As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Trauma em idosos atendidos pelo serviço pré-hospitalar móvel

O The aim of this study was to characterize the occurrence of trauma in the elderly population served by the mobile pre-hospital service, in Natal, Rio Grande do Norte. This is a descriptive, transversal and quantitative approach and whose population consisted of 2,080 trauma victims. The sample, of systematic random type, consisted of 400 elderly people, aged from 60 years old, assisted by the Office of Mobile Emergency in Natal / RN, between January 2011 and December 2012. Data collection began after consent and assent of the institution of a Research Ethics Committee under No. 309 505. It was proceeded to documentary retrospective analysis of records of this service through a form of self-development, validated by expert judges considered reliable (α> 0.75) and valid (CVI = 0.97) in their clarity and relevance. Data were tabulated by the Statistical Package for Social Sciences, version 20.0. The results show that older victims have an average age of 74.19 years old, with a prevalence of female involvement by chronic diseases, especially hypertension, average usage of 2.2 routine medications with vital signs within normal limits. The trauma prevailed during the daytime, in the residence of the victims, north of the city and on weekends. Among the mechanisms of trauma were falls, traffic accidents and physical aggression, whose most common type was brain-cerebral trauma and the main consequences were suture wounds and closed fractures. Basic Support Units were as more driven to pre-hospital care (87.8%) and the main destination place consisted of a referral hospital for emergency of the state (57.5%). Among the most commonly performed procedures by nursing staff immobilization with rigid board and neck collar and the peripheral venipuncture, and the main component used for volume replacement to saline were highlighted. There was a significant relationship between the deaths and the mechanism of injury, mechanism of injury and procedures, except medication administration procedures carried out, except immobilization and unit for service. It is highlighted the prevalence of trauma in the elderly, poor follow-up Pre-Hospital Trauma Life Support protocol and the paucity of records and nursing procedures performed. There is need for a protocol of care specific to elderly trauma victims and education strategies for the prevention of such events

Responsabilidade social e competitividade :um estudo sobre a influência de práticas sociais na decisão de escolha de um destino turístico

The work objective was to investigate the influence of social practices social in the choise decision of a tourist destination. For in such a way, a survey with the aid of a questionnaire, was used as being the research instrument. The study used a simple random sample without replacement, due to elements of the population had a equal probability different of zero, to be selected for forming part of the sample. The used collection method of data was personal interview. The data was collected at Augusto Severo International Airport at the moment in which tourists were embarking in return to the residence place or another tourist destination. For determination of sample size, it was considered the tourist who had visited Natal in November and December, 2004, supplied by the Secretariat of Tourism in the RN. The sample for the research was of 403 people. Results showed that the interviewed express the existence of high level of competitiveness in the tourism industry. It was observed that 42.5% of the interviewed believes to exist a very aggressive competition, and 47.5% believed that the competition is aggressive in the tourism industry. 10.4% of the interviewed expressed much interest in knowing about social practices in the tourism industry and 2.8% had not presented any interest in knowing about social practices in the tourism industry. For the interviewed, the travel agency image is a significant item in the choice for a tourist package, because of 35.6% believed that this factor is very important in the choice. 5% of the interviewed only find that little important or that sometimes the travel agency image can be seen as s decisive factor in the tourist package choice

Desenvolvimento e implementação de um sistema de supervisão e controle residencial

With the technological progress the people are more and more looking for convenience, comfort and safety to your homes. The residential automation is winning space on the market not only by the status and modernity that provide, but also to allow a better use of natural resources, reducing the expense to keep up a residence. This work shows the development of a control system and supervision to be destined to the residential automation. The developed software will be working together with a controller (PLC), acting in the administration, control and supervision all the linked devices, and offering to the user an environment simple and practical for the control residence

Análise do desempenho térmico de um sistema de aquecimento solar utilizando coletor com superfície absorvedora em chapas de PVC

It s presented a solar collector to be used in a system for heating bath water, whose main characteristic is its low cost. The collector consists of five plates of PVC with 10 mm thick, 200 mm in width and 1400mm in length, with an area equal to 1.4 square meters. The plates were connected in parallel to the ends of PVC tubes of  40 mm and 32 mm. The plates were coated on one side with aluminum sheets of soft drinks and beers cans open. The system worked on a thermosiphon and was tested in two configurations: the plates uncoated and coated with aluminum material, to determine the influence of material on the efficiency of the collector. For both configurations was used EPS plates below the surface to minimize heat losses from the botton. The thermal reservoir of the heating system is, also, alternative and low cost, since it was constructed from a polyethylene tank for storing water, with volume of 150 end 200 liters. It will be presented the thermal efficiency, heat loss, water temperature of the thermal reservoir at the end of the process and simulation of baths for a house with four residents. The will be demonstrated thermal, economic and material viability of the proposed collector, whose main innovation is the use of recyclables materials, cans of beer and soft drinks, to increase the temperature of the absorber plate.

