Use of performance indicators to assess the solid waste management of health services.

Modern society faces serious challenges, among them, the complexity of environmental problems. Thus, there are several possible sources of environmental degradation, however, the waste produced by health services have an important peculiarity due to its toxic or pathogenic characteristics, since when managed improperly provide also health risk public. The involvement of solid waste from healthcare services environmental impact integrates matters a little more complex, because in addition to environmental health, they also interfere with the healthiness of environments that generate, with the consequences of nosocomial infections, occupational health and public. Thus, the management has become an urgent need, especially when we see no use of performance indicators management in healthcare environments in the city of São Mateus, ES. For this, we used the Analytic Hierarchy Process Method to prioritize such indicators as the potential improvement in health services waste management process - WHS and thus environmental analysis was performed with the use of a template for SWOT analysis. The results showed that the performance indicator training strategies developed with employees has the greatest potential to assist in improvements in WHS (Health Services Waste) management process followed indicator knowledge of the regulations associated with procedures performed by employees and importance of biosafety regulations.

Use of performance indicators to assess the solid waste management of health services

ABSTRACT Modern society faces serious challenges, among them, the complexity of environmental problems. Thus, there are several possible sources of environmental degradation, however, the waste produced by health services have an important peculiarity due to its toxic or pathogenic characteristics, since when managed improperly provide also health risk public. The involvement of solid waste from healthcare services environmental impact integrates matters a little more complex, because in addition to environmental health, they also interfere with the healthiness of environments that generate, with the consequences of nosocomial infections, occupational health and public. Thus, the management has become an urgent need, especially when we see no use of performance indicators management in healthcare environments in the city of São Mateus, ES. For this, we used the Analytic Hierarchy Process Method to prioritize such indicators as the potential improvement in health services waste management process - WHS and thus environmental analysis was performed with the use of a template for SWOT analysis. The results showed that the performance indicator training strategies developed with employees has the greatest potential to assist in improvements in WHS (Health Services Waste) management process followed indicator knowledge of the regulations associated with procedures performed by employees and importance of biosafety regulations.

Epidemiology of hepatitis B virus in the cities of the northern region of Espírito Santo, Brazil.

The World Health Organization (WHO) estimates that approximately 2 billion people worldwide have already had contact with hepatitis B virus (HBV) and 373 million have become chronic carriers. Hepatitis B is a major cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma, leading to a large number of deaths annually. Both viral factors and the host immune response have been implicated in the pathogenesis and clinical result of HBV infection. Many Brazilian cities, including the cities of the northern region of the state of Espírito Santo are located in regions with little health infrastructure. Our study performed an epidemiological analysis of cases of Hepatitis B in São Mateus, using methodology of Geographic Information System (GIS), aiming to raise the number of disease cases, establishing preventive measures to control the disease, improving the quality of life of people affected by this pathology. The city of São Mateus had the largest number of reported cases of hepatitis B northern region of Espírito Santo. The age group with the highest number of hepatitis B notifications was 20-49 years, mostly females. The major forms of contact with HBV in these cities were dental treatment, use of injectable medications, surgical procedures and multiple sexual partners.

The effect of stocking density on the growth of apple snails native Pomacea bridgesii and exotic Pomacea lineata (Mollusca, Gastropoda).

The demand for alternative food sources is currently in evidence in the world and, therefore, the culture of animal species considered not conventional makes this theme relevant and appropriate. In the present study, the species Pomacea lineata and Pomacea bridgesii, each with three stowage densities (0.5 [T1], 1 [T2], and 1.5 [T3] animal/L), were tested. They were analyzed regarding growth rate, weight gain, final biomass, feed conversion and percentage of survival. There was not any statistically significant difference between the different densities for both species. The final average weight in the three waterworks did not differ significantly in P. bridgesii. In P. lineata, T1 (22.3 ± 1.80g) was significantly higher than T2 and T3. On the other hand, the absolute gain of weight in P. lineata and P. bridgesii was significantly higher in T1 (21.9 ± 1.80g and 37.2 ± 6.34g) than in T2 and T3 respectively. In contrast, the gain of biomass of P. lineata and P. bridgesii was significantly higher in T3 (276.3 ± 33.16g and 431.4 ± 37.20g) than in T1 and T2, respectively. Based on the results obtained, all species studied presented potential for aquaculture, mainly P. bridgesii, distinguished for showing a better development even in waterworks with higher densities.

