O processo de aprendizagem de professores do ensino fundamental: apropriação da habilidade de planejar situações de ensino de conceitos

La investigación fue realizada con profesores de los años iniciales de la enseñanza básica, alumnos de la carrera de Pedagogía Licenciatura Plena del PROBÁSICA de Ceará-Mirim (RN). Tuvo como objetivo general el estudio de lo proceso de apropiación de esa habilidad, segundo las siguientes perspectivas teóricas: históricocultural, de L.S. Vygotsky, teoría de la actividad, de A.N. Leontiev, y la teoría de la asimilación por etapas mentales, de P. Ya Galperin. La metodología se desarrolló organizándose en tres etapas: el diagnóstico inicial, con el análisis del nivel de desarrollo de la habilidad de los profesores; el proceso formativo, con la orientación del aprendizaje, el control y la evaluación del desarrollo; y el diagnóstico final, con el análisis del nivel alcanzado en la experiencia. Los instrumentos utilizados fueron: un cuestionario, para la caracterización de los sujetos de la investigación, el planeamiento de enseñanza de los profesores y el diario de clase, donde se registraba lo que ocurrió en cada orientación y realización del proceso formativo. Los resultados referentes a los niveles iniciales del desarrollo de la habilidad han revelado un grado de espontaneidad en el planeamiento de enseñanza de los conceptos. Durante el proceso de enseñanza y aprendizaje, los profesores han expresado sus dificultades, pero también las posibilidades de mudanza para que alcanzaran un nuevo nivel de desarrollo. Para el análisis del nivel inicial y del desarrollo de las habilidades de los profesores para planificar situaciones de enseñanza con la definición y con la identificación, fueron utilizados los siguientes elementos: el dominio del concepto, el dominio de esos procedimientos lógicos y las categorías del planeamiento (objetivos, contenidos, estrategias de enseñanza, control y evaluación). En cada etapa surgieron obstáculos, pero también aspectos que han revelado la posibilidad para aprender una nueva forma de planear, con apropiación de nuevos fundamentos teóricos. La práctica docente se constituyó en un elemento que facilitó la comprensión y la apropiación de las habilidades de planear situaciones de enseñanza de conceptos mediante la definición y la identificación

Sistema Híbrido de Inferência Baseado em Análise de Componentes Principais e Redes Neurais Artificiais Aplicado a Plantas de Processamento de Gás Natural

Nowadays, where the market competition requires products with better quality and a constant search for cost savings and a better use of raw materials, the research for more efficient control strategies becomes vital. In Natural Gas Processin Units (NGPUs), as in the most chemical processes, the quality control is accomplished through their products composition. However, the chemical composition analysis has a long measurement time, even when performed by instruments such as gas chromatographs. This fact hinders the development of control strategies to provide a better process yield. The natural gas processing is one of the most important activities in the petroleum industry. The main economic product of a NGPU is the liquefied petroleum gas (LPG). The LPG is ideally composed by propane and butane, however, in practice, its composition has some contaminants, such as ethane and pentane. In this work is proposed an inferential system using neural networks to estimate the ethane and pentane mole fractions in LPG and the propane mole fraction in residual gas. The goal is to provide the values of these estimated variables in every minute using a single multilayer neural network, making it possibly to apply inferential control techniques in order to monitor the LPG quality and to reduce the propane loss in the process. To develop this work a NGPU was simulated in HYSYS R software, composed by two distillation collumns: deethanizer and debutanizer. The inference is performed through the process variables of the PID controllers present in the instrumentation of these columns. To reduce the complexity of the inferential neural network is used the statistical technique of principal component analysis to decrease the number of network inputs, thus forming a hybrid inferential system. It is also proposed in this work a simple strategy to correct the inferential system in real-time, based on measurements of the chromatographs which may exist in process under study

A engenharia simultânea e o perfil da indústria de confecção da grande Natal/RN utilizando as ferramentas CAD/PDM e ERP

