O oncologista clínico diante da morte: implicações para a produção do cuidado

It is undeniable that all the extraordinary technological advances in contemporary society have increased the severe patients expectation and quality of life, especially cancer patients. On the other hand, it is easily verifiable by many researches that it was not possible to advance in the same proportion in caring for the human experience of death. Much is said about the anguish of a man facing death, of cancer patients in terminal stage, about their families, and very little about the feelings, anxieties and ways of coping with the medical professional who deals with this situation, specifically the clinical oncologist. Little is known about the experience of the doctor who has learned to take death as an enemy to be defeated, and increasingly is compelled to live at length with his advertisement. However, we started to watch in recent years a growing interest of researchers in this issue. This study seeks to add to this interest in order to understand the experience of clinical oncologists that accompany dying patients, the meanings they attach to death, ways of coping and the implications for providing care. This is a qualitative study in which was used as a tool for data collection an in-depth interview with the projective using script and scenes. Gadameriana Hermeneutics was used for analysis and interpretation of narratives. The subjects were 10 clinical oncologists who work at two institutions from cancer treatments in the state of Rio Grande do Norte, chosen from a variation in the time working in the specialty (minimum of one year, even old ones). However, you can bring some initial results for the dialogue. It was found that the death is still a topic that causes many difficulties in the daily lives of these professionals, the choice for oncology involves dealing with death without preparation in medical education; being close to the patient in the final moment, supporting the family, coping with own pain of loss and the inability to heal. These are central elements of the narratives. We also have investment in medical training and continuing education in setting up a demand that permeates the discourse of participants. Being able to listen to the subjective world of clinical oncologists will support the work not only for them as other professionals who deal with patients with advanced cancer, providing evidence to understand to what extent the meanings attributed to its know-how before patients on the verge of death interfere with the production of care and allow identify coping strategies in everyday life of these professionals that hinder or facilitate coping with death, promote or preclude the care with others and with themselves. It is hoped that research can contribute to the field of knowledge about the know-how in clinical oncology and their terminal-care-death oncologist-patient relationships, bringing runways capable of promoting a better quality of care in the production of all involved in this process: professionals, patients and families

Localização de faltas em linhas de transmissão usando morfologia matemática

This work an algorithm for fault location is proposed. It contains the following functions: fault detection, fault classification and fault location. Mathematical Morphology is used to process currents obtained in the monitored terminals. Unlike Fourier and Wavelet transforms that are usually applied to fault location, the Mathematical Morphology is a non-linear operation that uses only basic operation (sum, subtraction, maximum and minimum). Thus, Mathematical Morphology is computationally very efficient. For detection and classification functions, the Morphological Wavelet was used. On fault location module the Multiresolution Morphological Gradient was used to detect the traveling waves and their polarities. Hence, recorded the arrival in the two first traveling waves incident at the measured terminal and knowing the velocity of propagation, pinpoint the fault location can be estimated. The algorithm was applied in a 440 kV power transmission system, simulated on ATP. Several fault conditions where studied and the following parameters were evaluated: fault location, fault type, fault resistance, fault inception angle, noise level and sampling rate. The results show that the application of Mathematical Morphology in faults location is very promising

Distribuição de derivados de petróleo por redes de polidutos: uma abordagem através de algoritmos evolucionários híbridos para um problema triobjetivo

An important problem faced by the oil industry is to distribute multiple oil products through pipelines. Distribution is done in a network composed of refineries (source nodes), storage parks (intermediate nodes), and terminals (demand nodes) interconnected by a set of pipelines transporting oil and derivatives between adjacent areas. Constraints related to storage limits, delivery time, sources availability, sending and receiving limits, among others, must be satisfied. Some researchers deal with this problem under a discrete viewpoint in which the flow in the network is seen as batches sending. Usually, there is no separation device between batches of different products and the losses due to interfaces may be significant. Minimizing delivery time is a typical objective adopted by engineers when scheduling products sending in pipeline networks. However, costs incurred due to losses in interfaces cannot be disregarded. The cost also depends on pumping expenses, which are mostly due to the electricity cost. Since industrial electricity tariff varies over the day, pumping at different time periods have different cost. This work presents an experimental investigation of computational methods designed to deal with the problem of distributing oil derivatives in networks considering three minimization objectives simultaneously: delivery time, losses due to interfaces and electricity cost. The problem is NP-hard and is addressed with hybrid evolutionary algorithms. Hybridizations are mainly focused on Transgenetic Algorithms and classical multi-objective evolutionary algorithm architectures such as MOEA/D, NSGA2 and SPEA2. Three architectures named MOTA/D, NSTA and SPETA are applied to the problem. An experimental study compares the algorithms on thirty test cases. To analyse the results obtained with the algorithms Pareto-compliant quality indicators are used and the significance of the results evaluated with non-parametric statistical tests.

Mapeamento das projeções retinianas para o sistema óptico acessório, colículo superior e complexo pré-tectal do sagui (callithrix jacchus)

The accessory optical system, the pretectal complex, and superior colliculus are important control centers in a variety of eye movement, being extremely necessary for image formation, consequently to visual perception. The accessory optical system is constituted by the nuclei: dorsal terminal nucleus, lateral terminal nucleus, medial terminal nucleus and interstitial nucleus of the posterior superior fasciculus. From a functional point of view they contribute to the image stabilization, participating in the visuomotor activity where all system cells respond to slow eye movements and visual stimuli, which is important for the proper functioning of other visual systems. The pretectal complex comprises a group of nuclei situated in mesodiencephalic transition, they are: anterior pretectal nucleus, posterior pretectal nucleus, medial pretectal nucleus, olivary pretectal nucleus and the nucleus of the optic tract, all retinal projection recipients and functionally are related to the route of the pupillary light reflex and the optokinetic nystagmus. The superior colliculus is an important subcortical visual station formed by layers and has an important functional role in the control of eye movements and head in response to multisensory stimuli. Our aim was to make a mapping of retinal projections that focus on accessory optical system, the nuclei of pretectal complex and the superior colliculus, searching mainly for pretectal complex, better delineation of these structures through the anterograde tracing with the B subunit of cholera toxin (CTb) followed by immunohistochemistry and characterized (measured diameter) synaptic buttons present on the fibers / terminals of the nucleus complex pré-tectal. In our results accessory optical system, including a region which appears to be medial terminal nucleus and superior colliculus, were strongly marked by fibers / terminals immunoreactive CTb as well as pretectal complex in the nucleus: optic tract, olivary pretectal nucleus, anterior pretectal nucleus and posterior pretectal nucleus. According to the characterization of the buttons it was possible to make a better definition of these nucleus.