Evaluation of space adequateness of shrimp farms in Southern Brazil

In Rio Grande do Sul State, there are four marine shrimp (Litopenaeus vannamei) farms in the municipal districts of São José do Norte and Rio Grande, and other four with previous license for operation. Thus, the present study aimed to identify and characterize areas for marine shrimp farming located in the Southern portion of the Patos Lagoon estuary (32º00'S 52º00'W) by employing the analysis of satellite remote sensing (Landsat TM and ETM+/Google Earth), airborne remote sensing (35mm system ADAR 1000), terrestrial remote sensing (RICOH 500SE), and field expeditions, integrating data in a Geographical Information System (IDRISI Andes). As a result, the enterprises were built on coastal fields or in obliterated dune areas, which are favorable for cultivation. The proximity of possible consuming markets and local labor, relatively good access roads and local technical support also favor the projects. However, there must be caution in terms of changes in the original projects, which could cause environmental impacts and noncompliance of environmental norms, such as the occupation of salt marsh areas. Based on the obtained information, instruments can be created to help inherent legal decision-making to manage the activity for futures enterprises.

No estado do Rio Grande do Sul existem quatro fazendas produtoras de camarões (Litopenaeus vannamei) marinhos nos municípios de São José do Norte e Rio Grande, e outras quatro fazendas já possuem licença prévia. Assim, o presente estudo propôs identificar e caracterizar as áreas destinadas a cultivos de camarões marinhos localizadas na porção sul do estuário da lagoa dos Patos (32º00'S 52º00'W), empregando análises de sensoriamento remoto orbital (ETM+/Landsat, Google Earth), aéreo (35mm/sistema ADAR 1000), terrestre (RICOH 500SE) e de saídas de campo, integrando os dados num Sistema de Informação Geográfica (IDRISI Andes). Resultados apontaram que os empreendimentos foram construídos sobre campos litorâneos ou em regiões de dunas obliteradas, regiões estas propícias para o cultivo. A proximidade dos possíveis mercados consumidores e mão de obra local, estradas de acesso relativamente boas e suporte técnico local também favorecem os projetos. No entanto, deve haver cautela em termos de mudanças nos projetos originais, o que poderia causar impactos ambientais e descumprimento das normas ambientais, tais como a ocupação de áreas de marismas. A partir das informações obtidas, podem ser criados instrumentos que auxiliarão na tomada de decisões legais para gerenciar a atividade em futuros empreendimentos.

Evaluation of space adequateness of shrimp farms in Southern Brazil.

In Rio Grande do Sul State, there are four marine shrimp (Litopenaeus vannamei) farms in the municipal districts of São José do Norte and Rio Grande, and other four with previous license for operation. Thus, the present study aimed to identify and characterize areas for marine shrimp farming located in the Southern portion of the Patos Lagoon estuary (32º00'S 52º00'W) by employing the analysis of satellite remote sensing (Landsat TM and ETM+/Google Earth), airborne remote sensing (35mm system ADAR 1000), terrestrial remote sensing (RICOH 500SE), and field expeditions, integrating data in a Geographical Information System (IDRISI Andes). As a result, the enterprises were built on coastal fields or in obliterated dune areas, which are favorable for cultivation. The proximity of possible consuming markets and local labor, relatively good access roads and local technical support also favor the projects. However, there must be caution in terms of changes in the original projects, which could cause environmental impacts and noncompliance of environmental norms, such as the occupation of salt marsh areas. Based on the obtained information, instruments can be created to help inherent legal decision-making to manage the activity for futures enterprises.

Analysis of the marine shrimp culture production chain in Southern Brazil.

This study was elaborated to identify and describe the main links of the sea shrimp productive chain in the municipal district of Laguna, historically known as the main sea shrimp (Litopenaeus vannamei) production area in the State of Santa Catarina, Brazil. The study, held from April to July 2005, previously identified the local productive process through observation, interviews and bibliographical research. Afterwards, specific questionnaires were elaborated for each of the several segments connected to the local activity. A total of 90 interviews were conducted, intending to map out the procedures and functionality of the productive chain, from the necessary inputs for production to the moment of shrimp acquisition by final consumers. Results indicated that the entire productive chain requires actions that range from improvement of sanitary and genetic conditions of larvae to product commercialization. Reduction of bureaucracy in public organs, better investment credit conditions, improvement in productive practices, training of technical and productive labor, and reduction of production costs will not occur until industrialization politics and commercialization of local production are standardized.

Analysis of the marine shrimp culture production chain in Southern Brazil

This study was elaborated to identify and describe the main links of the sea shrimp productive chain in the municipal district of Laguna, historically known as the main sea shrimp (Litopenaeus vannamei) production area in the State of Santa Catarina, Brazil. The study, held from April to July 2005, previously identified the local productive process through observation, interviews and bibliographical research. Afterwards, specific questionnaires were elaborated for each of the several segments connected to the local activity. A total of 90 interviews were conducted, intending to map out the procedures and functionality of the productive chain, from the necessary inputs for production to the moment of shrimp acquisition by final consumers. Results indicated that the entire productive chain requires actions that range from improvement of sanitary and genetic conditions of larvae to product commercialization. Reduction of bureaucracy in public organs, better investment credit conditions, improvement in productive practices, training of technical and productive labor, and reduction of production costs will not occur until industrialization politics and commercialization of local production are standardized.

