Desenvolvimento de um sistema de planejamento, gestão de serviços e controle de custos em obras de construção civil

The increasing competitiveness of the construction industry, set in an economic environment in which the offer is now greater than the demand , causes the prices of many products and services, are strongly influenced by the processes of production and the final consumer. Thus, to become more competitive in the market and construction companies are seeking new alternatives to reduce and control costs, production processes and tools that allow for close monitoring of the construction schedule, with the consequent compliance deadline with the client. Based on this scenario, the creation of control tools, service management and planning work emerges as an investment opportunity and an area that can promote great benefits to construction companies. The goal of this work is to present a system of planning, service management and costs control that through worksheets provide information relating to the production phase of the work, allowing the visualization of possible irregularities in the planning and cost of the enterprise, enabling the company to take steps to achieve the goals of the enterprise in question, and correct them when necessary. The developed system has been used in a piece of real estate in Rio Grande do Norte, and the results showed that its use together allowed the construction company to accompany their results and take corrective and preventive actions during the production process, efficiently and effective

An adaptive system based on artificial neural networks for NPK fluid fertilizer application

The application process of fluid fertilizers through variable rates implemented by classical techniques with feedback and conventional equipments can be inefficient or unstable. This paper proposes an open-loop control system based on artificial neural network of the type multilayer perceptron for the identification and control of the fertilizer flow rate. The network training is made by the algorithm of Levenberg-Marquardt with training data obtained from measurements. Preliminary results indicate a fast, stable and low cost control system for precision fanning. Copyright (C) 2000 IFAC.

Effects of the eccentricity on the primaries in the gravitational capture phenomenon

Gravitational capture is a characteristic of some dynamical systems in celestial mechanics, as in the elliptic restricted three-body problem that is considered in this paper. The basic idea is that a spacecraft (or any particle with negligible mass) can change a hyperbolic orbit with a small positive energy around a celestial body into an elliptic orbit with a small negative energy without the use of any propulsive system. The force responsible for this modification in the orbit of the spacecraft is the gravitational force of the third body involved in the dynamics. In this way, this force is used as a zero cost control, equivalent to a continuous thrust applied in the spacecraft. One of the most important applications of this property is the construction of trajectories to the Moon. The objective of the present paper is to study in some detail the effects of the eccentricity of the primaries in this maneuver.

Análise das vantagens de duas técnicas anestésicas - Venosa e inalatória - Para colecistectomia por videolaparoscopia

Background and Objectives - It is essential to reduce health care costs without impairing the quality of care. Propofol is associated to faster recovery and it is known that post-anesthesia care unit (PACU) costs are high. The aim of this study was to evaluate the advantages of two anesthesia regimens - propofol continuous infusion or isoflurane - taking into account the cost of both techniques on PACU stay. Methods - Forty seven patients, physical status ASA I, II and III, undergoing laparoscopic cholecystectomy were divided into 2 groups according to the anesthetic agent: G1, conventional propofol continuous infusion (100-150 μg.kg-1.min-1) and G2, isoflurane. All patients were induced with sufentanil (1 μg.kg-1) and propofol (2 mg.kg-1) and were kept in a re-inhalation circuit (2 L.min-1 of fresh gas flow) with 50% N2O in O2, sufentanil (0.01 μg.kg-1.min-1) and atracurium (0.5 mg.kg-1), or pancuronium (0.1 mg.kg-1) for asthma patients. All patients received atropine and neostigmine at the end of the surgery. Prophylactic ondansetron, dipyrone and tenoxican were administered and, when necessary, tramadol and N-butylscopolamine. Costs of anesthetic drugs (COST), total PACU stay (t-PACU), and PACU stay after extubation (t-EXT) were computed for both groups. Results - Costs were significantly lower in the isoflurane group but t-PACU was 26 minutes longer and t-EXT G1COST were significant for G1 only. Therefore, in G1, t-PACU was a function of propofol doses. Conclusions - We concluded that the use of isoflurane as anesthesia maintenance agent for laparoscopic cholecystectomy showed lower drug costs as compared to propofol. However, isoflurane group patients stayed longer in PACU as compared to propofol continuous infusion group.

