A Produção mais Limpa como ferramenta em busca da sustentabilidade empresarial: um estudo de múltiplos casos em empresas do Estado do Rio Grande do Norte

This study aimed to assess the Cleaner Production CP as corporate sustainable tool, through the multiple case studies within companies from Rio Grande do Norte State. In order to achieve this goal a research methodology approach was set. The initial stage of the research methodology was based on a literature review on which it was observed that the CP can be linked with corporate sustainable once it prevents pollution and reduces the operational risks among employees, community and environment. In addition, CP can useful for companies position within competitive position as well as being applied to process, products and services. In order to observe these factors, CP was used within food industry (Company 1), textile industry (Company 2) and in a car dealer (Company 3). Regarding the results, Company 1 changed its raw material as well as implementing housekeeping (control use of water, energy and condensed milk). In Company 2, it was observed the three levels of CP. In other words, housekeeping (e.g. cutting process and manipulation of chemical products), changing technology (high pressure washing machine) and internal and external recycling. In addition, Company 3 considered only level 3 external recycling. As consequence, it was observed that can be applied either within industry as well as service sector. Unfortunately, it was not possible to observe any social gains on a monetary basis. This is due to limitations of the CP methodology and study complexity. Therefore, it was observed improvements regarding to social, environmental and economic areas. Nevertheless, it is necessary more commitment from top level management in order to consider CP like effective sustainable tool

Terceirização em tecnologia da informação sob os aspectos de estratégia, tomada de decisão e análise de investimentos :estudo de múltiplos casos em três organizações franqueadas da Coca-Cola do Brasil

Desde a criação da tecnologia e do seu uso pelas empresas, a relação custo e benefício nem sempre foi bem elucidada tanto para os responsáveis pela área de tecnologia quanto para a alta direção. Mas, apesar disto, cada vez mais as organizações investem maciçamente em tecnologia, esperando que esta seja a solução para diversos problemas. Por isto, esta questão tem se tornado crucial para o processo de tomada de decisões, visto que investimentos nesta área costumam ser dispendiosos e, na atual conjuntura, estas análises precisam ser extremamente criteriosas para que se miniminizem as possibilidades de insucesso dos projetos, principalmente numa economia estabilizada e de concorrência acirrada. Uma das alternativas que as empresas têm buscado para atingir o sucesso e correr menos riscos é a terceirização da área de TI. Partindo desta visão, a presente dissertação tem por objetivo realizar uma investigação sobre a terceirização dos serviços de TI em todos os seus aspectos, isto é, desde a sua motivação, serviços efetivamente terceirizados, vantagens, desvantagens e possíveis obstáculos, a visão do alinhamento estratégico da TI, os processos de gestão de contratos e formas de controle e, por fim, tendências futuras. Trata-se de uma pesquisa de múltiplos casos, envolvendo franquias do Sistema Coca-Cola no Brasil. O estudo apresenta uma pesquisa bibliográfica sobre o processo de tomada de decisão empresarial, a análise de investimentos, a gestão e a terceirização da TI, o que permitem definir as dimensões de análise da pesquisa. Na pesquisa de campo foram entrevistados os gerentes da área de TI, nas cidades de Brasília-DF, Goiânia-GO e Ribeirão Preto-SP. A pesquisa de campo permitiu identificar como as mesmas avaliam seus investimentos em TI, como esta área é gerenciada, o que as levou a optar pela terceirização e como os processos terceirizados afetam a organização. Por se tratar de uma pesquisa qualitativa, optou-se por analisar comparativamente as três organizações. Com a realização deste estudo, obtiveram-se, como principais resultados, que as organizações estão utilizando a terceirização em TI para focar no negócio principal e, mesmo encontrando diversas desvantagens, inclusive com relação a custos, acreditam que os benefícios justificam. Ainda identificaram-se alguns obstáculos internos para a terceirização, principalmente quanto ao receio de se perder a inteligência do negócio. O acompanhamento dessas atividades terceirizadas é realizado pela equipe interna e por critérios estruturados, onde se verificam os níveis de serviço

