Úlceras de pressão: um estudo com pacientes de unidade de terapia intensiva

To characterize patients according to gender, age category, internment time, diagnostical hypothesis and location of the pressure ulcer; to identify the susceptibility conditions, intrinsical and extrinsical factors present on ICU patients and to verify on the existence of association between the susceptibility conditions and the intrinsecal and extrinsecal factors on the occurrence of PU. Methods: It is a descriptive study, of longitudinal design of the panel type, with quantitative approach, performed on two ICU s of a private hospital located in Natal/RN, with 40 patients interned at these units. The data collection was performed on all three shifts through a structured observation and physical exam of the patients' skin form seeking to identify the presence of PU. Results: The greatest occurence of PU was on individuals of the male gender (70%) when compared to the female gender (30%), that difference being statistically significant (p=0,0267), with the male gender presenting 4,3 times greater chance of developing PU than the female; the predominant age category was from 60 years of age on (85%), 60,0% presented 1 to 2 PU s after 7 (seven) days of permanence in the ICU s, the predominant diagnostical hypothesis on the patients with PU were the respiratory diseases (42,3%) and the most frequent locations of PU were the sacral region (40,0%) and heels (36,0%). 25 PU s of stage I were diagnosed on 50,0% of the followed patients, with general incidence of 50,0% on both ICUs. from the 88 variables researched, 75 were identified on the patients from the study, being the predominant conditions (anemia, hypotension, leukocytosis, other diseases hypertension blood pressure, cardiac insuffience, pneumonia - and ansiolythic), the intrinsecal factors (diminished muscular strenght and/or mass, discrete edema, totally compromised mobile coordination and total inability for movement on the bed) and the extrinsecal factors (inadequate mattress type, permanence on a single position for >2 hours, shearing/friction force, bed clothes with folds that leave marks on the body, pressure force) predominated on patients with PU. The male gender variables (p=0,0267,OR=4,3), sedation (p=0,0006,OR=4,1), psychomotive agitation (p=0,0375,OR=5,8) and leukocytosis (p=0,0285,OR=5,0) presented a significant statistical diference when analyzed independently. We verified an association of 17,3%, statistically significant (p=0,0384), between the susceptibility conditions (anemia, leukocytosis and hypotension), the intrinsecal factors (age equal or above 60 years, diminished/absent pain sensibility and smooth, fine or delicate skin) and the extrinsecal factors (inadequate mattress, pressure forces, shearing/friction force, permanence on a single position for more than 2 hours, elevation between 30 to 45 degrees and inadequate bed clothes' conditions), with a chance ratio of 4,6 times the risk of occurrence of PU on the patients that presented the referred association. Conclusion: The incidence of PU detected on the ICU-interned patients was high and we made evident the existence of association between the susceptibility conditions, the intrinsecal and extrinsecal factors on the occurrence of PU s on the ICUinterned patients, and thus we accept the alternative hypothesis proposed on the study

Vivência do enfermeiro no cuidado humano na Unidade de Terapia Intensiva adulto

The purpose of the study was to understand the nurse s experience with human care in the Adult Intensive Care Unit (ICU). The objective was to describe the nurse s experience in caring for patients in the ICU and to analyze the nurse s perception of the care provided. The study is a descriptive inquiry of qualitative nature with a phenomenological approach. We interviewed eight nurses, 26 and 43 years of age, that provide care in the ICU of a private hospital in Natal/RN, during the manths of July and August of 2006. We analyzed the data acording to the method of Colaizzi. Four categories emerged from the data: The search for the maintenance of life, The technicalbureaucratic activities, The recognition of the patient s individuality, and the expression of the nurse s feelings.The analysis allowed us to describe the lived experience of the nurse s care the ICU and to comprehend the structural elements of this experience. The results showed that the nurse s experience presents itself as a process of the several actions and feelings that occur while the social relations between the patient and the nurse develop. Finally, we understand that although the study shows an experience based on a biological model of health, these nurses possess an initial idea on how to reach humanized care in its essence, needing, however, of an institutional policy that favors this practice, an educational formation that prepares her to recognize her field of work as a place of continuous learning and an understanding of the health model as an ally in the search of humanized care

Proposta de localização de uma unidade de tratamento de óleo e gordura residual de fritura na cidade do Natal/RN para produção de biodiesel