Compósito para fabricação de blocos para construção de casas: estudos térmico e de materiais

We present two models of blocks made of composite material obtained from the use of cement, plaster, EPS crushed, shredded tire, mud, sand and water, for the construction of popular housing. Were made metal molds for the manufacture of blocks to be used in the construction of a residence for low-income families. Performed tests of compressive strength of the composite for various formulations that met the specific standard for blocks used in construction. To study the thermal conductivity of the composite for further study of thermal comfort generated in a residence built with the proposed composite. We also determined the mass-specific and water absorption for each formulation studied. Using a home already built with another composite material, made up the closing of a window with the building blocks and found the thermal insulation, measuring external and internal temperatures of the blocks. The blocks had made good thermal insulation of the environment, resulting in differences of up to 12.6°C between the outer and inner faces. It will be shown the feasibility of using composite for the end proposed and chosen the most appropriate wording

Estudo da hidrodinâmica de um novo separador líquido-líquido: aplicação ao sistema óleo-bruto/água produzida

This work aims to use a different hydrodynamic condition applied to a new design of mixer-settler on treating wastewater produced by petroleum industry, called MDIF (Misturador-Decantador à Inversão de Fases/ Mixer-Settler based on Phase Inversion MSPI). The use of this different hydrodynamic behaviour is possible due to vertical disposition of the device and the principle of Phase Inversion that controls the MDIF, providing the generation (creation) of a cascade of drops, into an organic layer, that works as micro-decanters, thus making possible the formation of a bed of non-coalesced drops, called Bed Formation . The use of this new hydrodynamics condition allows to increase the residence time of the oil carrier drops, into an organic layer, and the device can treat a greater volume of wastewater. In view of to get this condition it is necessary to operate at high throughput (58,6 m3.m-2.h-1). By results, the condition of Bed Formation is the best one to be used when MSPI operates with throughput up to 58,6 m3.m-2.h-1. The results using the condition of Bed Formation show that increasing the height of the bed of non-coalesced drops and/or decreasing the volumetric ratio (O/A) an increase of the separation efficiency is detected

Recuperação e purificação de quitosanases usando adsorção em leito expandido com streamline DEAE com modelagem e simulação usando redes neurais

Expanded Bed Adsorption (EBA) is an integrative process that combines concepts of chromatography and fluidization of solids. The many parameters involved and their synergistic effects complicate the optimization of the process. Fortunately, some mathematical tools have been developed in order to guide the investigation of the EBA system. In this work the application of experimental design, phenomenological modeling and artificial neural networks (ANN) in understanding chitosanases adsorption on ion exchange resin Streamline® DEAE have been investigated. The strain Paenibacillus ehimensis NRRL B-23118 was used for chitosanase production. EBA experiments were carried out using a column of 2.6 cm inner diameter with 30.0 cm in height that was coupled to a peristaltic pump. At the bottom of the column there was a distributor of glass beads having a height of 3.0 cm. Assays for residence time distribution (RTD) revelead a high degree of mixing, however, the Richardson-Zaki coefficients showed that the column was on the threshold of stability. Isotherm models fitted the adsorption equilibrium data in the presence of lyotropic salts. The results of experiment design indicated that the ionic strength and superficial velocity are important to the recovery and purity of chitosanases. The molecular mass of the two chitosanases were approximately 23 kDa and 52 kDa as estimated by SDS-PAGE. The phenomenological modeling was aimed to describe the operations in batch and column chromatography. The simulations were performed in Microsoft Visual Studio. The kinetic rate constant model set to kinetic curves efficiently under conditions of initial enzyme activity 0.232, 0.142 e 0.079 UA/mL. The simulated breakthrough curves showed some differences with experimental data, especially regarding the slope. Sensitivity tests of the model on the surface velocity, axial dispersion and initial concentration showed agreement with the literature. The neural network was constructed in MATLAB and Neural Network Toolbox. The cross-validation was used to improve the ability of generalization. The parameters of ANN were improved to obtain the settings 6-6 (enzyme activity) and 9-6 (total protein), as well as tansig transfer function and Levenberg-Marquardt training algorithm. The neural Carlos Eduardo de Araújo Padilha dezembro/2013 9 networks simulations, including all the steps of cycle, showed good agreement with experimental data, with a correlation coefficient of approximately 0.974. The effects of input variables on profiles of the stages of loading, washing and elution were consistent with the literature

