À beira do leito : sentimentos de pacientes durante a passagem de plantão em Unidade de Terapia Intensiva

This study aims to understand the feelings of patients admitted to the Intensive Care Unit (ICU) that experienced a change of shift at the bedside. The change of shift is one of the routines used by nursing in their work process and of great significance for the patient; therefore, deserves careful analysis in seeking to perfect themselves for the improvement of nursing care. It is a descriptive research, with a qualitative approach. The collection of information was performed using semi-structured interview, in August and September of 2011, after authorization from the Ethics Committee of the Federal University of Rio Grande do Norte, as opinion 290/2011. The analysis, based on interviews of patients, took the humanization as the thread of investigation backed by authors who deal on the subject and the theory of the gift of Marcel Mauss that sits on drug give-receive-return. The results indicate that the change of shift at the bedside but has not configured, the content of the speech of patients interviewed, as a moment that has generated fear and anxiety, could be deduced by the expression of silence, tears and other signs during interviews, how hard it is to live this experience. Nevertheless, despite this apparent tranquility, revealed uncertainty and apprehension face the speech of professional, during the visit at the bedside, particularly when referring to their health and their neighbors. On the other hand, the indifference to the participation of the patient at the time of the visit, expressing an attitude of merely technical nature, dehumanizes the act of taking care, the essence of nursing. And, for all the patients that we understand, about the visit to the bedside, as well as the ICU, we can infer that there is suffering for them. However, we understand your feelings and revelations seeking support in the theory of Mauss's gift: the patient receives the gift (care), and imbued with a feeling of gratitude, the rewards in the form of compliments and courtesies. Precisely for this reason, we need to sharpen our sensitivity to deal about the human condition in all its vulnerability.

Metodologia de implantação da construção enxuta: estudo de caso em construtora de porte médio

In recent years, the Brazilian construction industry has gone by changes like currency stability, increasing competition, shortage of skilled labor and increasing quality importance required by the customer, who made the sector companies seek solutions through new management practices in order to become more efficient. A alternative to these management practices is known as Lean Construction which is derived from the Toyota System Production. Lean Construction main goals are to reduce parts of activities that do not add value, increase product value by considering customer needs, reduce variability and production cycle time, simplify process by reducing the number of parts or steps, increase the flexibility in the product execution and transparency process, focus the control on overall process, introduce continuous improvement process, maintain a balance between improvements in flows and conversions and seek to learn from practices adopted by competitors. However, the construction industry is characterized by having nomadic activity, which undertakes an unique product with high cost of production and big inertia for behavioral change, making it difficult to implement the philosophy of lean construction in companies. In this sense, the main objective of this study is to develop a methodology for implementation of the principles of Lean Construction. The method of implementing the proposed management system was designed with the aid of 5W2H tool, and the implementation process is divided into three phases. The first one aims to know in a macro way the current operation of construction, identify who is its target audience and what are the products and services offered to the Market. The second phase aims to describe what actions should be taken and which documents are needed to be created or modified; finally, the third step goal consists in how to control and monitor established processes, where through Strategic Planning the company goals would be set along with their respective targets and indicators in order to keep the system working, aiming for continuous improvement with focus on the customer. This methodology was conceived as a case study analyzing a medium size construction with more than 18 years of activity and certified for almost 10 years with ISO9001 and level A in PBQP-H. We also conclude that this implementation process can be used in any developer and / or builder

Uma Fundamentação Intervalar Aplicada à Morfologia Matemática

This work present a interval approach to deal with images with that contain uncertainties, as well, as treating these uncertainties through morphologic operations. Had been presented two intervals models. For the first, is introduced an algebraic space with three values, that was constructed based in the tri-valorada logic of Lukasiewiecz. With this algebraic structure, the theory of the interval binary images, that extends the classic binary model with the inclusion of the uncertainty information, was introduced. The same one can be applied to represent certain binary images with uncertainty in pixels, that it was originated, for example, during the process of the acquisition of the image. The lattice structure of these images, allow the definition of the morphologic operators, where the uncertainties are treated locally. The second model, extend the classic model to the images in gray levels, where the functions that represent these images are mapping in a finite set of interval values. The algebraic structure belong the complete lattices class, what also it allow the definition of the elementary operators of the mathematical morphology, dilation and erosion for this images. Thus, it is established a interval theory applied to the mathematical morphology to deal with problems of uncertainties in images

