Brincar, atividade humana e ferramenta pedagógica no contexto escolar da região metropolitana de natal

This thesis talks about the use of guided educational tools in play and playful in public schools in the Metropolitan Region of Natal (MRN), contributing to the teaching and students learning of basic education in the contents of portuguese and mathematics. We assume that the play is an activity / human need and therefore implies the proper development of children in physical, psychological, biological, cultural, social and historical aspects. We consider the mediation exercised by the teacher in the classroom, and the affection existing between teacher and student, sine qua non terms, so that the truth and fact of the process of teaching and learning occur. Thus, theoretically collaborated Paulo Freire, with his dialogical vision; Lev S. Vygotsky says that we learn and why we develop; Lev S. Vygotsky that states that we learn and for that we develop ourselves; Pierre Bourdieu and the concept of habitus, as something embedded and therefore procedural, and the cultural capital that needs to be fed and (re)meaning at school; Luiz Pereira, Bernard Lahire, Gilles Brougère and others brought their theoretical contributions. The empirical field of research was composed by the Municipal School Professor Ulysses de Góis, located in the neighborhood of Nova Descoberta in Natal, and the Municipal School José Horacio de Góis, located in the community of Guanduba, in São Gonçalo do Amarante, municipalities of the Metropolitan Region of Natal (MRN). We used as methodology the collaborative-action-research as a possible of effective participation of the research subjects, imputing them a voice and performance in the process, and not considering them just observers. The results indicate the effectiveness of the pedagogical tools in play and playful to the learning of students, but that alone is not able to solve all the problems of the school, other referrals need to be secured, as the planning of the actions to be developed in the school and in the classroom, systematized pedagogical orienttion for faculty, family participation/involvement in the school life of students, among other actions that need to be weighted so that education fulfills its role and promote the emancipation of the subject, because in the freireana liberating perspective, "the reading of the world preced the lecture of the word"

Evaluation of thermal simulation of households in the metropolitan region of So Paulo, Brazil

This paper aims at assessing the performance of a program of thermal simulation (Arquitrop) in different households in the city of Sao Paulo, Brazil. The households were selected for the Wheezing Project which followed up children under 2 years old to monitor the occurrence of respiratory diseases. The results show that in all three study households there is a good approximation between the observed and the simulated indoor temperatures. It was also observed a fairly consistent and realistic behavior between the simulated indoor and the outdoor temperatures, describing the Arquitrop model as an efficient estimator and good representative of the thermal behavior of households in the city of Sao Paulo. The worst simulation is linked to the poorest type of construction. This may be explained by the bad quality of the construction, which the Architrop could not simulate adequately.

Dietary Quality and Associated Factors among Factory Workers in the Metropolitan Region of Sao Paulo, Brazil

The workplace is a manageable community-based setting for ensuring proper nutrition. This study aimed to evaluate dietary quality and associated factors among adult workers at a cosmetics factory in the metropolitan area of Sao Paulo, Brazil. This factory was actively participating in the Brazilian Workers` Meal Program, which was created to ensure workers` nutritional health. In this cross-sectional study, data on 202 adult workers were assessed using questionnaires (sociodemographic, anthropometric, and lifestyle characteristics) administered during August and September 2006. Dietary intake, measured by 24-hour dietary recall, was used to calculate the modified Healthy Eating Index (HEI). A repeated administration of the 24-hour dietary recall was applied in a random subsample to calculate the modified HEI adjusted for the within-person variation in intake. Mean adjusted modified HEI scores were analyzed using multiple linear regression adjusted for energy. The mean adjusted modified HEI score was 72.3 +/- 8.0. The lowest adjusted modified HEI components scores were ""milk and dairy products"" (4.4 +/- 3.2) and ""sodium"" (3.7 +/- 3.1). Two percent of workers had ""poor diet"" (adjusted modified HEI score <51 points) and the majority (87%) had ""diet that needs modification"" (adjusted modified HEI score between 51 and 80), despite their participation in the meal program. Adjusted modified HEI scores were considerably higher for men (74.7 +/- 7.0) than for women (66.9 +/- 8.2) and for normal body mass index (calculated as kg/m(2)) (73.3 +/- 7.8) than for overweight/obese (70.9 +/- 8.1). Based on these results, the vast majority of workers were found to have diets that needed improvement. Individuals with higher-quality diets were more likely to have lower body mass index and to be male. J Am Diet Assoc. 2010;110:786-790.