Recuperação e purificação de proteínas do soro de queijo tipo coalho usando cromatografia de troca iônica e interação hidrofóbica em leito na forma expandida

Expanded Bed Adsorption plays an important role in the downstream processing mainly for reducing costs as well as steps besides could handling cells homogenates or fermentation broth. In this work Expanded Bed Adsorption was used to recover and purify whey proteins from coalho cheese manufacture using Streamline DEAE and Streamline SP both ionic resins as well as a hydrophobic resin Streamline Phenyl. A column of 2.6 cm inner diameter with 30 cm in height was coupled to a peristaltic pump. Hydrodynamics study was carried out with the three resins using Tris-HCl buffer in concentration of 30, 50 and 70 mM, with pH ranging from 7.0 to 8.0. In this case, assays of the expansion degree as well as Residence Time Distribution (RTD) were carried out. For the recovery and purification steps, a whey sample of 200 mL, was submitted to a column with 25mL of resin previously equilibrated with Tris/HCl (50 mM, pH 7.0) using a expanded bed. After washing, elution was carried out according the technique used. For ionic adsorption elution was carried out using 100 mL of Tris/HCl (50 mM, pH 7.0 in 1M NaCl). For Hydrophobyc interaction elution was carried out using Tris/HCl (50 mM, pH 7.0). Adsorption runs were carried out using the three resins as well as theirs combination. Results showed that for hydrodynamics studies a linear fit was observed for the three resins with a correlation coefficient (R2) about 0.9. In this case, Streamline Phenyl showed highest expansion degree reaching an expansion degree (H0/H) of 2.2. Bed porosity was of 0.7 when both resins Streamline DEAE and Streamline SP were used with StremLine Phenyl showing the highest bed porosity about 0.75. The number of theorical plates were 109, 41.5 and 17.8 and the axial dipersion coefficient (Daxial) were 0.5, 1.4 and 3.7 x 10-6 m2/s, for Streamline DEAE, Streamline SP and Streamline Phenyl, respectively. Whey proteins were adsorved fastly for the three resins with equilibrium reached in 10 minutes. Breakthrough curves showed that most of proteins stays in flowthrough as well as washing steps with 84, 77 and 96%, for Streamline DEAE, Streamline SP and Streamline Phenyl, respectively. It was observed protein peaks during elution for the three resins used. According to these peaks were identified 6 protein bands that could probably be albumin (69 KDa), lactoferrin (76 KDa), lactoperoxidase (89 KDa), β-lactoglobulin (18,3 KDa) e α-lactoalbumin (14 KDa), as well as the dimer of beta-lactoglobulin. The combined system compound for the elution of Streamline DEAE applied to the Streamline SP showed the best purification of whey proteins, mainly of the α-lactoalbumina

Simulações da ação do vento e da dispersão de contaminantes no estuário do Rio Potengi/ Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

A influência da poluição difusa e do regime hidrológico peculiar do semiárido na qualidade da água de um reservatório tropical

