53 resultados para Pressure Ulcers, Economic Costs


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Pós-graduação em Enfermagem - FMB

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Long term wheelchair usage has been related to a number of problems, among which pressure ulcers are one of most concern. The design of wheelchair seat cushions has been of increasing interest among researchers, as it can influence seat interface pressure and user's comfort. The aim of this study was to investigate the subjects' perception comfort, stability and body posture of six different commercially available wheelchair cushions. The evaluation was through a questionnaire, where the subjects rate their perceptions on a ten point visual analog scale after staying seated in the cushion for two minutes. The results shows that the RohoTM aircell cushion was preferred by the users, while the least preferred one was the water cushion. Individuals' subjective perceptions may compliment objective data on seat interface pressure, thus contributing to a more complete view of the users' experience during wheelchair cushion usage.

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This work has as objective to demonstrate technical and economic viability of hydrogen production utilizing glycerol. The volume of this substance, which was initially produced by synthetic ways (from oil-derived products), has increased dramatically due mainly to biodiesel production through transesterification process which has glycerol as main residue. The surplus amount of glycerol has been generally utilized to feed poultry or as fuel in boilers, beyond other applications such as production of soaps, chemical products for food industry, explosives, and others. The difficulty to allocate this additional amount of glycerol has become it in an enormous environment problem, in contrary to the objective of biodiesel chain, which is to diminish environmental impact substituting oil and its derivatives, which release more emissions than biofuels, do not contribute to CO2-cycle and are not renewable sources. Beyond to utilize glycerol in combustion processes, this material could be utilized for hydrogen production. However, a small quantity of works (theoretical and experimental) and reports concerning this theme could be encountered. Firstly, the produced glycerol must be purified since non-reacted amounts of materials, inclusively catalysts, contribute to deactivate catalysts utilized in hydrogen production processes. The volume of non-reacted reactants and non-utilized catalysts during transesterification process could be reutilized. Various technologies of thermochemical generation of hydrogen that utilizes glycerol (and other fuels) were evaluated and the greatest performances and their conditions are encountered as soon as the most efficient technology of hydrogen production. Firstly, a physicochemical analysis must be performed. This step has as objective to evaluate the necessary amount of reactants to produce a determined volume of hydrogen and determine thermodynamic conditions (such as temperature and pressure) where the major performances of hydrogen production could be encountered. The calculations are based on the process where advance degrees are found and hence, fractions of products (especially hydrogen, however, CO2, CO, CH4 and solid carbon could be also encountered) are calculated. To produce 1 Nm3/h of gaseous hydrogen (necessary for a PEMFC - Proton Exchange Membrane Fuel Cell - containing an electric efficiency of about 40%, to generate 1 kWh), 0,558 kg/h of glycerol is necessary in global steam reforming, 0,978 kg/h of glycerol in partial oxidation and cracking processes, and 0,782 kg/h of glycerol in autothermal reforming process. The dry reforming process could not be performed to produce hydrogen utilizing glycerol, in contrary to the utilization of methane, ethanol, and other hydrocarbons. In this study, steam reforming process was preferred due mainly to higher efficiencies of production and the need of minor amount of glycerol as cited above. In the global steam reforming of glycerine, for one mole of glycerol, three moles of water are necessary to produce three moles of CO2 and seven moles of H2. The response reactions process was utilized to predict steam reforming process more accurately. In this mean, the production of solid carbon, CO, and CH4, beyond CO2 and hydrogen was predicted. However, traces of acetaldehyde (C2H2), ethylene (C2H4), ethylene glycol, acetone, and others were encountered in some experimental studies. The rates of determined products obviously depend on the adopted catalysts (and its physical and chemical properties) and thermodynamic conditions of hydrogen production. Eight reactions of steam reforming and cracking were predicted considering only the determined products. In the case of steam reforming at 600°C, the advance degree of this reactor could attain its maximum value, i.e., overall volume of reactants could be