This work presents the research carried through in the industrial segment of confection of clothes of the Great Natal whose objective is to show the profile, enterprise and technological management as also the use of simultaneous engineering in the development of products. The research approaches two studies. The first one presents the current picture of the companies, synthesized through twelve variable. As, through fifteen variable it shows to the level of use of Simultaneous Engineering in the Development of Products and its amplitude in relation to the Integrated Management using tools CAD, PDM and ERP (Computer Aided Design, Product Management Date, Enterprise Resource Planning). The integration of these systems acts aiming the reduction of the cost and the development time of products. The reached results indicate that simultaneous engineering is a competitive advantage and becomes possible: to reduce the life cycle of the product, to rationalize the resources, to incorporate one high standard of the quality to the process and product as well as to personalize the product to take care of the global market. It is important to note that this work also is considered to contribute for the better understanding of the real companies situation of confection located at the Great Natal and its role in the economy of the State of the Rio Grande do Norte

Desenvolvimento de um núcleo versátil e integrado de ferramentas CAD/CAE para a modelagem e simulação de peças mecânicas

Currently there is still a high demand for quality control in manufacturing processes of mechanical parts. This keeps alive the need for the inspection activity of final products ranging from dimensional analysis to chemical composition of products. Usually this task may be done through various nondestructive and destructive methods that ensure the integrity of the parts. The result generated by these modern inspection tools ends up not being able to geometrically define the real damage and, therefore, cannot be properly displayed on a computing environment screen. Virtual 3D visualization may help identify damage that would hardly be detected by any other methods. One may find some commercial softwares that seek to address the stages of a design and simulation of mechanical parts in order to predict possible damages trying to diminish potential undesirable events. However, the challenge of developing softwares capable of integrating the various design activities, product inspection, results of non-destructive testing as well as the simulation of damage still needs the attention of researchers. This was the motivation to conduct a methodological study for implementation of a versatile CAD/CAE computer kernel capable of helping programmers in developing softwares applied to the activities of design and simulation of mechanics parts under stress. In this research it is presented interesting results obtained from the use of the developed kernel showing that it was successfully applied to case studies of design including parts presenting specific geometries, namely: mechanical prostheses, heat exchangers and piping of oil and gas. Finally, the conclusions regarding the experience of merging CAD and CAE theories to develop the kernel, so as to result in a tool adaptable to various applications of the metalworking industry are presented

Resposta celular Th1 /Th2 na doença periodontal experimental, em ratos: um estudo imuno-histoquímico

Host response plays a major role in the pathogenesis of periodontal disease. Mediators such as inflammatory cytokines which are secreted during the immune response to bacterial challenges have ambiguous functions that may or may not lead to protection of the attacked tissue. In this context, experimental evidence suggests that T-helper 1 (Th-1) and T-helper 2 (Th-2) mediated responses are potentially important during the disease process. The aims of this study therefore were to further clarify the role played by Th2 cells during different time points of the active phase of periodontal disease, as well as, to investigate whether there was any evidence of a Th1 response in the periodontal disease microenvironment. Experimental periodontitis was induced in 30 Wistar male rats by placing cotton ligatures around the mandibular first molars. The rats were then randomly divided into two groups. Group1 (G1=15) and Group 2 (G2=15). In G1 the ligatures were maintained for 2 days, whereas in G2 the ligatures were left for 15 days, a time point that corresponds to the advanced stage of periodontal disease The contra-lateral teeth served as controls (no ligatures). Immunohistochemical investigation for the presence in gingival tissue of Th2 specific transcription factor (GATA3) and the subunit of the IFN-γ receptor was carried out after the disease induction period. Light microscopy analysis revealed a decrease in the expression of GATA-3 as bone loss progressed. On the other hand, although IFN-γ R1 was detected at an early stage of the active phase of disease its expression remained unaltered during the remaining period of the study. These results indicate that the Th2 response have a protective role during the pathogenesis of periodontal disease and that the progression of the periodontal disease is related with the unbalance of the responses Th1/Th2

