216 resultados para Suplementar


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A presente dissertação tem por objetivo estudar como foram idealizados e como foram implementados os contatos de gestão, tendo por fim abordar limites e potencialidades deste instrumento, em relação as agências reguladoras federais, com uma abordagem mais dedicada a Agência Nacional de Saúde Suplementar, trançando um histórico do setor de saúde suplementar, porém com apontamentos de todas as agências reguladoras federais, quanto a utilização do contrato de gestão. O estudo foi desenvolvido com a apresentação de um breve retrato histórico desse instrumento, sua evolução e aspectos dos momentos histórico de sua implementação pelo governo federal. São apresentadas definições conceituais sobre contrato de gestão, descrição de sua organização e como se dá sua implementação nas agências reguladoras, como essas se organizam e utilizam essa ferramenta. Em seguida é feita uma breve abordagem de projeto de lei que entre outros assuntos trata sobre o contrato de gestão. Por fim, são apresentadas considerações sobre estudo realizado e apresenta-se a proposição de continuidade de novos estudos sobre o tema.

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This research was motivated by the requirement of asbestos s replacement in building systems and the need to generate jobs and income in the country side of the state of Bahia, Brazil. The project aimed at using fibers from licuri leaves (syagrus coronata), an abundant palm in the region, to produce composites appropriate for the sustainable production of cement fibre reinforced products in small plants. The composites were produced in laboratory using Portland cement CP-II-F32, sand, water, licuri palm fiber contents of 1.0, 1.5 and 2.0% by weight of binder (two different fiber length) and metakaolin. The latter was chosen as an additional binder for its efficiency to reduce the alkalinity of cementitious matrixes therefore preventing the degradation of vegetable fibers. The characterization of the composite components was carried out by sieving and laser particle size analyses, thermal analysis, fluorescence and X-ray diffraction. The composites performance was evaluated by 3- point-bending tests, compressive strength, ultrasound module of elasticity, free and restrained shrinkage, water capillarity absorption and apparent specific gravity. It has been found that the addition of fibers increased the time to onset of cracking over 200.00% and a 25% reduction in cracks opening in the restrained shrinkage test. The capillary absorption reduced about 25% when compared to fiber-free composites. It was also observed with regard to flexural strength, compressive strength and specific gravity, that the addiction of fibers did not affect the composite performance presenting similar results for compounds with and without fibers. In general it can be stated that the reinforced composite fibers of palm licuri presents physical and mechanical characteristics which enable them to be used in the intended proposals of this research

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Steam injection is the most used method of additional recovery for the extraction of heavy oil. In this type procedure is common to happen gravitational segregation and this phenomenon can affect the production of oil and therefore, it shoulds be considered in the projects of continuous steam injection. For many years, the gravitational segregation was not adequately considered in the calculation procedures in Reservoir Engineering. The effect of the gravity causes the segregation of fluids inside the porous media according to their densities. The results of simulation arising from reservoirs could provide the ability to deal with the gravity, and it became apparent that the effects of the gravity could significantly affect the performance of the reservoir. It know that the gravitational segregation can happen in almost every case where there is injection of light fluid, specially the steam, and occurs with greater intensity for viscous oil reservoirs. This work discusses the influence of some parameters of the rock-reservoir in segregation as viscosity, permeability, thickness, cover gas, porosity. From a model that shows the phenomenon with greater intensity, optimized some operational parameters as the rate flow rate steam, distance between the wells injector-producer, and interval of completion which contributed to the reduction in gravity override, thus increasing the oil recovery. It was shown a greater technical-economic viability for the model of distance between the wells 100 m. The analysis was performed using the simulator of CMG (Computer Modeling Group-Stars 2007.11, in which was observed by iterating between studied variables in heavy oil reservoirs with similar characteristics to Brazilian Northeast

