Avaliação da atenção básica em saúde: uma nova proposta

Este artigo apresenta uma nova proposta de avaliação da Atenção Básica em Saúde (ABS), utilizando a abordagem sistêmica de Donabedian, com a modificação de que a avaliação desse serviço deveria iniciar pelo componente Processo, visando identificar a adequação da oferta e das relações entre os distintos procedimentos desse nível de atenção. A partir dessa análise deverá ser realizada a busca do resultado preditivo, permitindo a relação entre esses componentes. Com base nessa análise, a avaliação de estrutura ganha significado para o processo de decisão. Faz parte da abordagem a avaliação da rede de atenção, tendo como foco e imagem-objetivo a atenção básica como porta de entrada da rede. Apresenta uma concepção de rede mais dinâmica e flexível e propõe a utilização na avaliação do método misto, englobando a abordagem quantitativa baseada nos bancos de dados existentes no sistema Datasus e complementada pela abordagem qualitativa, permitindo maior compreensão do significado das relações encontradas nos serviços e na rede. Nesse desenho metodológico, será possível a identificação das variáveis de funcionamento e a organização da ABS e da rede de serviços, possibilitando direcionar a tomada de decisão para a melhoria de qualidade da atenção básica de saúde.

Sistemas informatizados de registro de imunização: uma revisão com enfoque na saúde infantil

São apresentadas diferentes experiências e metodologias empregadas por registros informatizados de imunização (RII), no enfoque da saúde infantil. O levantamento bibliográfico abrangeu publicações de 1990 a 2006, existentes nas bases MEDLINE, SciELO, PubMed e EMBASE. Outros sítios eletrônicos de organizações nacionais e internacionais de saúde foram pesquisados. Em virtude da ausência de publicações sobre RII no Brasil, as fontes de informação foram a Coordenação Nacional e as Coordenações Estaduais do Programa Nacional de Imunizações, além do Departamento de Informática do Sistema Único de Saúde. Selecionaram-se apenas artigos que abordam RII em saúde infantil. Foram localizados 109 artigos publicados em 35 revistas especializadas. São apresentados aspectos históricos e conceituais, objetivos, funções, relevância e indicadores de desempenho e de custo-efetividade, além das próprias limitações dos RII, assim como experiências em países selecionados, inclusive no Brasil. Os RII integrados a outros sistemas de informação vêm sendo aplicados como importante instrumento para a identificação de populações com menor acesso ou adesão aos programas de vacinação e em sistemas de vigilância ativa de eventos adversos pós-vacina

Brazilian flavonoid database: Application of quality evaluation system

Much information on flavonoid content of Brazilian foods has already been obtained; however, this information is spread in scientific publications and non-published data. The objectives of this work were to compile and evaluate the quality of national flavonoid data according to the United States Department of Agriculture`s Data Quality Evaluation System (USDA-DQES) with few modifications, for future dissemination in the TBCA-USP (Brazilian Food Composition Database). For the compilation, the most abundant compounds in the flavonoid subclasses were considered (flavonols, flavones, isoflavones, flavanones, flavan-3-ols, and anthocyanidins) and the analysis of the compounds by HPLC was adopted as criteria for data inclusion. The evaluation system considers five categories, and the maximum score assigned to each category is 20. For each data, a confidence code (CC) was attributed (A, B, C and D), indicating the quality and reliability of the information. Flavonoid data (773) present in 197 Brazilian foods were evaluated. The CC ""C"" (as average) was attributed to 99% of the data and ""B"" (above average) to 1%. The main categories assigned low average scores were: number of samples; sampling plan and analytical quality control (average scores 2, 5 and 4, respectively). The analytical method category received an average score of 9. The category assigned the highest score was the sample handling (20 average). These results show that researchers need to be conscious about the importance of the number and plan of evaluated samples and the complete description and documentation of all the processes of methodology execution and analytical quality control. (C) 2010 Elsevier Inc. All rights reserved.