Localização e mapeamento simultâneos de ambientes planos usando visão monocular e representação híbrida do ambiente

The goal of this work is to propose a SLAM (Simultaneous Localization and Mapping) solution based on Extended Kalman Filter (EKF) in order to make possible a robot navigates along the environment using information from odometry and pre-existing lines on the floor. Initially, a segmentation step is necessary to classify parts of the image in floor or non floor . Then the image processing identifies floor lines and the parameters of these lines are mapped to world using a homography matrix. Finally, the identified lines are used in SLAM as landmarks in order to build a feature map. In parallel, using the corrected robot pose, the uncertainty about the pose and also the part non floor of the image, it is possible to build an occupancy grid map and generate a metric map with the obstacle s description. A greater autonomy for the robot is attained by using the two types of obtained map (the metric map and the features map). Thus, it is possible to run path planning tasks in parallel with localization and mapping. Practical results are presented to validate the proposal

Probabilidades imprecisas: intervalar, fuzzy e fuzzy intuicionista

The idea of considering imprecision in probabilities is old, beginning with the Booles George work, who in 1854 wanted to reconcile the classical logic, which allows the modeling of complete ignorance, with probabilities. In 1921, John Maynard Keynes in his book made explicit use of intervals to represent the imprecision in probabilities. But only from the work ofWalley in 1991 that were established principles that should be respected by a probability theory that deals with inaccuracies. With the emergence of the theory of fuzzy sets by Lotfi Zadeh in 1965, there is another way of dealing with uncertainty and imprecision of concepts. Quickly, they began to propose several ways to consider the ideas of Zadeh in probabilities, to deal with inaccuracies, either in the events associated with the probabilities or in the values of probabilities. In particular, James Buckley, from 2003 begins to develop a probability theory in which the fuzzy values of the probabilities are fuzzy numbers. This fuzzy probability, follows analogous principles to Walley imprecise probabilities. On the other hand, the uses of real numbers between 0 and 1 as truth degrees, as originally proposed by Zadeh, has the drawback to use very precise values for dealing with uncertainties (as one can distinguish a fairly element satisfies a property with a 0.423 level of something that meets with grade 0.424?). This motivated the development of several extensions of fuzzy set theory which includes some kind of inaccuracy. This work consider the Krassimir Atanassov extension proposed in 1983, which add an extra degree of uncertainty to model the moment of hesitation to assign the membership degree, and therefore a value indicate the degree to which the object belongs to the set while the other, the degree to which it not belongs to the set. In the Zadeh fuzzy set theory, this non membership degree is, by default, the complement of the membership degree. Thus, in this approach the non-membership degree is somehow independent of the membership degree, and this difference between the non-membership degree and the complement of the membership degree reveals the hesitation at the moment to assign a membership degree. This new extension today is called of Atanassov s intuitionistic fuzzy sets theory. It is worth noting that the term intuitionistic here has no relation to the term intuitionistic as known in the context of intuitionistic logic. In this work, will be developed two proposals for interval probability: the restricted interval probability and the unrestricted interval probability, are also introduced two notions of fuzzy probability: the constrained fuzzy probability and the unconstrained fuzzy probability and will eventually be introduced two notions of intuitionistic fuzzy probability: the restricted intuitionistic fuzzy probability and the unrestricted intuitionistic fuzzy probability

Uma metodologia para redução de incertezas em sistema de medição de vazão de óleo e gás

The objective of this research is to discuss about the need for implementation of new alternatives for the implementation on the metrological control: on the findings of initial and subsequent measurements, the control procedures of measurement uncertainty applied in assessing the loss or remains found in handling operations of bulk liquids, when used turbine meters used in measuring the tax on the business of Petrobras, due to the current environment of legal metrology and scientific, both domestic and international. We aim, with these alternatives: standardizing the minimization of random and systematic errors, the estimate of the remaining errors, as well as the management control of metrological calibration procedures, control of measurement uncertainty, and contribute to the change in the form of performance of legal metrology and scientific disseminating new information to change management of metrological control, objectively focused on aspects of supervision in implementing these activities in the control of the uncertainties of measurement used in our processes in the fiscal measurement system Petrobras. Results are presented, information and comments on the influence of measurement uncertainty in the current results of the fiscal and transfer of custody. This will emphasize the need, among other things, improvement and expansion of metrological control monitored by setting a better meet demand, calibration equipment and measuring instruments for Petrobras. Finally, we intend to establish the need for improving the method of evaluation of the data meter applied to the current management control of measurement uncertainty by proposing a methodology for addressing the problem, as well as highlighting the expected results.