obtained whether this reaction is maintained at 1 atm. As soon as temperature of this reaction increases the advance degree also increase, in contrary to the pressure, where advance degree decrease as soon as pressure increase. The fact of temperature of reforming is relatively small, lower costs of installation could be attained, especially cheaper thermocouples and smaller amount of thermo insulators and materials for its assembling. Utilizing the response reactions process in steam reforming, the predicted volumes of products, for the production of 1 Nm3/h of H2 and thermodynamic conditions as cited previously, were 0,264 kg/h of CO (13% of molar fraction of reaction products), 0,038 kg/h of CH4 (3% of molar fraction), 0,028 kg/h of C (3% of molar fraction), and 0,623 kg/h of CO2 (20% of molar fraction). Through process of water-gas shift reactions (WGSR) an additional amount of hydrogen could be produced utilizing mainly the volumes of produced CO and CH4. The overall results (steam reforming plus WGSR) could be similar to global steam reforming. An attention must to be taking into account due to the possibility to produce an additional amount of CH4 (through methanation process) and solid carbon (through Boudouard process). The production of solid carbon must to be avoided because this reactant diminishes (filling the pores) and even deactivate active area of catalysts. To avoid solid carbon production, an additional amount of water is suggested. This method could be also utilized to diminish the volume of CO (through WGSR process) since this product is prejudicial for the activity of low temperature fuel cells (such as PEMFC). In some works, more three or even six moles of water are suggested. A net energy balance of studied hydrogen production processes (at 1 atm only) was developed. In this balance, low heat value of reactant and products and utilized energy for the process (heat supply) were cited. In the case of steam reforming utilizing response reactions, global steam reforming, and cracking processes, the maximum net energy was detected at 700°C. Partial oxidation and autothermal reforming obtained negative net energy in all cited temperatures despite to be exothermic reactions. For global steam reforming, the major value was 114 kJ/h. In the case of steam reforming, the highest value of net energy was detected in this temperature (-170 kJ/h). The major values were detected in the cracking process (up to 2586 kJ/h). The exergetic analysis has as objective, associated with physicochemical analysis, to determine conditions where reactions could be performed at higher efficiencies with lower losses. This study was performed through calculations of exergetic and rational efficiencies, and irreversibilities. In this analysis, as in the previously performed physicochemical analysis, conditions such as temperature of 600°C and pressure of 1 atm for global steam reforming process were suggested due to lower irreversibility and higher efficiencies. Subsequently, higher irreversibilities and lower efficiencies were detected in autothermal reforming, partial oxidation and cracking process. Comparing global reaction of steam reforming with more-accurate steam reforming, it was verified that efficiencies were diminished and irreversibilities were increased. These results could be altered with introduction of WGSR process. An economic analysis could be performed to evaluate the cost of generated hydrogen and determine means to diminish the costs. This analysis suggests an annual period of operation between 5000-7000 hours, interest rates of up to 20% per annum (considering Brazilian conditions), and pay-back of up to 20 years. Another considerations must to be take into account such as tariffs of utilized glycerol and electricity (to be utilized as heat source and (or) for own process as pumps, lamps, valves, and other devices), installation (estimated as US$ 15.000 for a plant of 1 Nm3/h) and maintenance cost. The adoption of emission trading schemes such as carbon credits could be performed since this is a process with potential of mitigates environment impact. Not considering credit carbons, the minor cost of calculated H2 was 0,16288 US$/kWh if glycerol is also utilized as heat sources and 0,17677 US$/kWh if electricity is utilized as heat sources. The range of considered tariff of glycerol was 0-0,1 US$/kWh (taking as basis LHV of H2) and the tariff of electricity is US$ 0,0867 US$/kWh, with demand cost of 12,49 US$/kW. The costs of electricity were obtained by Companhia Bandeirante, localized in São Paulo State. The differences among costs of hydrogen production utilizing glycerol and electricity as heat source was in a range between 0,3-5,8%. This technology in this moment is not mature. However, it allows the employment generation with the additional utilization of glycerol, especially with plants associated with biodiesel plants. The produced hydrogen and electricity could be utilized in own process, increasing its final performance.

