Saúde da família: uma estratégia de mudança no processo de produção dos serviços de saúde

The purpose of this study is to analyze, from the point of view of nurses, changes that took place in the process of providing health services after the introduction of the Family Health Program (FHP). It is na investigation of qualitative nature that uses semi-structured interviews as a main empirical approach tool. Six nurses from the city of Caicó, Rio Grande do Norte, who were working with basic care before the introduction of the FHP, within basic care, were: adscription and ties with the community; hospitality and the humanizacion of care-giving; decrease in cases of inpatient treatment; strengthening of the prevention of injuries and health promotion; improvemente of health indicatiors, finally, actions that point towads meeting the principles of wholeness, equity and universality as a declaration of the Brazilian National Health Care System (SUS). Nevertheless, in spite of all recognizable positive aspects, the FHP has some weaknesses, such as: the difficulty posed by colletive work; the mismatch between professional education and the demands of the current health standard; a poor physical infrastructure of the Basic Health Units; a high heath staff turnover and precarious work conditions. In addition to this, some strategies that can be used to help improve the process of providing health services have been pointed out, such as, coordination between sectors, continuous education, making work conditions less precarious and improving the means whereby heathy service management is conveyed,Tthus, finally, we understand that the FHP does bring forward meaningful changes to the process of provinding health services to strengthen the Brasilian National Health Care System (SUS), in spite of the fact that it lies within a scenario of adversities that can be overcome through the collective endeavor of the several social actors

Florística e fitossociologia de área de cerrado S.S. no município de Patrocínio Paulista, nordeste do Estado de São Paulo

A necessidade de se conhecer mais sobre o Bioma Cerrado torna-se cada vez mais urgente, devido à sua destruição acelerada. Este trabalho realizou o levantamento florístico-fitossociológico de uma área de cerrado sensu stricto na Fazenda Santa Cecília, município de Patrocínio Paulista, nordeste do Estado de São Paulo (20º 46' 2 S e 47º 14' 24 W, 836 m de altitude e Neossolo Quartzarênico). em 30 parcelas de 10 x 10 m, foram amostrados 511 indivíduos arbustivo-arbóreos de PAP > 15 cm, pertencentes a 30 famílias, 38 gêneros e 53 espécies. As famílias com maior riqueza específica foram Fabaceae (sete espécies), Myrtaceae (cinco espécies), Vochysiaceae (quatro espécies), Annonaceae (três espécies) e Caesalpiniaceae (três espécies), totalizando 45% das espécies. As espécies de maior valor de importância (IVI) foram: Qualea grandiflora (62,38), Dalbergia miscolobium (22,24), Styrax camporum (21,86), Ocotea corymbosa (18,02), Qualea parviflora (14,97) e Qualea multiflora (11,46). A comunidade arbórea apresentou densidade de 1.703 indivíduos por hectare, índice de Shannon (H') de 3,05 e índice de similaridade de Jaccard (ISj) de 45% quando comparado com área próxima de cerrado.

Vivência de mulheres no puerpério : significado atribuído à revisão pósparto

The consultation for women during the postpartum period should occur between the seventh and tenth days, and 42 days after childbirth, to decrease the incidence of maternal and neonatal morbidity and mortality. However, the effectiveness of such assistance in primary health care has not been achieved, especially in the forty-second day of puerperium. Facing this reality, the research aimed to understand the views of women about postpartum consultation. This is an exploratory and descriptive research with qualitative approach, developed in the municipality of Lajes/RN, Brazil, with women inscribed on the four teams that make up the Family Health Strategy. Data were collected through semistructured interviews with 15 women who met the following criteria: be enrolled in ESF; have health mental preserved, have been entered in the Humanization Program of Prenatal and Birth, and that was, at maximum, 60 days postpartum. The data were organized according to the precepts of content analysis according to Bardin, generating three categories: prevention of puerperal complications, feelings related to life changes after childbirth, and postpartum care. This process of coding and categorizing a central theme emerged: the experience of women in the postpartum period. The data were analyzed according to the principles of symbolic interactionism, according to Blumer. The study revealed that the meanings attributed to the postpartum period for prevention of complications were directly related to home, to the consultation and postpartum care provided by family members and health professionals. The interviewees strictly complied with the rest under the influence of the context in which they were entered. But that has not happened with the postpartum revision because few mothers underwent this procedure. Therefore, the interaction of the interviewed people in their living standard as well as the feelings that permeated the post-partum were crucial to consider whether or not the post-partum visit as significant. According to the results, it was noted that disability guidelines and counter-references has impaired the access of women to postpartum review. Thus, further studies are needed on the subject, as well as a reorientation of health care activities in view of the consolidation of postpartum consultation in primary care