Relations between Depression, Alcohol and Gender in the Metropolitan Region of São Paulo, Brazil

Como parte do projeto GENACIS, este artigo visou estimar a prevalência de depressão em amostra urbana de São Paulo, Brasil, assim como a associação entre depressão e padrão de uso de álcool segundo gênero. Para tanto, foi realizado inquérito epidemiológico com amostra probabilística e por conglomerados, com um total de 2083 adultos. Utilizou-se o CIDI SF para identificação de depressão. A análise estatística utilizou o teste de Rao Scott e regressão logística multivariada. A taxa de resposta foi de 74,9%. Predominaram mulheres (58,8%), menores de 40 anos de idade (52%). A prevalência de depressão foi de 28,3% para as mulheres e 12,7% para os homens. Entre os homens, 61,1% são de bebedores no último ano e a depressão esteve associada ao padrão de consumo de álcool, à maior frequência de binge drinking e à presença de problemas decorrentes do álcool. Entre as mulheres, 69,5% são abstinentes e a depressão se associou à convivência com cônjuge com problemas devidos ao álcool. Os resultados ressaltam que a associação entre depressão e consumo de álcool é distinta entre os gêneros.

Relations between Depression, Alcohol and Gender in the Metropolitan Region of Sao Paulo, Brazil

As part of the GENACIS project, this paper sought to assess the prevalence of depression in an urban sample in the city of Sao Paulo, Brazil, as well as the association between depression and alcohol abuse according to gender. To achieve this, an epidemiological survey was conducted using a stratified probability sample, including 2,083 adults. CIDI SF was used to identify depression. The Rao Scott test and multivariate logistic regression were used for statistical analysis. The response rate was 74.9%. Females (58.3%) under 40 years of age (52%) were predominant. The prevalence of depression was 28.3% for women and 12.7% for men. Most men declared being drinkers (61.1%) in the last year. Depression was associated with an alcohol drinking pattern, mostly binge drinking, in addition to the occurrence of problems derived from alcohol use. Most women declared being abstainers (69.5%). Depression was associated with cohabiting with spouses with alcohol-related problems. Results reveal that the association between depression and alcohol consumption is distinct between genders.

Relations between Depression, Alcohol and Gender in the Metropolitan Region of São Paulo, Brazil

As part of the GENACIS project, this paper sought to assess the prevalence of depression in an urban sample in the city of São Paulo, Brazil, as well as the association between depression and alcohol abuse according to gender. To achieve this, an epidemiological survey was conducted using a stratified probability sample, including 2,083 adults. CIDI SF was used to identify depression. The Rao Scott test and multivariate logistic regression were used for statistical analysis. The response rate was 74.9%. Females (58.3%) under 40 years of age (52%) were predominant. The prevalence of depression was 28.3% for women and 12.7% for men. Most men declared being drinkers (61.1%) in the last year. Depression was associated with an alcohol drinking pattern, mostly binge drinking, in addition to the occurrence of problems derived from alcohol use. Most women declared being abstainers (69.5%). Depression was associated with cohabiting with spouses with alcohol-related problems. Results reveal that the association between depression and alcohol consumption is distinct between genders.

Família, aluno e professor: as forças tipológicas da educação básica na região metropolitana de Natal

This work was developed in the research line: "The habitus of study: builder of a new reality in the basic education of metropolitan area Natal" which is being developed with the support of CAPES by the Centre for Education. Acts, especially the problem of academic performance of students in basic education of the public in the Metropolitan Region of Natal (RMN). Thus, the aim of this paper is to construct a typology of students in the 9th year of basic education, attending the public schools (state or municipal) of MRN, 2009, and assess, according to these profiles, what personal characteristics student and their families: economic, social and cultural capital as well as teaching practices create environments capable of favoring a good educational development as measured by the performance obtained in the assessments in mathematics and English language. The data used were provided through the microdata Brazil Exam 2009 held by INEP. We used the methods Grade of Membership (GoM) for construction of profiles relevance of students according to the characteristics already mentioned. With these profiles was verified, which were effectively generating good performance in school curriculum components evaluated. The findings indicate that students belonging to the profile considered good environment, able to achieve better school performance both in Portuguese as in Mathematics, compared to the extreme profiles and adverse deficit