Estudo termoanalítico de medicamentos de referência, genérico e similar

This study aimed to apply, thermogravimetriy /derivative Thermogravimetriy (TG/DTG), differential scanning calorimetry (DSC), Differential Thermal Analysis (DTA), to conduct a comparative study on drug reference, generic and whose active principles are similar captopril hydrochlorothiazide, ampicillin, paracetamol, aspirin and mebendazole sold in local pharmacies. Samples of the active ingredients and dosage forms were also characterized by absorption infrared spectroscopy (IR), X-ray diffraction (XRD) and microscopy scanning electron (SEM). The TG / DTG curves showed a general similarity in the thermal behavior of the samples, but also showed the influence of excipients on the thermal stability. The DSC curve of the generic base hydrochlorothiazide showed no peak on the fusion of the drug due to interference of lactose as a diluent, which causes interaction with the active principle causing their degradation before the merger. The DSC curves of the drugs consisting of paracetamol showed reproducibility at the melting point of the active and the other thermal events. The DSC result of binary mixtures involving captopril / magnesium stearate and mebendazole/magnesium stearate showed possible interactions or incompatibilities evidenced by the displacement of the melting point of both drugs. The other mixtures showed no change. The infrared spectra presented were very similar, indicating the presence of functional groups characteristic of the constituents of the samples. The X-ray diffraction showed peaks indicative of crystalline structure of the active ingredients as well as some of the ingredients in the formulation of the drug and the micrographs indicate a general heterogeneity in the size distribution of particles in the samples

Beta: uma ferramenta para geração de testes de unidade a partir de especificações B

Formal methods and software testing are tools to obtain and control software quality. When used together, they provide mechanisms for software specification, verification and error detection. Even though formal methods allow software to be mathematically verified, they are not enough to assure that a system is free of faults, thus, software testing techniques are necessary to complement the process of verification and validation of a system. Model Based Testing techniques allow tests to be generated from other software artifacts such as specifications and abstract models. Using formal specifications as basis for test creation, we can generate better quality tests, because these specifications are usually precise and free of ambiguity. Fernanda Souza (2009) proposed a method to define test cases from B Method specifications. This method used information from the machine s invariant and the operation s precondition to define positive and negative test cases for an operation, using equivalent class partitioning and boundary value analysis based techniques. However, the method proposed in 2009 was not automated and had conceptual deficiencies like, for instance, it did not fit in a well defined coverage criteria classification. We started our work with a case study that applied the method in an example of B specification from the industry. Based in this case study we ve obtained subsidies to improve it. In our work we evolved the proposed method, rewriting it and adding characteristics to make it compatible with a test classification used by the community. We also improved the method to support specifications structured in different components, to use information from the operation s behavior on the test case generation process and to use new coverage criterias. Besides, we have implemented a tool to automate the method and we have submitted it to more complex case studies

Ação Sacietogênica de um inibidor de tripsina da semente de tamarindo (Tamarindus indica L.)

The seeds are excellent sources of proteinase inhibitors and have been highlighted owing to various applications. Among these applications are those in effect on food intake and weight gain that stand out because of the increasing number of obese individuals. This study evaluated the effects of trypsin inhibitor present in the seed of tamarind (Tamarindus indica L.) reduction in weight gain, biochemical and morphological alterations in Wistar rats. For this, we partially purified a trypsin inhibitor tamarind seed. This inhibitor, ITT2 at a concentration of 25 mg / kg body weight, over a period of 14 days was able to reduce food intake in rats (n = 6) by approximately 47%, causing a reduction in weight gain approximately 70% when compared with the control group. With the evaluation of the in vivo digestibility was demonstrated that the animals lost weight due to satiety, presented by the reduction of food intake, since there were significant differences between true digestibility for the control group (90.7%) and the group treated with inhibitor (89.88%). Additionally, we checked the deeds of ITT2 on biochemical parameters (glucose, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, glutamic-pyruvic transaminase, glutamic oxaloacetic transaminase, gamma glutamyl transferase albumin, globulin, total protein and C-reactive protein) and these, when assessed in the study groups showed no statistically significant variations. We also evaluate the histology of some organs, liver, stomach, intestine, and pancreas, and showed no changes. And to evaluate the effect of trypsin inhibitor on food intake due to the satiety is regulated by cholecystokinin (CCK) were measured plasma levels, and it was observed that the levels of CCK in animals receiving ITT2 were significantly higher ( 20 + 1.22) than in animals receiving only solution with casein (10.14 + 2.9) or water (5.92 + 1.15). Thus, the results indicate that the effect caused ITT2 satiety, reducing food intake, which in turn caused a reduction in weight gain in animals without causing morphological and biochemical changes, this effect caused by the elevation of plasma levels CCK

Um sistema para a inferência de variáveis usando redes neurais artificiais

This work aims to obtain a low-cost virtual sensor to estimate the quality of LPG. For the acquisition of data from a distillation tower, software HYSYS ® was used to simulate chemical processes. These data will be used for training and validation of an Artificial Neural Network (ANN). This network will aim to estimate from available simulated variables such as temperature, pressure and discharge flow of a distillation tower, the mole fraction of pentane present in LPG. Thus, allowing a better control of product quality

