Acurácia dos indicadores clínicos do diagnóstico de enfermagem falta de adesão em pessoas vivendo com AIDS

In the early 1990s, a major milestone in the treatment of Acquired Immune Deficiency Syndrome was the development of highly active combination antiretroviral therapy. The great benefit generated by the use of this therapy was prolonging the survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Despite improvements generated by this therapy, there are still many difficulties to be overcome. One is the patient adherence to their treatment, bringing challenges to services and health professionals. Hence the need for early identification of nursing diagnosis Lack of Accession so that solutions are sought by the nurse with the patient and his family. With this problem, adds to the difficulty of hospital nurses in inferring that diagnosis, especially in identifying their defining characteristics. In this context, the objective was to evaluate the accuracy of clinical indicators of nursing diagnosis Lack of Adherence to antiretroviral treatment for people living with the Acquired Immunodeficiency Syndrome. The research took place in two stages. The first consists of the evaluation of the diagnostic indicators in the study; and second, the diagnostic inference performed by specialist nurses. The first step took place in a referral hospital in the treatment of infectious diseases in the Northeast of Brazil, and data were collected through an instrument for carrying out history and physical examination and analyzed for the presence or absence of the diagnostic indicators. In the second stage, the data were sent to experts, who judged the presence or absence of the diagnosis in the studied clientele. The project was submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the General Certificate for Ethics Assessment (CAAE) No 46206215.3.0000.5537. Data were analyzed using descriptive and inferential statistics. Test were used Fisher's exact, chi-square test of Pearson and logistic regression. Since the accuracy of clinical indicators was measured by sensitivity, specificity, predictive values, likelihood ratios. As a result, we identified the presence of diagnosis Lack of Accession on 69% (n = 78) of the study patients. The defining characteristics that showed statistically significant association with the diagnosis studied were: lack of adherence behavior, complications related to development, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. The characteristic with greater sensitivity was missing scheduled appointments and the highest specificity behavior of noncompliance. The logistic regression showed as predictors for the diagnosis Lack of Accession: lack of adherence behavior, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. It was concluded that the identification of clinical indicators accurately enabled a good prediction of the nursing diagnosis Lack of Accession on people living with the Acquired Immune Deficiency Syndrome, helping nurses develop early on strategies for promoting adherence to the use of antiretrovirals.

Acurácia dos indicadores clínicos do diagnóstico de enfermagem falta de adesão em pessoas vivendo com AIDS

In the early 1990s, a major milestone in the treatment of Acquired Immune Deficiency Syndrome was the development of highly active combination antiretroviral therapy. The great benefit generated by the use of this therapy was prolonging the survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Despite improvements generated by this therapy, there are still many difficulties to be overcome. One is the patient adherence to their treatment, bringing challenges to services and health professionals. Hence the need for early identification of nursing diagnosis Lack of Accession so that solutions are sought by the nurse with the patient and his family. With this problem, adds to the difficulty of hospital nurses in inferring that diagnosis, especially in identifying their defining characteristics. In this context, the objective was to evaluate the accuracy of clinical indicators of nursing diagnosis Lack of Adherence to antiretroviral treatment for people living with the Acquired Immunodeficiency Syndrome. The research took place in two stages. The first consists of the evaluation of the diagnostic indicators in the study; and second, the diagnostic inference performed by specialist nurses. The first step took place in a referral hospital in the treatment of infectious diseases in the Northeast of Brazil, and data were collected through an instrument for carrying out history and physical examination and analyzed for the presence or absence of the diagnostic indicators. In the second stage, the data were sent to experts, who judged the presence or absence of the diagnosis in the studied clientele. The project was submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the General Certificate for Ethics Assessment (CAAE) No 46206215.3.0000.5537. Data were analyzed using descriptive and inferential statistics. Test were used Fisher's exact, chi-square test of Pearson and logistic regression. Since the accuracy of clinical indicators was measured by sensitivity, specificity, predictive values, likelihood ratios. As a result, we identified the presence of diagnosis Lack of Accession on 69% (n = 78) of the study patients. The defining characteristics that showed statistically significant association with the diagnosis studied were: lack of adherence behavior, complications related to development, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. The characteristic with greater sensitivity was missing scheduled appointments and the highest specificity behavior of noncompliance. The logistic regression showed as predictors for the diagnosis Lack of Accession: lack of adherence behavior, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. It was concluded that the identification of clinical indicators accurately enabled a good prediction of the nursing diagnosis Lack of Accession on people living with the Acquired Immune Deficiency Syndrome, helping nurses develop early on strategies for promoting adherence to the use of antiretrovirals.