In semiarid region of northeast Brazil, the majority of reservoirs used for public supply has suffered degradation of water quality affected by diffuse pollution from agricultural and livestock areas of the watershed and by hydrologic regime peculiar to the region, characterized by a rainy season with higher volumes stored in reservoirs and a dry season with a reduction in water level due to high evaporation and increase of eutrophication. The Dourado reservoir, located in Currais Novos city, semiarid region of Rio Grande do Norte state, is one example of a water supply reservoir that can have degradation of water quality and impracticability of their use, due to the high external input of nutrients from non-point sources of watershed during the rainy season and increasing of eutrophication due to decrease the stored volume during the dry period. This study aimed to investigate and quantify diffuse pollution and the hydrologic regime of semiarid region in order to establish standards regarding the water quality of Dourado reservoir. The study period was between the months of May 2011 to March 2012. The diffuse pollution was quantified in terms of watershed from the mass balance of phosphorus in the reservoir, as in relation to areas under different types of land use within the riparian zone of the reservoir from the assessment of soil chemical properties and losses of phosphorus in each area. The influence of hydrological regime on water quality of the reservoir was evaluated from the monthly monitoring of the morphometric, meteorological and limnological features throughout the study period. The results showed that the reservoir has received a high load of phosphorus coming from the drainage basin and presents itself as a system able to retain some of that load tributary, giving an upward trend of the eutrophication process. Diffuse pollution by nutrients from areas under different types of land use within the riparian zone of the reservoir was higher in areas under the influence of livestock, being this area considered a potential diffuse source of nutrients to the reservoir. Regarding the water regime during the rainy season the reservoir was characterized by high concentrations of nutrients and small algal biomass, while in the dry season the reduction of volume and increase of the water retention time of the reservoir, contributing to the excessive growth algal biomass, favoring an increase in eutrophication and deterioration of water quality. In synthesis the water quality of Dourado reservoir is directed by diffuse pollution coming from the drainage basin and the hydrological regime of the peculiar semiarid region, where the rainy season is characterized by high input of allochthonous compounds from the tributaries and erosion of the soil in the reservoir riparian zone, and the dry season characterized by reducing the storage volume due to high evaporation, high residence time of water and consequent degradation of water quality due to the increase of eutrophication process

A responsabilidade enunciativa em Itinéraire d un Voyage en Allemagne

Nossa pesquisa se circunscreve nos estudos da Análise Textual dos Discursos, proposta pelo linguista Jean-Michel Adam. Nosso foco principal está voltado para o fenômeno da Responsabilidade Enunciativa (doravante RE). Além das categorias de análise para se estudar a RE, conforme Adam (2008, 2010, 2011), também seguiremos outros estudiosos no assunto, como Oswald Ducrot (1984), os teóricos Teoria Escandinava da Polifonia Linguística, (2004), Zlatka Guentchéva (1994), Jean-Pierre Desclés (2009) e Jacqueline Authier-Revuz (1998, 2004). Utilizaremos os pressupostos apresentados por Alain Rabatel (2004, 2008, 2009, 2010), sobretudo, no que concerne às noções de locutor/enunciador, ponto de vista ou vozes que podem ser encontradas em um texto. Para tanto, analisaremos um relato de viagem, Itinéraire d un Voyage en Allemagne (doravante Itinéraire), escrito no século XIX por Nísia Floresta, uma norte-rio-grandense que fez residência na França e ficou conhecida como uma das primeiras feministas do Brasil. O relato de viagem é um gênero diferenciado para se analisar a RE, sobretudo o Itinéraire, pois nele também podemos encontrar a presença de outros gêneros, quais sejam: epistolar e autobiográfico. Assim, percorreremos, primeiramente, algumas abordagens sobre gêneros de discurso, utilizando-nos, principalmente, dos pressupostos de Mikhail Bakhtin (1992, 2003), Geneviève Bordet (2011), Jean Michel Adam (2011) e Luiz Antônio Marcuschi (2008) e, posteriormente, apresentaremos algumas características que envolvem os gêneros citados. Por fim, para análise dos dados, estamos seguindo a abordagem qualitativa de natureza interpretativista. Nossa pesquisa comprovou que o Itinéraire apresenta muitas marcas de assunção da RE, mas que, apesar de Nísia Floresta ser locutora e enunciadora, é possível encontrar marcas de não assunção da RE, ou seja, outros PDV

Caracterização do repertório acústico do botocinza, sotalia guianensis, e impacto de embarcações no nordeste do brasil

