Esta tese explora o campo da Saúde e Segurança no Trabalho - SST destacando as recentes propostas de inclusão dos aspectos psicossociais nas abordagens dos chamados "riscos ocupacionais" que tradicionalmente valorizam os aspectos objetivos (químicos, físicos, biológicos, ergonômicos e de acidentes) e as prescrições. Em busca de novas fundamentações teoricometodológicas, revisita-se conceitos/práticas envolvidos em SST à luz de observações oriundas da atuação como psicóloga em um setor de saúde de uma empresa no ramo de energia e de referenciais teóricos que tomam como pontos de partida e chegada a atividade, a defasagem entre o trabalho prescrito e o real, o diálogo sinérgico entre os saberes e a dimensão coletiva do trabalho. Dentre os referenciais utilizados destacam-se as contribuições de Georges Canguilhem, em especial sua concepção de saúde, a Psicodinâmica do Trabalho e a Ergologia. Sob uma perspectiva ergológica, aponta-se para norteadores de um redirecionamento, para que a prevenção incorpore aquilo que é da ordem do não antecipável, que advém das situações reais com suas dramáticas, encontros de encontros, escolhas e ressingularizações, para além do patrimônio acumulado na forma de normas antecedentes (sem desconsiderá-lo). Nesse sentido, uma vez ressaltada a dimensão gestionária das atividades, seus protagonistas são convocados não apenas a cumprir prescrições elaboradas por especialistas, mas também a exercer, individual e coletivamente, a coautoria na gestão de sua saúde, segurança, trabalho e vida.

Submitted by ANTONIO LOPES NOGUEIRA DA SILVA null (antonio.silva@mpsa.com) on 2015-12-22T21:12:05Z No. of bitstreams: 1 Analise dos Fatores Influentes nos Riscos de Descontinuidade na Cadeia de Peças de Reposição Automotivas.pdf: 1396317 bytes, checksum: 1e49dd8b0c8d353fd740b74ea0216995 (MD5) / Approved for entry into archive by Cássia Adriana de Sant ana Gatti (cgatti@marilia.unesp.br) on 2015-12-23T10:49:16Z (GMT) No. of bitstreams: 1 Analise dos Fatores Influentes nos Riscos de Descontinuidade na Cadeia de Peças de Reposição Automotivas.pdf: 1396317 bytes, checksum: 1e49dd8b0c8d353fd740b74ea0216995 (MD5) / Made available in DSpace on 2015-12-23T10:49:16Z (GMT). No. of bitstreams: 1 Analise dos Fatores Influentes nos Riscos de Descontinuidade na Cadeia de Peças de Reposição Automotivas.pdf: 1396317 bytes, checksum: 1e49dd8b0c8d353fd740b74ea0216995 (MD5) Previous issue date: 2015-12-18 / O mercado brasileiro de veículos leves possui uma frota onde 43% dos veículos têm até cinco anos de fabricação, fazendo com que os setores de reposição de peças automotivas movimentem bilhões de reais por ano. Ainda assim, é comum a falta de peças de reposição, o que exige do gerenciamento da cadeia de suprimentos a mitigação dos riscos de descontinuidade. Este trabalho analisa os riscos de suprimentos na cadeia de peças de reposição nas redes concessionárias de veículos leves por meio da priorização das variáveis que influenciam a descontinuidade de suprimentos desta cadeia. O método aplicado apresenta uma abordagem quali-quanti junto às concessionárias da região Sul Fluminense. Estas concessionárias representam quatorze das principais marcas atuantes no Brasil com um volume de vendas na ordem de 93% em 2015. As variáveis mais importantes são capacitação da equipe, comunicação e lead time. A pesquisa também evidencia que fatores organizacionais são relevantes para o suprimento de peças de reposição o que não é indicado pela literatura, juntamente com os fatores relacionados à cadeia de suprimentos. / The Brazilian market for light vehicles has a fleet where 43% of vehicles have up to five years of manufacture, causing the spare sectors of automotive parts move billions a year. Still, it is common to lack of spare parts, which requires management of the supply chain to mitigate the discontinuity risks. This paper analyzes the risks of supply in the chain of spare parts for light vehicle dealerships networks by prioritizing the variables that influence the supply disruption in this chain. The applied method presents a qualitative and quantitative approach with the concessionaires of the South Fluminense region. These dealerships represent fourteen major brands operating in Brazil with a sales volume of around 93% in 2015. The most important variables are staff training, communication and lead time. The survey also shows that organizational factors are relevant to the spare parts supply which is not mentioned in the literature, together with the factors related to the supply chain.