Controlador preditivo generalizado multi-modelo aplicado ao controle de pressão arterial

Postsurgical complication of hypertension may occur in cardiac patients. To decrease the chances of complication it is necessary to reduce elevated blood pressure as soon as possible. Continuous infusion of vasodilator drugs, such as sodium nitroprusside (Nipride), would quickly lower the blood pressure in most patients. However, each patient has a different sensitivity to infusion of Nipride. The parameters and the time delays of the system are initially unknown. Moreover, the parameters of the transfer function associated with a particular patient are time varying. the objective of the study is to develop a procedure for blood pressure control i the presence of uncertainty of parameters and considerable time delays. So, a methodology was developed multi-model, and for each such model a Preditive Controller can be a priori designed. An adaptive mechanism is then needed for deciding which controller should be dominant for a given plant

Controle preditivo robusto baseado em desigualdades matriciais lineares aplicado a um sistema de tanques acoplados

This work deals with an on-line control strategy based on Robust Model Predictive Control (RMPC) technique applied in a real coupled tanks system. This process consists of two coupled tanks and a pump to feed the liquid to the system. The control objective (regulator problem) is to keep the tanks levels in the considered operation point even in the presence of disturbance. The RMPC is a technique that allows explicit incorporation of the plant uncertainty in the problem formulation. The goal is to design, at each time step, a state-feedback control law that minimizes a 'worst-case' infinite horizon objective function, subject to constraint in the control. The existence of a feedback control law satisfying the input constraints is reduced to a convex optimization over linear matrix inequalities (LMIs) problem. It is shown in this work that for the plant uncertainty described by the polytope, the feasible receding horizon state feedback control design is robustly stabilizing. The software implementation of the RMPC is made using Scilab, and its communication with Coupled Tanks Systems is done through the OLE for Process Control (OPC) industrial protocol

CAD e engenharia reversa como ferramentas de auxílio na fabricação de cartuchos para próteses ortopédicas

The manufacturing of above and below-knee prosthesis starts by taking surfac measurements of the patient s residual limb. This demands the making of a cartridg with appropriate fitting and customized to the profile of each patient. The traditiona process in public hospitals in Brazil begins with the completion of a record file (according to law nº388, of July 28, 1999 by the ministry of the health) for obtaining o the prosthesis, where it is identified the amputation level, equipment type, fitting type material, measures etc. Nowadays, that work is covered by the Brazilian Nationa Health Service (SUS) and is accomplished in a manual way being used commo measuring tapes characterizing a quite rudimentary, handmade work and without an accuracy.In this dissertation it is presented the development of a computer integrate tool that it include CAD theory, for visualization of both above and below-knee prosthesis in 3D (i.e. OrtoCAD), as well as, the design and the construction a low cos electro-mechanic 3D scanner (EMS). This apparatus is capable to automatically obtain geometric information of the stump or of the healthy leg while ensuring smalle uncertainty degree for all measurements. The methodology is based on reverse engineering concepts so that the EMS output is fed into the above mentioned academi CAD software in charge of the 3D computer graphics reconstruction of the residualimb s negative plaster cast or even the healthy leg s mirror image. The obtained results demonstrate that the proposed model is valid, because it allows the structura analysis to be performed based on the requested loads, boundary conditions, material chosen and wall thickness. Furthermore it allows the manufacturing of a prosthesis cartridge meeting high accuracy engineering patterns with consequent improvement in the quality of the overall production process

Desenvolvimento de métodos construtivos e de novos materiais empregados na confecção de cartuchos de próteses de membros inferiores