Desenvolvimento de metodologias analíticas alternativas por cromatografia gasosa para análise de biodiesel

Since the beginning of the National Program for Production and Use of Biodiesel in Brazil, in 2004, different raw materials were evaluated for biodiesel production, trying to combine the agricultural diversity of the country to the desire to reduce production coasts. To determine the chemical composition of biodiesel produced from common vegetables oils, international methods have been used widely in Brazil. However, for analyzing biodiesel samples produced from some alternative raw materials analytical problems have been detected. That was the case of biodiesel from castor oil. Due the need to overcome these problems, new methodologies were developed using different chromatographic columns, standards and quantitative methods. The priority was simplifying the equipment configuration, realizing faster analyses, reducing the costs and facilitating the routine of biodiesel research and production laboratories. For quantifying free glycerin, the ethylene glycol was used in instead of 1,2,4-butanetriol, without loss of quality results. The ethylene glycol is a cheaper and easier standard. For methanol analyses the headspace was not used and the cost of the equipment used was lower. A detailed determination of the esters helped the deeper knowledge of the biodiesel composition. The report of the experiments and conclusions of the research that resulted in the development of alternative methods for quality control of the composition of the biodiesel produced in Brazil, a country with considerable variability of species in agriculture, are the goals of this thesis and are reported in the following pages

Avaliação do controle da diagênese na qualidade de reservatório siliciclástico do cenomaniano superior da formação Açu, sudoeste da bacia potiguar

The distribution of diagenetic alterations in Late Cenomanian siliciclastic reservoirs from Potiguar Basin was influenced by the stratigraphic framework and the depositional system. Seismic sections and geophysical logs of two wells drilled in the SW portion of the mentioned basin above register regional stratigraphic surfaces representing maximum floods related to a transgressive event. The sequential analysis of 80 m of drill core (~450 m deep) recognized nine depositional facies with an upwards granodecrescent standard piling that limits cycles with an erosional conglomeratic base (lag) overlain by intercalations of medium to very fine sandstones showing cross bedding (channel, planar and low angled) and horizontal bedding (plane-parallel , wave and flaser). The top of the cycles is marked by the deposition of pelites and the development of paleosoils and lagoons. The correlation of genetically related facies reveals associations of channel fillings, crevasse, and flood plains deposited in a transgressive system. Detailed descriptions of seventy nine thin sections aided by MEV-EBSD/EDS, DRX and stable isotope analyses in sandstones revealed an arcosian composition and complex textural arrays with abundant smectite fringes continuously covering primary components, mechanically infiltrated cuticles and moldic and intragrain pores. K-feldspar epitaxial overgrowth covers microcline and orthoclase grains before any other phase. Abundant pseudomatrix due to the compactation of mud intraclasts concentrate along the stratification planes, locally replaced by macrocristalline calcite and microcrystalline and framboidal pyrite. Kaolinite (booklets and vermicular), microcrystalline smectite, microcrystalline titanium minerals and pyrite replace the primary components. The intergrain porosity prevails over the moldic, intragrain and contraction porosities. The pores are poorly connected due to the presence of intergranular smectite, k-feldspar overgrowth, infiltrated mud and pseudomatrix. The sandstones were subjected to eodiagenetic conditions next to the surface and shallow burial mesodiagenetic conditions. The diagenetic alterations reduced the porosity and the permeability mainly due to the precipitation of smectite fringes, compactation of mud intraclasts onto the pseudomatrix and cementing by poikilotopic calcite characterizing different reservoir petrofacies. These diagenetic products acted as barriers and detours to the flow of fluids thus reducing the quality of the reservoir.