The survey of environmental risks to worker health from their respective workplaces constitutes as essential tools in a qualitative way, to produce maps of environmental risks. Thus, recognition of potential hazards in the workplace and the possibility of intervention, reduction or elimination of these constitute the major concern of security professionals, and occupational medicine. Therefore, the use of georeferenced information systems manifests itself as a valuable tool in analyzing the data on the health of workers and their working environment. Therefore, the main objective of this research is to implement a Georeferenced Information System as the basis for preparation of risk maps of the work environment at the campus of Universidade Federal de Santa Maria. Therefore, the methodology uses satellite images and geographical information system, surveys of environmental hazards and Prevention Programs of Environmental Risks - PPRA's made between the period 2006 to 2010. Thus, the availability of new resources used for health and safety of workers can contribute to the success of surveillance activities and environments to promote health at work. / O levantamento de riscos ambientais à saúde do trabalhador junto aos seus respectivos ambientes de trabalho se constitui como ferramenta inicial, de forma qualitativa, para a elaboração de mapas de riscos ambientais. Assim, o reconhecimento dos riscos existentes nos locais de trabalho e a possibilidade de intervenção, redução ou eliminação dos mesmos se constituem na maior preocupação dos profissionais de segurança e medicina do trabalho. Portanto, o uso de sistemas de informações georreferenciadas manifesta-se como uma ferramenta de grande valia na análise dos dados sobre a saúde do trabalhador e de seu ambiente de trabalho. Logo, o principal objetivo desta pesquisa é implementar um Sistema de Informações Georreferenciadas como base para elaboração de mapas de riscos dos ambientes de trabalho do campus da Universidade Federal de Santa Maria. Assim sendo, a metodologia utiliza imagens de satélites e sistema de informações geográficas, levantamentos de riscos ambientais e Programas de Prevenção de Riscos Ambientais PPRA s, realizados entre o período de 2006 a 2010. Deste modo, a disponibilidade de novos recursos utilizados em prol da saúde e segurança dos trabalhadores pode contribuir para o sucesso de ações de vigilância aos ambientes e promoção de saúde no trabalho.

Made available in DSpace on 2015-03-03T11:52:24Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-03-11Bitstream added on 2015-03-03T12:07:20Z : No. of bitstreams: 1 000809501.pdf: 784712 bytes, checksum: 0ea0788bc46ef920205857dd55beb4e2 (MD5) / A Leishmaniose Visceral Canina (LVC) é uma zoonose parasitária causada pelo protozoário Leishmania infantum transmitido principalmente pela picada do vetor flebotomíneo da espécie Lutzomyia longipalpis. O presente estudo objetivou avaliar a prevalência da LVC em cães, a distribuição de flebotomíneos e os fatores de riscos associados à doença, em uma área rural periurbana denominada por Cinturão Verde, localizada do município de Ilha Solteira, SP. Dessa forma, amostras de 250 cães, incluindo aspirados de linfonodos, de sangue e de suabe conjuntival foram coletadas para a realização dos exames parasitológico direto (PA), sorológico (ELISA e RIFI) e PCR (suabe conjuntival). A positividade dos cães para LVC foi de 31,6% (79/250) à RIFI, 28,8% (72/250) ao teste ELISA, 25,2% (63/250) ao PA e 20,4% (49/240) à PCR. A concordância entre os métodos, quando analisada pelo índice Kappa (p ? 0,05), foi considerada excelente entre ELISA x RIFI (94,5%), moderada entre ELISA x PA (81,7%) e entre RIFI x PA (78,3%), mas foi baixíssima entre PCR e os demais testes analisados. Os flebotomíneos da espécie Lu. longipalpis foram capturados com auxilio de armadilhas luminosas do tipo CDC (“Center for Disease Control and Prevention”), colocadas mensalmente no peridomicílio das propriedades rurais do Cinturão Verde, no período de setembro/2012 a agosto/2013, com três coletas em três dias consecutivos por mês. O numero de flebotomíneos capturados totalizou 65 machos e 25 fêmeas em 12 meses. O maior número de flebotomíneos capturados foi nos meses de dezembro/2012, fevereiro/2013, maio/2013 e julho/2013. Os fatores de riscos associados à LVC foram determinados estatisticamente pela análise univariada, os quais foram estatisticamente significativos (p ? 0,05) para os cães de porte grande, mostrando serem estes os mais susceptíveis à LVC, além da presença de galinhas nas propriedades ... / Canine Visceral Leishmaniasis (CVL) is a parasitic zoonosis caused by Leishmania infantum, which is transmitted by the bite of Phebotominae insect of the Lutzomyia longipalpis species (sandfly). This study aimed to survey the prevalence of CVL in dogs, the distribution of sand flies and the risk factors associated with the disease in a rural area called “Cinturão Verde”, located in the municipality of Ilha Solteira, SP. Thus, samples of lymph node aspirates and blood were collected from 250 dogs for ELISA and indirect fluorescence antibody test (IFAT) and direct parasitological (PA) exams. In addition, conjunctival swab samples were also collected for Polymerase Chain Reaction (PCR). 