48 resultados para Sobrecarga.
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Urinary incontinence (UI) is a geriatric syndrome that is especially prevalent in institutionalized individuals, and that causes economic and social impacts derived from treatment costs and overload of caregiver. UI also entails physical consequences to the health of the elderly, such as urinary tract infections or pressure ulcers, among other health problems. However, the existing national research on this condition is still scarce and comprises serious methodological biases. Therefore, the objective of this study is to determine the prevalence of urinary incontinence and associated factors in institutionalized elderly. A cross-sectional study is presented herein, conducted between October and December, 2013 and carried out in 10 nursing homes in the city of Natal (Northeast Brazil). UI was verified through the program Minimum Data Set version 3.0, which was also used to assess fecal incontinence, urinary devices and UI control programs. Data collection included sociodemographic information, UI characterization, as well as variables related to the institution itself and to health conditions (comorbidities, medication, pelvic floor surgery, Barthel Index for functional capacity and Pfeiffer test for cognitive status). Bivariate analysis was performed using the Chi-Square Test (or Fisher‟s Exact Test) and the Linear Chi-Square Test, calculating the prevalence ratio with 95% confidence interval. Variables with p value under 0.20 were included in the multivariate analysis, which was performed using the Stepwise Forward logistic regression. The inclusion of variables in the final model depended on the likelihood ratio test, absence of multicollinearity and on the Hosmer-Lemeshow test. A statistical significance level of 0.05 was considered. Six (1.8%) hospitalized elderly, one individual in palliative care (0.3%) and one (0.3%) individual under the age of 60 were excluded from the study. The final sample consisted of 321 elderly, mostly females, with a mean age of 81.5 years. The prevalence of UI was 59.43% and the final model revealed statistically a significant association between UI and white race, physical inactivity, stroke, mobility constraints and cognitive decline. The most frequent UI type was functional UI due to physical or cognitive disability, and incontinence control measures were applied only to a minority of residents (approximately 8%). It is concluded that UI is a health issue that affects more than half of the institutionalized elderly, and is associated with white race, physical inactivity, stroke and other geriatric syndromes such as immobility and cognitive disability. Most of these associated factors are modifiable and therefore the findings of this study highlight the importance of UI prevention and treatment in nursing homes, which include general measures, such as physical and psychosocial activities, and specific measures, such as prompted voiding
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On the last years, several middleware platforms for Wireless Sensor Networks (WSN) were proposed. Most of these platforms does not consider issues of how integrate components from generic middleware architectures. Many requirements need to be considered in a middleware design for WSN and the design, in this case, it is possibility to modify the source code of the middleware without changing the external behavior of the middleware. Thus, it is desired that there is a middleware generic architecture that is able to offer an optimal configuration according to the requirements of the application. The adoption of middleware based in component model consists of a promising approach because it allows a better abstraction, low coupling, modularization and management features built-in middleware. Another problem present in current middleware consists of treatment of interoperability with external networks to sensor networks, such as Web. Most current middleware lacks the functionality to access the data provided by the WSN via the World Wide Web in order to treat these data as Web resources, and they can be accessed through protocols already adopted the World Wide Web. Thus, this work presents the Midgard, a component-based middleware specifically designed for WSNs, which adopts the architectural patterns microkernel and REST. The microkernel architectural complements the component model, since microkernel can be understood as a component that encapsulates the core system and it is responsible for initializing the core services only when needed, as well as remove them when are no more needed. Already REST defines a standardized way of communication between different applications based on standards adopted by the Web and enables him to treat WSN data as web resources, allowing them to be accessed through protocol already adopted in the World Wide Web. The main goals of Midgard are: (i) to provide easy Web access to data generated