This work addresses biodiesel by transesterification from the use of waste frying oil as a possible technological alternative for both reducing greenhouse gas emissions and by presenting themselves as an environmental call to designate a rational use of oil when no longer played in the environment to become renewable energy. It has proposed location of a residual oil and fat treatment plant to produce biodiesel, using models of Location and Routing for the improvement of routes. To achieve the goal, questionnaires were administered in establishments that use oil or vegetable fat in their productive activities in order to quantify the residue, to analyze actions and environmental perception of people who work directly with the residue on the destination you are being given to oil and fat used. It has indicated using of two single setup location, the method of Center of Gravity and the model of Ardalan, a geographical point that minimizes the costs of transporting waste to the treatment plant. Actions have been proposed for the improvement of collection routes this residue using the Routing Method of Scanning, as an illustration. The results demonstrated the lack of knowledge of the people who deal directly with large amounts of waste, on the environmental impacts caused by their incorrect disposal. The models used were uniform since point out to neighborhoods in similar regions. The neighborhoods of Lagoa Nova / Morro Branco (Ardalan) and Nova Descoberta (Center of Gravity) as ideal for the installation of treatment plant. However, it is suggested to be tested other models that take into account new variables than those used (supply of waste and the distance between points). The routing through the method of scanning has shown that it is possible, in a simple way to optimize routes in order to reduce distances and therefore the logistics costs in the collection of such waste. Introducing a route as a test to gather the twenty largest oil suppliers used in sample frying, using as a main factor time 8 hour of working shift every day

A pegada de carbono como um dos indicadores de sustentabilidade para medição da responsabilidade socioambiental empresarial: um estudo de caso na unidade sede da Petrobras em Natal-RN

As a contemporary tendency, it is been evidenced that the environmental changes theme, already admitted as a concernment to international economical and political reality, is also gaining repercussion on industrial and business sector. Firms are implementing actions on trial to minimize their own greenhouse gases (GHG) emissions impacts. However, the great majority of those actions of Corporative Social-Environmental Responsibility (CSR) are referred only to direct emissions of the main production systems. Direct emissions are those derived of an isolate process, without considering the upstream and downstream processes emissions, which respond for the majority of emissions originated because of respective firm‟s production system existence. Because the greenhouse effect occurs globally and the GHG emissions contribute to the environmental changes independently of their origin, it must be taken into account the whole productive life cycle of products and systems, since the energy invested on resources extraction and necessary materials to the final disposal. To do so, it must be investigated all relevant steps of a product/production system life cycle, tracking all activities which emit greenhouse gases, directly or indirectly. This amount of emissions consists in the firm‟s Carbon Footprint. This research purpose is to defend the Carbon Footprint relevance and its adoption viability to be used as an Environmental Indicator on measurement/assessment of CSR. It has been realized a study case on Petrobras‟s seat unity at Natal-Brazil, assessing part of its Carbon Footprint. It has been used the software GEMIS 4.6 to do the emissions quantifying. The items measured were the direct emissions of the own unity vehicles and indirect emissions of offset paper (A4), energy and disposable plastic cups consumed. To 2009, these emissions were 3.811,94 tCO2eq. We may conclude that Carbon Footprint quantification is indispensable to the knowledge of real emissions caused by a productive process existence, must serving as basis to CSR decisions about the environmental changes reversion challenge

Balanced scorecard como ferramenta de gestão aplicada a unidade hospitalar privada

In this study the objective is to implant Balanced Scorecard administration for the development of a Strategic Map, for the support of the electric outlet of decisions in the administration of operations of an unit of attendance doctor-hospitalar. The present work presents a case study developed at a private hospital in the State of Rio Grande do Norte. The collection of data was developed after the analysis of the revision of the literature, and he/she had as critical judgement of evaluation used by the following Unit. The work is concluded in the proposition of a strategic map that elevates the return on investment (financial perspective), in the item profitability and growth. In the search of the customer's satisfaction (customer's perspective), that is nothing else than it already exists inside of the Unit in study, just needing to be organized and aligned with the executive picture and the other collaborators. The requirements competitiveness, information, innovation and technology (perspective of the internal processes), they were indispensable to eliminate the re-work, waste and to improve the automation. It is finally, the investment and development of innovation mechanisms, they enlarge important competitive advantage in the processes for creation of value, through the ability, attitude and knowledge (perspective of the learning and growth). As one of the results of this study a strategic map was developed, looked for in Balanced Scorecard, for support in the electric outlet of decisions of the administration of operations of an Unit Doctor- Healthcare