79/250 (31.6%) dogs were positive by IFAT; 72/250 (28.8%) by ELISA; 63/250 (25.2%) by PA and 49/240 (20.4%) by PCR. The concordance of methods when statistically analysed two by two by the Kappa índexes (p ? 0.05) were considered of excellent agreement between ELISA and IFAT (94.5%), moderate between ELISA and PA (81.7%) and between IFAT and PA (78.3%), but when PCR was compared with the other tests, the agrrement indexes were very low. Lu. longipalpis were captured with the help of CDC (Center for Disease Control and Prevention) light traps, placed three consecutive times per month in the rural peridomiciliary properties of the “Cinturão Verde”, from September/2012 to August/2013 in 100 % of the properties visited. The parasite density ranged from 01 to 12 per month including males and females, totaling 64 males and 25 females over 12 months. The largest number of insects captured was in December 2012, February/2013, May/2013 and July/2013. The univaried statistical analysis of risk factors associated with CVL revealed that the big size-dogs, the presence of chickens in the properties as well as the lack of knowledge by the rural population about the CVL disease were considered indicators to predict infection ...

Les crises naturelles ou anthropiques récentes montrent la nécessité de former les gestionnaires de crises à réagir rapidement, sous stress et dans une position d’inconfort. Ce mémoire traite de la scénarisation des exercices de crise pour des exercices pratiques (fonctionnels, grandeur réelle et sur simulateur) impliquant une cellule de crise stratégique. L’état de l’art des méthodes de scénarisation a montré des lacunes dans l’accompagnement des scénaristes pour créer des scénarios pédagogiques et représentatifs d’une crise. Fort de ce constat, les travaux de recherche se sont orientés sur l’élaboration d’une méthode permettant de solliciter les compétences de gestion de crise à travers les scénarios d’exercices de crise. Pour reproduire la dynamique d’une crise dans les scénarios créés, une grille de lecture basée sur des caractéristiques spécifiques aux situations de crise et liée aux types de stimuli injectables dans un scénario a été appliquée à six crises passées. Parallèlement, l’étude des compétences des gestionnaires de crise a permis de créer une base de données d’objectifs de formation couplée aux stimuli.In fine, la méthodologie développe une démarche pas à pas permettant au scénariste de créer et positionner dans le scénario les stimuli nécessaires à la sollicitation des compétences à mobiliser pour différents profils de participants.Les scénarios sont ensuite vérifiés à travers des critères validant la scénarisation effectuée et le caractère pédagogique du scénario.La méthode de scénarisation a été testée pour un exercice fonctionnel et appliquée par plusieurs catégories de scénaristes qui ont validé son caractère opérationnel. / Recent major crises show the necessity to train crisis managers to react quickly, under stress and in an uncomfortable position. This thesis deals with the scripting of crisis exercises for practical exercises (functional, large scale and simulator) involving strategic crisis cell. The art state of scriptwriting methods has shown shortcomings in accompanying scriptwriters to create pedagogical scenarios representative of a crisis. This work leads to the creation of a method that calls crisis management skills through crisis exercise scenarios. On the basis of this analysis, research has oriented on developing a method to solicit crisis management skills through crisis scenarios. To reproduce the crisis dynamic in created scenarios, a reading grid based on specific characteristics of crisis situations and related to the types of injectable stimuli in a scenario has been applied to six past crises. At the same time, the study of crisis managers skills allow us to create a database of training objectives coupled with stimuli.Finally, the methodology develops a step-by-step approach. It creates and situates the stimuli in the scenario. This original approach inserts these stimuli to solicit needed skills for several profiles of participants.Then, the scenarios are verified using criteria that validate the scriptwriting and the pedagogical nature of the scenario.The scriptwriting method was tested through a functional exercise and applied by several categories of scriptwriters (novice or crisis management experts) which validated its operational nature.