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The artificial lifting of oil is needed when the pressure of the reservoir is not high enough so that the fluid contained in it can reach the surface spontaneously. Thus the increase in energy supplies artificial or additional fluid integral to the well to come to the surface. The rod pump is the artificial lift method most used in the world and the dynamometer card (surface and down-hole) is the best tool for the analysis of a well equipped with such method. A computational method using Artificial Neural Networks MLP was and developed using pre-established patterns, based on its geometry, the downhole card are used for training the network and then the network provides the knowledge for classification of new cards, allows the fails diagnose in the system and operation conditions of the lifting system. These routines could be integrated to a supervisory system that collects the cards to be analyzed

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Water injection is the most widely used method for supplementary recovery in many oil fields due to various reasons, like the fact that water is an effective displacing agent of low viscosity oils, the water injection projects are relatively simple to establish and the water availability at a relatively low cost. For design of water injection projects is necessary to do reservoir studies in order to define the various parameters needed to increase the effectiveness of the method. For this kind of study can be used several mathematical models classified into two general categories: analytical or numerical. The present work aims to do a comparative analysis between the results presented by flow lines simulator and conventional finite differences simulator; both types of simulators are based on numerical methods designed to model light oil reservoirs subjected to water injection. Therefore, it was defined two reservoir models: the first one was a heterogeneous model whose petrophysical properties vary along the reservoir and the other one was created using average petrophysical properties obtained from the first model. Comparisons were done considering that the results of these two models were always in the same operational conditions. Then some rock and fluid parameters have been changed in both models and again the results were compared. From the factorial design, that was done to study the sensitivity analysis of reservoir parameters, a few cases were chosen to study the role of water injection rate and the vertical position of wells perforations in production forecast. It was observed that the results from the two simulators are quite similar in most of the cases; differences were found only in those cases where there was an increase in gas solubility ratio of the model. Thus, it was concluded that in flow simulation of reservoirs analogous of those now studied, mainly when the gas solubility ratio is low, the conventional finite differences simulator may be replaced by flow lines simulator the production forecast is compatible but the computational processing time is lower.

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The National School Nutrition Program is the oldest program in the country directed at food and nutrition safety. Its aims are to offer nutritional food as a supplement to students of public and philanthropic schools. Studying school nutrition transcends the investigation as a purely social program, given that it reaches the fields of public health, nutrition and food, using a wide variety of approaches. Thus, it is characterized by a multidisciplinary study, where the disciplines work side by side in distinct aspects of a single problem. Aim: This study aims to assess hygiene practices during the preparation of meat-based meals in public schools in the city of Natal, Brazil. Methods: A list was applied at 27 schools to identify the procedures of good food preparation practices. In addition, cooking and meal distribution temperature were measured and a microbiological analysis of the final preparation and of the water used in preparing it was performed. For microbiological analyses of the food, we analyzed coliforms at 45°C, coliforms at 35°C and Enterococcus, and for the water, we analyzed thermotolerant coliforms and total coliforms, using the methods recommended by APHA, 1995. Results: Most of the schools did not meet the required standards in all the variables related to good food preparation practices, except for the time spent preparing the meat, in which 89% were within the norm. Cooking temperature of the meals was within the standard; however, the temperature at distribution and the time spent dispensing the meals were inadequate. Of the 27 schools, 22 (81.5%) showed the presence of coliforms at 35° C in at least one meal sample and 18 (66.7%) had values above the recommended limit for coliforms at 45°C. The presence of E. coli was identified in 6.1% of the samples analyzed. The presence of Enterococcus was not found at any of the schools. With respect to the water, the North district of the city was the only one that did not meet the standards for the two indicators evaluated. The contamination found was not associated with the hygiene or food storage problems observed. Conclusions: The results show that the hygiene-sanitary conditions of meat-based public school meals were unsatisfactory, demonstrating the need for improvements in the production process to preserve the health of the student population. Multidisciplinarity: Researchers from the areas of food microbiology, nutrition, public health and statistics took part in this study, a decisive factor for characterizing the research as multidisciplinary