O presente estudo foi elaborado para identificar e descrever os principais elos da cadeia produtiva no município de Laguna, região que historicamente constitui-se em principal área de produção de camarão marinho (Litopenaeus vannamei) em Santa Catarina, Brasil. O estudo foi desenvolvido de abril a julho de 2005, a partir de uma prévia identificação do processo produtivo local, através de observação, entrevistas e busca bibliográfica. Foram elaborados questionários específicos para os vários segmentos atrelados à atividade local. Foi realizado um total de 90 entrevistas, pretendendo-se fazer um acompanhamento do desempenho e funcionalidade da cadeia produtiva desde os insumos necessários à produção até o momento da aquisição do camarão pelo consumidor final. Os resultados indicam que todos os elos descritos necessitam ações que visem desde o melhoramento sanitário e genético das pós-larvas até a comercialização do produto. Desburocratização dos órgãos públicos, maior acesso ao crédito para investimentos, melhorias nas práticas produtivas, capacitação da mão-de-obra técnica e produtiva e redução de custos produtivos não ocorrerão até haver uma normalização das políticas industriais e de comercialização da produção local.

Avaliação hemogasométrica em cães submetidos à pneumonectomia esquerda / Hemogasometric evaluation in dogs submitted to left pneumonectomy

Moléstias de natureza infecciosa, traumática ou neoplásica acometem o pulmão dos cães, constituindo-se a pneumonectomia como possibilidade de tratamento para algumas dessas afecções. Assim, diante da escassez de dados encontrados na literatura, objetivou-se avaliar e comparar parâmetros hemogasométricos, pressão parcial de oxigênio (PaO2), de dióxido de carbono (PaCO2), concentração do íon hidrogênio (pH) e do íon bicarbonato [HCO3-] no sangue arterial de cães adultos, antes e após pneumonectomia esquerda. Foram estudados 18 cães, machos e fêmeas de idades variadas, pesando entre 15 e 20 kg, distribuídos aleatoriamente em dois grupos de 9 animais cada. No Grupo A, o coto brôn-quico esquerdo dos cães foi suturado manualmente com fio de polipropileno 5-0, e no Grupo B, o coto brônquico esquerdo foi suturado mecanicamente com grampeador cirúrgico. Os dados foram colhidos em 6 momentos: antes da administração da medicação pré-anestésica (T0), 1 hora após a extubação do animal (T1EXT), 48 horas após a intervenção cirúrgica (T48h), 17 (T7d), 15 (T15d) e 36 dias (T36d) após intervenção cirúrgica. Em seguida, foi realizada a análise estatística (teste de normalidade de Anderson-Darling, Wilcox e teste U de Man-Whitney). Os valores de PaO2 do Grupo A no T1EXT (67,00±11,31) mostraram-se significativamente inferiores em relação ao T0 (99,44±18,34), fato este que não ocorreu no Grupo B: T1EXT (87,00±8,35) em relação ao T0 (87,00±7,55). Não houve diferença do pH entre os momentos nos cães do grupo A, porém no grupo B observou-se uma diminuição em T1EXT (7,3644±0,0353) em relação ao T0 (7,4189±0,0136), sem que os animais tenham desenvolvido acidose. Apesar dessas alterações, concluiu-se que os cães submetidos à pneumonectomia esquerda (sutura manual ou mecânica do coto brônquico esquerdo) não apresentaram tendência a desenvolver desequilíbrio ácido-básico no período em que foram avaliados.

It is well known that different diseases of infectious, traumatic or neoplasic origin can occur in the lungs of dogs, and pneumonectomy technique may be an option for the treatment of some of these diseases. The objective was to evaluate hemogasometric parameters, oxygen partial pressure (PaO2), carbon dioxide partial pressure (PaCO2), hydrogen ion concentration (pH) and bicarbonate ion concentration on the pre- and post-operative moments of the left pneumonectomy. Eighteen adult mongrel dogs, males and females, were randomly distributed into two groups with 9 dogs each. In Group A, the left bronchial stump of the dogs was sutured manually with polypropylene 5-0, and, in Group B, the left bronchial stump of the dogs was sutured mechanically with a surgical stapler. The data were collected at 6 moments: Before the pre-anesthetic administration (T0), one hour after the extubation (T1EXT), 48 hours after the surgery (T48h), 7 days after the surgery (T7d), 15 days after the surgery (T15d), and 36 days after the surgery (T36d). The results were statistically analyzed. PaO2 values of Group A on T1EXT (67.00±11.31) were significantly lower in relation to T0 (99.4±18.34), a fact that did not happen in Group B: T1EXT (87.00±8.35) in regard to T0 (87.00±7.55). There was no difference on pH values in dogs of Group A, but in Group B was observed a decrease on T1EXT (7.3644±0.0353) in relation to T0 (7.4189±0.0136), although the animals did not develop acidosis. It was concluded that dogs submitted to left pneumonectomy (sutured manually or sutured mechanically of left bronchial) did not show immediate and mediate acid-basic instability during the study.

