939 resultados para Work organization models


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

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Brazilian Psychiatry Reform, through Psychosocial Care Strategy, has intended to build insane people care practices from community care services which contemplates the subjects complete lives. However, to change the traditional care ways demands the facing of a series of epistemological, political and cultural obstacles. One of the current challenges deals with patients aggravation processes, with management ways, with devices and with professionals, as well as with the assistance network. The purpose of this thesis was to investigate how these aggravation processes has been constituted in Natal mental healthcare network, understanding its effects in the work teams and patients. Theoretical and methodological perspective used was Institutional analysis was, subsidizing the usage of concept-tools as the implication analysis, selfmanagement and self-analysis, and restitution. The research was carried out at the Natal East Sanitary District Mental Healthcare Clinic, with the participation of technicians and patients. The research procedures were: literature and document research on the attendance and the analyzed theme; attendance registers analysis; participating observation of the institutional routine for three months and field log entries; talking groups, one with the team and one with the patients. Two main discussion points are shown: 1. The mental healthcare clinic organization logic and the intersector politics; 2. The work and management processes developed at the mental healthcare clinic. The analysis show diversity in the attended demands in the service, which has favored the patients aggravation, this device and the substitute network processes. The work processes are apart from the political sphere and from the managements processes. In this sense, we show the need to reevaluate the clinic device as well as the management models adopted in the Brazilian Psychiatry Reform context

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Este artigo apresenta o desenvolvimento, validação e utilização de uma metodologia de avaliação da qualidade dos serviços de atenção primária do Sistema Único de Saúde (SUS), o Questionário de Avaliação da Qualidade de Serviços de Atenção Básica (QualiAB). Destina-se aos serviços de atenção básica, organizados segundo diferentes modelos de atenção, incluindo a Saúde da Família. Contém 50 indicadores sobre oferta e organização do trabalho assistencial e programático e 15 sobre gerenciamento, na forma de questões de múltipla escolha, autorespondidas via web pela equipe local do serviço. Confere a cada resposta valor zero, um ou dois; a média geral atribui ao serviço um grau de qualidade expresso pela distância do melhor padrão correspondente à média dois. Foi construído por processo de consenso interativo, que incluiu metodologias qualitativas, teste-piloto, aplicação em 127 serviços, validação de construto e confiabilidade. Respondido, em 2007, por 598 (92%) dos serviços de 115 municípios paulistas, mostrou bom poder para discriminar níveis de qualidade. Adotado em 2010 como parte de um programa de apoio à Atenção Básica da Secretaria de Estado da Saúde de São Paulo, foi respondido por 95% (2.735) dos serviços de 586 municípios (90,8% do Estado). Os resultados foram encaminhados aos municípios. O QualiAB fornece uma avaliação válida, simples e com a possibilidade de retorno imediato para gerentes e profissionais. Mostrou factibilidade, aceitabilidade, bom poder de discriminação e utilidade para auxiliar a gestão da rede de atenção básica do SUS em São Paulo. A experiência indica aplicabilidade nas redes de atenção básica do Brasil.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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This work develops a new methodology in order to discriminate models for interval-censored data based on bootstrap residual simulation by observing the deviance difference from one model in relation to another, according to Hinde (1992). Generally, this sort of data can generate a large number of tied observations and, in this case, survival time can be regarded as discrete. Therefore, the Cox proportional hazards model for grouped data (Prentice & Gloeckler, 1978) and the logistic model (Lawless, 1982) can befitted by means of generalized linear models. Whitehead (1989) considered censoring to be an indicative variable with a binomial distribution and fitted the Cox proportional hazards model using complementary log-log as a link function. In addition, a logistic model can be fitted using logit as a link function. The proposed methodology arises as an alternative to the score tests developed by Colosimo et al. (2000), where such models can be obtained for discrete binary data as particular cases from the Aranda-Ordaz distribution asymmetric family. These tests are thus developed with a basis on link functions to generate such a fit. The example that motivates this study was the dataset from an experiment carried out on a flax cultivar planted on four substrata susceptible to the pathogen Fusarium oxysoprum. The response variable, which is the time until blighting, was observed in intervals during 52 days. The results were compared with the model fit and the AIC values.