Qualidade do gasto público em educação para os municípios da região metropolitana de Natal-2007

The aim of this thesis is to evaluate the quality of public spending on education for the municipalities of the Metropolitan Region of Natal (RMN) in 2009 by use of two theories: The Theory of Welfare (Welfare State) and the Public Choice Theory (TEP), both important to understand the relationship between education and economics. The study also uses principles of microeconomics and public sector economics to get a better idea of the role of education in economy and society. It describes the development of the educational policy in Brazil from 1988 to the Federal Constitution of 2010, following the major changes in basic education during each government. The characteristics of the RMN municipalities were illustrated with socioeconomic indicators, while educational indicators were used to characterize each municipality regarding education. The model used in this study was developed by Bertê, Brunet and Borges, the data was collected on the back of the School Census 2009 and the Brazil Exam 2009 and it was processed quantitavely in the Information System on Public Budgets in Education (SIOPE) by use of the statistical method called standardized score of the normal cumulative distribution function. The quality of public spending on education is the result of the relation between performance indicator ratio and expense ratio. For the qualitative analysis of results, the criteria of efficiency, efficacy and effectiveness were used. The study found that municipalities with higher expenses showed a worse quality of spending and failed to convert the expenditure incurred into performance, thus confirming ineffectiveness

O Litoral e a metrópole dinâmica imobiliária, turismo e expansão urbana na região metropolitana de Natal-RN

The metropolitan regions of Northeast Brazil are being gradually included in a scenario of international investments, which are motivated by the restructuring of both touristic and real-estate sectors. The new capital, real-estate developers and space configurations that result from this process indicate the need for the creation and implementation of public tools which should, at least, allow the mitigation of the urban impacts and environmental losses resulting from this situation. The effects on landscape and on the socio-spatial configuration result from the intensification caused by the dynamism of the "real estate-tourism" sector. There is a regional integration as an expression of the urban expansion of the metropolitan area of Natal. This study investigates the uniqueness of the restructuring and territorial integration of coastal areas and the strategies of the circuit of capital accumulation formed by linking the real estate to tourism. It is intended to increase the understanding about the strategies of tourism, real estate and public policy agents involved in this territorial reconfiguration and in the fund-raising needed for the investments, to understand the existing social and environmental effects and their future trends and also to understand the forms of spatial production as results from the practices of approaching the land transformation and the tourism valorization of the landscape, in a synchronous manner, first in the Northeast region and, as a focal study, in the Metropolitan Area of Natal. Likewise, it is intended to apprehend the current processes of metropolization of the eastern coast of Rio Grande do Norte, in addition to indicate its physical-territorial transformation and the types of projects/developments promoted by the market in the recent period. Based upon analysis undertaken for the Metropolitan Region of Natal RN, this piece of work presents some considerations on possible legal instruments that can be adjusted to the municipalities which are experiencing the impact of this peculiar and recent phenomenon in the region, caused by the arrival of the real estate-touristic capital. It is also intended to point out basic proposals to the forms of public intervention, in a speculative way, starting from a Metropolitan Planning project within a medium and long term

Cooperativa habitacional autofinanciável :uma alternativa de mercado à escassez de financiamento

As an example of what happened in Brazil in the 90s, it s noticed in Natal a new system of cooperative housing production which is done by advancing the users resources selffinancing. This system comes as an alternative for the real state market performance since the end of the National Housing Bank (BNH), in 1986. Self-financed housing cooperatives play an important social role by contributing to own housing acquisition by low-income population, without, however, becoming a mechanism of social interest housing production. It is important to consider that Brazil registers a housing deficit of 6.6 million housing units (IBGE 2000/Census), which, compared to 1991, shows an increment of 21.7% to a growth rate of 2.2% a year. This deficit figure has been deepening, mainly with the end of the National Housing Bank (BNH). The self-financed cooperative housing production broadens around the Metropolitan Region of Natal (RMN) and remains as an alternative to the lack of financing in the housing / real state market. In general, the aim of this work is to analyze the role of self-financing housing cooperatives on the housing production in the RMN, in order to identify their role in the real state market, in the own housing promotion and in the housing policy. The Universe of this study is performance of four housing cooperatives - CHAF-RN, COOPHAB-RN, MULTHCOOP e CNH - that work through self-financing. It is considered here an amount of 38 undertakings launched between 1993 and 2002, including 8143 housing units. The methodology adopted consists of bibliographic, documental and field research. As a result, actions like brokerage, marketing, speculation, and the criteria to define places for undertakings and final products, show how close they are to the housing market production. As a matter of fact, this short distance explains why the self-financed cooperative production for social interest housing is still limited. This reinforces the theory that it is necessary to define and implement a subsidized housing policy to serve the low-income Brazilian population