Conversor CC/CA de alta freqüência baseado em inversores ressonantes com comutação seqüencial para excitação de uma tocha indutiva a plasma térmico

This work describes the study, the analysis, the project methodology and the constructive details of a high frequency DC/AC resonant series converter using sequential commutation techniques for the excitation of an inductive coupled thermal plasma torch. The aim of this thesis is to show the new modulation technique potentialities and to present a technological option for the high-frequency electronic power converters development. The resonant converter operates at 50 kW output power under a 400 kHz frequency and it is constituted by inverter cells using ultra-fast IGBT devices. In order to minimize the turn-off losses, the inverter cells operates in a ZVS mode referred by a modified PLL loop that maintains this condition stable, despite the load variations. The sequential pulse gating command strategy used it allows to operate the IGBT devices on its maximum power limits using the derating and destressing current scheme, as well as it propitiates a frequency multiplication of the inverters set. The output converter is connected to a series resonant circuit constituted by the applicator ICTP torch, a compensation capacitor and an impedance matching RF transformer. At the final, are presented the experimental results and the many tests achieved in laboratory as form to validate the proposed new technique

Uma fonte chaveada de 50kW com correção de fator de potência para alimentação de uma tocha de plasma Indutiva utilizando técnicas de controle digital

This work deals with the development of an experimental study on a power supply of high frequency that provides the toch plasmica to be implemented in PLASPETRO project, which consists of two static converters developed by using Insulated Gate Bipolar Transistor (IGBT). The drivers used to control these keys are triggered by Digital Signal Processor (DSP) through optical fibers to reduce problems with electromagnetic interference (EMI). The first stage consists of a pre-regulator in the form of an AC to DC converter with three-phase boost power factor correction which is the main theme of this work, while the second is the source of high frequency itself. A series-resonant inverter consists of four (4) cell inverters operating in a frequency around 115 kHz each one in soft switching mode, alternating itself to supply the load (plasma torch) an alternating current with a frequency of 450 kHz. The first stage has the function of providing the series-resonant inverter a DC voltage, with the value controlled from the power supply provided by the electrical system of the utility, and correct the power factor of the system as a whole. This level of DC bus voltage at the output of the first stage will be used to control the power transferred by the inverter to the load, and it may vary from 550 VDC to a maximum of 800 VDC. To control the voltage level of DC bus driver used a proportional integral (PI) controller and to achieve the unity power factor it was used two other proportional integral currents controllers. Computational simulations were performed to assist in sizing and forecasting performance. All the control and communications needed to stage supervisory were implemented on a DSP

Suco desidratado de caju (Anacardium occidentale L.) por atomização: caracterização físico-química, bioativa e estudo da vida de prateleira do produto