Avaliação hemogasométrica em cães submetidos à pneumonectomia esquerda / Hemogasometric evaluation in dogs submitted to left pneumonectomy

Moléstias de natureza infecciosa, traumática ou neoplásica acometem o pulmão dos cães, constituindo-se a pneumonectomia como possibilidade de tratamento para algumas dessas afecções. Assim, diante da escassez de dados encontrados na literatura, objetivou-se avaliar e comparar parâmetros hemogasométricos, pressão parcial de oxigênio (PaO2), de dióxido de carbono (PaCO2), concentração do íon hidrogênio (pH) e do íon bicarbonato [HCO3-] no sangue arterial de cães adultos, antes e após pneumonectomia esquerda. Foram estudados 18 cães, machos e fêmeas de idades variadas, pesando entre 15 e 20 kg, distribuídos aleatoriamente em dois grupos de 9 animais cada. No Grupo A, o coto brôn-quico esquerdo dos cães foi suturado manualmente com fio de polipropileno 5-0, e no Grupo B, o coto brônquico esquerdo foi suturado mecanicamente com grampeador cirúrgico. Os dados foram colhidos em 6 momentos: antes da administração da medicação pré-anestésica (T0), 1 hora após a extubação do animal (T1EXT), 48 horas após a intervenção cirúrgica (T48h), 17 (T7d), 15 (T15d) e 36 dias (T36d) após intervenção cirúrgica. Em seguida, foi realizada a análise estatística (teste de normalidade de Anderson-Darling, Wilcox e teste U de Man-Whitney). Os valores de PaO2 do Grupo A no T1EXT (67,00±11,31) mostraram-se significativamente inferiores em relação ao T0 (99,44±18,34), fato este que não ocorreu no Grupo B: T1EXT (87,00±8,35) em relação ao T0 (87,00±7,55). Não houve diferença do pH entre os momentos nos cães do grupo A, porém no grupo B observou-se uma diminuição em T1EXT (7,3644±0,0353) em relação ao T0 (7,4189±0,0136), sem que os animais tenham desenvolvido acidose. Apesar dessas alterações, concluiu-se que os cães submetidos à pneumonectomia esquerda (sutura manual ou mecânica do coto brônquico esquerdo) não apresentaram tendência a desenvolver desequilíbrio ácido-básico no período em que foram avaliados.(AU)

It is well known that different diseases of infectious, traumatic or neoplasic origin can occur in the lungs of dogs, and pneumonectomy technique may be an option for the treatment of some of these diseases. The objective was to evaluate hemogasometric parameters, oxygen partial pressure (PaO2), carbon dioxide partial pressure (PaCO2), hydrogen ion concentration (pH) and bicarbonate ion concentration on the pre- and post-operative moments of the left pneumonectomy. Eighteen adult mongrel dogs, males and females, were randomly distributed into two groups with 9 dogs each. In Group A, the left bronchial stump of the dogs was sutured manually with polypropylene 5-0, and, in Group B, the left bronchial stump of the dogs was sutured mechanically with a surgical stapler. The data were collected at 6 moments: Before the pre-anesthetic administration (T0), one hour after the extubation (T1EXT), 48 hours after the surgery (T48h), 7 days after the surgery (T7d), 15 days after the surgery (T15d), and 36 days after the surgery (T36d). The results were statistically analyzed. PaO2 values of Group A on T1EXT (67.00±11.31) were significantly lower in relation to T0 (99.4±18.34), a fact that did not happen in Group B: T1EXT (87.00±8.35) in regard to T0 (87.00±7.55). There was no difference on pH values in dogs of Group A, but in Group B was observed a decrease on T1EXT (7.3644±0.0353) in relation to T0 (7.4189±0.0136), although the animals did not develop acidosis. It was concluded that dogs submitted to left pneumonectomy (sutured manually or sutured mechanically of left bronchial) did not show immediate and mediate acid-basic instability during the study.(AU)