Effects of the eccentricity on the primames in the gravitational capture phenomenon

Gravitational capture is a characteristic of some dynamical systems in celestial mechanics, as in the elliptic restricted three-body problem that is considered in this paper. The basic idea is that a spacecraft (or any particle with negligible mass) can change a hyperbolic orbit with a small positive energy around a celestial body into an elliptic orbit with a small negative energy without the use of any propulsive system. The force responsible for this modification in the orbit of the spacecraft is the gravitational force of the third body involved in the dynamics. In this way, this force is used as a zero cost control, equivalent to a continuous thrust applied in the spacecraft. One of the most important applications of this property is the construction of trajectories to the Moon. The objective of the present paper is to study in some detail the effects of the eccentricity of the primaries in this maneuver.

Medicação de alto custo para portador de sofrimento psíquico: Um estudo preliminar dos custos

The present work aims to raise the costs of high-cost drugs used to treat patients of Refractory Schizophrenia in ambulatory unit. The study was carried out in the Psychosocial Support Center, which treated 33 patients with these medications, during the period of June, 2005 to May, 2006. Data analysis disclosed that the mostly used drugs to treat the carriers of Refractory Schizophrenia were: clozapina and risperidona. It was observed that the treatment with olanzapina is more expensive than that with risperidona. The study concluded that the analysis of the consumption and costs of drugs of high cost is necessary to subside better management of the expenses and new investments in the service. Moreover, the necessity of more studies in the area was also identified to contribute with the control of costs.

Comparative Analysis of 2 Techniques of Double-Gloving Protection During Arch Bar Placement for Intermaxillary Fixation

Purpose: This study was conducted to comparatively evaluate, in a prospective and randomized manner, 2 techniques for providing double-gloving protection during arch bar placement for intermaxillary fixation. Materials and Methods: A total of 42 consecutive patients in whom application of an Erich bar was indicated for intermaxillary fixation were equally divided into 2 groups. In group 1, 2 sterile surgical gloves were used; in group 2, a nonsterile disposable inner glove was used under a sterile surgical glove. Wilcoxon, Mann-Whitney, Kruskal-Wallis, and binomial statistical tests were used to analyze the findings. Results: A total of 103 perforations were found in the outer gloves (47 in group 1 and 56 in group 2), along with 5 perforations in inner gloves in both groups (α = .01). No significant statistical difference was found between groups in terms of inner glove perforations (α = .05). The nondominant hand presented with 70.9% of the perforations, statistically significant to 1%. Conclusions: Both double-gloving techniques were found to provide effective clinician protection. The use of a nonsterile disposable glove under the surgical glove is possible for less-invasive procedures, offering the same safety as using 2 sterile surgical gloves while decreasing operational costs. This method does not eliminate the need to change gloves when a perforation is suspected or noted during the surgery, however. © 2007 American Association of Oral and Maxillofacial Surgeons.

A comparative study of health care policy in the United States and Canada: what policymakers in Latin America might and might not learn from their neighbors to the North

Includes bibliography

Sistema de classificação de pacientes cirúrgicos em hospitais especializado: construção e validação de um instrumento

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

Diabete e gravidez: estudo prospectivo do custo benefício da hospilização comparado com atenção ambulatorial

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Comparação de gastos com serviços de atenção básica à saúde de homens e mulheres em Bauru, São Paulo, 2010

OBJECTIVE: to compare expenditure on primary health care services for men and women in Bauru-SP, Brazil. METHODS: cross-sectional study with a sample composed of randomly selected health service users' aged ≥50 years. Healthcare expenditure over the last 12 months was analyzed and stratified into: medical consultations, exams, medication and overall expenditure. RESULTS: 707 women and 256 men were assessed. Women had higher overall expenditures than men (median: R$128.1 versus R$108.6; p-value=0.027). Comparing females and males, being female was associated with higher medical consultation expenditure (27.6% versus 18.4%, respectively p-value=0.005) and exams (27.1% versus 19.5%, respectively p-value=0.022). After statistical adjustments (smoking, socioeconomic status, physical activity and overweight), being female was still associated with higher exam-related expenditure (Odds Ratio= 1.47; 95% confidence interval: 1.01-2.14). CONCLUSION: women have higher expenditure related to exams than men. Female obesity was associated with medical consultation higher expenditure.