O discurso autobiográfico nos relatos de viagem de Nísia Floresta

En plein XIXe siècle, Nísia Floresta Brasileira Augusta a écrit sur deux voyages faits en Europe. Quelques années plus tard, cette norte-rio-grandense a livré au public ses récits de voyage : Itinéraire d un voyage en Allemagne (1857) et Trois ans en Italie Suivis d un Voyage en Grèce (1864/1872). Malgré les particularités qui entourent chacun de ces récits, un aspect y est fortement présent : les marques autobiographiques. Notre travail a comme principal objectif enquêter comment se manifeste ce discours autobiographique. A partir de l‟Analyse du Discours, nous avons travaillé quelques positionnements sur certaines oeuvres littéraires, comme par exemple, le fait qu‟elles aient plus d‟un genre. Ce qui se passe dans les récits de voyage de Nísia Floresta est semblable, car au-délà de raconter le passage de Nísia par ces lieux, nous pouvons trouver des caractéristiques qui appartiennent à l‟écriture fragmentaire, autobiographique et épistolaire. Devant les propositions indiquées par Philippe Lejeune, nous avons pu confirmer que ces récits de Nísia font partie de l‟écriture autobiographique. Sous l‟optique de quelques théories, nous avons parcouru des points intéressants qui enveloppent ces récits et, de cette façon, nous avons voyagé avec Nísia Floresta par l‟Allemagne et ultérieurement par l‟Italie et Grèce, en connaissant ainsi, pas seulement un peu plus sur ces lieux, mais beaucoup de confidences sur cette écrivain potiguar, qui a ouvert son coeur au plublic

Efeitos da eletroestimulação percutânea na incontinência urinária e qualidade de vida pós-prostatectomia: registro de seis casos

Introduction: Radical prostatectomy surgery is the best treatment currently adopted by detecting prostate cancer. The urinary incontinence is one more common and difficult to treat postoperative complications, which causes a negative impact on quality of life of the individual prostatectomy . The surface electrical nerve stimulation involves the transmission of electrical impulses from an external stimulator for peripheral nerve through surface electrodes attached to skin. It is an easy and efficient technique, widely used for pain relief, rehabilitation and muscle strengthening. Objective: To analyze the effect of T10-L2 percutaneous electrical stimulation, in individuals with urinary incontinence who underwent radical prostatectomy by the laparoscopic technique. Methods: Six patients had previously undergone radical prostatectomy were submitted to 20 sections of surface electrical stimulation with frequency of 4 Hz, pulse width of 1ms during 20 minutes. All subjects fillid a quality of life - International Consultation on Incontinence Questionnaire- Short FormI - ICIQ-SF questionnaire evaluating. Results: Results showed reduction in the use of the number of pads, number of leaks before and after treatment, and reduced voiding frequency and consequent improvement in quality of life. No side effects were reported. Conclusion: Percutanous electrical stimulation in T10-L2 may be an effective technique to treat urinary incontinence (UI) after radical prostatectomy video laparoscopy

Uma análise comportamentalista de relatos verbais e práticas educativas parentais: alcance e limites

O presente artigo discute a relevância de algumas estratégias metodológicas da Análise Aplicada do Comportamento para examinar práticas educativas parentais. Um instrumento e um conceito relacionados à coleta e análise de dados são discutidos sob a ótica teórica e aplicada: relatos verbais e análise funcional comportamental descritiva. Conclui-se que, consideradas as limitações dos relatos, as informações obtidas com essa estratégia e com a análise funcional comportamental descritiva permitem inferir algumas hipóteses sobre os comportamentos de pais e de filhos que podem ser utilizadas em ações que procuram investigar e intervir sobre os comportamentos problema e as habilidades sociais.

Análise de grafos aplicada a relatos de sonhos: ferramenta diagnóstica objetiva e diferencial para psicose esquizofrênica e bipolar

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Estudo clínico e níveis de ansiedade em uma série de casos de líquen plano oral