Avaliação da ecotoxicidade de percolados em áreas de disposição de resíduos na região metropolitana de Natal/RN

Leachates are effluent produced by decomposition of solid waste, they have complex composition and can be highly toxic. Therefore such percolated liquid should be collected and treated properly to avoid environmental contamination of soil and of water bodies. The objective of this study was to evaluate the toxicity through ecotoxicological tests with Ceriodaphnia dubia (Cladocera - Crustacea) of percolated liquids generated in two different systems of municipal solid waste (MSW) disposal in the city of Natal/ RN: A Sanitary Landfill in the Metropolitan Region of Natal/ RN, and in a dump off area. Furthermore, it was evaluated the possible contamination of the underground water of the dump off area. Two monthly samples were taken at four points between the months of May/2009 and January/2010. The Point "A" corresponds to the end of the pond leachate treatment in ASRMN; The Point "B" corresponds to a containment pond at the dump. The Point "C" is an area near one of the cells of the dump off area where the leachate outcrops; The Point "D" stands for an underground water well at the area. The last point, called "E" was sampled only once and corresponds to the slurry produced by temporary accumulation of solid waste in the open area of the dump. The ecotoxicological tests, acute and chronic, followed the ABNT 13373/2005 rules, with some modifications. The samples were characterized by measuring the pH number, the dissolved oxygen (DO), the salinity, BOD5, COD, Cd, Cu, Pb, Cr, Fe, Mg, Ni, and Zn. At Point A, the average number of EC50-48h ranged between 1.0% and 2.77% (v/v), showing a high toxicity of the leachate to C.dubia in all months. To this point, positive correlations were found between the EC50- 48 with precipitation. Negative correlations were found between the EC50- 48h with salinity. At point B there was no response of the acute exposure of organisms to the test samples. At point C the EC50-48h ranged from 17.68% to 35.36% in just two months of the five ones analyzed, not correlated meaning. Point D, the EC50-48h level ranged between 12.31% and 71.27%, showed a negative correlation with, only, precipitation. Although it was observed toxicity of underground water in the Landfill Area, there was no evidence of water contamination by leachate, however, due to the toxic character of this water, additional tests should be conducted to confirm the quality of water that is used for human supply. At point E there was no acute toxicity. These results support the dangers of inappropriate disposal of MSW to water bodies due to the high toxicity of the leachate produced highlighting the necessity of places of safe confinement and a treatment system more effective to it

Um estudo sobre o estágio supervisionado na formação inicial de professores de matemática na Bahia

This work arose from our concerns with the issues of teacher training for early childhood education. From the difficulties encountered as a novice teacher in elementary, we deem important to research training needs of these professionals. Thus, we define the objective of this research to investigate the training needs of novice teachers teaching Early Childhood Education/Elementary school. Our work fits in Educational Research Qualitative Approach, and its construction procedures of the semistructured interview data and document analysis. Our empirical field was made up of schools in the metropolitan region of Natal / RN, offering kindergarten / elementary school. The subjects are five teachers who act as holder of the elementary school class and have 0-3 years of teaching practice, characterizing the second Huberman (2007) as novice teachers. Data analysis, based on principles of content analysis, three themes emerged: Beginner Teaching Professor in Early Childhood Education / Preschool; Reasons explaining the difficulties Faculty / Formative Needs Teaching and Training in Early Childhood Education / Elementary school, from the Training Needs Analysis, with their respective categories, subcategories, contributing to our understanding of the subject matter. The entry into the profession is marked by mixed feelings of euphoria and fear, where there seems to be a "clash" with reality. The difficulties are related to the planning / execution of activities, meet the individual needs of learning and assessment of children. As a strategy to overcome the difficulties the teachers exercise the action-reflection-action in their practices and seek continuous updates in the theoretical and methodological framework of early childhood education. The reasons that define these difficulties may be related to the teacher, school, family, and students of these institutions. In experiencing these difficulties has outlined the need for teacher training, among which stand out studies on ethics in teaching with children, the concept of children and their childhoods, peculiarities of teaching / learning in preschool, toys and legal determinations on early childhood education, multi-language and expressions in early childhood education, specific content areas of knowledge, among others. Furthermore, studies on the theoretical as Piaget, Vigotsky, Maria Carmen Barbosa and Emily Smith. For these professionals to be a professional early childhood education is: like children, be patient and careful, have specific theoretical and practical training for teachers in kindergarten, being able to improvise with seriousness and competence and get updates on continuing education. The surveys, together with the authors and teachers, to confirm our understanding that the training needs of beginners may be related to shortcomings in the initial and continuing education