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A theoretical model was developed in order to determine the optimal moment for substituting the sprayer and pressure regulator kit on a center pivot irrigation machine. The model is based on the hypothesis that pressure regulator and sprayer deterioration decrease irrigation uniformity. To compensate the deficit that happens at under irrigated areas, an increase on irrigation depth is required. The model considers: additional water consumption and energy costs, maintenance and labor costs, as well as yield losses associated with under or over irrigated areas. The sum of all these components is compared to buying and installing a new spray kit cost, allowing the farmer to decide the best moment to renovate the sprayer and pressure regulator kits on a center pivot irrigation machine based on economic criteria.

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The implementation of a hypothetical aquaculture facility with hatchery, nursery and grow-out earthen ponds for raising the Amazon River Prawn Macrobrachium amazonicum in the Pantanal was considered. Eight larviculture cycles per year were projected: four to produce post-larvae for stocking in grow-out bait ponds, and four to stock nursery tanks to sell juveniles as seed to grow-out farms, which produce prawns for human consumption. Annual production would be 146,880 dozen bait prawns and 2,938 thousand juveniles. The assumed sale prices were US$ 1.38 per dozen baits and US$ 15.39 per thousand juveniles. The net present value was US$ 555,890.79, internal rate of return was 48% per year, payback period was 2.4 years and benefit-cost ratio was 3.90. The breakeven price to cover total costs per dozen baits was US$ 0.70 and per thousand juveniles was US$ 17.00, indicating that the selling price assumed for juveniles in base scenario is not realistic. Net return was US$ 84,773.80. The results indicate that this activity would be a lucrative and attractive investment in the Pantanal.

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Performance and economic indicators of a large scale fish farm that produces round fish, located in Mato Grosso State, Brazil, were evaluated. The 130.8 ha-water surface area was distributed in 30 ponds. Average total production costs and the following economic indicators were calculated: gross income (GI), gross margin (GM), gross margin index (GMI), profitability index (PI) and profit (P) for the farm as a whole and for ten ponds individually. Production performance indicators were also obtained, such as: production cycle (PC), apparent feed conversion (FC), average biomass storage (ABS), survival index (SI) and final average weight (FAW). The average costs to produce an average 2.971 kg.ha-1 per year were: R$ 2.43, R$ 0.72 and R$ 3.15 as average variable, fixed and total costs, respectively. Gross margin and profit per year per hectare of water surface were R$ 2,316.91 and R$ 180.98, respectively. The individual evaluation of the ponds showed that the best pond performance was obtained for PI 38%, FC 1.7, ABS 0.980 kg.m-2, TS 56%, FAW 1.873 kg with PC of 12.3 months. The worst PI was obtained for the pond that displayed losses of 138%, FC 2.6, ABS 0.110 kg.m-2, SI 16% and FAW 1.811 kg. However, large scale production of round-fish in farms is economically feasible. The studied farm displays favorable conditions to improve performance and economic indicators, but it is necessary to reproduce the breeding techniques and performance indicators achieved in few ponds to the entire farm.

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Brazilian fish farms presented an accelerated development during the early 90's, mainly because of the increase in fee-fishing operations. To meet the demand of this market, fish production and supply became excessive and, as a consequence, the number of fee-fishing operations, farmers and the final selling price, decreased. This study analyzes the technical aspects, production cost, profitability and economic viability of the production of piaucu (L. macrocephalus) in ponds, based on information from a rural property. Feeding and fingerling costs amount to approximately 47.1 % of the total production cost, representing together with the final selling price the most important factor affecting profitability. The payback period was 8.3 years, the liquid present value US$ 291.07, the internal return margin 9%, and the income-outcome ratio was 1.01, which represents an unattractive investment as a projection based on current conditions. The improvement in productive efficiency enhances the economic valuation index, and that the relative magnitude of cost and income are the most important points for the economic viability of the studied farm.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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