Despite the relatively organized cashew (Anacardium occidentale L.) productive chain and the number of cashew derivatives found in the market, it is estimated that over 90% of the cashew peduncle is wasted. A possible strategy for a better commercial exploitation of this agroindustrial commodity would be the production of spray dried cashew pulp. Thus, this paper approaches the yellow cashew pulp spray drying process and the final product evaluation. Based on that, the shelf life of the spray dried cashew pulp packed in different packaging was evaluated. Drying was conducted in two drying temperatures (140 °C to 150 °C) and two concentrations of Arabic gum (AG, 15% and 25%), which summed four experimental groups. The drying performance was evaluated as well as the physicochemical characteristics (moisture, water activity, total soluble solids, pH, density, solubility, particle diameter, hygroscopicity, degree of caking, color, scanning electronic microscopy and X-ray diffraction), composition (protein, ash, fat and sugars) and bioactive and functional value (total phenolic compounds, carotenoids, ascorbic acid and antioxidant activity) of the final products. Results showed spray drying efficiency higher than 65% for all experiments, mainly for the C4 group (150 °C and 25% AG) which reached efficiency of 93.4%. It was also observed high solubility (94.7% to 97.9%) and the groups with lower hygroscopicity (5.8% and 6.5%) were those with the highest proportion of drying coadjuvant. The particle diameters ranged between 14.7 μm and 30.2 μm and increased with the proportion of AG. When comparing the product before and after spray drying, the drying impact was evident. However, despite the observed losses, dried yellow cashew showed high phenolic concentration (from 235.9 to 380.4 mg GAE eq / 100 g DM), carotenoids between 0.22 and 0.49 mg/100 g DM and remarkable ascorbic acid levels (852.4 to 1346.2 mg/100 g DM), in addition to antioxidant activity ranging from 12.9 to 16.4 μmol TE/ g DM. The shelf life study revealed decreased phenolic content over time associated to a slight water activity increase. Overall, our results unveil the technological and bioactive potential of dried yellow cashew as a functional ingredient to be used in food formulations or as a ready-to-use product. The technological approach presented here can serve as an efficient strategy for a rational use of the cashew apple, avoiding its current underutilization

Prevalência e fatores de risco à persistência de hábitos bucais de sucção não nutritiva em crianças de 3 a 5 anos de idade

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

A cidade sem barreiras é para todos?: avaliação das condições de deslocamento no bairro da Cidade Alta, Natal/RN

In this present work, the conditions of displacements and the behaviors of the users are evaluated, face to the physical adequacies in accessibility in the inserted area in the central quadrilateral of the Quarter of Cidade Alta, in the City of Natal/RN, space clipping established by its great meaning historical and cultural. For this reason such area was a target of an integrated actions plan during the years of 1993 and 1998, with the implantation of part of the Project CIDADE SEM BARREIRAS (City without Barriers) and, later, the implementation of the Project CIDADE PARA TODOS's proposals (City for All), having as supports the constant Brazilian norms inserted into the NB9050/1994 and in the Municipal law number 4.090/92, effective ones in the period of the interventions. Considering that the carried through actions at the time were directed to the elimination of the architectural barriers to guarantee the right to go and to come, the research received a human universe formed by all the people in situation of displacement in the central area of the interventions in the quarter of the Cidade Alta, independently of their locomotive or sensorial conditions, emphasizing the aspects most excellent how much to the accessibility of the sidewalk, as promotional of mobility, integration and urban organization, as well as of the public squares of that one quadrilateral, conceived, originally, as spaces of aggregation and social inclusion. The work appealed to the direct comment and the gotten results had been collated with the ex port facto law and technique norms, of the year of 2004, and with the legal devices contained in the Federal Decree number 5.296/2004, as way to certify the levels of efficiency of these adaptations in that it says respect to the current conditions of demanded accessibility and urban mobility

Percepção ambiental do patrimônio cultural: estudo de caso na Cidade Alta e Ribeira em Natal-RN

Contemporary studies have shown that the evolution of the heritage concepts is accompanied by an affirmation of the importance of social participation in recognizing heritage values and in managing cultural assets. We used the Brazilian context to emphasize the challenges for democratizing this process. This problematic is discussed based on the cases of Cidade Altaand Ribeira, neighborhoods that date from the formation of Natal-RNand have cultural assets recognized by levels of government. The study builds elements to answer the research question: what meanings and representations does the culturalheritage in the case study have for its users? The research method analyzes the representations and the meanings of the neighborhoods, firstly is based on historiographical studies, memories records of the city and on the process of heritage management. Secondly, it isbased on the field research, it is structured in environmental perception studies (areas of Environmental Psychology, Architecture and Urbanism) and has been applied with users with different bonds with the studied environment (residents, workers and visitors). The data were obtained with the multi-method which included direct observation, questionnaire survey and mentalmaps (that replicate Kevin Lynch). The analysis of result verified the research hypothesis, emphasizing aspects of the relationship between users and cultural heritage relevant to strengthening collective memory, local identity, contributing to heritage management. Among the results, the socio-environmental image obtained which emphasized a "cultural axis" linkingboth studied neighborhoods and confirms the influences of elements rein the memories records of the city and in the area s management. Identified aspects to strengthen the relationship between the users and cultural assets, such as the presence of placeswith affective ties to certain groups, as well as the need to fight off negative images (of degradation and insecurity) associated to the site and also expand the participation of the population, including residents, in policies and cultural activities. After all, recognition of value and the involvement of societycultural assets have the potential of contribute to integrate city development with heritage conservation