Necessidades de formação de professoras principiantes da educação infantil/pré-escola

This work arose from our concerns with the issues of teacher training for early childhood education. From the difficulties encountered as a novice teacher in elementary, we deem important to research training needs of these professionals. Thus, we define the objective of this research to investigate the training needs of novice teachers teaching Early Childhood Education/Elementary school. Our work fits in Educational Research Qualitative Approach, and its construction procedures of the semistructured interview data and document analysis. Our empirical field was made up of schools in the metropolitan region of Natal / RN, offering kindergarten / elementary school. The subjects are five teachers who act as holder of the elementary school class and have 0-3 years of teaching practice, characterizing the second Huberman (2007) as novice teachers. Data analysis, based on principles of content analysis, three themes emerged: Beginner Teaching Professor in Early Childhood Education / Preschool; Reasons explaining the difficulties Faculty / Formative Needs Teaching and Training in Early Childhood Education / Elementary school, from the Training Needs Analysis, with their respective categories, subcategories, contributing to our understanding of the subject matter. The entry into the profession is marked by mixed feelings of euphoria and fear, where there seems to be a "clash" with reality. The difficulties are related to the planning / execution of activities, meet the individual needs of learning and assessment of children. As a strategy to overcome the difficulties the teachers exercise the action-reflection-action in their practices and seek continuous updates in the theoretical and methodological framework of early childhood education. The reasons that define these difficulties may be related to the teacher, school, family, and students of these institutions. In experiencing these difficulties has outlined the need for teacher training, among which stand out studies on ethics in teaching with children, the concept of children and their childhoods, peculiarities of teaching / learning in preschool, toys and legal determinations on early childhood education, multi-language and expressions in early childhood education, specific content areas of knowledge, among others. Furthermore, studies on the theoretical as Piaget, Vigotsky, Maria Carmen Barbosa and Emily Smith. For these professionals to be a professional early childhood education is: like children, be patient and careful, have specific theoretical and practical training for teachers in kindergarten, being able to improvise with seriousness and competence and get updates on continuing education. The surveys, together with the authors and teachers, to confirm our understanding that the training needs of beginners may be related to shortcomings in the initial and continuing education

Riscos ocupacionais e acidentes de trabalho em um serviço de atendimento móvel de urgência do Rio Grande do Norte