by WSN, exposing such data as Web resources, following the principles of Web of Things paradigm and (ii) to provide WSN application developer with capabilities to instantiate only specific services required by the application, thus generating a customized middleware and saving node resources. The Midgard allows use the WSN as Web resources and still provide a cohesive and weakly coupled software architecture, addressing interoperability and customization. In addition, Midgard provides two services needed for most WSN applications: (i) configuration and (ii) inspection and adaptation services. New services can be implemented by others and easily incorporated into the middleware, because of its flexible and extensible architecture. According to the assessment, the Midgard provides interoperability between the WSN and external networks, such as web, as well as between different applications within a single WSN. In addition, we assessed the memory consumption, the application image size, the size of messages exchanged in the network, and response time, overhead and scalability on Midgard. During the evaluation, the Midgard proved satisfies their goals and shown to be scalable without consuming resources prohibitively
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Logic courses represent a pedagogical challenge and the recorded number of cases of failures and of discontinuity in them is often high. Amont other difficulties, students face a cognitive overload to understand logical concepts in a relevant way. On that track, computational tools for learning are resources that help both in alleviating the cognitive overload scenarios and in allowing for the practical experimenting with theoretical concepts. The present study proposes an interactive tutorial, namely the TryLogic, aimed at teaching to solve logical conjectures either by proofs or refutations. The tool was developed from the architecture of the tool TryOcaml, through support of the communication of the web interface ProofWeb in accessing the proof assistant Coq. The goals of TryLogic are: (1) presenting a set of lessons for applying heuristic strategies in solving problems set in Propositional Logic; (2) stepwise organizing the exposition of concepts related to Natural Deduction and to Propositional Semantics in sequential steps; (3) providing interactive tasks to the students. The present study also aims at: presenting our implementation of a formal system for refutation; describing the integration of our infrastructure with the Virtual Learning Environment Moodle through the IMS Learning Tools Interoperability specification; presenting the Conjecture Generator that works for the tasks involving proving and refuting; and, finally to evaluate the learning experience of Logic students through the application of the conjecture solving task associated to the use of the TryLogic
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The Araripe Basin is located over Precambrian terrains of the Borborema Province, being part of Northeast Brazil inner basins. Its origin is related to the fragmentation of the Gondwana supercontinent and consequently opening of South Atlantic during early Cretaceous. The basin has a sedimentary infill encompassing four distinct evolution stages, comprising Paleozoic syneclisis, pre-rift, rift and post-rift. The target of this study comprises the post-rift section of the basin focusing deformational styles which affect evaporates from Ipubi Member of the Santana Formation, which is composed by gypsum and anidrite layers interbedded with shales. These units occur widespread across the basin. In the central part of the basin, near Nova Olinda-Santana do Cariri, evaporites are affected by an essentialy brittle deformation tipified by fibrous gypsum filled fractures, cutting massive layers of gypsum and anidrite. Veins with variable orientations and dips are observed in the region distributed over three main populations: i) a dominant NWSE with shallow to moderate NE dipping population, consisting of gypsum filled veins in which fibers are normal to vein walls; i) NE-SW veins with moderate SE dips containing subhorizontal growth fibers; and iii) N-S veins with shallow E-W dips with fibers oblique to vein walls. In the west portion of the basin, near Trindade-Ipubi-Araripina towns, evaporate layers are dominantly constituted by gypsum/anidrite finely stratified, showing a minor density of veins. These layers are affected by a unique style of deformation, more ductile, typified by gentle to open horizontal normal folding with several tens of meters length and with double plunging NW-SE or NE-SW hinges, configuring domic features. In detail, gypsum/anidrite laminae are affected by metre to decimeter scale close to tight folding, usually kinked, with broken hinges, locally turning into box folds. Veins show NE-SW main directions with shallow NE dips, growth fibers are parallel to vein walls, constituting slickenfibers. This region is marked by