Oral Lichen Planus (OLP) is a relatively common, cronic inflammatory disease. Its etiopathogenesis is no completely understood and several factors have proposed in attempt to explain the appearance, variety of clinical manifestations and periods of exacerbation and remission of the symptons of the lesions. The objective of the present study was to assess the presence of local factors, systemic diseases and levels of anxiety in patients with OLP, investigating their association with the clinical characteristics of the lesions. The sample consisted of 37 patients with histopathologically confirmed OLP that were submitted to a clinical exam to evaluate the presence of smoking habits, consumption of alcoholic beverages, diabetes mellitus, hypertension and hepatitis C virus (HCV) infection. The existence of skin lesions, as well as the time course, clinical form, symptomatology, number and location of the oral lesions were also registered. The trait anxiety was measured by Spielberger s Stai-Trait Anxiety Inventory (STAI), and to associate the variables we used the chi-square or Fisher s exact test. It was observed that females were the most affected (75%) and the mean age of the patients was 53,3 years. Most cases were non-smoker (97,3%) and none was drinker. Diabetes mellitus and hypertension were present in 10,8% e 16,2% of the sample, respectively and only one patient was HCV-seropositive (2,7%). Moderate levels of anxiety were seen in most cases (78,4%) and 21,6% had elevated levels. The oral lesions persisted in 95% of the cases for a period of 6 months to 13 years. The erosive form was the most prevalent (57,1%) and symptons were reported by 45,7% of the patients. Multiple lesions were frequent (60%), affecting mainly the buccal mucosa, followed by gums e tongue. There was no significant association of the presence of diabetes mellitus, hypertension and levels of anxiety with the clinical form or symptomatology of the oral lesions (p>0,005), despite a trend in patients with hypertension to have erosive lesions. It was concluded that, in the sample studied, moderate levels of anxiety were commonly observed, and the HCV infection apparently is not related to the onset of the OLP. In this study, the presence of diabetes mellitus, hypertension and levels of anxiety seem not to be associated with the clinical characteristics of the lesions of OLP

Estudo da influência de linfócitos tcd-8 e das células nk em casos de carcinoma epidermóide de lábio inferior sem metástase e com metástase e sua relação com a progressão da lesão

The presence of inflammatory cells within the tumor microenvironment plays a dual role that may contribute both to the progression and for inhibition of tumor growth. Recent studies suggest that the quality, not the quantity, of the inflammatory infiltrate is the most important determinant for prognosis. Therefore, TCD8 cells and natural killer cells are the main effector cells in combating cancer. The aim of this study was to assess, through the immunohistochemical study, the expression of TCD8 lymphocytes and NK cells in epidermoid carcinoma (EC) of the lower lip. The sample consisted of 32 specimens of EC of the lower lip, of which 16 had regional lymph node metastasis, and the 16 remaining, free of metastases. The total number of positive cells at the front of invasion were evaluated quantitatively and the results were related to clinical TNM staging, histological grade of malignancy and prognostic factors. It was observed for the group with metastasis, prevalence of stages III and IV (p<0.0001). Most patients with metastasis, had a high grade of malignancy (p=0.006). Most cases classified as high grade of malignancy had stages III and IV (p=0.032). Of the total sample, there were three cases of recurrence and five with death, however these variables were not statistically significant when associated with clinicopathological parameters. The immunostaining of CD8 and CD57, respectively, showed no statistically significant association with any of the clinicopathological parameters studied, metastasis (p=0.346, p=0.622), TNM classification (p=0.146, p=0.576), histological grade of malignancy (p=0.936, p=936), recurrence (p=0.075, p=0.075) and death (p=0.897, p=0.856). Believing in the function of the immunological system against malignant cells, it is concluded that the TD8 lymphocytes and NK cells, would be acting in the control of the progression of malignant neoplasms, but not in isolated manner

Imunoexpressão da IL-17 e RORγt em carcinomas de células escamosas de lábio e língua

Th17 cells have been strongly associated to the pathogenesis of inflammatory and autoimmune diseases, although their influence on the carcinogenesis is still little known, there are reports of anti-tumor and protumoral actions. The objective of this study is to research the presence of Th17 lineage in lip and tongue SCC, using the analysis of the immunoexpression of IL-17 and RORγt, relating this immunoexpression with clinical and morphological findings in the attempt to better comprehend the role of these cells on the tumoral immunity of OSCCs. The results were submitted to non-parametric statistical tests with significance level of 5%. On the histomorphological analysis, it was observed the predominance of low level lesions on lip and high level lesions on tongue (p=0,024). It was not observed statistical significance between clinical stage and histological gradation of malignancy (p=0,644). For the immunohistochemical study, 5 random fields with greater immunoreactivity of the peritumoral inflammatory infiltrate were photomicrographed on the 400x magnification. It was done the count of lymphocytes which showed cytoplasmic and pericytoplasmic staining for the IL-17 cytokine as well as nuclear and cytoplasmic staining for RORγt. It was observed statistical significance difference on the quantity of immunopositive lymphocytes to IL-17 between the groups of SCC of lip and tongue (p=0,028). For the RORγt it was not observed statistical significance difference between the groups of SCC of lip and tongue (p=0,915). It was not observed statistical difference between the immunostaining of IL-17 and RORγt with histological gradation of malignancy and clinical staging. The findings of this research suggest a possible anti-tumor role of IL-17 for cases of lip. The results of the analysis of the RORγt are possibly due to the wide duality of the anti-tumor and protumoral role of the Th17 cells and their plasticity which, in the presence of different cytokines expressed on the tumor microenvironment, can alter its phenotype.

