Metodologia para o desenvolvimento de um protocolo de indicadores para a avaliação da capacidade de gestão da assistência farmacêutica

Este artigo apresenta o desenvolvimento de um protocolo de indicadores para a avaliação da capacidade de gestão do Componente Especializado da Assistência Farmacêutica no âmbito estadual. Avaliar este componente é detectar obstáculos e oportunidades e propor estratégias de avanços na gestão. A escolha do referencial teórico de capacidade de governo de Carlos Matus, refletido no conceito de capacidade de gestão e de gestão da assistência farmacêutica, tem por base a necessidade de superar a fragmentação e a redução tecnicista imposta à assistência farmacêutica. Iniciou-se com estudos exploratórios com os atores diretamente envolvidos com o cotidiano do componente, os quais visaram aprofundar os conhecimentos sobre o objeto. Tendo como base estes estudos foram propostos os modelos teórico e lógico, para definição das categorias de análise e o protocolo de indicadores. A metodologia utilizada, incluindo a validação do protocolo, a definição dos instrumentos de coleta de dados e as diretrizes para a pesquisa de campo, assim como a discussão sobre o processo de construção, são apresentadas neste artigo. Os referenciais adotados e o protocolo de indicadores proposto trazem avanços para o referencial da gestão da assistência farmacêutica ao propor uma mudança do foco técnico-logístico, para as ações de natureza estratégica e política, ou aquelas que fomentem maior participação, autonomia e sustentabilidade.

Avaliando a capacidade funcional com o VES-13

Vídeo do Curso de Atenção integral à saúde do idoso. Explicita sobre o cuidado integral à população idosa na atenção básica e apresenta o VES-13, presente na caderneta de saúde da pessoa do idoso. A caderneta ajuda a avaliar o idoso em várias dimensões: sociofamiliar, clínica, ambiental e funcional. A mais impactante é a funcionalidade, que pode ser feita por meio do VES-13, instrumento capaz de identificar a pessoa idosa vulnerável residente na comunidade. O VES-13 permite o acompanhamento do idoso e facilita a adoção de condutas e diagnósticos pela equipe de saúde.

Capacidade funcional de idosos: Uma revisão bibliográfica sobre os fatores associados

O objetivo deste trabalho foi identificar os principais fatores que atuam sobre a capacidade funcional dos idosos, através de uma revisão bibliográfica integrativa sobre o tema proposto. Inicialmente foi realizada uma busca por descritores do assunto no site Ciências da Saúde. Estabelecidos os descritores foram realizadas buscas por artigos científicos relacionados ao assunto da pesquisa, usando as bases bibliográficas da Literatura Latino-Americana e do Caribe (LILACS) e Scientific Electronic Library Online (Scielo). Assim, foram encontrados inicialmente 169 artigos, dos quais inicialmente, 24 atendiam aos critérios de refinamento. Desses 24 artigos,após a leitura na íntegra, foram selecionados 16 artigos. Foram apontados pelos autores pesquisados, como principais fatores associados a dependência funcional em idosos: condições de saúde (doenças crônicas ou não crônicas), sexo feminino, baixa escolaridade, idade superior a 80 anos, institucionalização, quedas, síndrome de fragilidade e fatores socioeconômicos e demográficos (baixa renda, viuvez, composição familiar, poucas relações sociais, etc). Esses resultados demonstram que é importante conhecer os fatores relacionados ao desenvolvimento da dependência funcional nos idosos, pois esses elementos permitirão ao profissional atuar antes,que o problema se torne crônico e complexo, bem como fortalecer as ações das equipes de saúde da família na promoção da saúde da pessoa idosa, preservando sua autonomia e dependência funcional

O desenvolvimento do texto dissertativo em crianças da 4ª série

This reaserch analysed the developmental stage of fourth grade (primary school) children in ability of writting argumentative texts joint with their context. The reason of this reaserch is the lack of new studies in linguistical area and high ratio of unable students to make this kind of text. It will be showed the analysis of making text by public schools children for three months. These data were analysed trying identify argumentative operators, the kinds of arguments used and the stage of the argumentative ability of these children. The study showed that the introduction of argumentative text in first grades give them more chances of succeed, preparing these pupils in their finishing high school. This fact obviously will make easier the development of their critical point of view, helping the students to think about their living social reality.

Amostragem e variabilidade espacial de atributos químicos do solo em área de vegetação natural em regeneração

The objectives of this work was to estimate the number of soil subsamples considering the classical statistics and geostatistics and determine the spatial variability of soil fertility attributes of an Ultisol, with clay texture, in an area of regenerating natural vegetation in Alegre - ES. Soil samples were collected in a depth of 0.0-0.2 m, at the crossing points of a regular grid, comprising a total of 64 points located at 10 m-intervals. The area presented low fertility soil. Considering a variation of 5% around the mean in the classic statistics, it is necessary a larger number of samples in relation to geostatistics. All the chemical attributes showed moderate to high spatial dependence, except for the effective cation exchange capacity (CECe), which showed pure nugget effect. The spherical semivariogram model gave the best fit to the data. Isoline maps allowed visualizing the differentiated spatial distribution of the contents of soil chemical attributes.