The manufacture of prostheses for lower limb amputees (transfemural and transtibial) requires the preparation of a cartridge with appropriate and custom fit to the profile of each patient. The traditional process to the patients, mainly in public hospitals in Brazil, begins with the completion of a form where types of equipment, plugins, measures, levels of amputation etc. are identified. Currently, such work is carried out manually using a common metric tape and caliper of wood to take the measures of the stump, featuring a very rudimentary, and with a high degree of uncertainty geometry of the final product. To address this problem, it was necessary to act in two simultaneously and correlated directions. Originally, it was developed an integrated tool for viewing 3D CAD for transfemoral types of prostheses and transtibial called OrtoCAD I. At the same time, it was necessary to design and build a reader Mechanical equipment (sort of three-dimensional scanner simplified) able to obtain, automatically and with accuracy, the geometric information of either of the stump or the healthy leg. The methodology includes the application of concepts of reverse engineering to computationally generate the representation of the stump and/or the reverse image of the healthy member. The materials used in the manufacturing of prostheses nor always obey to a technical scientific criteria, because, if by one way it meets the criteria of resistance, by the other, it brings serious problems mainly due to excess of weight. This causes to the user various disorders due to lack of conformity. That problem was addressed with the creation of a hybrid composite material for the manufacture of cartridges of prostheses. Using the Reader Fitter and OrtoCAD, the new composite material, which aggregates the mechanical properties of strength and rigidity on important parameters such as low weight and low cost, it can be defined in its better way. Besides, it brings a reduction of up steps in the current processes of manufacturing or even the feasibility of using new processes, in the industries, in order to obtain the prostheses. In this sense, the hybridization of the composite with the combination of natural and synthetic fibers can be a viable solution to the challenges offered above

Adaptação eletrônica de um leitor mecânico de coto, investigação e desenvolvimento de interface CAD

Due to advances in the manufacturing process of orthopedic prostheses, the need for better quality shape reading techniques (i.e. with less uncertainty) of the residual limb of amputees became a challenge. To overcome these problems means to be able in obtaining accurate geometry information of the limb and, consequently, better manufacturing processes of both transfemural and transtibial prosthetic sockets. The key point for this task is to customize these readings trying to be as faithful as possible to the real profile of each patient. Within this context, firstly two prototype versions (α and β) of a 3D mechanical scanner for reading residual limbs shape based on reverse engineering techniques were designed. Prototype β is an improved version of prototype α, despite remaining working in analogical mode. Both prototypes are capable of producing a CAD representation of the limb via appropriated graphical sheets and were conceived to work purely by mechanical means. The first results were encouraging as they were able to achieve a great decrease concerning the degree of uncertainty of measurements when compared to traditional methods that are very inaccurate and outdated. For instance, it's not unusual to see these archaic methods in action by making use of ordinary home kind measure-tapes for exploring the limb's shape. Although prototype β improved the readings, it still required someone to input the plotted points (i.e. those marked in disk shape graphical sheets) to an academic CAD software called OrtoCAD. This task is performed by manual typing which is time consuming and carries very limited reliability. Furthermore, the number of coordinates obtained from the purely mechanical system is limited to sub-divisions of the graphical sheet (it records a point every 10 degrees with a resolution of one millimeter). These drawbacks were overcome by designing the second release of prototype β in which it was developed an electronic variation of the reading table components now capable of performing an automatic reading (i.e. no human intervention in digital mode). An interface software (i.e. drive) was built to facilitate data transfer. Much better results were obtained meaning less degree of uncertainty (it records a point every 2 degrees with a resolution of 1/10 mm). Additionally, it was proposed an algorithm to convert the CAD geometry, used by OrtoCAD, to an appropriate format and enabling the use of rapid prototyping equipment aiming future automation of the manufacturing process of prosthetic sockets.

O entardecer de uma era: técnica, poesia e pensamento em Heidegger

The thinking dialog between Heidegger s philosophy and the poetry of Hölderlin and Rilke must be dealt in language s domains. The difficulty to establish this dialog comes from the man in itself, unable to think out of the understructure of science and the modern technique. The poetic language was forgotten or ignored, turning itself obsolete in front of improvements and resources of the technique. Heidegger searches the essences to the poetry so may it be comprehended in its plenitude for the man. Technique, poetry and existence must be pronounced and investigated so the being shows itself again. To Heidegger, the man lives in a period of uncertainty due finding himself at the sunset of age. The uncertainty generates the poverty and the night of world represents the absence of god and original truth. Only with the fundamental comprehension of poetry, the man of today can project himself to the future not anymore as technique product, but with freedom to choose. The message of poetry of Hölderlin and Rilke, according to Heidegger s interpretation, transmits an alert to the contemporary man against the coming danger in his maintained relation with nature. The purpose of the following work is to build this thinking dialog, without disfigure the poetry, but taking approach over its essence, so from there to remove its true existential value.