O sistema de garantia dos direitos da criança e do adolescente: análise da trajetória e do processo de resolubilidade dos casos de violência doméstica sexual em Recife PE (2007-2011)

This work discourses about the child and adolescent s Guaranty System of Rights (GSR), on the intervention in cases of juvenile domestic sexual violence, in Recife. The course (trajectory) is analyzed, where circulate cases of sexual violence, until its resolution, in (GSR). Actually, the violence represents a serious problem of public health. Was thought about the difficulties and the limits that make GSR become a full field of contradictions and challenges for the effectiveness of the children and adolescents rights. Therefore, it was verified the treatments that are developed by GSR, how this system is structured and articulated and how occurs the resolution of the sexual violence cases against children and adolescents. Proceedings of the quantitative and qualitative research were used, was done observation, directed interview and analysis of documents. Thus, the field research was the visits in these institutions: Restauração Hospital, Police Management of the Child and Adolescent (PMCA) three Guardianship Councils, Dom Helder Camara Center of Studies and Social Action (CENDHEC) and the Tribunal of Childhood and Adolescence. The research subjects were seven professionals of GSR. The theoretical discussion is guided in reflections about the children and youth rights, in the violence theme and in the construction and institutionalization process of GSR. In this experiment, was noticed there are many difficulties for working together the GSR, because many obstacles are found when we call the responsible institutions, besides some violence cases happen again. This system is not totally institutionalized and articulated, faces structural problems, material, poorly qualified professionals, underinvestment, low transfer of public resources, among other difficulties, causing many losses in the implementation of public policies that enforce secured rights by legislation

Geração de casos de teste a partir de especificações B

With the increasing complexity of software systems, there is also an increased concern about its faults. These faults can cause financial losses and even loss of life. Therefore, we propose in this paper the minimization of faults in software by using formally specified tests. The combination of testing and formal specifications is gaining strength in searches mainly through the MBT (Model-Based Testing). The development of software from formal specifications, when the whole process of refinement is done rigorously, ensures that what is specified in the application will be implemented. Thus, the implementation generated from these specifications would accurately depict what was specified. But not always the specification is refined to the level of implementation and code generation, and in these cases the tests generated from the specification tend to find fault. Additionally, the generation of so-called "invalid tests", ie tests that exercise the application scenarios that were not addressed in the specification, complements more significantly the formal development process. Therefore, this paper proposes a method for generating tests from B formal specifications. This method was structured in pseudo-code. The method is based on the systematization of the techniques of black box testing of boundary value analysis, equivalence partitioning, as well as the technique of orthogonal pairs. The method was applied to a B specification and B test machines that generate test cases independent of implementation language were generated. Aiming to validate the method, test cases were transformed manually in JUnit test cases and the application, created from the B specification and developed in Java, was tested. Faults were found with the execution of the JUnit test cases

Melanoma anorretal: relato de 2 casos e revisão da literatura

Os tumores malignos do canal anal e do anus são muito raros, não ultrapassam 2% de todos os tumores do colo, reto e anus; segundo os principais levantamentos os melanomas não ultrapassam a incidência de 0,1 a 1,2% dos tumores malignos. Os autores descrevem 2 casos de melanoma, discutindo os principais dados da literatura, enfocando os aspectos diagnósticos, tratamento, evolução e prognostico. Os indicies de cura s são baixos e com elevados índices de mortalidade a curto prazo.

Trombose venosa profunda de membros superiores: estudo coorte retrospectivo de 52 casos