Assistência de enfermagem às urgências e emergências psiquiátricas no serviço de atendimento móvel de urgência em Mossoró-RN

This study aims to identify the concepts of professional nursing team on assistance in urgency and psychiatric emergencies in SAMU in Mossoró/RN, identifying the difficulties in implementing an emergency assistance to the user in psychiatric distress in this service and point strategies in pursuit of consolidation and expansion of comprehensive health care to the public. It is a descriptive research with qualitative and exploratory approach. The subjects were employees of the nursing staff of SAMU of that mentioned municipality. Semi-structured interviews are applied as tool for data collection. It was counted on the consent of the institution where the study was developed and approval by the Ethics Committee in Research of UFRN with CAAE No 17326513.0.0000.5537, besides signing the Informed Free Consent Term by the participants. Data analysis was done by means of thematic analysis proposed by Bardin. Thus , as a result of the research produced the following categories: mechanistic practice; dehumanization of care; need for qualification, barriers to assistance in urgency and psychiatric emergency and strategies in pursuit of comprehensive care, which proceeded in preparing two articles entitled "Nursing care to the emergency room and psychiatric emergencies in the mobile emergency care service" and "Barriers for emergency service and psychiatric emergencies in the mobile emergency care service". In the studied reality it was identified that nursing care offered to users in situations of urgency and psychiatric emergency is made based primarily on the use of chemical and physical restraints, as well as transportation to the general hospital, constantly using the police force support, which meets the guidelines of the Psychiatric Reform and thereby undermining the provision of an effective and humane care. This scenario is worsened by the lack of an organized network of services in mental health, where after the service the user is taken to a general hospital, considering that there is no ready or appropriate psychiatric emergency service as a Center of Psychosocial Care - CAPs III to reference it, thereby precluding the realization of a resolute and comprehensive care. Thus, it is concluded that nursing care is based on biologicist and medicine-centered model advocated by classical psychiatry, and that despite all the advances in psychiatric reform, still guides the mental health care, so the lack of service network organized in hierarchical and mental health, where the user in urgency and emergency service can be watched in full and the guidelines of the psychiatric reform can be realized in practice

Sistema de gestão ambiental na produção de água mineral

It s more and more evident the subject of the shortage of water, worsened by the accelerated urbanization, growth of the population, increase of the demand and of the costs of its treatment, factors that are also tied up to the increase of the consumption of mineral waters, whose chemical composition or physical-chemistries characteristics do with that are considered beneficial to the health. The growth accelerated all over the world in its consumption aims the concern with the waters quality, the health and the incentive to the consumption of natural products. However, in spite of quite valuable, that resource is explored, most of the time, without optimization of production or actions that avoid wastefulness. This research is justified for the need of minimizing the negative environmental impacts caused by the mineral water s production, mainly in what it say about the generation of effluents and wastes in the productive process, through the study, development and application of cleaner production tools for the environmental management, pertinent for that section. The applicability of Environmental Management System was determined by means of the characterization of the environmental aspects of productive process in a company of the section, in the state of Rio Grande do Norte and of the discussion of the panoramas that demonstrate the tendency for a sustainable development. Actions as a reforestation, optimization of energy and water uses, recycle of solid residues and water reuse were applied during the research, resulting in the considerable reduction of wastes of raw materials and inputs and consequent environmental and economic won. A specific methodology was proposed with concepts of Environmental Management, integrating with Quality Management. As foundations for the elaboration of the methodology, it was realized a similarity analysis among the systems and, mainly, an analysis of the experiences observed in the case study, including specificities, needs and difficulties of the company. With these results, the implantation of a EMS as a company strategy has environmental, economic and social benefits, and this research can be applied and adequate to others companies and sectors

Construção e implementação do Balanced Scorecard em uma organização educacional: o caso do Serviço Nacional de Aprendizagem Comercial do Rio Grande do Norte SENAC RN