faults that affect Araripina Formation with NW-SE, NE-SW and E-W directions. The main structural styles and general orientations of structures which affected the post-rift section of Araripe Basin yielded important kinematic information analysis which led us to infer a E-W to NE-SW extension direction to the northeastern part of the Basin, whereas in the southeastern part, extension occurred in N-S direction. Thus, it was possible to determine a regional kinematic setting, through this analysis, characterizing a NE-SW to ENE-WSW system for the post-rift section, which is compatible with the tension settings for the Sout American Plate since Albian. Local variations at the fluid pressure linked (or not) to sedimentary overload variation define local tension settings. This way, at the northeastern portion of the basin, the post-rift deformation was governed by a setting which σ 1 is sub-horizontal trending NE-SW and, σ 3 is sub-vertical, emphasizing a reverse fault situation. At the southwestern portion however there was characterized a strike slip fault setting, featuring σ 1 trending ENEWSW and σ3 trending NNW-SSE
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The Cumuruxatiba basin is located at the southern coast State of Bahia in northeastern of Brazil. This basin was formed in distensional context, with rifting and subsequent thermal phase during Neocomian to late Cretaceous. At Cenozoic ages, the Abrolhos magmatism occurs in the basin with peaks during the Paleocene and Eocene. In this period, there was a kinematic inversion in the basin represented by folds related to reverse faults. Structural restoration of regional 2D seismic sections revealed that most of the deformation was concentrated at the beginning of the Cenozoic time with the peak at the Lower Eocene. The post-Eocene is marked by a decrease of strain rate to the present. The 3D structural modeling revealed a fold belt (trending EW to NE-SW) accommodating the deformation between the Royal Charlotte and Sulphur Minerva volcanic highs. The volcanic eruptions have caused a differential overburden on the borders of the basin. This acted as the trigger for halokinesis, as demonstrated by physical modeling in literature. Consequently, the deformation tends to be higher in the edges of the basin. The volcanic rocks occur mainly as concordant structures (sills) in the syn-tectonic sediment deposition showing a concomitant deformation. The isopach maps and diagrams of axis orientation of deformation revealed that most of the folds were activated and reactivated at different times during the Cenozoic. The folds exhibit diverse kinematic patterns over time as response to behavior of adjacent volcanic highs. These interpretations allied with information on the petroleum system of the basin are important in mapping the prospects for hydrocarbons
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Introdução: A obesidade infantil apresenta incidência crescente e as possíveis comorbidades, como alteração da função respiratória, estão cada vez mais presente nessa faixa etária. O tecido adiposo impõe carga ao sistema respiratório o que leva a um padrão restritivo. Essa condição sofre alterações com as mudanças posturais, onde a gravidade influencia o padrão respiratório de acordo com o posicionamento adotado. Objetivo: Avaliar a distribuição dos volumes total e regional e o movimento tóracoabdominal de crianças e adolescentes que estão acima do peso nas posturas supino e sentado. Métodos: Cinqüenta e duas crianças/adolescentes (8-12 anos) divididas em três grupos: Grupo Obeso (GO=22); Grupo Sobrepeso (GSP=9); Grupo Controle (GC=21) foram avaliadas quanto às medidas antropométricas, teste de função pulmonar, exame das pressões respiratórias máxima e a pletismografia optoeletrônica em duas posturas, supino e sentado, durante a respiração tranquila. Resultados: As crianças que estão obesas apresentaram maiores valores em relação ao GSP e GC das seguintes variáveis espirométricas: volume expiratório forçado no primeiro segundo (VEF1) (p<0.05) e capacidade vital forçada (CVF) (p<0.01). No exame de manovacuometria o GO apresentou um aumento na pressão inspiratória máxima (PImáx) (p<0.01) em comparação com os outros grupos. Quanto à distribuição do volume corrente, o GO possui uma maior contribuição do compartimento abdominal (AB) na postura supina (p<0.05) em relação ao GC e GSP, enquanto que na postura sentada os grupos não diferiram em relação à distribuição dos volumes. O GO apresentou maior assincronia na postura supina (p<0.05) e maior velocidade de encurtamento (p<0.05) em relação os outros grupos. Conclusão: A obesidade em crianças/adolescentes não provoca prejuízos na função pulmonar, incrementa a força muscular inspiratória, aumenta a participação do compartimento AB e a assincronia no MTA na postura em supino, conclui-se que a postura supina associada à obesidade provoca aumento da sobrecarga do diafragma, desfavorecendo o desempenho do sistema respiratório.