As estruturas sociais e econômicas do Império Romano do Ocidente e o estabelecimento do reino dos visigodos nas Galliae Aquitania e Narbonensis

In the year 376 of the Common Era, a tribe of Germanic warriors known as Tervingi , of Gothic extraction, crossed the Hister (Danube) river due south, entering the Roman Empire. They fled the Huns, a nomadic group that came plundering their way from the East. It did not take long for a conflict between the Roman imperial authorities and the refugees to begin. Peace was reached in 382 and, henceforth, the Tervingi would be officially foederati (allies) of the Romans, gaining the right to remain an autonomous tribe inside the borders of the Empire. For the next thirteen years the Tervingi warriors fought beside the Roman imperial armies in every major conflict. Nevertheless, after the death of the emperor Theodosius I in 395, their relations deteriorated severely. In theory, the Tervingi remained Roman allies; in practice, they begun to extort monies and other assets from the emperors Honorius and Arcadius. The sack of Rome by the Tervingi king Alaric in 410 was both the culmination and the point of inflection of this state of affairs. During the 410s the Tervingi warriors would fought again beside the Roman Imperial armies and be rewarded with a piece of land in the southwestern portion of the Gallic diocese. Dubbed Visigoths , they would remain trusted Roman allies throughout the next decades, consolidating their own kingdom in the process. This dissertation deals not only with the institution of the Visigothic kingdom in the southwestern portion of the Galliae but also with the social and economic conditions that hindered the Roman ability to defend their territory by themselves, hence opening opportunities for foederati like the Tervingi to carve out a piece of it for themselves.

Quando as mulheres se tornam mães: a história reprodutiva feminina numa visão evolucionista

In this thesis we tested evolutionary hypotheses, with empirically collected data, in a sample composed of pregnant Brazilian women. We consider that during pregnancy and soon after the baby's birth fundamental reproductive decisions take place, given the complete feminine involvement with the reproduction phenomenon. The results are presented in four empirical articles related to the history of female reproduction. The topics approached were mate selection, the life-history theory, the strategies of parental investment and postpartum depression. Data collection was accomplished through interviews with pregnant women and after the baby s birth, with a sample composed of women from two income classes (low income and middle class), in Natal, Brazil. With respect to mate selection, the results suggest that a real situation of reproductive mate selection shows significant differences when compared to the results obtained in studies involving potential mate selection (Article I). Considering the life-history theory, we have partially confirmed the hypothesis of the father`s absence influencing the development of the young female syndrome (Article II). In regard to parental investment strategies and the decrease of fatherhood uncertainty, we identified a larger attribution of the baby's resemblance after birth with the father, confirming our hypothesis (Article III). The results related to postpartum depression occurrence partially support the hypothesis that it is an evolutionary adaptation (Article IV). This thesis is part of a consolidation movement of Evolutionary Psychology in Brazil and it presents results on female reproductive history hitherto unpublished.

Sentidos e perspectivas atribuídos por crianças à sua condição de estar para adoção

Considering the Brazilian current context, where many children are in institutional shelter waiting for adoption, the aim of this study was to know the meaning that sheltered children (whose families had already lost their custody or were in the process of losing it, at the moment of the field work) gave to their adoption condition. The research was carried out with three children in the shelter where they lived, in Natal, Rio Grande do Norte, Brazil. The field work took six months approximately. In order to meet the objective of this research, individual procedures were structuralized using figures and drawing material. With these procedures the children could speak directly or indirectly about the application of the legal measure of institutional shelter, about their lives before the application of this legal measure and what happened since then, and their original families and future perspectives. The content of the procedures was tape recorded and registered in the field work diary. The analysis of the corpus occurred with the Thematic Content Analysis, considering the theoretical methodological perspective of the Net of Meanings approach. The analysis of the corpus showed the ambiguity of the children, who consider good to live in the institution where they are, recognizing the responsibility of the original caregivers for their sheltered condition and, at the same time, they miss their relatives and wish to be with them. The subjects recognize the perspective of adoption and imagine it in a positive way. However, when the children were questioned about what could happen to them in the future, they said that they did not know, expressing uncertainty concerning their destinations