Análise de desempenho de sistemas de comunicação sem-fio para monitoramento de unidade de produção de poços petrolíferos terrestres

The greater part of monitoring onshore Oil and Gas environment currently are based on wireless solutions. However, these solutions have a technological configuration that are out-of-date, mainly because analog radios and inefficient communication topologies are used. On the other hand, solutions based in digital radios can provide more efficient solutions related to energy consumption, security and fault tolerance. Thus, this paper evaluated if the Wireless Sensor Network, communication technology based on digital radios, are adequate to monitoring Oil and Gas onshore wells. Percent of packets transmitted with successful, energy consumption, communication delay and routing techniques applied to a mesh topology will be used as metrics to validate the proposal in the different routing techniques through network simulation tool NS-2

Desenvolvimento de um software de comunicação sem fio aplicado à instrumentação de unidade de elevação de petróleo tipo Plunger Lift

This dissertation aims to develop a software applied to a communication system for a wireless sensor network (WSN) for tracking analog and digital variables and control valve of the gas flow in artificial oil s elevation units, Plunger Lift type. The reason for this implementation is due to the fact that, in the studied plant configuration, the sensors communicate with the PLC (Programmable and Logic Controller) by the cables and pipelines, making any changes in that system, such as changing the layout of it, as well as inconveniences that arise from the nature of the site, such as the vicinity s animals presence that tend to destroy the cables for interconnection of sensors to the PLC. For software development, was used communication polling method via SMAC protocol (Simple Medium Access ControlIEEE 802.15.4 standard) in the CodeWarrior environment to which generated a firmware, loaded into the WSN s transceivers, present in the kit MC13193-EVK, (all items described above are owners of Freescale Semiconductors Inc.). The network monitoring and parameterization used in its application, was developed in LabVIEW software from National Instruments. The results were obtained through the observation of the network s behavior of sensors proposal, focusing on aspects such as: indoor and outdoor quantity of packages received and lost, general aspects of reliability in data transmission, coexistence with other types of wireless networks and power consumption under different operating conditions. The results were considered satisfactory, which showed the software efficiency in this communication system

Um modelo de unidade de medida inercial utilizando três acelerômetros triaxiais

No espaço tridimensional, um corpo rígido qualquer pode efetuar translações e ou rotações em relação a cada um de seus eixos. Identificar com precisão o deslocamento realizado por um corpo é fundamental para alguns tipos de sistemas em engenharia. Em sistemas de navegação inercial tradicionais, utilizam-se acelerômetros para reconhecer a aceleração linear e giroscópios para reconhecer a velocidade angular registrada durante o deslocamento. O giroscópio, entretanto, é um dispositivo de custo mais elevado e com alto consumo de energia quando comparado a um acelerômetro. Essa desvantagem deu origem a pesquisas a respeito de sistemas e unidades de medidas inerciais que não utilizam giroscópios. A ideia de utilizar apenas acelerômetros para calcular o movimento linear e angular surgiu no início da década de 60 e vem se desenvolvendo através de modelos que variam no número de sensores, na maneira como estes são organizados e no modelo matemático que é utilizado para derivar o movimento do corpo. Esse trabalho propõe um esquema de configuração para construção de uma unidade de medida inercial que utiliza três acelerômetros triaxiais. Para identificar o deslocamento de um corpo rígido a partir deste esquema, foi utilizado um modelo matemático que utiliza apenas os nove sinais de aceleração extraídos dos três sensores. A proposta sugere que os sensores sejam montados e distribuídos em formato de L . Essa disposição permite a utilização de um único plano do sistema de coordenadas, facilitando assim a instalação e configuração destes dispositivos e possibilitando a implantação dos sensores em uma única placa de circuito integrado. Os resultados encontrados a partir das simulações iniciais demonstram a viabilidade da utilização do esquema de configuração proposto

Protótipo de uma unidade com tri-geração de energia para utilizações remotas: aplicação de módulo secondutivo gerador termoelétrico