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The present study aimed to understand the experience of being a family caregiver of a patient with Cerebrovascular Accident (CVA). The relevance of the study is to prove existence of a large number of caregivers of incapacitated patients, due to the CVA and it is not an academic research object, according to the literature. It is a qualitative research, which the guiding principle is the oral history of life, according to the theoretical foundation and operating of Meihy. Therefore, the following steps were highlighted: the target community, composed of all family caregivers of CVA patients; the colony, composed by family caregivers of CVA patients assisted by Home Care Service (HCS) of the Hospital José Pedro Bezerra (HJPB), in the city of Natal/RN; the network was composed of six caregivers who met the criteria for inclusion, and as zero point the first volunteer group. The population was composed of all family caregivers of patients attended by the HCS, of the HJPB having been addressed through interviews. For the empirical research there was the consent of that institution and approval by the Ethics Committee in Research of the Federal University of Rio Grande do Norte as CAAE 24569413.0.0000.5537 and, above all, with the acquiescence of employees in participating in the investigation, signing an informed consent. Of the empirical material, five categories of analysis were identified: the sense of being a caregiver; what has changed in the life of the caregiver; the feelings emerge in the relationship of care; the distance from family and friends; difficulties faced by the caregiver. The results show that the caregiver's life goes through profound transformations within the family as well as in all spheres of life. For the caregivers, assuming the care of a relative with CVA means renunciation and donation, compromising sometimes the individual projects and the family as a whole. In addition, they point out the confrontation of difficulties within the the assistance and humanization in healthcare, information, physical and emotional overload, as well as financial problems. Despite all the adversities that compromise the caregiver's life, it was possible to identify attitudes of resilience among caregivers, making them their daily life less strenuous and with more lightness. It is expected, therefore, that this research can contribute to a better orientation of professionals with the caregivers
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The proposal of teaching-service integration from work experience brings a challenge to the professionals involved in health services: to combine their healthcare practice to the preparation of new professionals in accordance with the national health model. In Recife, the assistance network is known as school network, since it provides all its health equipment for Higher Education Institutions, in special for professionals who work as preceptors, making this activity an important component of the services network. The objective of the present study was to analyze preceptorship experience herein Multidisciplinary Residences in Health in the look of health professionals. This is a qualitative descriptive study, involving physicians, dentists, and nurses that have worked as preceptors for at least two years in multidisciplinary residency linked to two Higher Education Institutions. A semistructured interview was used as research instrument and data were processed by using the software Alceste 4.9. Results indicated four semantic classes which were divided into two axis. Axis 1, composed of class 4, and Axis 2, composed of classes 3, 2 and 1. Categorization considered the relation between classes. It was observed that in class 4 work overload is a dilemma for professional participation in preceptorship. This is noted by the words manage, time, patient, give, and complicated. However, it is also observed that the preceptorship involves positive learning and teaching actions, reinforced by the words say, explain, and discuss. Class 2 shows the preceptorship as an experience exchange, a positive moment that provides theoretical upgrade to the preceptor, associated to the professional practices performed by the binominal preceptor-student in health services and communities. In this perspective, everyone is benefited since preceptorship is structured according to dynamic aspects of knowledge, experienced in settings permeated by people´s health necessities. In class 3, potentialities of this practice are shown, and personal compromise is the main reason of acting as a preceptor in this network of education/attention, demonstrated in the words reason, formation, to like and professionals. Last, but not the least, class 1 suggests the importance of preceptorship and one of the strategies to create the National Politics of Humanization, from the teachingservice-community integration, observed in the words: arrives, university, fundamental, manner, partnership, service, and student. Besides, it rates perspectives and challenges for the improvement of the preceptorship in health services. Integrating teaching and service can enhance the proposals of changes concerning the healthcare model practiced in services, but this relation is still superficial. The preceptor is an actor in action, playing real life roles, and that is when he becomes essential to seek training with the profile defended in the proposed training of a professional who is capable of learning to learn
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Data Visualization is widely used to facilitate the comprehension of information and find relationships between data. One of the most widely used techniques for multivariate data (4 or more variables) visualization is the 2D scatterplot. This technique associates each data item to a visual mark in the following way: two variables are mapped to Cartesian coordinates so that a visual mark can be placed on the Cartesian plane; the others variables are mapped gradually to visual properties of the mark, such as size, color, shape, among others. As the number of variables to be visualized increases, the amount of visual properties associated to the mark increases as well. As a result, the complexity of the final visualization is higher. However, increasing the complexity of the visualization does not necessarily implies a better visualization and, sometimes, it provides an inverse situation, producing a visually polluted and confusing visualization—this problem is called visual properties overload. This work aims to investigate whether it is possible to work around the overload of the visual channel and improve insight about multivariate data visualized through a modification in the 2D scatterplot technique. In this modification, we map the variables from data items to multisensoriy marks. These marks are composed not only by visual properties, but haptic properties, such as vibration, viscosity and elastic resistance, as well. We believed that this approach could ease the insight process, through the transposition of properties from the visual channel to the haptic channel. The hypothesis was verified through experiments, in which we have analyzed (a) the accuracy of the answers; (b) response time; and (c) the grade of personal satisfaction with the proposed approach. However, the hypothesis was not validated. The results suggest that there is an equivalence between the investigated visual and haptic properties in all analyzed aspects, though in strictly numeric terms the multisensory visualization achieved better results in response time and personal satisfaction.