Avaliação do impacto do plano de expansão da rede federal na qualidade dos institutos federais de educação segundo indicadores de desempenho

The Expansion Plan of the Federal Network of Vocational Education foresees the construction of 860 new units of instruction until 2020, representing a strong growth against the 140 existing units prior to its disclosure by Federal Government of Brazil, in 2005. The Federal Institutes of Education, Science and Technology have been performing the expansion while experiencing the shortcomings and challenges of units still in development, created in previous phases of the Plan. The quality of the services of these institutions has been evaluated by the control bodies, which require the submission of performance indicators in annual management reports of institutions under their jurisdiction. In this context of expansion process, particularly, is desirable to identify possible changes in quality standards. Thus, this research was motivated by the following problem: there was difference in the performance of the Federal Institutes of Education, Science and Technology after the inauguration of the first units of phase II of the Expansion Plan of the Federal Network of Vocational Education? This is an exploratory-descriptive, ex-post-facto, quantitative approach research, which aims to contribute to the knowledge of the impact of the expansion of the Federal Network. The data were collected from 12 indicators presented in management reports of 38 Federal Institutes through years 2007 to 2011 to evaluate the performances using descriptive statistical techniques. The indicators were analyzed in both consolidated and open manners by the following perspectives: country region, growth of instruction units and institutions origin. Was also performed a multivariate analysis of clusters in order to identify excellence groups of Institutes. The results showed differences in the expansion plan s development among Brazilian regions, both in terms of infrastructure and academic indicators, with better results in the Midwest and South, and that there are differentiated profiles of institutes as its origin, where the best quality indicators occur in those originated by integration of different educational institutions. Still, were identified two excellence groups, with emphasis on academic management, human resources and expansion

Avaliação da Qualidade da Água do rio Pitimbu

The Pitimbu River Basin is concern reason, therefore this is one of the mains freshwater sources for the Natal city supplying. The Pitimbu waters river flow into Jiqui pond, as the main supplier of this, that supplies 16% of Natal population and there is a bigger importance despite the supplying of a parcel of Natal city made joining underground waters with the water proceeding from the Jiqui pond, being used for dilution waters of contaminated wells with nitrate. Even with the importance of the Pitimbu, there is a strong pressure of occupation of its edge according to a critical urban growth, becoming the situation worse and increasing the necessity of management of the use and occupation of the ground and keeping the control of the prompt pollution, as punctual as diffuse. There are many studies about Pitimbu River Basin, however they summarize themselves to some months or even in a few years. This work, that gathers these information, increasing the amplitude and making possible an evaluation of the attitude of the water in a period extended for an evaluation of values of variable quality of water referring to the standards, that usually happens about the variable frequency distribution, central tendency and measures of dispersion, as the coefficient of variation, coefficient of skewness and the coefficient of determination of certain variable on another one. This work to evaluates the quality conditions of the Pitimbu river waters by analyzing thirty five (35) variables Physical, chemical and biological in eight (8) points of water course since 1993 to 2007. Given this situation, all knowledge about the waters quality conditions obtained in this work, is a strong subsidy for management of use and ground occupation, considering the river basin as territorial unit of management, and as the water is public good domain, being a priority human use, It is necessary to guarantee to current and the future generations available water resources in appropriate standards of quality as the established standard and identifying possible reasons of pollution through statistics analysis

Avaliação da relação entre qualidade de sono e uma intervenção com jogos para o desempenho de crianças e adolescentes