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The distribution of natural gas is carried out by means of long ducts and intermediate compression stations to compensate the pressure drops due to friction. The natural gas compressors are usually driven by an electric motor or a gas turbine system, offering possibilities for energy management, one of these consisting in generating energy for use in-plant or to commercialize as independent power producer. It can be done by matching the natural gas demand, at the minimum pressure allowed in the reception point, and the storage capacity of the feed duct with the maximum compressor capacity, for storing the natural gas at the maximum permitted pressure. This allows the gas turbine to drive an electric generator during the time in which the decreasing pressure in duct is above the minimum acceptable by the sink unit. In this paper, a line-pack management analysis is done for an existing compression station considering its actual demand curve for determining the economic feasibility of maintaining the gas turbine system driver generating electricity in a peak and off-peak tariff structure. The potential of cost reduction from the point of view of energy resources (natural gas and electric costs) is also analyzed. (C) 2010 Elsevier Ltd. All rights reserved.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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É importante a busca por melhores rentabilidades para a cultura do trigo por meio de tecnologias que reduzam custos de produção e proporcionem sustentabilidade à agricultura brasileira. Assim, o objetivo deste trabalho foi avaliar a rentabilidade da cultura do trigo em sistema plantio direto, visando reduzir doses de nitrogênio em cobertura, pelo cultivo de adubos verdes anterior ao do trigo. O experimento foi realizado em Selvíria (MS), Brasil, no ano 2009/10. O delineamento utilizado foi o de blocos casualizados com 36 tratamentos, em parcelas subdividas, com quatro repetições. As parcelas foram formadas por seis tipos de adubos verdes (guandu BRS Mandarim, Crotalaria juncea, milheto BRS 1501, pousio e os consórcios milheto + guandu e milheto + crotalária), que forneceram palha para o plantio direto do trigo no inverno, após a cultura de arroz na safra de verão. As subparcelas foram formadas por seis doses de nitrogênio (0, 25, 50,75, 100 e 125 kg ha-1 de N) em uma aplicação em cobertura, ten-do como fonte a ureia. O trigo cultivado, após a semeadura dos adubos verdes na safra de inverno anterior, sem a aplicação de nitrogênio em cobertura e na dose 25 kg ha-1 de N, apresentou com maior frequência custos de produção superior à receita bruta. O custo de produção de trigo cultivado após os consórcios de milheto + guandu e milheto + crotalária na safra de inverno anterior, associado a doses de nitrogênio de 50 e 75 kg ha-1 de N, proporcionou maior lucratividade em relação aos demais adubos verdes avaliados.

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Venous ulcers of the lower limbs complicated by infection or chronicity represent a serious public health problem. The elevated number of those afflicted burdens the health services, interferes in quality of life and causes absenteeism. Although there are 2,500 items on the market, ranging from the simplest dressing up to the most complex types of dressing, treatment remains a challenge. Among the substances used, fibrin sealant is the one that promotes diminution of bacterial colonization and of edema, controls hemorrhaging, alters the pain threshold by protecting the nerve endings, hydrates the wound bed and forms granulation tissue that favors healing. Its disadvantages include higher cost and utilization of human fibrinogen that can transmit infectious diseases. The Center for the Study of Venoms and Venomous Animals (CEVAP) at São Paulo State University (UNESP) developed a new sealant made up of fibrinogen extracted from large animals and from an enzyme obtained from snake venom. The present study, developed in the Health Education Clinic (CEPS) of Sacred Heart University (USC) aimed to evaluate the effect of the new sealant on the healing process of venous ulcers in 24 adult patients, seven of whom were male and 17 female. Two study groups were formed as follows: Group 1 (G1) - control group of 11 patients treated with essential fatty acid (EFA) and Unna's boot, and Group 2 (G2) - 13 patients treated with essential fatty acid (EFA), fibrin sealant and Unna's boot. The follow-up lasted eight weeks and the sealant was applied at only the first and fourth weeks. The results showed that Group 2 presented worse lesion conditions as to healing, but, when comparing the two groups, it was noteworthy that the the sealant was effective in healing venous ulcers. There is evidence that the new sealant is recommended for leg ulcers with the following advantages: ease of application, preparation of the wound bed, diminution of pain and a higher number of discharges in the eighth week. More important, other positive characteristics are non-transmission of infectious diseases, absence of adverse reactions, and economic advantage of being produced by Brazilian technology. Finally, it is suggested that the weekly application of sealant, for at least eight weeks, could improve the healing process and consequently life quality.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)