OBJETIVO: Rever os fatores predisponentes e a evolução em série de casos de trombose venosa profunda dos membros superiores de nossa instituição. MÉTODOS: Cinqüenta e dois pacientes consecutivos, com trombose venosa profunda dos membros superiores (29 homens e 23 mulheres), idade média de 52,3 anos, documentados por mapeamento dúplex (71,1%), flebografia (11,1%) ou clinicamente (15,6%), foram incluídos no presente estudo. RESULTADOS: As manifestações clínicas foram: dor no antebraço (24 casos - 46,1%), dor no braço (27 casos - 51,9%), edema do membro superior (45 casos - 86,5%), dor à compressão do membro superior (36 casos - 70,2%) e dor à movimentação do mesmo (32 casos - 61,7%). Os principais fatores de risco foram: punção ou acesso venoso (20 casos - 39,1%) e câncer (16 casos - 32,6%). As veias envolvidas foram: umeral (n = 18), axilar (n = 27), subclávia (n = 15) e jugular (n = 11). A embolia pulmonar estava inicialmente presente em quatro casos (7,6%). O tratamento inicial foi feito com heparina não-fracionada intravenosa (64,3%), subcutânea (16,7%), ou heparina de baixo peso molecular (17,1%), seguido de varfarina. Doze pacientes morreram antes da alta, em função de causas não relacionadas à embolia pulmonar. Foram acompanhados os 40 pacientes restantes por período de 3 meses a 10 anos, sendo que dois morreram de causas não relacionadas à embolia pulmonar, um paciente desenvolveu seqüelas pós-trombóticas, como edema residual e limitações aos movimentos, e seis ficaram com discretos sintomas residuais (edema e dor). CONCLUSÕES: A trombose venosa profunda dos membros superiores foi mais freqüente em pacientes submetidos a acessos venosos e com neoplasia em atividade. Comparando com dados da literatura, a evolução dos pacientes sob tratamento exclusivo com anticoagulantes foi, no mínimo, similar a outros tratamentos propostos.

Cirurgia ambulatorial em proctologia: análise retrospectiva de 437 casos

RACIONAL: O número de cirurgias ambulatoriais realizadas em hospitais, como em clínicas particulares, cresce a cada dia. Hoje, em alguns países, como a França, há predomínio das cirurgias ambulatoriais em relação às hospitalares. OBJETIVO: Avaliar retrospectivamente os pacientes operados no Serviço de Cirurgia Ambulatorial do Hospital das Clínicas da Faculdade de Medicina de Botucatu, SP. CASUÍSTICA E MÉTODO: Foram estudados retrospectivamente 437 casos clínicos de patologias orificiais, analisando a distribuição por faixa etária, por sexo, por patologias e as complicações pós-operatórias. RESULTADOS: Notou-se predomínio de pacientes com idade inferior a 45 anos (62,8%), prevalência do sexo feminino (56%), sendo a doença hemorroidária (45,1%) a principal patologia e a dor e sangramento as complicações mais freqüentes (9,8% e 7,3%). CONCLUSÕES: Os resultados satisfatórios observados demonstram a possibilidade de realização, em ambulatório, de diversos procedimentos simples em patologias anorretais freqüentes, a baixo custo e poucas complicações, sendo estas não superiores às observadas em cirurgia hospitalar.

Carcinoma de pequenas células do esôfago: estudo clínico patológico de dois casos

RACIONAL: O carcinoma de pequenas células primário do esôfago é tumor raro, agressivo, morfologicamente indistinguível de seu correspondente no pulmão. OBJETIVO: Apresentar os aspectos clínico-patológicos de dois pacientes com carcinoma de pequenas células do esôfago. RELATO DE CASOS: Paciente 1: masculino, 56 anos com disfagia progressiva há seis meses e emagrecimento, com antecedentes de tabagismo e etilismo. A endoscopia mostrou lesão vegetante dos 30 aos 40 cm da arcada dentária superior e o exame anatomopatológico, diagnosticou neoplasia maligna indiferenciada de pequenas células com marcadores imunoistoquímicos positivos para cromogranina e sinaptofisina, caracterizando a linhagem neuroendócrina da neoplasia. Após dois ciclos de quimioterapia (cisplatina e etoposide) associada à radioterapia ele apresentou remissão da disfagia. Paciente 2: masculino, 55 anos, com queixas de pirose, disfagia, rouquidão há seis meses, com emagrecimento de 10 kg no período. A endoscopia mostrou lesão vegetante à 30 cm da arcada dentária superior, obstrutiva. O exame anatomopatológico revelou carcinoma de pequenas células, com os mesmos marcadores imunoistoquímicos positivos para linhagem neuroendócrina. Tomografia computadorizada mostrou metástases hepáticas. Frente ao estadio avançado da doença optou-se pela indicação de gastrostomia. O paciente desenvolveu pneumonia e faleceu dois meses após o diagnóstico. CONCLUSÃO: A evolução dos portadores de carcinoma de pequenas células do esôfago depende do estadiamento da doença e apesar da alta agressividade biológica, este tumor apresenta boa resposta à quimioterapia associada à radioterapia.