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Objective: Evaluate the work structure and process in Psychos ocial Care Centers (CAPS) and the professionals profile, the satisfaction, conditions and work overload. Methods: Cross - sectional study conducted in five CAPS in Campina Grande city. The study sample consisted of five coordinators, 42 graduate professional s, 26 mid - level (technical and auxiliary nurses, and caregivers), and the medical records pertaining to 413 users followed up. Data were collected using validated questionnaires (CAPSUL - rating CAPS in southern Brazil) and adapted to the study, between July and October 2014. The questionnaires were double entered and submitted to validation in the sub - program “Validate Epi Info 3.5.4” , used along with the “SPSS 17.0” for processing the statistical analyzes. Measures of central tendency and dispersion were ap plied to the descriptive analyzes; “Fisher's” exact test to check the CAPS impact on hospital admissions and the “Bonferroni” adjusted to verify the diagnoses according to sex. 5% significance level was adopted. The study was approved by the Ethics Committ ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of 05.30.2014. Results: From the structure analysis were identified contextual factors that influenced the work process of CAPS professionals, such as: deficiencies with regard to h uman resources; forms of health professionals employment and qualifications; temporary contract existence. As to process dimension, it was found that the home visits performance by health professionals shows to be ineffective, given its insufficiency and i rregularity, which can be explained by the high demand, reduced staff and transportation lack. It was low coverage of items inherent to Therapeutic Individual Project, as the income generation program, insertion at work and home visit. The reference and co unter reference flow are still not satisfactorily organized. There was statistically significant difference for the diagnosis, with a predominance of mood disorders related to stress among women and those related to alcohol and other drugs among men (p <0. 05). There was an association between the degree of health professionals satisfaction and working conditions, overload and factors related to the content and working conditions, the security measures, comfort and CAPS appearance, contact between the teams and users, families treatment by the teams, temporary employment relationship. Conclusion: The data collected indicate the need for the CAPS organization through increased investments in the sector in order to enhance the infrastructure as potentiating el ement of practices with a view to changing the care model for mental health proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to better planning in CAPS unit management, with another tool to improve the dimensions involving the structure and the professional work process and improve this mental health care model.
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This research aims to systematize a proposal of developing a mobile tablet application in order to help implementing the Semantic Differential technique – SD, under the approach of Participatory Design. In 1975, Osgood et al. created the Semantic Differential technique. Since then, many experiments use it to measure the affective perception of individuals concerning objects and concepts by means of compounded scales of bipolar adjectives, based on the theoretical models that support the technique: the conductible, spatial and metric models. During the application of the technique with potential users, the researcher must simultaneously manage several contexts, that is, audio recorder, when authorized, and observe and record spontaneous reports of the respondent. It is noticeable that often occurs a cognitive overload during this event. Thus, the use of a single application whose interface is assigned to its users and respondents could assist researchers in applying the SD technique. This research aimed to understand the processes inherent to the task of implementing the Semantic Differential technique and obeyed the following steps: a) training of users, b) background questionnaire c) interview with Focus Group, and d) cooperative evaluation. Besides these procedures, one can also observe the degrees of facilitation or difficulty concerning the use of the conventional model, which is the development and application of scales with the aid of printed material, pencil, pens, clipboards, and recorder software for editing the document and data analysis. This paper comprises reactions and impressions from the experiences of users of SD technique. Considering the data recollected from the user’s observation, the hypothesis of the experiment proved to be right. It means that the development of the application for mobile tablet employing the technique of Semantic Differential is viable, since it assembles all the steps in one only tool, increases the accomplishment of the task between user/researcher and user/respondent resulting in their mutual satisfaction.