Avaliação de técnicas de classificação digital de imagens landsat em diferentes padrões de cobertura da terra em Rondônia

Remotely sensed imagery has been widely used for land use/cover classification thanks to the periodic data acquisition and the widespread use of digital image processing systems offering a wide range of classification algorithms. The aim of this work was to evaluate some of the most commonly used supervised and unsupervised classification algorithms under different landscape patterns found in Rondônia, including (1) areas of mid-size farms, (2) fish-bone settlements and (3) a gradient of forest and Cerrado (Brazilian savannah). Comparison with a reference map based on the kappa statistics resulted in good to superior indicators (best results - K-means: k=0.68; k=0.77; k=0.64 and MaxVer: k=0.71; k=0.89; k=0.70 respectively for three areas mentioned). Results show that choosing a specific algorithm requires to take into account both its capacity to discriminate among various spectral signatures under different landscape patterns as well as a cost/benefit analysis considering the different steps performed by the operator performing a land cover/use map. it is suggested that a more systematic assessment of several options of implementation of a specific project is needed prior to beginning a land use/cover mapping job.

Análise do investimento em climatização para bovinos de leite em sistema de alojamento free-stall

The difficulty in adapting European dairy cows breeds in Brazil affect considerably the milk production sector. Brazilian climatic conditions are not totally favorable and the development of new tecnologies is needed for the animals express their genetic potential, as well as their best feed conversion. An economical analysis of the applied investment in the free-stall climatization equipment in dairy housing, for estimating studies related to profit, possibility of return investment as well as time for this return is necessary. The objective of this research was to evaluate the influence of climatization investment in the milk production process and analyze the economical aspect of this investment. There were used 470 high productive dairy cows with genetic and morphologic homogeneous characteristics, and analyzed in two similar periods. Investment calculations were done using Excell®. The results were satisfactory and the invested capital was proved to return to the producer in a short term, 57 days.

Avaliação da biodegradabilidade anaeróbia de resíduos da bovinocultura e da suinocultura

The biodegradability of animal wastes production was evaluated through a simplified methodology that allowed the verification of the applicability of anaerobic processes. The experiments were performed in bath reactors, with granular sludge of three origins: UASB reactor treating dairy effluent, UASB reactor treating swine effluent and UASB reactor treating effluent of slaughterhouse of poultry. The experiments (1) - dairy effluent and poultry slaughterhouse non-adapted sludge; (2) -swine effluent and poultry slaughterhouse non-adapted sludge; (3) - dairy effluent and poultry slaughterhouse adapted sludge; (4) - swine effluent and poultry slaughterhouse adapted sludge; (5) - dairy effluent and dairy sludge, and (6) - swine effluent and swine sludge were performed in Incubator Shaker, at a temperature of 35 °C, under agitation at a 150 rpm, for 5 minutes, every 1 hour. A substrat:biomass relationship of 0.5 was used. Kinetic models of Monod, Zero Order, First and Second Order were tested and it was verified that the First Order model provided the best adjustment. The apparent First Order kinetic parameter (k1) was estimated for the experiments 1; 2; 3; 4; 5, and 6, as 2.51 x 10-2; 2.49 x 10-2; 1.90 x 10-2; 3.09 x 10-2; 2.54 x 10-2; 4.09 x 10-2 h-1, respectively.

Desempenho físico-mecânico de minipainéis de terra crua tratada com aditivos químicos

The aim of this research was to study the effect of chemical additives (lime and Portland cement) associated with sodium silicate on soil in order to obtain compressed soil bricks. Mini panels were constructed with such bricks being their physical and mechanical characteristics determined in laboratory conditions and their behavior evaluated through the association of destructive and non-destructive methods. For this purpose a sandy soil and a finely divided one were added to Portland cement and lime in the dosage of 6% and 10% taken in dry weight basis in relation to the dry soil. The sodium silicate dosage of 4% was also taken in dry weight basis in relation to the dry soil-cement or to the dry soil-lime. The compressed soil bricks were cured in a humidity chamber for 7; 28; 56 and 91 days. The bricks were laid on the fourteenth day to form prismatic mini panels each one with four layers of bricks. After 28; 56 and 91 days the mini panels were submitted to both; ultrasonic and compressive tests to determine its elastic properties (dynamic modulus) and the compressive resistance. The best results in terms of compressive strength, water absorption capacity or dynamic elastic modulus, were reached by the sandy soil added to 10% of Portland cement or lime associated with sodium silicate.