Resposta de Chromobacterium Violaceum cultivada em alta concentração de ferro

The Chromobacterium violaceum is a β-proteobacterium Gram-negative widely found in tropical and subtropical regions, whose genome was sequenced in 2003 showing great metabolic versatility and biotechnological and pharmaceutical potential. Given the large number of ORFs related to iron metabolism described in the genome of C. violaceum, the importance of this metal for various biological processes and due to lack of data about the consequences of excess of iron in free-living organisms, it is important to study the response mechanism of this bacterium in a culture filled with iron. Previous work showed that C. violaceum is resistant to high concentrations of this metal, but has not yet been described the mechanism which is used to this survival. Thus, to elucidate the response of C. violaceum cultured in high concentrations of iron and expecting to obtain candidate genes for use in bioremediation processes, this study used a shotgun proteomics approach and systems biology to assess the response of C. violaceum grown in the presence and absence of 9 mM of iron. The analysis identified 531 proteins, being 71 exclusively expressed by the bacteria grown in the presence of the metal and 100 just in the control condition. The increase in expression of proteins related to the TCA cycle possibly represents a metabolic reprogramming of the bacteria caused by high concentration of iron in the medium. Moreover, we observed an increase in the activity assay of superoxide dismutase and catalase as well as in Total Antioxidant Activity assay, suggesting that the metal is inducing oxidative stress in C. violaceum that increases the levels of violacein and antioxidant enzymes to better adapt to the emerging conditions. Are also part of the adaptive response changes in expression of proteins related to transport, including iron, as well as an increased expression of proteins related to chemotaxis response, which would lead the bacteria to change the direction of its movement away from the metal. Systems Biology results, also suggest a metabolic reprogramming with mechanisms coordinated by bottleneck proteins involved in transcription (GreA), energy metabolism (Rpe and TpiA) and methylation (AhcY)

Estudo da moagem de alta energia e sinterização de pós compósitos W-Cu

The Tungsten/copper composites are commonly used for electrical and thermal objectives like heat sinks and lectrical conductors, propitiating an excellent thermal and electrical conductivity. These properties are dependents of the composition, crystallite size and production process. The high energy milling of the powder of W-Cu produces an dispersion high and homogenization levels with crystallite size of W very small in the ductile Cu phase. This work discusses the effect of the HEM in preparation of the W-25Cu composite powders. Three techniques of powder preparation were utilized: milling the dry with powder of thick Cu, milling the dry with powder of fine Cu and milling the wet with powder of thick Cu. The form, size and composition of the particles of the powders milled were observed by scanning electron microscopy (SEM). The X-ray diffraction (XRD) was used to analyse the phases, lattice parameters, size and microstrain of the crystallite. The analyse of the crystalline structure of the W-25Cu powders milled made by Rietveld Method suggests the partial solid solubility of the constituent elements of the Cu in lattice of the W. This analyse shows too that the HEM produces the reduction high on the crystallite size and the increase in the lattice strain of both phases, this is more intense in the phase W

Desenvolvimento de tubulação em compósito polimérico revestida externamente com poliuretano de alta densidade