The wide distribution along the Brazilian coast of specie Sotalia guianensis has been growing interest in searchers on the ecology of this species, addition to commercial interests by whalewatching. This work described the accoustic repertory of S. guianensis and their behavior associated and found if underwater noises affect this repertorie in Pipa-RN. It were analyzed 18:49h of recordings maked between april and june/2009. It were found 3258 whistles, 289 calls, 873 clicks and no gargle. The frequencies range of guiana dolphins was 1 a 48kHz and may be related to system response recorder and population s regionalization. The frequencies overlaps the noise made by motorboats, schooners and water bomb. The behavior travelling ocurred siletly in 72,58% and socialization presented no sound (56,4%) and presence of sound (43,6%). This great absence of sound may be relacioned to saving energy, probably because in this behaviors they can use physical and visual contacts. The foraging presented highest records of all class noise with 46,84% clicks, 33,84% whistles and 9,02% calls. All this sounds occurred differently in each behavior (travelling: x2 = 134,35 df = 3 p = 0,0001; foraging: x2 = 19,83 df = 3 p= 0,00018 and socialization x2 = 60,35 df = 3 p = 0,0001). It was possible to determine that underwater noise cause changes in the repertorie and does a considerable increase in whistle s number and reduce clicks. Also occurs changes in some whistles (FI: t=2,42, p=0,015; FF: t= -2,22, p=0,025), calls (FMI: t= -3,13, p=0,001; FMA: t= -3,49, p=0,0005; FD: t= -2,21, p=0,027; D: t=2,89, p=0,004) and clicks parameters (D: t= -3,85, p=0,0001; I: t= -5,32, p=0,0001) during presence of noise. These changes may be a strategy of these animals to win this sound barrier. We can not say which noise has more impact, ix however the water bomb seems to affect more the clicks and the motorboats seems to affect the others sounds. Little is know about auditive sensibility of this specie, but daily exposure to this noise may cause damage and this specie appears to have residence. The specie conservation is necessary because the population already seems to suffer damage as decrease in length of stay, number of individuals entering the inlet and the apparent diminution in the foragind during vessels presence and control standards and ambiental education can help. So, we can advance in knowledge about the ecology of this specie especially when it come to bioacoustics and their behaviors associated and reveals some of the impacts that the noise have brought to this population

Fidelidade à área e padrão de associação em Sotalia guianensis, baseado na técnica de foto-identificação

The behavioral patterns follow to environmental changes, including area fidelity and individuals association patterns. Several techniques are used to record these behavioral patterns and the photo-identification has been suggested as a proper tool because of its various advantages. Based on this technique, this research verified, between August of 2005 and January of 2006, area fidelity and association patterns of Sotalia guianensis, at Distrito de Pipa s bays, Rio Grande do Norte State south coast. Besides, we measured the association patterns by using the Jaccard index or Half-Weight Index (HWI). According the observation, 22 individuals were not resighted, 11 were resighted, and 36 new individuals were recorded. Nowadays, 69 individuals are cataloged. The residency rate indicated heterogeneity on studied area permanence and the association patterns between photo-identified seem to be context-specific. In addiction, the comparison of associations between two different age classes showed some individuals more frequently interacting with immature individuals. We also observed fluidity on association patterns among our individuals. We suggest that S. guianensis population from Pipa shows plasticity

O afeto além dos muros e portões : o apego a vizinhanças na cidade do Natal

Place Attachment is a positive affective bond between people and environments, and its main characteristic is the desire to maintain closeness to the place of attachment. Neighborhoods, in turn, are spaces close to the dwelling, which varies according to environmental, social and cultural characteristics. Facing the contemporary scenario of diminishment of neighborhood relations and its importance to the understanding of cities social-environmental context, the present work aimed to investigate the attachment to neighborhoods at the city of Natal-RN. This study had two stages. The first stage consisted on investigating, through an experts panel, the main characteristics of attached neighborhoods, aspects that contributes to the development of these neighborhoods, the ones that difficult, as well as look for indications of neighborhoods at the city of Natal that may be identified by these elements. In the following stage I interviewed 11 residents of two indicated neighborhoods at the district of Alecrim, to better comprehend the main characteristics of this attachment and the elements of the context that enable its development. The content of the interviews, categorized and evaluated by judges, indicated that, due to the 10 participant experts, the main characteristics of attached neighborhoods encompass elements of socialization, cooperation, physical space usage, intimacy and identity. According to them, these are characteristics enabled by temporal and rootedness aspects, by spatial contact, familiarity between neighbors, and cultural inheritance. The interviews with residents showed that attachment to the studied neighborhoods is specially grounded on support and cooperation networks between neighbors, on satisfaction with the proximity of services, and on the bond to symbolic aspects and local traditions. In addition to be enabled by spatial organization, by low displacement of residents, and by the district s history, relations at these neighborhoods are fostered by an intention to establish this kind of ties, carried by cultural values