The generation for termoeletricity is characterized as a solid process of conversion of thermal energy (heat) in electric without the necessity of mobile parts. Although the conversion process is of low efficiency the system presents high degree of trustworthiness and low requisite of maintenance and durability. Its principle is based on the studies of termogeneration carried through by Thomas Seebeck in 1800. The frank development of the technologies of solid state for termoeletricity generation, the necessity of the best exploitation of the energy, also with incentive the cogeneration processes, the reduction of the ambient impact allies to the development of modules semiconductors of high efficiency, converge to the use of the thermoeletric generation through components of solid state in remote applications. The work presents the development, construction and performance evaluation of an prototype, in pilot scale, for energy tri-generation aiming at application in remote areas. The unit is composed of a gas lamp as primary source of energy, a module commercial semiconductor for thermoelectric generation and a shirt for production of the luminosity. The project of the device made compatible a headstock for adaptation in the gas lamp, a hot source for adaptation of the module, an exchanger of to be used heat as cold source and to compose first stage of cogeneration, an exchanger of tubular heat to compose second stage of cogeneration, the elaboration of a converter dc-dc type push pull, adequacy of a system of acquisition of temperature. It was become fullfilled assembly of the prototype in group of benches for tests and assay in the full load condition in order to evaluate its efficiency, had been carried through energy balance of the unit. The prototype presented an electric efficiency of 0,73%, thermal of 56,55%, illumination of 1,35% and global of 58,62%. The developed prototype, as the adopted methodology of assay had also taken care of to the considered objectives, making possible the attainment of conclusive results concerning to the experiment. Optimization in the system of setting of the semicondutor module, improvement in the thermal insulation and design of the prototype and system of protection to the user are suggestions to become it a commercial product

Desenvolvimento de uma unidade laboratorial para quantificação de BTX como poluentes atmosféricos, usando microextração em fase sólida

This dissertation aims the development of an experimental device to determine quantitatively the content of benzene, toluene and xylenes (BTX) in the atmosphere. BTX are extremely volatile solvents, and therefore play an important role in atmospheric chemistry, being precursors in the tropospheric ozone formation. In this work a BTX new standard gas was produced in nitrogen for stagnant systems. The aim of this dissertation is to develop a new method, simple and cheaper, to quantify and monitor BTX in air using solid phase microextraction/ gas chromatography/mass spectrometry (SPME/CG/MS). The features of the calibration method proposed are presented in this dissertation. SPME sampling was carried out under non-equilibrium conditions using a Carboxen/PDMS fiber exposed for 10 min standard gas mixtures. It is observed that the main parameters that affect the extraction process are sampling time and concentration. The results of the BTX multicomponent system studied have shown a linear and a nonlinear range. In the non-linear range, it is remarkable the effect of competition by selective adsorption with the following affinity order p-xylene > toluene > benzene. This behavior represents a limitation of the method, however being in accordance with the literature. Furthermore, this behavior does not prevent the application of the technique out of the non-linear region to quantify the BTX contents in the atmosphere.

A fotossíntese vegetal no 3º ano do Ensino médio: concepções alternativas, erros conceituais e uma proposta de unidade didática baseada no Desenvolvimento Sustentável.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Contribuições de uma unidade de ensino potencialmente significativa UEPS para o ensino de ecologia em escola pública da educação básica

The research aims to evaluate the contributions of a teaching unit to enhance the learning contents ecological green areas in elementary school. The work was conducted with elementary students in a public school in Natal-RN. We sought to identify the students´ previous knowledge about the contents of ecology, develop and implement a Potentially Meaningful Teaching Units PMTU; assess learning of ecological concepts in Teaching Unit Potentially Significant; assess the contribution of interpretative trail as strategy teaching to learning content ecology. The survey of students´ previous knowledge through the pre-test was essential to identify the appropriate subsumers and partially correct, since they served as "anchor" for further expansion of scientific concepts contained in this research. The green areas of the school as an educational, contributed the motivational aspect, as students were protagonists throughout the entire process of teaching and learning. The method of stimulated memory was effective to evidence learning ecological concepts in interpretive trails. The use of diverse activities organized on a PMTU promoted intellectual autonomy of the students and facilitated the acquisition of new meanings through progressive differentiation, and integrative reconciliation consolidation of ecological content and concepts related to biotic and abiotic factors on the basis of the central ideas thematic Life and Environment. The development of procedural skills to capture and share meanings, observe, collect and record data, hypotheses, ability to explain, to apply knowledge to solve problem situations, argue, identify, compare, differentiate and relate concepts, negotiate meanings, reflecting Critically, systematize data was evidenced. Collaborative activities promoted the incorporation of attitudinal contents as developing respect for differences, learn to work in teams to plan, develop and implement actions together for citizenship and environmental responsibility. The application of the Potentially Meaningful Teaching Units PMTU showed evidence of Critical meaningful learning ecological concepts covered in elementary school.