The changes that have taken place in the organizational environment in recent decades have led to new performance measurement systems being proposed, given the inadequacy of traditional models. The Balanced Scorecard (BSC) emerged as an instrument to translate financial and non-financial assets into real values for all interested parties in the organization, allowing the introduction of strategies to achieve the desired goals. Research shows that most errors committed with the use of this method are related to the implementation process. Thus, the aim of this dissertation is to analyze the process of building and implementing the BSC in an organization. This empirical exploratory study is based on the classic case study method, which enables the researcher to work with a set of evidence, including direct observation, interviews and document analysis. The results show that the use of BSC in the company investigated posed problems during the process of building and implementing the method. These problems were caused mainly by the lack of involvement on the part of upper management and the team s scant knowledge of Balanced Scorecard. One of the gains obtained from adopting the system was the introduction and/or consolidation of a culture of strategic planning and participative management. The continuous implementation phase was highlighted in the monitoring program, created by the organization in an attempt to reverse existing problems, using the BSC as a third generation strategic management system, which led to significant gains, better use of the system and stronger management practices

Sistema de gestão ambiental sob a perspectiva da resource-based view: um estudo de caso no verdegreen Hotel - João Pessoa/PB

The pressure for a new pattern of sustainable development began to require of modern organizations the conciliation between competitiveness and a environmental protection. In this sense, a tool that acts in the implementation of structured strategies is the Environmental Management System (EMS), which focuses on improving environmental performance. This improvement, in turn, can generate to the organizations many benefits , among which, obtaining competitive advantages, susceptible of measurement from different perspectives. One of these is the application of VRIO model, reasoned by the Resource-Based View (RBV), which considers that differences between companies occurs due to differences between its internal resources and capabilities. However, although was been found some studies in the literature that evaluate the competitive potential of certain organizations , such assessments are not performed on specific objects, like the SEM s. Thus, the aim of this study was to evaluate the resources and capabilities (environmental strategies) adopted by the SGA of the Verdegreen Hotel, identifying which of these have the potential to generate competitive advantage. For this, this exploratory-descriptive character study and delineated as field research and case study was used as data collection tools: a literature survey, semi-structured interviews, document research and participant observation. The interpretation of results and consolidation of information were conducted from a qualitative approach, using two techniques of data analysis, namely: content analysis and analysis through VRIO model. The results show that the hotel is quite structured in relation to their EMS, as well as reaching related to improving the management of environmental factors, strengthening the image and gains in competitiveness benefits. On the other hand, the main difficulties for the implementation of the system are related to employees and suppliers. With regard to environmental strategies adopted, of the 25 strategies identified, 10 showed the potential to generate competitive advantage

Indicadores bibliométricos em sistemas de informação: uma análise a partir de artigos publicados no Encontro Nacional de Engenharia de Produção

This research aims at to contribute to show the consolidation of the area of Information Systems (IS) as area of knowledge in Production Engineering. For this, it according to presents a scenery of the publication in IS in the field of the Production Engineering in Brazil amount of articles, the authorship profile, the methodologies, the citations, the research thematic and the continuity of the research thematic. The base for this study was the works published in the National Meeting of Production Engineering - ENEGEP of years 2000, 2001, 2002, 2003 and 2004, inside of the area of Information Systems. Classified as bibliographical research, of applied nature, quantitative boarding, of the point of view of the objectives description-exploration was called and for the collection of data its comment was systematic with bibliographical survey. As field research, the method of collection of data if constituted of the elaboration of an analysis protocol and, to arrive itself at the final diagnosis, it operation the data through the statistical method, with the accomplishment of descriptive analyses. It approached concepts of IS and the seek areas and, it studied research correlate in Production Engineering, in Information Systems, in Information Science and other areas of the knowledge. How much to the results one concluded that the national and international contents are compatible and that the area of IS is in constant evolution. For the continuity of research lines it was observed that the majority of the authors was faithful to the area of Systems of Information. Amongst other found results, some institutions must try to increase its volume of publications and research, while others must look for to keep its reached mark already in the last years

SurRFE -Sub-rede de filtragens específicas

The increasing of the number of attacks in the computer networks has been treated with the increment of the resources that are applied directly in the active routers equip-ments of these networks. In this context, the firewalls had been consolidated as essential elements in the input and output control process of packets in a network. With the advent of intrusion detectors systems (IDS), efforts have been done in the direction to incorporate packets filtering based in standards of traditional firewalls. This integration incorporates the IDS functions (as filtering based on signatures, until then a passive element) with the already existing functions in firewall. In opposite of the efficiency due this incorporation in the blockage of signature known attacks, the filtering in the application level provokes a natural retard in the analyzed packets, and it can reduce the machine performance to filter the others packets because of machine resources demand by this level of filtering. This work presents models of treatment for this problem based in the packets re-routing for analysis by a sub-network with specific filterings. The suggestion of implementa- tion of this model aims reducing the performance problem and opening a space for the consolidation of scenes where others not conventional filtering solutions (spam blockage, P2P traffic control/blockage, etc.) can be inserted in the filtering sub-network, without inplying in overload of the main firewall in a corporative network