Colheita de cana-de-açúcar com auxílio mecânico

Civil society and sugarcane farmer demands indicate that harvesting technology has enough limitations to jeopardize production in large sugar cane producing areas. This work analyses the current mechanical harvesting compared to a semi-mechanical harvesting proposal, on the bases of eleven characteristics considered determinant for a quick spreading of green cane harvesting on hilly areas, with lower impact on agricultural labor and farmers investment capacity.

Durabilidade de compósito biomassa vegetal-cimento modificado por polímero

The durability of the cellulose-cement composites is a decisive factor to introduce such material in the market. Polymers have been used in concrete and mortar production to increase its durability. The goal of this work was the physical and mechanical characterization of cellulose-cement composites modified by a polymer and the subsequent durability evaluation. The work also evaluated the dispersion of acrylic polymer in composites made of Pinus caribaea residues. The physical properties observed were water absorption by immersion and bulk density. Rupture modulus and toughness were determined by flexural test. The specimens were obtained from pads, produced by pressing and wet curing. Samples were subjected to accelerated aging tests by repeated wetting and drying cycles and hot-water bath and natural aging. The scanning electron microscopy (SEM) allowed verifying the fiber and composite characteristics along the time. For the composite range analyzed, it was observed the polymer improved the mechanical properties of composites besides a significant decreasing in water absorption. The use of polymer improved the performance of vegetable fiber-cement composites when compared to the conventional mortar, due to water absorption decreasing.

Sistema de sincronismo entre a colhedora de cana-de-açúcar e o veículo de transbordo

One of the problems found in mechanical harvest of sugar cane is the lack of synchronism between the harvest machine and the infield wagon, causing crop losses as well as operational capacity. The objective of the present research was to design a system capable of helping to synchronize the sugar cane harvest machine with the wagon. The communication between tractor and harvest machine is wireless. Two ultrasound sensors coupled to the elevator and a microprocessor manage such information, generating a correct synchronization among the machines. The system was tested in laboratory and on field performing its function adequately, maintaining the two machines in synchronization, indicating and alerting the operators their relative positions. The developed system reduced the sugar cane lost in 60 kg ha-1 comparing to the harvest with the system turned off.

Fundações de construções submetidas a esforços de tração em solo de alta porosidade da região de Campinas - SP

This paper presents the behavior of three bored piles conducted in diabasic soil submitted to uplift forces. The piles were built at the site for Experimental Studies in Soil Mechanics and Foundations of UNICAMP, located in the city of Campinas, Brazil. Field tests have already been conducted at the site (SPT, CPT, DMT and PMT), as well as laboratory tests by using sample soils taken from a well up to 17 m deep. The water table is not checked until a depth of 17 m. In order to check the behavior of the piles when submitted to uplift forces, slow static load tests were carried out as the recommendations of NBR 12131. The carrying capacity of these piles was also provided by means of theoretical methods, appropriate for uplift forces, and through semi-empirical methods appropriate for compression forces, considering only the portion of lateral resistance. The values estimated by using the considered methods were compared to those obtained by means of load tests. One of the tested piles was extracted from the soil to be the subject of a study on its geometry.

The relationship between physical aspects of quality of life and extreme levels of regular physical activity in adults

This study aimed to check for any significant differences in perceived quality of life, specifically aspects of a physical nature, among volunteers who are more physically active and those less physically active in a university community. The sample consisted of 1,966 volunteers in a university community in Brazil. To assess physical activity levels, volunteers responded to the International Physical Activity Questionnaire (IPAQ), and to analyse the perception of quality of life they responded to WHOQOL-bref, which is classified into three groups according to level of physical activity, taking into account the metabolic equivalent index (MET) over a full week. For comparison, consideration was given to the first and third tertiles, respectively, namely groups of more and less active students. The results indicated that individuals who engaged in more physical activity had a more positive perception of quality of life compared to those who were less active in physical aspects related to the ability to work, energy for day-to-day activities and locomotion.

Germinação e crescimento de Calophyllum brasiliense (Clusiaceae), uma espécie típica de florestas inundadas

Soil waterlogging and the subsequent reduction in the amount of oxygen available for the respiration of the root system selected, along the evolutive process, plants able to thrive in seasonally or permanently flooded areas. In neotropical plants there are many types of adaptations to flooding. In this paper we present the results of the work carried out with seeds and seedlings of C brasiliense subjected to hypoxia during germination and early development. C brasiliense seeds are not photoblastic and survive up to three months burried in a water saturated substrate, but germination only takes place in well-drained soils. Soil waterlogging does not inhibit seedling growth and there are no apparent morphological changes of the aerial part of flooded plants. New and aerated roots that make plant survival possible replace old and spoiled roots. In contrast to many typical species of flood-prone areas where growth is inhibited by oxygen stress. C. brasiliense seedlings seem to be well adapted to their waterlogged environment. Seed dispersion, the absence of photoblastic response as well as seed and seedling capacity of surviving and growing in waterlogged soils contribute to the wide geographic distribution of C. brasiliense always associated with areas subjected to soil waterlogging.