Physical inactivity of adults and 1-year health care expenditures in Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Costs of most frequent nursing activities in highly dependent hospitalized patients

This quantitative study aimed to identify the costs of the most frequent nursing activities in highly dependent hospitalized patients at a medical clinic. The non-probabilistic convenience sample corresponded to 607 observations regarding oral feeding activities (OF), blood pressure verification (BP)/heart rate (HR), body temperature checking (BTC), performance of intimate hygiene and management of feeding probe. The costs identified corresponded to R$2.40 (SD+/-2.64) for OF feeding; R$1.26 (SD+/-0.48) to verify the BP/HR; R$1.17 (SD+/-0.46) for BTC; R$15.59 (SD+/-8.62) to perform intimate hygiene and R$5.95 (SD+/-2.13) for management of feeding probe. This study will facilitate cost management, with a view to avoiding waste related to unnecessary resource consumption and establish a correlation between costs and care delivery results. Supported by Pro-Reitoria de Pesquisa, Universidade de Sao Paulo, Brazil.

Health, Justice, and Fairness

In this study I will endeavor to show that the American system of health care violates any conception of distributive justice understood as equality of opportunity. This system fails to provide equal access through a lack of universal insurance, a consumer driven conception of quality, and a system wide focus on cost control, leaving millions of Americans exposed to the ravages of disease. However, if health is understood as an antecedent for one's ability to function across a number of categories that have been objectively deemed as vital to engage in a life that is fully human than the commitment our nation has to the protection of fair equality of opportunity, established by our adoption of a Rawlsian conception of justice, necessitates a revision of our nation's conception of quality to encapsulate health outcomes as well as the advent of a system of universal coverage. Quality care will come to be understood as care that returns to the patient the ability to function across those categories of functioning that illness has jeopardized, and this conception of quality will precipitate system wide reform geared at the creation of positive health outcomes. This paper will articulate this argument by reconstructing and synthesizing precepts from the contemporary philosophical sources and then applying these to the practical workings of our healthcare system, while concurrently demonstrating that a system of distributive justice is compatible with the creation of a universal system of healthcare.

Agro-estratégias através do tempo

No início dos anos 2000 consolidou-se o quadro de significativas alterações e ajustes nas estratégias das organizações agrícolas. Destacam-se: a consolidação das organizações, a internacionalização dos sistemas de base agrícola, a inovação presente em processos e produtos e de natureza organizacional, a introdução da variável socioambiental, e a adoção de estratégias de transparência. A cooperação pode exigir investimentos especializados, e os incentivos para a sua realização dependem de mecanismos de controle de custos de transação. Com a presença de incerteza no ambiente econômico e nas transações, a flexibilidade planejada visa eventuais ajustes em face de eventos inesperados. Arranjos institucionais complexos (leia-se, contratos) são observados como forma de responder a necessidades apontadas. Além de confiança, reputação, e mecanismos relacionais, a evolução dos mecanismos sociais por trás dos contratos de sociedade é algo a ser desenvolvido. O presente estudo propõe que as cooperativas agrícolas podem desenvolver mecanismos de governança que geram uma competência adaptativa para enfrentar eventos inesperados. O presente estudo explorou uma visão retrospectiva de estratégias adotadas por cooperativas brasileiras. Assumiu-se aqui uma nova vertente analítica da \"História de Negócios\" e suas implicações voltadas ao sistema agroindustrial. Como diretriz de método, foram seguidas as etapas de identificação das principais estratégias relatadas nos estudos de casos escolhidos, sobre cooperativas, desenvolvidos entre 1991 e 2002. Na sequência compararam-se as estratégias com as diretrizes apresentadas no capítulo teórico. Admite-se que as estratégias que implicam em maiores investimentos em ativos específicos tendem a tornarem mais rígidos os arranjos e dificultam a plasticidade, ou adaptação, das cooperativas agrícolas - onde naturalmente as mudanças ocorrem de forma mais lenta - frente a choques ou eventos externos.