Dinâmica da Plasticidade Sináptica em neurônios do hipocampo durante ciclos de sono: um estudo computacional

Several research lines show that sleep favors memory consolidation and learning. It has been proposed that the cognitive role of sleep is derived from a global scaling of synaptic weights, able to homeostatically restore the ability to learn new things, erasing memories overnight. This phenomenon is typical of slow-wave sleep (SWS) and characterized by non-Hebbian mechanisms, i.e., mechanisms independent of synchronous neuronal activity. Another view holds that sleep also triggers the specific enhancement of synaptic connections, carrying out the embossing of certain mnemonic traces within a lattice of synaptic weights rescaled each night. Such an embossing is understood as the combination of Hebbian and non-Hebbian mechanisms, capable of increasing and decreasing respectively the synaptic weights in complementary circuits, leading to selective memory improvement and a restructuring of synaptic configuration (SC) that can be crucial for the generation of new behaviors ( insights ). The empirical findings indicate that initiation of Hebbian plasticity during sleep occurs in the transition of the SWS to the stage of rapid eye movement (REM), possibly due to the significant differences between the firing rates regimes of the stages and the up-regulation of factors involved in longterm synaptic plasticity. In this study the theories of homeostasis and embossing were compared using an artificial neural network (ANN) fed with action potentials recorded in the hippocampus of rats during the sleep-wake cycle. In the simulation in which the ANN did not apply the long-term plasticity mechanisms during sleep (SWS-transition REM), the synaptic weights distribution was re-scaled inexorably, for its mean value proportional to the input firing rate, erasing the synaptic weights pattern that had been established initially. In contrast, when the long-term plasticity is modeled during the transition SWSREM, an increase of synaptic weights were observed in the range of initial/low values, redistributing effectively the weights in a way to reinforce a subset of synapses over time. The results suggest that a positive regulation coming from the long-term plasticity can completely change the role of sleep: its absence leads to forgetting; its presence leads to a positive mnemonic change

Um ambiente integrado para manipulação de tráfego multicast

In the two last decades of the past century, following the consolidation of the Internet as the world-wide computer network, applications generating more robust data flows started to appear. The increasing use of videoconferencing stimulated the creation of a new form of point-to-multipoint transmission called IP Multicast. All companies working in the area of software and the hardware development for network videoconferencing have adjusted their products as well as developed new solutionsfor the use of multicast. However the configuration of such different solutions is not easy done, moreover when changes in the operational system are also requirede. Besides, the existing free tools have limited functions, and the current comercial solutions are heavily dependent on specific platforms. Along with the maturity of IP Multicast technology and with its inclusion in all the current operational systems, the object-oriented programming languages had developed classes able to handle multicast traflic. So, with the help of Java APIs for network, data bases and hipertext, it became possible to the develop an Integrated Environment able to handle multicast traffic, which is the major objective of this work. This document describes the implementation of the above mentioned environment, which provides many functions to use and manage multicast traffic, functions which existed only in a limited way and just in few tools, normally the comercial ones. This environment is useful to different kinds of users, so that it can be used by common users, who want to join multimedia Internet sessions, as well as more advenced users such engineers and network administrators who may need to monitor and handle multicast traffic

Estudo da topologia de redes de conexão funcional no córtex sensorial primário e hipocampo durante o sono de ondas lentas

Complex network analysis is a powerful tool into research of complex systems like brain networks. This work aims to describe the topological changes in neural functional connectivity networks of neocortex and hippocampus during slow-wave sleep (SWS) in animals submited to a novel experience exposure. Slow-wave sleep is an important sleep stage where occurs reverberations of electrical activities patterns of wakeness, playing a fundamental role in memory consolidation. Although its importance there s a lack of studies that characterize the topological dynamical of functional connectivity networks during that sleep stage. There s no studies that describe the topological modifications that novel exposure leads to this networks. We have observed that several topological properties have been modified after novel exposure and this modification remains for a long time. Major part of this changes in topological properties by novel exposure are related to fault tolerance

Análise da sensibilidade do biodiesel B5 em frotas de transporte coletivo com motorização diesel