Pipelines for the transport of crude oil from the production wells to the collecting stations are named production lines . These pipes are subjected to chemical and electrochemical corrosion according to the environment and the type of petroleum transported. Some of these lines, depending upon the composition of the fluid produced, may leak within less than one year of operation due to internal corrosion. This work aims at the development of composite pipes with an external protecting layer of high density polyurethane for use in production lines of onshore oil wells, meeting operational requirements. The pipes were manufactured using glass fibers, epoxy resin, polyester resin, quartz sand and high density polyurethane. The pipes were produced by filament winding with the deposition of high density polyurethane on the external surface and threaded ends (API 15 HR/PM-VII). Three types of pipes were manufactured: glass/epoxy, glass/epoxy with an external polyurethane layer and glass/epoxy with an intermediate layer of glass fiber, polyester, sand and with an external polyurethane layer. The three samples were characterized by Scanning Electronic Microscopy (SEM) and for the determination of constituent content. In addition, the following tests were conducted: hydrostatic test, instant rupture, shorttime failure pressure, Gardner impact, transverse stiffness and axial tension. Field tests were conducted in Mossoró RN (BRAZIL), where 1,677 meters of piping were used. The tests results of the three types of pipes were compared in two events: after two months from manufacturing of the samples and after nine months of field application. The results indicate that the glass/epoxy pipes with an intermediate layer of fiber glass composite, polyester e sand and with an external layer of high density polyurethane showed superior properties as compared to the other two and met the requirements of pressure class, axial tensile strength, transverse stiffness, impact and environmental conditions, for onshore applications as production lines

Efeito da moagem de alta energia na microestrutura e nas propriedades magnéticas do compósito wc-10%p.Co

This work a studied the high energy milling effect in microstructure and magnetic properties of the WC-10wt.%Co composite. The composite powders were prepared by mechanical mixed and milled at 2 hours, 100 hours, 200 hours and 300 hours in planetary milling. After this process the composite were compacted in stainless steel die with cylindrical county of 10 mm of diameter, at pressure 200 Mpa and sintered in a resistive furnace in argon atmosphere at 1400 oC for 5 min. The sintered composite were cutted, inlaid, sandpapered, and polished. The microestrutural parameters of the composite was analyzed by X-ray diffraction, scanning electronic microscopy, optical microscopy, hardness, magnetic propriety and Rietveld method analyze. The results shows, with milling time increase the particle size decrease, it possibility minor temperature of sintering. The increase of milling time caused allotropic transformation in cobalt phase and cold welding between particles. The cold welding caused the formation of the particle composite. The X-ray diffraction pattern of composite powders shows the WC peaks intensity decrease with the milling time increase. The X-ray diffraction pattern of the composite sintered samples shows the other phases. The magnetic measurements detected a significant increase in the coercitive field and a decrease in the saturation magnetization with milling time increase. The increase coercitive field it was also verified with decrease grain size with milling time increase. For the composite powders the increase coercitive field it was verified with particle size reduction and saturation magnetization variation is relate with the variation of free cobalt. The Rietveld method analyze shows at milling time increase the mean crystalline size of WC, and Co-cfc phases in composite sintered sample are higher than in composite powders. The mean crystallite size of Co-hc phase in composite powders is higher than in composite sintered sample. The mean lattice strains of WC, Co-hc and Co-cfc phases in composite powders are higher than in composite sintered samples. The cells parameters of the composite powder decrease at milling time increase this effect came from the particle size reduction at milling time increase. In sintered composite the cells parameters is constant with milling time increase

Caracterização de compósitos Nb-20%cu obtidos por moagem de alta energia e sinterizados por fase líquida

In this work, was studied the formation of a composite of the refractory metal niobium with copper, through the process of high-energy milling and liquid phase sintering. The HEM can be used to synthesize composite powders with high homogeneity and fine size particle distribution. It may also produce the solid solubility in immiscible systems such as Nb-Cu, or extend the solubility of systems with limited solubility. Therefore, in the immiscible system Cu-Nb, the high-energy milling was successfully used to obtain the composite powder particles. Initially, the formation of composite particles during the HEM and the effect of preparation technique on the microstructure of the material was evaluated. Four loads of Nb and Cu powders containing 20%wt Cu were synthesized by MAE in a planetary type ball mill under different periods of grinding. The influence of grinding time on the metal particles is evaluated during the process by the withdrawal of samples at intermediate times of milling. After compaction under different forces, the samples were sintered in a vacuum furnace. The liquid phase sintering of these samples prepared by HEM produced a homogeneous and fine grained. The composite particles forming the sintered samples are the addition of a hard phase (Nb) with a high melting point, and a ductile phase (Cu) with low melting point and high thermal and electrical conductivities. Based on these properties, the Nb-Cu system is a potential material for many applications, such as electrical contacts, welding electrodes, coils for generating high magnetic fields, heat sinks and microwave absorbers, which are coupled to electronic devices. The characterization techniques used in this study, were laser granulometry, used to evaluate the homogeneity and particle size, and the X-ray diffraction, in the phase identification and to analyze the crystalline structure of the powders during milling. The morphology and dispersion of the phases in the composite powder particles, as well the microstructures of the sintered samples, were observed by scanning electron microscopy (SEM). Subsequently, the sintered samples are evaluated for density and densification. And finally, they were characterized by techniques of measuring the electrical conductivity and microhardness, whose properties are analyzed as a function of the parameters for obtaining the composite