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The interprofessional education still represents a great challenge for the health education. This paper aims at implementing the Interprofessional Cardiology Visit (VIC, acronym in Portuguese) as a teaching strategy for the interprofessional education in the undergraduate and graduate courses of UFRN (Federal University of Rio Grande do Norte, acronym in Portuguese). It is a prospective and exploratory study held from March 2013 to November 2014, in the cardiology department of HUOL (Portuguese acronym for Onofre Lopes University Hospital), including health professionals from the mentioned hospital (doctor, psycologist, physiotherapist, dentist, social assistant, nutritionist, pharmacist and nurse), undergraduate and graduate students from the health courses of UFRN. The study happened in three parts: interprofessional activity planning; Implementation of the activity “Interprofessional Cardiology Visit (VIC)”; and Activity evaluation, this last one was made through focus groups. The process of planning and implementation of the VIC was described during the implementation phase: 60 meetings in which 1324 participants discussed one specific patient per meeting. After each case presentation, an interprofessional discussion was held, pointing out each professional’s specific point of view towards improving the overall care of that discussed patient. From the focus group analysis, five categories emerged: Recognition of previous participations in interprofessional activities; Conceptual vision of interprofessional activities; Impacts of the VIC to the patient’s care; Contributions of VIC to the professional training; and Challenges of VIC continuation. The making and planning of VIC process has reached its goals, despite of some health professional’s participation not being systematic due to work overload, such as the nurses’ case, as well as schedule difficulties. The VIC was praised as a successful experience and considered an initiative with positive impact for improving the care of patients with heart diseases. It is clear, from analyzing the discourses, that the VIC is a strategy which positively impacts both the care and the teaching. However, some difficulties remain, such as the lack of human resources and the challenge of making it systematic.
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The process mapping is an important tool in the management of organizations, allowing better levels of productivity, quality and reciprocity concerning the implementation and decision-making. It benefits in a clear way the process organization and assures the manager a macro vision of the system. In this sense, the objective of this study is to describe the mapping process as it occurs in the Januario Cicco Maternity School–MEJC. The bibliographic and descriptive research included interviews, observations and researches in many databases. The study analyzed the limiting points of the detected flow trying to find a better comprehension of the flow of patients in the maternity in order to offer the gestors the information necessary to improve the quality of the assistance as well as a general view of the flow of patients and any change detected there. As a result, we believe that the process mapping may become a relevant factor to the organizational management of MEJC, in view that it is an element that can contribute to ease up the management of information studied, considering that the perfect change of information inside a complex system will produce improvements in all spheres of this institution.
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The spread of wireless networks and growing proliferation of mobile devices require the development of mobility control mechanisms to support the different demands of traffic in different network conditions. A major obstacle to developing this kind of technology is the complexity involved in handling all the information about the large number of Moving Objects (MO), as well as the entire signaling overhead required to manage these procedures in the network. Despite several initiatives have been proposed by the scientific community to address this issue they have not proved to be effective since they depend on the particular request of the MO that is responsible for triggering the mobility process. Moreover, they are often only guided by wireless medium statistics, such as Received Signal Strength Indicator (RSSI) of the candidate Point of Attachment (PoA). Thus, this work seeks to develop, evaluate and validate a sophisticated communication infrastructure for Wireless Networking for Moving Objects (WiNeMO) systems by making use of the flexibility provided by the Software-Defined Networking (SDN) paradigm, where network functions are easily and efficiently deployed by integrating OpenFlow and IEEE 802.21 standards. For purposes of benchmarking, the analysis was conducted in the control and data planes aspects, which demonstrate that the proposal significantly outperforms typical IPbased SDN and QoS-enabled capabilities, by allowing the network to handle the multimedia traffic with optimal Quality of Service (QoS) transport and acceptable Quality of Experience (QoE) over time.
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COMASSETTO, Isabel, ENDERS, Bertha Cruz. Fenômeno vivido por familiares de pacientes internados em Unidade de Terapia Intensiva. Revista Gaúcha de Enfermagem., Porto Alegre(RS), v.30,n., p.46-53. Mar. 2009. Disponivel em: < http://www.seer.ufrgs.br/index.php/RevistaGauchadeEnfermagem/search/results>.