in the vertical pipe which feeds the platform. Also known as severe slugging, it is capable of causing severe pressure fluctuations in the flow of the process, excessive vibration, flooding in separator tanks, limited production, nonscheduled stop of production, among other negative aspects that motivated the production of this work . A feasible solution to deal with this problem would be to design an effective method for the removal or reduction of the system, a controller. According to the literature, a conventional PID controller did not produce good results due to the high degree of nonlinearity of the process, fueling the development of advanced control techniques. Among these, the model predictive controller (MPC), where the control action results from the solution of an optimization problem, it is robust, can incorporate physical and /or security constraints. The objective of this work is to apply a non-conventional non-linear model predictive control technique to severe slugging, where the amount of liquid mass in the riser is controlled by the production valve and, indirectly, the oscillation of flow and pressure is suppressed, while looking for environmental and economic benefits. The proposed strategy is based on the use of the model linear approximations and repeatedly solving of a quadratic optimization problem, providing solutions that improve at each iteration. In the event where the convergence of this algorithm is satisfied, the predicted values of the process variables are the same as to those obtained by the original nonlinear model, ensuring that the constraints are satisfied for them along the prediction horizon. A mathematical model recently published in the literature, capable of representing characteristics of severe slugging in a real oil well, is used both for simulation and for the project of the proposed controller, whose performance is compared to a linear MPC

A influência da adição de caulim, quartzo e feldspato potássico na formulação de massas cerâmicas para telhas: Modelo estatístico

The production of roof tiles in the state of Rio Grande do Norte accounts for around 60% of the total of ceramic pieces produced. There is a need for investment to improve quality and productivity, thereby promoting technological innovations. Accordingly, the aim of this study is to determine the effect of kaolin, potassium feldspar and quartz in two standard formulations, as well as the effect of sintering temperature on the technological properties of linear firing shrinkage, water absorption and bending rupture stress, by fitting the statistical model and using multiple linear regression to assess the relationship between technological properties and independent variables. The raw materials were characterized using the following techniques: X-ray fluorescence (XRF), X-ray diffraction (XRF), rational analysis (RA), differential thermal analysis (DTA) and granulometric analysis (GA). The test specimens were compacted by uniaxial pressure (25 MPa), dried in a stove at 110 ºC for 24 hours and sinterized at 850 ºC, 950 ºC and 1050 ºC and held isothermal for 30 minutes. The results obtained indicate that the addition of kaolin to two standard formulations (M and R) promoted a reduction in water absorption values and an increase in bending rupture stress values. The sintering temperatures for group M that resulted in the lowest linear firing shrinkage and water absorption values were 850 ºC and 950 ºC, respectively, and the highest bending rupture stress values were reached at a temperature of 950 ºC. In the case of group R, the sintering temperature that obtained the lowest water absorption and linear firing shrinkage values was 850 ºC, and the highest bending rupture stress values were attained at a temperature of 1050 ºC. This work explains the statistical approach used to fit the model that describes the relationship between the technological properties and percentage of kaolin, quartz and feldspar, as well as the models that enable predictions, provided that the lower and upper limits of the percentage of clay minerals, flux and quartz used in this study are respected. Statistica 6 software was used and results were obtained by stepwise forward regression

Períodos de interferência de uma comunidade de plantas daninhas na cultura da batata

Objetivou-se neste trabalho avaliar diferentes períodos de controle e de convivência de uma comunidade de plantas daninhas na cultura da batata 'Atlantic'. O experimento foi realizado no município de Botucatu-SP, e o delineamento experimental utilizado foi de blocos ao acaso com quatro repetições. Os tratamentos constituíram-se de seis períodos de controle, nos quais a cultura foi mantida livre da comunidade de plantas daninhas e após cada período, as plantas daninhas foram deixadas crescer livremente; e de seis períodos de convivência, nos quais a cultura foi mantida na presença da comunidade de plantas daninhas e após cada período, as plantas daninhas foram eliminadas até a colheita. Os períodos foram de 7, 14, 21, 28, 35 e 42 dias após o plantio dos tubérculos, além de uma testemunha mantida sempre livre de plantas daninhas e outra mantida sempre na presença dessas plantas. Foram identificadas 9 famílias e 15 espécies de plantas daninhas, com destaque para Bidens pilosa, Galinsoga parviflora,Brachiaria plantaginea,Commelina benghalensis e Digitaria horizontalis. Os resultados de produção de tubérculos ajustaram-se ao modelo de regressão não-linear: y = 8,907+(17,722/[1+(x/16,865)-8,412]), (R² = 0,963*) - equação para os períodos de controle e y = 5,728+(24,789/[1+(x/39,292)2,247 ]), (R² = 0,947*) - equação para os períodos de convivência. Assim, considerando perda de 5% na produtividade como aceitável, foram determinados o período anterior à interferência (PAI), que foi de 20 dias; o período total de prevenção à interferência (PTPI), de 21 dias; e o período crítico de prevenção da interferência (PCPI), de apenas de um dia, dos 20 aos 21 dias após o plantio dos tubérculos.

Atributos polarimétricos de imagem radar na inferência de parâmetros morfológicos de macrófitas

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