Obtenção de uma porcelana dielétrica a partir de matérias-primas do Rio Grande do Norte

The dielectric porcelain is usually obtained by mixing various raw materials proportions and is used in the production of electronic equipment for various applications, from capacitors of high and low Power to insulators for low, medium, high and extra high voltage, which are used in distribution lines and transmission of electricity.This work was directed to the s tudy of technological properties of technic porcelain, made from raw materials extracted from pegmatites found in the regions of Seridó and the Alto Oeste of Rio Grande do Norte, which are made of kaolin, quartz and feldspar, abundant and high quality in these regions. The technic ceramics were obtained by mixing in appropriate levels, kaolin, feldspar, quartz and clay, the last item from a pottery in the city of Sao Gonçalo do Amarante, Rio Grande do Norte. During the development the following characterizations correlated to raw materials were made: laser particle sizing, x-ray diffraction, DTA and TG. The compositions studied were formed by uniaxial pressing at a pressure of 50 MPa and sintered at temperatures ranging from 1150 to 1350ºC and levels (times) of sintering between 30, 60, 90 and 120 minutes. The characterization of the samples were taken from the analysis of weight loss, linear shrinkage, porosity, stoneware curve, bulk density, flexural strength of three points, SEM and X-ray diffraction, TMA, Dielectric and cross Resistivity. The studied materials can be employed in producing the objects used in electrical engineering such as: insulators for low, medium and high-voltage electrical systems, command devices, bushing insulation for transformers, power capacitors, spark plugs, receptacles for fluorescent and incandescent light bulbs and others

Monitoramento da morfologia costeira em setores da bacia potiguar sob influência da indústria petrolífera utilizando geodésia de alta precisão e laser escâner terrestre

The objective of this Doctoral Thesis was monitoring, in trimestral scale, the coastal morphology of the Northeastern coast sections of Rio Grande do Norte State, in Brazil, which is an area of Potiguar Basin influenced by the oil industry activities. The studied sections compose coastal areas with intense sedimentary erosion and high environmental sensitivity to the oil spill. In order to achieve the general objective of this study, the work has been systematized in four steps. The first one refers to the evaluation of the geomorphological data acquisition methodologies used on Digital Elevation Model (DEM) of sandy beaches. The data has been obtained from Soledade beach, located on the Northeastern coast of Rio Grande Norte. The second step has been centered on the increasing of the reference geodetic infrastructure to accomplish the geodetic survey of the studied area by implanting a station in Corta Cachorro Barrier Island and by conducting monitoring geodetic surveys to understand the beach system based on the Coastline (CL) and on DEM multitemporal analysis. The third phase has been related to the usage of the methodology developed by Santos; Amaro (2011) and Santos et al. (2012) for the surveying, processing, representation, integration and analysis of Coastlines from sandy coast, which have been obtained through geodetic techniques of positioning, morphological change analysis and sediment transport. The fourth stage represents the innovation of surveys in coastal environment by using the Terrestrial Laser Scanning (TLS), based on Light Detection and Ranging (LiDAR), to evaluate a highly eroded section on Soledade beach where the oil industry structures are located. The evaluation has been achieved through high-precision DEM and accuracy during the modeling of the coast morphology changes. The result analysis of the integrated study about the spatial and temporal interrelations of the intense coastal processes in areas of building cycles and destruction of beaches has allowed identifying the causes and consequences of the intense coastal erosion in exposed beach sections and in barrier islands