Cette thèse a été conduite dans le cadre d’une convention industrielle avec SNCF Réseau. Elle se situe dans le domaine de la géovisualisation d’informations spatio-temporelles, et porte plus particulièrement sur l’élaboration de méthodes de visualisation cartographiques adaptées à l’analyse des impacts des inondations sur le système ferroviaire. Les événements historiques sont une source d’informations importante pour la compréhension et la gestion des risques naturels. La cartographie s’est imposée comme un outil clé pour appréhender les risques dans leurs contextes territoriaux. Mais l’élaboration de visualisations cartographiques qui soient lisibles tout en restituant la complexité des processus survenus lors d’une catastrophe naturelle n’est pas aisée. Les verrous principaux sont la nécessité de représenter à la fois les dimensions spatiales et temporelles des événements issus de risques, le besoin de visualiser les effets dominos, qui conduisent à amplifier les dommages, et la volonté d’adapter les représentations aux besoins et aux capacités cognitives des utilisateurs. Ce travail a conduit à quatre contributions. La première contribution a consisté à formaliser les récits d’inondations dans une ontologie de domaine, qui décrit à la fois les événements issus d’inondations, les effets dominos et leurs impacts sur le système ferroviaire et les mesures de réaction pour ramener le système ferroviaire à l’état d’équilibre. Cinq cas d’inondations historiques ont été instanciés dans le modèle. Leur étude a permis de formuler des principes sémiologiques génériques pour cartographier les récits d’inondations, ce qui constitue la deuxième contribution. La troisième contribution est la production d’une interface de géovisualisation intégrant des représentations graphiques innovantes pour visualiser les temporalités associées aux événements. Cette interface de géovisualisation a fait l’objet d’une expérimentation auprès des experts ferroviaires. Les résultats ont validé les propositions relatives à la représentation du temps mais ont infirmé les propositions de visualisation des effets dominos. Suite à l’analyse des résultats, la quatrième contribution consiste en un modèle de protocole expérimental réutilisable, adapté au test d’interfaces de géovisualisation. / This research was led in an industrial partnership with SNCF Réseau. In the field of geovisualization of spatio-temporal information, it focuses on developing cartographical visualization methods adapted to the analysis of the impacts of floods on the railway system.Historical events are of great help to understand and manage natural risks. Cartography became a key tool to analyze risks in their territorial contexts. But making maps which remain legible while showing all the complexity of risk processes that occurred during natural disaster is not easy. The main challenges are the need to represent both the temporal and the spatial dimensions of risk events, the need to visualize domino-effect, because they often lead to worsen damages, and the will to adapt representations to the cognitive capacities of users.This research resulted in four contributions. The first one is the formalization of flood narratives in a domain ontology, which describes flood events, domino-effects, their impacts on the railway system and also response measures to restore the system. Five case studies of historical floods were instantiated in the model. Resulting from their study, the second contribution consists in generic semiology principles to visualize the narratives of floods on maps. The third contribution is a geovisualization interface, which includes original graphical representations to visualize the temporal features associated with flood events. This geovisualization interface was tested in an experiment with expert users of the railway field. Results confirmed the proposals of representation of time but disconfirm proposals of visualization of domino effects. The analysis of results led to the fourth contribution, which consists in a reusable model of an experimental procedure that is adapted to test geovisualization interfaces.