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Diabetes mellitus has been associated with bone metabolism alterations, such as osteopenia and osteporosis. So, the search of new anabolic agents promote bone mass gain can be important to prevent osteoporosis. The aim of this study was evaluate zinc anabolic effect over bone in diabetic and post-menopausal osteopenic models. Diabetes was induced by STZ (45mg/Kg of body weight) administration and post-menopausal by bilateral ovariectomy. Adults female Wistar rats (n=65) were divided in 5 groups: control group (n=15), ovariectomized without (n=15) and with zinc supplementation (n=10) groups, diabetic and ovarioctomized without (n=15) and with zinc supplementation (n=10) groups. Studied periods had been untill 90 days. Diabetic condition was confirmed hiperglicemic state and alterations of state with polyuria, polyphagia, polydipsia and glucosuria. Histomorphometric analysis showed that zinc supplementation increased trabecular thickness and reduced trabecular distance significantly in diabetic groups with similar values to those showed in control group. Correlation analysis of histomorphometric parameters with serum glucose concentration showed that more time in hyperglycemia more bone damage, as well as, zinc supplementation contributed to prevent this damage. Elevated serum glucose caused hyperzincuria, phosphaturia and calciuria. Zinc supplementation promoted increased levels of calcium and phosphorous ions in 90th days diabetic group. No alteration was observed by ovariectomy in mineral (Ca, P and Zn) serum and urine concentrations. Total serum Alkaline Phosphatase activity increased in diabetic groups, supplemented or not, compared with control group. However, Tartarate-Resistant Acid Phosphatase, magnesium and serum zinc did not altered in studied groups. Serum albumin was reduced only in diabetic groups. Serum creatinine was unaltered. These results support the hypotesis that zinc can be used to prevent and treat diabetic and post-menopausal osteopenia

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Gene therapy is based on the transfer of exogenous genetic material into cells or tissues in order to correct, supplement or silencing a particular gene. To achieve this goal, efficient vehicles, viral or non-viral, should be developed. The aim of this work was to produce and evaluate a nanoemulsion system as a possible carrier for no-viral gene therapy able to load a plasmid model (pIRES2-EGFP). The nanoemulsion was produced by the sonication method, after been choose in a pseudo-ternary phase diagram build with 5 % of Captex 355®, 1.2 % of Tween 80®, 0.8 % of Span 80®, 0.16% of stearylamine and water (to 100 %). Measurements of droplet size, polydispersity index (PI), zeta potential, pH and conductivity, were performed to characterize the system. Results showed droplets smaller than 200 nm (PI < 0.2) and zeta potential > 30 mV. The formulation pH was near to 7.0 and conductivity was that expected to oil in water systems (70 to 90 μS/s) A scale up study, the stability of the system and the best sterilization method were also evaluated. We found that the system may be scaled up considering the time of sonication according to the volume produced, filtration was the best sterilization process and nanoemulsions were stable by 180 days at 4 ºC. Once developed, the complexation efficiency of the plasmid (pDNA) by the system was tested by agarose gel electrophoresis retardation assay.. The complexation efficiency increases when stearylamine was incorporated into aqueous phase (from 46 to 115 ng/μL); regarding a contact period (nanoemulsion / pDNA) of at least 2 hours in an ice bath, for complete lipoplex formation. The nanoemulsion showed low toxicity in MRC-5 cells at the usual transfection concentration, 81.49 % of survival was found. So, it can be concluded that a nanoemulsion in which a plasmid model was loaded was achieved. However, further studies concerning transfectation efficiency should be performed to confirm the system as non-viral gene carrier

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

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Objetivou-se avaliar os efeitos da suplementação com diferentes fontes de energia e de compostos nitrogenados sobre o crescimento e produção de bacteriocinas de bactérias ácido-láticas in vitro. As incubações foram conduzidas utilizando-se fluido ruminal originado de um novilho Holandês-Zebu fistulado no rúmen. O animal foi mantido em pastagem de Brachiaria decumbens recebendo 200 g/dia de proteína bruta suplementar. Os substratos e o inóculo foram acondicionados em frascos de vidro considerando-se oito tratamentos: celulose, celulose e caseína, celulose e peptona de soja, celulose e ureia, amido, amido e caseína, amido e peptona de soja e amido e ureia. Incubações sucessivas foram conduzidas para seleção dos microrganismos em função das fontes energéticas e de compostos nitrogenados. O amido favoreceu o crescimento de bactérias ácido-láticas em comparação à celulose. A suplementação com proteína verdadeira (peptona de soja e caseína) estimulou o crescimento dessas bactérias em comparação ao controle (sem suplementação com compostos nitrogenados). A adição de ureia não estimulou o crescimento de bactérias ácido-láticas. Nenhuma atividade antimicrobiana foi detectada a partir das colônias de bactérias ácido-láticas isoladas. Fontes de proteína verdadeira incrementam a competição entre bactérias fermentadoras de carboidratos estruturais e não-estruturais.