The sleep is an active brain process that allows the efficient realization of daily tasks. The changes on sleep patterns may influence the different cognitive processes performance. Many recent studies show the possibility of cognitive performance improvement, through the cognitive training with the use of computer games. The question is if these interventions may be influenced by the sleep quality. Thus, we evaluated the sleep quality effect about the efficacy of an intervention with computers games based on the working memory and attention for a cognitive performance training of elementary school students. The sample was constituted by 42 students with average age of 10,43 years old (SD=1,23), with 22 male participants and 20 female participants. We used to evaluate the sleep with the parents a sleep questionnaire, a sleep diary and the Sleep Behavior Questionnaire. In regard to intervention, the subjectives were distributed in an experimental and in a control group, both with 21 participants. In the first group occurred the intervention that consisted in the working memory and attention training with two cognitive tasks (Safari e Brain Workshop) during 30 daily minutes, for a 6 weeks period. In an equal period, the students from the control group should reproduce an artwork using drawing software. To evaluate the cognitive performance we applied before and after the intervention period the Wechsler Intelligence Scale for Children (WISC-III). The results showed that in both the groups the performance of the intelligence, working memory, attention and visuospatial skills was below of the mean. The cognitive processes evaluated after of intervention in the experimental group had a performance significantly higher in the Perceptual Reasoning Index (t = -6,24; p < 0,01) and in the Full Scale IQ (t = -5,09; p < 0,01) and Performance IQ (t = -6,52; p < 0,01), suggesting a improvement on the visuospatial skills, attention, working memory and processing speed. On the control group, the performance was significantly higher in the Coding subtest (t = -5,38; p< 0,01) and in the Perceptual Reasoning Index (t = -3,66; p = 0,01), suggesting a improvement on the visuospatial skills and attention. The mean obtained with the Sleep Behavior Questionnaire was 53,76 (SD=14,96) for an experimental group and 61,19 (SD=12,82) for a control group, indicating tendency for a bad sleep quality in that last one. Not only during the first days, but also in the last fifteen days of the intervention we verified in the two groups an adequate time to sleep, duration and regularity, in the weekdays and on the weekends. We didn t find significant differences between the two groups in none of the sleep variables. We verified statistically meaningful improvement on the performance of the experimental group with the intervention in the two games. We didn t verify significant correlations between the games performance index and in the sleep variables of the experimental group individuals. We verified significant correlations among the performance on the Brain Workshop and the Cubes subtest, the Perceptual Reasoning Index and the Scale Performance IQ, suggesting that the significant improvement of the visuospatial skills and of the attention was correlated with the performance in the Brain Workshop. Although the absence of correlations with the performance in the Safari, possibly it also has relieved in the improvement of the cognitive performance. The findings support the hypothesis that the computer games might be a satisfactory tool for the improvement of the performance in visuospatial skills and attention. This can be resulted of the insertion of visuospatial stimulations in the task, for example, graphical elements with thematic for children that increase the interest. The IQ below mean the individuals might have influenced the improvement absence on the cognitive processes like the working memory with games. Moreover, it wasn t verified a relation between the sleep quality and the intervention efficacy. It might have been influenced by the n of the sample. Future studies must focalize in the improvement of the effect of the interventions with games

Avaliação do acesso aos serviços de reabilitação física para vítimas de acidentes de trânsito: caminhos para melhoria da qualidade do sistema de saúde

The Physical Rehabilitation services (PR) are of fundamental importance in combating the global epidemic of Traffic Accidents (TA). Considering the numerous physical and social consequences of the survivors, quality problems in access to PR are a hazard to recovery of victims. It is necessary to improve the management of quality of services, assessing priority dimensions and intervening in their causes, to ensure rehabilitation available in time and suitable conditions. This study aimed to identify barriers to access to rehabilitation considering the perception of TA victims and professionals. The aim is also to estimate the access to rehabilitation and their associated factors. This is a qualitative and quantitative study of exploratory nature developed in Natal / RN with semi-structured interviews with 19 health professionals and telephone survey to 155 victims of traffic accidents. To explore barriers to access the speeches were transcribed and analyzed using the Alceste software (version 4.9). During the interviews used the following guiding question: “What barriers hinder or prevent access to physical rehabilitation for victims of traffic accidents?”. The names of classes and axes resulting from Alceste was performed by ad hoc query to three external researchers with subsequent consensus of the most representative name of analysis. We conducted multivariate analysis of the influence of the variables of the accident, sociodemographic, clinical and assistance on access to rehabilitation. Associations with p <0.20 in the bivariate analysis were submitted to logistic regression, step by step, with p <0.05 and confidence interval (CI) of 95%. The main barriers identified were: “Bureaucratic regulation”, “Long time to start rehabilitation”, “No post-surgery referral” and “inefficiency of public services”. These barriers were divided into a theoretical model built from the cause-effect diagram, in which we observed that insufficient access to rehabilitation is the product of causes related to organizational structure, work processes, professional and patients. Was constructed two logistic regression models: “General access to rehabilitation” and “Access to rehabilitation to public service”. 51.6% of patients had access to rehabilitation, and 32.9% in public and 17.9% in the private sector. The regression model “General access to rehabilitation” included the variables Income (OR:3.7), Informal Employment (OR:0.11), Unemployment (OR:0.15), Perceived Need for PR (OR:10) and Referral (OR: 27.5). The model “Access to rehabilitation in the public service” was represented by the “Referral to Public Service” (OR: 23.0) and “Private Health Plan” (OR: 0.07). Despite the known influence of social determinants on access to health services, a situation difficult to control by the public administration, this study found that the organizational and bureaucratic procedures established in health care greatly determine access to rehabilitation. Access difficulties show the seriousness of the problem and the factors suggest the need for improvements in comprehensive care for TA survivors and avoid unnecessary prolongation of the suffering of the victims of this epidemic.