La compétitivité d'une entreprise est conditionnée par l'aptitude de son organisation de trouver des solutions pour améliorer l'efficacité de son processus de fabrication en maîtrisant sa variabilité tout en garantissant des coûts bas, des délais réduits et, parfois, une certaine capacité de produire à des grands volumes. La maîtrise du processus de fabrication est un ensemble d'activités réalisées par un processus opérationnel de contrôle en suivant un plan de surveillance préétabli avec des objectifs précis en termes de maîtrise des risques. La mise en application du plan de surveillance est souvent mise à mal par : les aléas liées aux flux physiques et informationnels, l'interaction du processus de contrôle avec d'autres processus opérationnels de l'entreprise et les limitations en ressources de maîtrise. L'objectif de cette thèse était de répondre à cette problématique en proposant des approches nouvelles pour la conception des plans de surveillance. Pour cela, nous proposons une approche assurantielle permettant de définir un plan de surveillance qui limite l'exposition aux risques et optimise l'utilisation des ressources de maîtrise. Une formalisation simplifiée a permit d'expliquer cette approche à travers des exemples. Les résultats des expérimentations sur un cas industriel, montrent l'intérêt de l'approche pour la maîtrise des risques opérationnels dans un processus de fabrication. Par la suite, une formalisation généralisée de l'approche a été proposé concevoir le plan de surveillance généralisé d'un processus disposant d'un ensemble des moyens de contrôle interposé sur plusieurs couches le long du processus qui est assujetti à multiples risques. Mots clés : Plan de surveillance, Maîtrise des risques, Allocation des inspections, Capabilité, Capacité, Performances. / The competitiveness of a company depends on its organization ability to improve the efficiency of the manufacturing process by controlling its variability while maintaining low costs, reduced delays and, sometimes, a certain capacity to produce at high volumes. Process monitoring is a set of activities performed by an operational process of control according to the control plan which is predetermined with specific goals in terms of risk control. The implementation of the control plan is often undermined by: the uncertainties associated with physical and informational flows, the interaction of the control process with other operational processes and the limitations of control resources. The objective of this thesis was to address this problem by proposing new approaches to the design of control plans. For this, we propose an approach for defining an insurance-based control plan that limits exposure to risk and optimizes control resources utilization. A simplified formalization has allowed explaining this approach through examples. The results of experiments, done on an industrial case study, demonstrate the value of the approach for operational risk management in a manufacturing process. Subsequently, a generalized formalization of the approach has been proposed to design the control plan of a generalized process with a set of control resources interposed in several layers along the process which is subject to multiple risks. Keywords : Control plan, Risks monitoring, Inspection allocation, Capability, Capacity, Performances.

Depuis les années 2000, le développement des nanotechnologies suscite des oppositions liées à de « nouveaux risques » que l'on commence tout juste à cerner, ainsi qu'à des questionnements éthiques, ce qui n'empêche pas le développement à l'échelle mondiale de ces technologies, sous la forme de pôles localisés soumis à de rudes exigences de compétitivité. Or, ces projets d'aménagement donnent lieu à des conflits autour de risques difficiles à appréhender à l'échelle locale : quelles conséquences cela a-t-il sur la façon dont sont conduits les projets d'aménagement ? Et qu'en est-il de la contestation face à des risques insaisissables ? Le cas de Grenoble permet d'étudier cette tension entre des projets d'aménagement et un conflit aux conséquences très localisées, et le développement scientifique et économique de ces technologies selon une logique mondialisée. Comment, pour les acteurs publics, penser l'aménagement du territoire à l'échelle locale face à cette incertitude radicale, globale, dans le contexte d'une concurrence économique qui les dépasse mais qui les contraint? Comment la question des risques et de l'incertitude, dont la « nouveauté » devra être questionnée, est-elle susceptible de renouveler ou non le processus de territorialisation, la maîtrise des projets, les logiques de justification et la façon dont les acteurs parviennent à fonder en raison l'anticipation ? / Since the 2000's, the development of nanotechnologies gives rise to oppositions in connection with "new risks" that are only just starting to be defined, together with an ethical questioning, which doesn't prevent the worldwide development of those technologies, in the form of localized poles subject to harsh requirements of competitiveness. Now, those territorial development projects generate conflicts about risks which are difficult to assess on a local scale : what are the consequences on the way the territorial development projects are conducted ? And what about the protest facing elusive risks ? The case of Grenoble allows to study this tension between development projects and a conflict with very local consequences, and the scientific and economic development of those technologies following a worldwide practice. For local actors, how to think out territorial development on a local scale when faced with this radical global uncertainty, in the context of an economical competition that exceeds but compels them ? How is the question of risks and uncertainty, whose "novelty" will have to be questioned, likely to renew or not the process of territorialisation, the control of projetcs, the practices of justification, and the way the actors manage to base anticipation on the rule of reason.