ScriptLattes: an open-source knowledge extraction system from the Lattes platform

The Lattes platform is the major scientific information system maintained by the National Council for Scientific and Technological Development (CNPq). This platform allows to manage the curricular information of researchers and institutions working in Brazil based on the so called Lattes Curriculum. However, the public information is individually available for each researcher, not providing the automatic creation of reports of several scientific productions for research groups. It is thus difficult to extract and to summarize useful knowledge for medium to large size groups of researchers. This paper describes the design, implementation and experiences with scriptLattes: an open-source system to create academic reports of groups based on curricula of the Lattes Database. The scriptLattes system is composed by the following modules: (a) data selection, (b) data preprocessing, (c) redundancy treatment, (d) collaboration graph generation among group members, (e) research map generation based on geographical information, and (f) automatic report creation of bibliographical, technical and artistic production, and academic supervisions. The system has been extensively tested for a large variety of research groups of Brazilian institutions, and the generated reports have shown an alternative to easily extract knowledge from data in the context of Lattes platform. The source code, usage instructions and examples are available at http://scriptlattes.sourceforge.net/.

Crowbar System in Doubly Fed Induction Wind Generators

In the last 15 years, the use of doubly fed induction machines in modern variable-speed wind turbines has increased rapidly. This development has been driven by the cost reduction as well as the low-loss generation of Insulated Gate Bipolar Transistors (IGBT). According to new grid code requirements, wind turbines must remain connected to the grid during grid disturbances. Moreover, they must also contribute to voltage support during and after grid faults. The crowbar system is essential to avoid the disconnection of the doubly fed induction wind generators from the network during faults. The insertion of the crowbar in the rotor circuits for a short period of time enables a more efficient terminal voltage control. As a general rule, the activation and the deactivation of the crowbar system is based only on the DC-link voltage level of the back-to-back converters. In this context, the authors discuss the critical rotor speed to analyze the instability of doubly fed induction generators during grid faults.

A score system for quality evaluation of RNA sequence tags: an improvement for gene expression profiling

Background: High-throughput molecular approaches for gene expression profiling, such as Serial Analysis of Gene Expression (SAGE), Massively Parallel Signature Sequencing (MPSS) or Sequencing-by-Synthesis (SBS) represent powerful techniques that provide global transcription profiles of different cell types through sequencing of short fragments of transcripts, denominated sequence tags. These techniques have improved our understanding about the relationships between these expression profiles and cellular phenotypes. Despite this, more reliable datasets are still necessary. In this work, we present a web-based tool named S3T: Score System for Sequence Tags, to index sequenced tags in accordance with their reliability. This is made through a series of evaluations based on a defined rule set. S3T allows the identification/selection of tags, considered more reliable for further gene expression analysis. Results: This methodology was applied to a public SAGE dataset. In order to compare data before and after filtering, a hierarchical clustering analysis was performed in samples from the same type of tissue, in distinct biological conditions, using these two datasets. Our results provide evidences suggesting that it is possible to find more congruous clusters after using S3T scoring system. Conclusion: These results substantiate the proposed application to generate more reliable data. This is a significant contribution for determination of global gene expression profiles. The library analysis with S3T is freely available at http://gdm.fmrp.usp.br/s3t/.S3T source code and datasets can also be downloaded from the aforementioned website.

The Coupled Aerosol and Tracer Transport model to the Brazilian developments on the Regional Atmospheric Modeling System (CATT-BRAMS) - Part 1: Model description and evaluation