Contando histórias de cuidado à infância em unidade de terapia intensiva pediátrica

The tales of children's literature, in their plots, mark existential dilemmas belonging in human‟s lives, such as death, situations of separation, loss, abandonment, fear, challenges, achievements and other elements that make them suitable material to assist children in their developmental process. Such elements, present in children‟s storybooks, are close to the experiences lived by the children in the context of hospitalization in a special manner. With that said this study focus on the understanding of the therapeutic possibilities of the tales of children's literature in the care of hospitalized children in Pediatric Intensive Care Units (UTIPED) based on the Heidegger's concept of Care and adopting the Phenomenology as the method. The UTIPED of a state public hospital located in the municipality of Natal/RN was elected as the study site and four hospitalized children aged between six and nine years, all males, presenting different clinical conditions were selected to participate in the study following age and clinical conditions as the selective criteria. The procedure of corpus construction included eight individual sessions of storytelling accompanied by the use of ludic resources. The phenomenological understanding about the therapeutic possibilities of tales was structured under three main elements: (1) the ludic axis; (2) the reflective axis; and (3) the affective axis. The appropriateness of the proposed therapy in the context of the UTIPED and the potential of the tales as a protection factor to the child was evident. The storytelling activity framed a scenario of care unusual in the context of intensive care units, establishing a symbolic space for children‟s expression. Therefore, this study indicates this therapeutic proposal for children‟s care in the UTIPED that considers their evolutionary stage, their clinical conditions at the time and especially their emotional needs during their immersion in a diverse and foreign environment which is filled with potentially harmful elements to their full development.

Atenção precoce do câncer de mama :um olhar sobre o cotidiano institucional de uma unidade de saúde de Natal

Breast cancer has been considered a grave global public health problem due to its increase in incidence, in women s mortality and in the amount of financial resources spent on the therapeutic interventions used in the treatment of this neoplasia. However, this scenario presents some variations. In developing countries, the incidence of breast cancer is increasing but, on the other hand, the mortality is declining among patients because of public health actions toward early diagnostic that also result in cure of patients and decreasing levels of physical and psychosocial stress. In Brazil, we face of both the increasing number of breast cancer incidence and number of mortalities. Almost always the reason for that is a delayed detection that will provide a late diagnostic. The early detection of breast cancer has been studied in several researches. Some of them are concerned with women s experiences. Despite that, there is a lack of researches on dynamic comprehension of early attention to breast cancer from the health professionals points of view. The present research was carried out at the Unidade Mista de Felipe Camarão (UMFC) and it was conducted with 11 professionals who work in the Family Health Program (PSF). The aim was to understand how early diagnostic and attention to breast cancer is being planned, discussed and accomplished by health professionals in their day-to-day actions. Semi-structure interviews were held individually with each professional, in a way that they could feel free to express their ideas about several issues. All the information from these interviews was analyzed and discussed using an Institutional Ethnographic approach. It was observed that the actions of health professionals working with early detection of breast cancer does not take place in a vacuum; they occur within institutional, relational and social ways. This interdependence influences their actions and points of view on the theme

Construção de modelos multivariados para determinação de lipídios totais e unidade em leite em pó comercial utilizando espectroscopia no infravermelho próximo

In this work calibration models were constructed to determine the content of total lipids and moisture in powdered milk samples. For this, used the near-infrared spectroscopy by diffuse reflectance, combined with multivariate calibration. Initially, the spectral data were submitted to correction of multiplicative light scattering (MSC) and Savitzsky-Golay smoothing. Then, the samples were divided into subgroups by application of hierarchical clustering analysis of the classes (HCA) and Ward Linkage criterion. Thus, it became possible to build regression models by partial least squares (PLS) that allowed the calibration and prediction of the content total lipid and moisture, based on the values obtained by the reference methods of Soxhlet and 105 ° C, respectively . Therefore, conclude that the NIR had a good performance for the quantification of samples of powdered milk, mainly by minimizing the analysis time, not destruction of the samples and not waste. Prediction models for determination of total lipids correlated (R) of 0.9955, RMSEP of 0.8952, therefore the average error between the Soxhlet and NIR was ± 0.70%, while the model prediction to content moisture correlated (R) of 0.9184, RMSEP, 0.3778 and error of ± 0.76%