Made available in DSpace on 2016-06-02T19:48:22Z (GMT). No. of bitstreams: 1 4966.pdf: 4823144 bytes, checksum: f916ca657580a893ffcefa462ee29c79 (MD5) Previous issue date: 2013-02-19 / Financiadora de Estudos e Projetos / The nursing staff performs procedures, which often involve the handling of sharpened material, which offers risk of exposure to biological material. The frequency of these procedures in psychiatric hospitals has not been quantified, nor the risks that professionals are exposed. To avoid accidents, the adoption of Standard Precautions (SP) is necessary. The Hand Hygiene (HH) is an important strategy for prevention and control of Infections Related to Health Care (IRHC). This was an exploratory and crosssectional study, quantitative in nature, with the purpose of identifying the biological risk situations that nursing professionals in care are exposed are subject, performed in a psychiatric hospital of the interior of state of São Paulo, Brazil. We observed 830 nursing procedures, wich 40.6% offer moderate to high risk of biological exposure. The quantitative of biological high-risk procedures was not significant, however, the unexpected situations that arise during the care of these patients, intensify this exposure. Became evident an accident with sharpened material and various situations and behaviors that exposes professional to the risk, for example, the improper handling and disposal of sharpened material and non-adherence to the Personal Protective Equipment (PPE). The HH was below recommended, with an adhesion rate of 0.96%. In some situations was observed low compliance with good practices of prevention and control of IRHC, especially the indiscriminate and inappropriate use of gloves. Was noticed that the adhesion to SP was strongly influenced by individual, labor and organizational factors. Significant difference was observed between the professions of nursing and nursing assistant, and the latter showed low levels of training and low perceived availability of PPE, contributing negatively to adherence to preventive action. It was evident that the support offered by the institution to the professionals did not improve the adoption of the SP, making the organizational factors one of most relevant. It is necessary that institutions provide safe working conditions and continued training to nursing staff, contributing to the advance in the control of IRHC and in adherence to standard precautions. It was concluded that the professional nursing staff are exposed to biological risk and that this research was the first nationally and internationally on this topic in a psychiatric institution. The fact that the results portray the reality of this hospital can be considered a limitation of this study, however contributed to the expansion of knowledge about biological risk, control of IRHC and adherence to SP in psychiatric hospitals. Thus, it is expected to encourage further research in other institutions and mental health services that might contribute to achieving safer assistance for professionals and care for patients with psychiatric disorders. / A equipe de enfermagem realiza procedimentos, que frequentemente envolvem a manipulação de objetos perfurocortantes, os quais oferecem risco de exposição a material biológico. Em hospitais psiquiátricos ainda não foi quantificada a frequência desses procedimentos, nem os riscos que os profissionais estão sujeitos. Para evitar acidentes é necessária a adoção das Precauções-Padrão (PP). A Higienização das Mãos (HM) é uma importante estratégia de controle e prevenção das Infecções Relacionadas à Assistência à Saúde (IRAS). Tratou-se de um estudo exploratório e transversal, de natureza quantitativa, com o objetivo de identificar as situações de risco biológico que os profissionais de enfermagem estão sujeitos na assistência realizada em um Hospital Psiquiátrico do Interior do Estado de São Paulo, SP, Brasil. Foram observados 830 procedimentos de enfermagem, dos quais 40,6% ofereceram moderado e alto risco de exposição biológica. O quantitativo de procedimentos de alto risco biológico não foi expressivo, porém as situações inesperadas que surgem durante a assistência destes pacientes, intensifica essa exposição. Evidenciou-se um acidente com perfurocortante e várias situações e comportamentos que expõem o profissional ao risco, como, por exemplo, a manipulação e descarte inadequados de perfurocortantes e a não-adesão aos Equipamentos de Proteção Individual (EPI). A HM ficou aquém do recomendado, apresentando uma taxa de adesão de 0,96%. Em algumas