The aim of this study was investigate the consolidation of the biodiesel fuel used in (a) engines of urban and intercity bus companies, (b) a stationary engine. It was necessary to investigate and analyze, technologically, if the biodiesel fuels were presenting troubleshooting relative to wear of parts lied to fuel and to evaluate the consumption fluctuations of this fuel. The urban and intercity bus companies, localized in Natal, Rio Grande do Norte state, Brazil, had 41 and 12 vehicles, respectively. It were analyzed datasheet of each one vehicle during three years, since 2008 until 2010 and were interviewed the management of the maintenance team of bus companies relative to aspects concerning the substitution of the diesel fuel by the B5 biodiesel. The second aim of this study was visually inspect the wear of the parts directly lied to combustion process. For this reason, it was investigated a stationary engine, manufactured by Branco BD5, 5 HP of power, fueled by (a) diesel, (b) biodiesel B5, (c) biodiesel B20 and (d) diesel or biodiesel, both contaminated by distilled water. In this engine, its power utilizing biodiesel B5 versus diesel was lower about 5.2% and, in the investigated case of B20 versus diesel, it was lower around 11.5%

Sobrevivência de fungos fitopatogênicos habitantes do solo, em microcosmo, simulando solarização com prévia incorporação de materiais orgânicos

Os fungos fitopatogênicos habitantes do solo podem sobreviver por vários anos nesse ambiente por meio de estruturas de resistência, causando perdas em muitas culturas, por vezes, inviabilizando o pleno aproveitamento de vastas áreas agrícolas. O uso de materiais orgânicos no solo consorciado com a técnica de solarização propicia a retenção de compostos voláteis fungitóxicos emanados da rápida degradação dos materiais e que são letais a vários fitopatógenos. O objetivo deste experimento foi à prospecção de novos materiais orgânicos que produzissem voláteis fungitóxicos capazes de controlar fungos fitopatogênicos habitantes do solo, em condições de associação com a simulação da técnica de solarização (microcosmo). Portanto, o presente trabalho consistiu de seis tratamentos (Solarizado; Solarizado+Brócolos; Solarizado+Eucalipto; Solarizado+Mamona; Solarizado+Mandioca e Laboratório) e cinco períodos (0, 7, 14, 21 e 28 dias) para avaliar a sobrevivência de quatro fungos de solo (Fusarium oxysporum f. sp. lycopersici Raça 2; Macrophomina phaseolina; Rhizoctonia solani AG-4 HGI e Sclerotium rolfsii). em cada uma das duas câmaras de vidro (microcosmo) por dia avaliado continha uma bolsa de náilon contendo as estruturas de resistência de cada fitopatógeno. Estruturas dos fitopatógenos foram mantidas também em condições de laboratório como referencial de controle. Todos os materiais quando associados à simulação da solarização propiciaram o controle de todos os fitopatógenos estudados, entretanto, foi observado variação no controle dos fungos. O tratamento que apenas simulou a solarização não controlou nenhum fitopatógeno.

Variação da qualidade da água de chuva no início da precipitação

One of the most evident and actual concern, not only in the scientific means, but also of the public knowledge in general, is the lack problem of the potable water, that come increasing more each time, motivated mainly for the po llution of the sources, the bad use of the water and the increase of the population. In such a way, the necessity of looking for new water sources and the development of techniques to use sources minus explored is becoming even more important and urgent. T he rainwater comes being used since a long time like a supplying source, but, due the few knowledge of its characteristics, the generated preconception and the discrimination around its consumption and to the bad use of the technique of collection and stor age, it comes being little used, wasting consequently a significant parcel of this source. Trying to develop the knowing of some characteristics of the rainwater, the present work looks for to define the curve of variation of the quality of the rainwater i n three points with distinct characteristics of the city of Natal -RN, in the course of the precipitation, in some situations of time and space. For describe the curve of variation of the water s quality, some variables must be analyzed, and to be identifie d when they modify themselves in the endurance of rain, showing in which moment the purification of the water is more or less quickly. The pH, the Turbidity and the Electric Conductivity can be related with a big part of the physicist -chemistries variables found in the water and, like its analyses don't spend any material, they have easy access and measurement. The present work analyzes the curves of decline of these three variables, in three points with distinct characteristics in the city of Natal -RN, being these points: one next to the sea, another one in region with great buildings concentration and the last point in a less polluted area. For the studied region, it was during the five first millimeters of rain that occurs the biggest reduction of the exi sting impurities in the atmosphere, mainly between the first and the second millimeter, and after the five first millimeters the values of the variables stabilize. With exception of the University Campus, where initially the rainwater already has very good quality, the values of Turbidity and Electric Conductivity suffer a brusque reduction after the first millimeter of rain