We introduce the Coupled Aerosol and Tracer Transport model to the Brazilian developments on the Regional Atmospheric Modeling System (CATT-BRAMS). CATT-BRAMS is an on-line transport model fully consistent with the simulated atmospheric dynamics. Emission sources from biomass burning and urban-industrial-vehicular activities for trace gases and from biomass burning aerosol particles are obtained from several published datasets and remote sensing information. The tracer and aerosol mass concentration prognostics include the effects of sub-grid scale turbulence in the planetary boundary layer, convective transport by shallow and deep moist convection, wet and dry deposition, and plume rise associated with vegetation fires in addition to the grid scale transport. The radiation parameterization takes into account the interaction between the simulated biomass burning aerosol particles and short and long wave radiation. The atmospheric model BRAMS is based on the Regional Atmospheric Modeling System (RAMS), with several improvements associated with cumulus convection representation, soil moisture initialization and surface scheme tuned for the tropics, among others. In this paper the CATT-BRAMS model is used to simulate carbon monoxide and particulate material (PM(2.5)) surface fluxes and atmospheric transport during the 2002 LBA field campaigns, conducted during the transition from the dry to wet season in the southwest Amazon Basin. Model evaluation is addressed with comparisons between model results and near surface, radiosondes and airborne measurements performed during the field campaign, as well as remote sensing derived products. We show the matching of emissions strengths to observed carbon monoxide in the LBA campaign. A relatively good comparison to the MOPITT data, in spite of the fact that MOPITT a priori assumptions imply several difficulties, is also obtained.

Flow injection analysis of paracetamol using a biomimetic sensor as a sensitive and selective amperometric detector

This work describes the coupling of a biomimetic sensor to a flow injection system for the sensitive determination of paracetamol. The sensor was prepared as previously described in the literature (M. D. P. T. Sotomayor, A. Sigoli, M. R. V. Lanza, A. A. Tanaka and L. T. Kubota, J. Braz. Chem. Soc., 2008, 19, 734) by modifying a glassy carbon electrode surface with a Nafion (R) membrane doped with iron tetrapyridinoporphyrazine (FeTPyPz), a biomimetic catalyst of the P450 enzyme. The performance of the sensor for paracetamol detection was investigated and optimized in a flow injection system (FIA) using a wall jet electrochemical cell. Under optimized conditions a wide linear response range (1.0 x 10(-5) to 5.0 x 10(-2) mol L(-1)) was obtained, with a sensitivity of 2579 (+/- 129) mu A L mu mol(-1). The detection and quantification limits of the sensor for paracetamol in the FIA system were 1.0 and 3.5 mu mol L(-1), respectively. The analytical frequency was 51 samples h(-1), and over a period of five days (320 determinations) the biosensor maintained practically the same response. The system was successfully applied to paracetamol quantification in seven pharmaceutical formulations and in water samples from six rivers in Sao Paulo State, Brazil.

Online Mammographic Images Database for Development and Comparison of CAD Schemes

Considering the difficulties in finding good-quality images for the development and test of computer-aided diagnosis (CAD), this paper presents a public online mammographic images database free for all interested viewers and aimed to help develop and evaluate CAD schemes. The digitalization of the mammographic images is made with suitable contrast and spatial resolution for processing purposes. The broad recuperation system allows the user to search for different images, exams, or patient characteristics. Comparison with other databases currently available has shown that the presented database has a sufficient number of images, is of high quality, and is the only one to include a functional search system.

Control system design for flexible rotors supported by actively lubricated bearings

This article presents a methodology for calculating the gains of an output feedback controller for active vibration control of flexible rotors. The methodology is based on modal reduction. The proportional and derivative gains are obtained by adjusting the first two damping factors of the system and keeping the lengths of the two eigenvalues constant in the real-imaginary plane. The methodology is applied to an industrial gas compressor supported by active tilting-pad journal bearings. The unbalance response functions and mode shapes of the flexible rotor with and without active control are presented, showing significative improvement in damping reserve with the control. The importance of sensor location is emphasized, on the basis of the energy necessary to operate the active system over the entire frequency range studied. The best results are obtained by a decentralized controller, observing displacement and velocity of the shaft at the bearing positions.