situações notou-se baixa conformidade com as boas práticas de prevenção e controle das IRAS, destacando-se o uso indiscriminado e inadequado de luvas. Percebeu-se que a adesão às PP foi fortemente influenciada por fatores individuais, relativos ao trabalho e organizacionais. Houve diferença significativa entre as categorias profissionais de enfermeiro e auxiliar de enfermagem, sendo que esta última apresentou baixos níveis de treinamento e menor percepção da disponibilidade de EPI, contribuindo negativamente para a adesão às medidas preventivas. Evidenciou-se que o suporte oferecido pela instituição aos profissionais não favoreceu a adoção das PP, tornando os fatores organizacionais um dos mais relevantes. É necessário que as instituições ofereçam condições seguras de trabalho e capacitação permanente à equipe de enfermagem, colaborando para o avanço no controle das IRAS e na adesão às PP. Concluiu-se que os profissionais da equipe de enfermagem estão expostos ao risco biológico e que esta pesquisa foi a primeira nacional e internacional sobre essa temática em instituição psiquiátrica. O fato dos resultados retratarem apenas a realidade deste hospital pode ser considerado uma das limitações deste estudo, no entanto contribuíram para a ampliação do conhecimento sobre risco biológico, controle de IRAS e adesão às PP em hospitais psiquiátricos. Desta forma, almeja-se incentivo às investigações futuras em outras instituições e serviços de saúde mental que poderão contribuir para a realização de assistência mais segura aos profissionais e aos pacientes com transtornos psiquiátricos.

Made available in DSpace on 2015-04-17T15:02:56Z (GMT). No. of bitstreams: 1 Arquivototal.pdf: 1666576 bytes, checksum: a0768dc2b54028b4d396d2117f5f50b5 (MD5) Previous issue date: 2011-12-14 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The aim of this study was to evaluate fluoride and calcium metabolism in a region endemic on fluorosis (Brejo das Freiras-PB) after the implantation of a defluoridation system. There were 13 children and 16 adults as volunteers of this study. In order to evaluate ingestion it was used the methodology of the duplicated dish. To analyze fluoride derived from dentifrice the volunteer were asked to simulate the way they brush their teeth and the descart was collected. For the analysis of excretion it was used the 24 hours urine collection. All the samples collected was evaluated for fluoride concentration, through the fluoride specific electrode and through HMDS technique. The calcium was analyzed through arsenazo II methodology. The metabolism evaluation occurred at three periods named D1 (baseline, that is, before the defluoridation system was implanted), D2 (after a period of thirty days of the implantation of the system) and D3 (after after a period of six months of the implantation of the system). All data analysis was done through statistical packages (SPSS and graphpad). It could be observed that ingestion and excretion of fluoride diminished after the implantation of the system moreover fluoride retention decreased. Fluorosis risks decreased from twelve children to zero six months after the defluoridation system was implanted. We concluded that the defluoridation system was effective for diminishing fluoride retention as well as the fluorosis risk. / O presente estudo teve por objetivo avaliar o metabolismo de flúor e cálcio em uma região de fluorose endêmica no estado da Paraíba após a implantação de um filtro de desfluoretação. Participaram desse estudo 13 adultos e 16 crianças residentes na região de Brejo das Freiras. Para análise de ingestão foi realizada a coleta duplicada pela metodologia do prato duplicado e coleta de dentifrício, para análise de excreção foi feita a coleta de urina 24 horas. Todo o material coletado foi avaliado para concentrações de flúor, através do eletrodo especifico e técnica do HMDS e cálcio através do método do arsenazo III. A avaliação foi realizada em três momentos D1 (baseline), D2 (30 dias após a instalação do filtro) e D3 (seis meses após). As análises estatísticas foram realizadas através dos programas estatísticos SPSS e Graphpad. Foi observado que tanto a ingestão quanto a excreção de flúor diminuiu após a instalação do filtro de desfluoretação, diminuindo ainda a exposição ao flúor. Pode-se observar ainda que o risco de fluorose dentária diminuiu de 12 crianças para zero seis meses após a instalação do filtro. Conclui-se que o filtro de desfluoretação foi eficaz ao diminuir a exposição ao flúor, diminuindo assim o risco de fluorose dentária.