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Ties among event times are often recorded in survival studies. For example, in a two week laboratory study where event times are measured in days, ties are very likely to occur. The proportional hazards model might be used in this setting using an approximated partial likelihood function. This approximation works well when the number of ties is small. on the other hand, discrete regression models are suggested when the data are heavily tied. However, in many situations it is not clear which approach should be used in practice. In this work, empirical guidelines based on Monte Carlo simulations are provided. These recommendations are based on a measure of the amount of tied data present and the mean square error. An example illustrates the proposed criterion.

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Structural characterization of enzymes that belong to microbial metabolic pathways is very important for structure-based drug design since some of these proteins may be present in the bacterial genome, but absent in humans. Thus, metabolic pathways became potential targets for drug design. The motivation of this work is the fact that Mycobacterium tuberculosis is the cause of the deaths of millions of people in the world, so that the structural characterization of protein targets to propose new drugs has become essential. DBMODELING is a relational database, created to highlight the importance of methods of molecular modeling applied to the Mycobacterium tuberculosis genome with the aim of proposing protein-ligand docking analysis. There are currently more than 300 models for proteins from Mycobacterium tuberculosis genome in the database. The database contains a detailed description of the reaction catalyzed by each enzyme and their atomic coordinates. Information about structures, a tool for animated gif image, a table with a specification of the metabolic pathway, modeled protein, inputs used in modeling, and analysis methods used in this project are available in the database for download. The search tool can be used for reseachers to find specific pathways or enzymes.

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

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The development of new therapies against infectious diseases is vital in developing countries. Among infectious diseases, tuberculosis is considered the leading cause of death. A target for development of new drugs is the tryptophan pathway. The last enzyme of this pathway, tryptophan synthase (TRPS), is responsible for conversion of the indole 3-glycerol phosphate into indol and the condensation of this molecule with serine-producing tryptophan. The present work describes the molecular models of TRPS from Mycobacterium tuberculosis (MtTRPS) complexed with six inhibitors, the indole 3-propanol phosphate and five arylthioalkyl-phosphonated analogs of substrate of the a-subunit. The molecular models of MtTRPS present good stereochemistry, and the binding of the inhibitors is favorable. Thus, the generated models can be used in the design of more specific drugs against tuberculosis and other infectious diseases.

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This work studies through the Floquet theory the stability of breathers generated by the anti-continuous limit. We used the Peyrard-Bishop model for DNA and two kinds of nonlinear potential: the Morse potential and a potential with a hump. The comparison of their stability was done in function of the coupling parameter. We also investigate the dynamic behaviour of the system in stable and unstable regions. Qualitatively, the dynamic of mobile breathers resembles DNA.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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

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OBJETIVO: a ancoragem óssea é fundamental para o sucesso do tratamento de algumas más oclusões, pois permite a aplicação de forças contínuas, diminui o tempo de tratamento e independe da colaboração do paciente. MÉTODOS: o propósito desse trabalho foi comparar, por meio de modelos dentários, a perda de ancoragem após a retração inicial de caninos superiores entre dois grupos. O grupo A utilizou o mini-implante enquanto o grupo B utilizou o Botão de Nance. Para todos os pacientes foram realizados dois modelos (M1 e M2). Os primeiros modelos foram realizados ao início (M1), e os outros ao final da retração inicial de canino (M2). RESULTADOS: todas as medidas foram tabuladas e submetidas à análise estatística. Para verificar o erro sistemático intraexaminador foi utilizado o teste t pareado. Na determinação do erro casual utilizou-se o cálculo de erro proposto por Dahlberg. Para comparação entre as fases Início e Após, foi utilizado o teste t pareado. Para a comparação entre os grupos de mini-implante e Botão de Nance, foi utilizado o teste t de Student para medidas independentes. em todos os testes foi adotado nível de significância de 5% (p<0,05). CONCLUSÃO: ao se medir e comparar em modelos dentários a perda de ancoragem dos molares após a retração inicial de canino utilizando-se dois sistemas de ancoragem distintos (Mini-implante e Botão de Nance), pôde-se observar a inexistência de diferença estatisticamente significativa entre os dois grupos.