Exploratory, descriptive and quantitative study with prospective data, performed in the Mobile Emergency Care Service in the metropolitan region of Natal/RN, in order to identify the knowledge of the multidisciplinary team about the rules of standard precautions and worker safety, to identify occupational hazards peculiar to the activities of this service; characterize work-related accidents (WRA) and know the procedures adopted after each WRA. The population consisted of 162 professionals and data were collected between the months of November and December 2010. As for personal and professional characteristics, of the 162 professional, 12,96% were physicians; 6,79%, nurses; 33,95%, nursing technicians, 46,29%, conductors; 74,70% were male; 43,21% were between 31 and 40 years old; 69,33% lived in Natal/RN, 50,00% had completed high school; 58,64% were married; 69,75% had children, 46,91% were between 1 and 4 years of training; 61,73% had improvement courses; 59,25% had 3 to 4 years of service; 54,32%, with 1-4 years experience in emergency; 44,44% received 1-2 minimum wages; 78,40% received insalubrity premium; 67,28% worked in Basic Support Unit (BSU); 83,95% had journey on SAMU Metropolitano of 31-40 hours per week; 52,47% had other employments. As for knowledge of rules of standard precautions, safety and occupational hazards, 99,38% knew what it was WRA; 62,96% gave incomplete answers; 74,07% knew the rules of prevent WRA; 46,67% acquired this knowledge in lectures; 53,09% knew Personal Protective Equipment (PPE); 71,60% gave incorrect answers about the importance of standard precautions; 45,06% never received an educational intervention on this issue; 89,51% said that educational interventions in the prevention of WRA are very important; 90,12% pointed out this as a very important issue in the workplace; 27,00% suggested guidance on the topic in the workplace; regarding the physical hazards, 34,57% considered noise as the most important; about chemical hazards, 78,40% chose the gases and smoke; for biological hazards, 48,77% reported contact with the blood; for mechanical hazards, 80,86% said that were transport accidents; about ergonomic risks, 40,12% say it is the tension/stress in the care of critically ill, psychiatric and aggressive patients; and there was an average of 4,5 to the feeling of safety in the workplace. Regarding the data on the WRAs occurred, 31,48% experienced at least one accident event; 72,55% did not notify it; 60,98% answered that there was no routine for notification; 56,86% were performing patient transportation; 49,02% were hurt in the Basic Support Unit/Rescue Unit (BSU/RH); 60,78% occurred during the day; 96,08% of professionals were in normal work schedule (24 hours on duty); 31,37% had contusion; 58.82% had damage to members/pelvic girdle; 43,14% had traffic accidents. About the evolution of the WRA, 62,75% did not have to take time away from work; 76,47% had no sequelae; 88,24% did not require rehabilitation; no professional had a change of occupation. And by means of univariate logistic regression, showed that the nurses and male sex were risk factors for the occurrence of WRA. We conclude that there were gaps in the knowledge of staff regarding WRA, emphasizing the need for continuing education in biosafety in the service.

Fatores associados à efetividade da doação de órgãos e tecidos para transplantes

The transplantation of organs and tissues presents itself as an important therapeutic option, both from a medical standpoint, the social or economic. Thus, the identification of variables that can interfere in the effectiveness of organs and tissues donation for transplantation needs to be investigated adequately, because it stands before increasing index of chronic and degenerative diseases in the population, what makes the waiting list for transplantation grow disproportionately and patients come to death without the opportunity of realization the treatment due to a lack of donors. In this context, has defined as objective of this study evaluate the factors associated with the effectiveness of organs and tissues donation for transplantation. It is a evaluative research, quantitative, prospective, with longitudinal design, developed at Central of Catchment, Notification and organ donation for transplant, Organ Procurement Organization and in six accredited hospitals to collect and transplantation of organs and tissues, in Natal/RN, between august 2010 and february 2011, after the approval of the Research Ethics Committee, under No. 414/10 and CAAE 007.0.294.000-10. The probabilistic sample without replacement was composed of 65 potential donors. It was used as an instrument of data collection a structured script non-participant observation of checklist type. Data were analyzed using descriptive statistics and presented in tables, charts, graphs and figures. For this, was used Microsoft Excel 2007 and statistical program SPSS version 20.0. To check the level of significance was chosen by applying the chi-square test (χ2) and Mann Whitney and caselas for less than five, it is considered the Fisher exact test. It was adopted as the significance level p-value <0.05. Among the surveyed it was observed that most of the individuals were male (50,8%), in the age group 45 years (53,8%), mean age of 42,3 years, minimum 5 and maximum 73 years (± 17,32 years). Single / widowers / divorced (56,9%), with up to completed elementary school (60,0%) in the exercise of professional activity (86,2%), catholic (83,1%) and residents in metropolitan region of Natal (52,3%). Was obtained donation effectiveness of 27,7%. There was no statistical significance between structure and effectiveness of the donation, but were observed inadequacies in physical resources (36,9%), materials (30,8%), organizational structure (29,2%) and human resources (18,5%). In the process, the maintenance phase (p= 0.004), diagnosis of brain death (p= 0.032), family interview (p≤ 0.001) and documentation (p= 0.001) presented statistical significance with effectiveness. Thus, it is accepts the alternative hypothesis of the study, in which is evidenced that the adequacy of the factors related to structure and process is associated to effectiveness of organs and tissues donation for transplantation. In this way, the effectiveness of organ and tissue donation ends in an essential way the rapidity and accuracy with which the donation process is conducted, requiring appropriate structure, with appropriate physical and material resources and skilled human resources to optimize the reduction of time and the suffering of those waiting for an organ or tissue transplant queued in Brazil