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

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The relevance of rising healthcare costs is a main topic in complementary health companies in Brazil. In 2011, these expenses consumed more than 80% of the monthly health insurance in Brazil. Considering the administrative costs, it is observed that the companies operating in this market work, on average, at the threshold between profit and loss. This paper presents results after an investigation of the welfare costs of a health plan company in Brazil. It was based on the KDD process and explorative Data Mining. A diversity of results is presented, such as data summarization, providing compact descriptions of the data, revealing common features and intrinsic observations. Among the key findings was observed that a small portion of the population is responsible for the most demanding of resources devoted to health care

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Em diversas lavouras de algodão, no Brasil e no exterior, tem ocorrido deficiência tardia de potássio. Com o objetivo de verificar a influência da adubação foliar com nitrato de potássio (KNO3) na nutrição e produção de algodão (Gossypium hirsutum L.), em vista do nível de nutrição potássica, da época de aplicação e dose do produto, em locais com diferentes potenciais de produtividade, foram desenvolvidos experimentos em dois anos agrícolas (2000/2001 e 2001/2002). Foram empregadas doses de 16 e 32 kg ha-1 de KNO3, divididas em duas ou quatro aplicações, a partir da primeira semana de florescimento do algodoeiro. em outro experimento, foi aplicado 32 kg ha-1 de KNO3, em quatro aplicações realizadas da segunda à quinta semana de florescimento. A diminuição dos teores de potássio nas folhas do algodoeiro é um processo normal na fase de senescência da folha em fim de ciclo e não foi revertido com uso suplementar de K. A adubação foliar com KNO3 pode, em algumas condições, como por exemplo, em plantas deficientes em potássio, aumentar o teor do nutriente na folha. Entretanto, isso não afeta o conteúdo do nutriente nos frutos, a produtividade e a qualidade da fibra.

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Mirror therapy (MT) is being used as a rehabilitation tool in various diseases, including stroke. Although some studies have shown its effectiveness, little is known about neural mechanisms that underlie the rehabilitation process. Therefore, this study aimed at assessing cortical neuromodulation after a single MT intervention in ischemic stroke survivors, by means of by functional Magnetic Resonance Imaging (fMRI) and Transcranial Magnetic Stimulation (TMS). Fifteen patients participated in a single thirty minutes MT session. fMRI data was analyzed bilaterally in the following Regions of Interest (ROI): Supplementary Motor Area (SMA), Premotor cortex (PMC), Primary Motor cortex (M1), Primary Sensory cortex (S1) and Cerebellum. In each ROI, changes in the percentage of occupation and beta values were computed. Group fMRI data showed a significant decreased in the percentage of occupation in PMC and cerebellum, contralateral to the affected hand (p <0.05). Significant increase in beta values was observed in the following contralateral motor areas: SMA, Cerebellum, PMC and M1 (p<0,005). Moreover, a significant decrease was observed in the following ipsilateral motor areas: PMC and M1 (p <0,001). In S1 a bilateral significant decrease (p<0.0005) was observed.TMS consisted of the analysis of Motor Evoked Potential (MEP) of M1 hotspot. A significant increase in the amplitude of the MEP was observed after therapy in the group (p<0,0001) and individually in 4 patients (p <0.05). Altogether, our results imply that single MT intervention is already capable of promoting changes in neurobiological markers toward patterns observed in healthy subjects. Furthermore, the contralateral hemisphere motor areas changes are opposite to the ones in the ipsilateral side, suggesting an increase system homeostasis.