A Study on the Relationship of Embedded Sensitivity With Measuring Grid and Mode Shapes

Embedded sensitivity analysis has proven to be a useful tool in finding optimum positions of structure reinforcements. However, it was not clear how sensitivities obtained from the embedded sensitivity method were related to the normal mode, or operational mode, associated to the frequency of interest. In this work, this relationship is studied based on a finite element of a slender sheet metal piece, with preponderant bending modes. It is shown that higher sensitivities always occur at nodes or antinodes of the vibrating system. [DOI: 10.1115/1.4002127]

Digital control and integration of a 192 MW wind farm with doubly fed induction generator into the Brazilian power system

This paper reports on design of digital control for wind turbines and its relation to the quality of power fed into the Brazilian grid on connecting to it a 192 MW wind farm equipped with doubly fed induction generators. PWM converters are deployed as vector controlled regulated current voltage sources for their rotors, for independent control of both active and reactive power of those generators. Both speed control and active power control strategies are analyzed, in the search for maximum efficiency of conversion of wind kinetic energy into electric power and enhanced quality of delivered power. (C) 2009 Elsevier B.V. All rights reserved.

Integral Piezoactuator System with Optimum Placement of Functionally Graded Material - A Topology Optimization Paradigm

Piezoactuators consist of compliant mechanisms actuated by two or more piezoceramic devices. During the assembling process, such flexible structures are usually bonded to the piezoceramics. The thin bonding layer(s) between the compliant mechanism and the piezoceramic may induce undesirable behavior, including unusual interfacial nonlinearities. This constitutes a drawback of piezoelectric actuators and, in some applications, such as those associated to vibration control and structural health monitoring (e. g., aircraft industry), their use may become either unfeasible or at least limited. A possible solution to this standing problem can be achieved through the functionally graded material concept and consists of developing `integral piezoactuators`, that is those with no bonding layer(s) and whose performance can be improved by tailoring their structural topology and material gradation. Thus, a topology optimization formulation is developed, which allows simultaneous distribution of void and functionally graded piezoelectric materials (including both piezo and non-piezoelectric materials) in the design domain in order to achieve certain specified actuation movements. Two concurrent design problems are considered, that is the optimum design of the piezoceramic property gradation, and the design of the functionally graded structural topology. Two-dimensional piezoactuator designs are investigated because the applications of interest consist of planar devices. Moreover, material gradation is considered in only one direction in order to account for manufacturability issues. To broaden the range of such devices in the field of smart structures, the design of integral Moonie-type functionally graded piezoactuators is provided according to specified performance requirements.

On-line fault diagnostic system for proton exchange membrane fuel cells

In this paper, a supervisor system, able to diagnose different types of faults during the operation of a proton exchange membrane fuel cell is introduced. The diagnosis is developed by applying Bayesian networks, which qualify and quantify the cause-effect relationship among the variables of the process. The fault diagnosis is based on the on-line monitoring of variables easy to measure in the machine such as voltage, electric current, and temperature. The equipment is a fuel cell system which can operate even when a fault occurs. The fault effects are based on experiments on the fault tolerant fuel cell, which are reproduced in a fuel cell model. A database of fault records is constructed from the fuel cell model, improving the generation time and avoiding permanent damage to the equipment. (C) 2007 Elsevier B.V. All rights reserved.

A sensor array based on mass and capacitance transducers for the detection of adulterated gasolines

The simultaneous use of different sensors technologies is an efficient method to increase the performance of chemical sensors systems. Among the available technologies, mass and capacitance transducers are particularly interesting because they can take advantage also from non-conductive sensing layers, such as most of the more interesting molecular recognition systems. In this paper, an array of quartz microbalance sensors is complemented by an array of capacitors obtained from a commercial biometrics fingerprints detector. The two sets of transducers, properly functionalized by sensitive molecular and polymeric films, are utilized for the estimation of adulteration in gasolines, and in particular to quantify the content of ethanol in gasolines, an application of importance for Brazilian market. Results indicate that the hybrid system outperforms the individual sensor arrays even if the quantification of ethanol in gasoline, due to the variability of gasolines formulation, is affected by a barely acceptable error. (C) 2009 Elsevier B.V. All rights reserved.