69 resultados para Coração - Hipertrofia - Hipertensão
Resumo:
The Nossa Senhora da Conceição Seminary, installed in 1894, by Dom Adauto Aurélio de Miranda Henriques, first Paraíba Bishop, and the Episcopal Seminary of the Sagrado Coração de Jesus, implanted in 1913, by Dom José Thomas Gomes da Silva, first Aracaju s Bishop diocese, were created as a result of lack of an official religious process proposed by the Brazilian Republic Proclamation, in 1889. With the appoint to enlarge the number of priests and change the image of the priest married and unrolled who used to identify the Catholic Church in the colonial and imperial Brazil. Such bishops developed into intellectuals in the government, dioceses and formation priest houses. I take as a study object, for this doctorate paper, the academic formation and priesthood developed in theses seminaries, from 1894 to 1933, once 1894 the year of João Pessoa Creation Seminar that was implied the Minor Course (preparation) and the Major one (built by Philosophy and God related studies) and the research limit year of 1933, is concerned about the Major Sergipe Seminary ending, which was created and has worked offering the Minor and Major courses, from 1913 to 1933. Showing the teaching models that guided and leaded the priest formation, referred as Seminaries, and the application result is the objective of this investigation. To comprehend the teaching models seminaries studied, my research line is the Catholic Church theme and priest formation in Brazil. In front of the object and the objective desired, I chose the historical comparative method and the scholars modals notions of Araujo de Barros (2004) and the Sirinelli intellectuals (1996). Such references allowed me to analyze the formation given in the seminary and seminarian participation and actions, included the sequence after the scholars formation. The thesis defended is that the teaching model developed in the Brazilian Seminaries, created after a non official religious process in the Brazilian government, deal with a model of one unique center (Seminary formation and aim pre arranged by Santa Sé), although adapted, presuming the local reality and formation structure (privileged not only spiritual and moral speaking, but intellectual also), was it responsible for intellectuals generations (teachers priests, educationalist priest, journalists priests and so on) that boost the education in Brazil. During the Republic first three decades, when, in thesis, the Government was becoming free religion, i.e., the government did not subsidize the Church anymore, and the Government, among others aspects, did not received any Church care to help the public teaching in the country. The investigation reveled accede, by bishops and their followers, such as by the Concílio de Trento pre concept, or by the others ideas, leading by the priests formation in Seminaries. By creating and stalling diocese Seminary, Bishop Dom Adauto and Dom José went further their functions, by the time they built inside themselves a teaching model thought from the main pedagogic logic, based on several religious exercises, moral and ethic, considered by themselves several knowledge connected to humanity, philosophy and God related studies). Following clearly rationalism principle (the way of teaching, which each subject has its own teacher and this class get together students with the same knowledge, regardless of age) and efficiency (trying to teach the whole content in each class), the Seminaries researched developed a whole education, allowed the structure of a spiritual education, moral and intellectual, for a quality developed by priests, including different levels that they used to performance. Their bottom line, actions and priest matter achievement allowed their broad fulfillment, in the way that priests matter were associated with cultural, educational, welfare assistance, at last, intellectuals
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Prétendant contribuer au progrès sur le champ épistémologique de l éducation environnementale, nous avons défini l objetif principal de cette recherche visant construire et évaluer initialement des structures éco-vécues appliquées aux sentiers écologiques interprétatifs dans des zones de protection environnementale. Pour conduire la tâche de l investigation écophénoménologique, l objectif présent a été déplié spécifiquement de la façon suivante: 1. Approfondir la discussion sur le rôle de l émotion et du sentiment dans l éducation. 2. Démarquer un trajet de sentier écologique du Parque das Dunas en identifiant des aires éco-sensorielles pour le développement du vécu écologique. 3. Construire des structures des vécus écologiques pour les environnements préalablement définis dans un sentier du Parque das Dunas. 4. Vivre l expérience des structures éco-vécues en tant qu éducateurs, visant leur validation méthodologique. 5. Présenter la conception de l éducation environnementale corpororalisée qui valorise les émotions et les sentiments dans les structures des éco-vécus. Pour orienter notre investigation écophénoménologique à fin de construire et évaluer des structures des éco-vécues appliquées aux sentiers écologiques interprétatifs, quelques présupposés ont été définis pour agir comme une boussole pendant toute notre promenade écologique: Du point de vue biologique, l amour est l émotion qui constitue le domaine des actions dans lequel l autre est accepté comme il est dans le présent, sans attente par rapport aux conséquences de l intimité, même si c est légitime de les attendre (Maturana e Verden-Zöller, 2004). Éduquer dans la biologie de l amour est s occuper du développement, de la pensée et des intelligences et, au même temps, éduquer l écoute du sentiment et l ouverture du coeur (Moraes, 2003). La corporéité est le siège radiant, le premier et le principal le critère éducationnel (Assmann, 1995). Les activités qui fluent, proportionnent la sensation de découverte, un sentiment créatif qui transpose l individu vers une nouvelle réalité (Csikszntmihalyi, 1992). Ressentir le sentiment fait exalter la portée des émotions (Damásio, 2004). L ethnographie et l écophénoménologie ont été les approches méthodologiques utilisées dans l étude. Onze éducateurs ont participé du processus de l expérience vécue et de l évaluation des structures éco-vécues construites dans la perspective d une Education Environnementale Corporalisée. Le développement de la conception d une Education Environnementale Corporalisée à partir du vécu sur les sentiers écologiques du Parque das Dunas, à Natal-RN, nous a amenés à structurer un système autopoïétique pour proposer des propriétés ou des principes configurant les intentions fondamentales d une Éducation Environnementale Corporalisée. Telle conception considère la métaphore de la Toile de la Corporéité vécue dans la Base de Recherche Corporéité et Éducation BACOR/UFRN et le phénomène de la ludopoïèse capable de faire émerger la joie de vivre la vie avec le sens de luminescence humaine. Associés à la Biologie de l amour, nous espérons pouvoir contribuer à la présence des émotions et des sentiments pour une perspective transdisciplinaire et corporalisée pour l Education Environnementale. Nous présentons cinq principes de guidage pour la concrétisation d une Education Environnementale Corporalisée: Ecopréservation, Ecoterritorialité, Ecoconectivité, Ecovaleur, Ecojouissance
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Quasi-experimental study, prospective with quantitative approach, performed at the Hospital do Coração in Natal, aimed at verified the existence of difference between the care given by health professionals to the patients under mechanical ventilation (MV) in the Intensive Care Unit, before and after an educative intervention. The population was of 31 professionals, with data collected between november 05 of 2007 to march 27 of 2008. The results show a yong population, female gender, middle level of education, nursing technique, working between 05 and 09 years on nursing profession, and 01 to 04 years on Intensive Care Unit; almost all, never had an kind of training over prevent pneumonia associated to mechanical ventilation; from those that had training, occur on the work place with duration from 12 to 24 hours. About endotracheal intubation, the cuff was tested with a sterilized syringe had a positive change after a educative intervention, increased from 75,0% to 100,0%; the sterile guide was used on 75,0% before and 100,0% after an educative intervention. Regarding endotracheal suction procedure, was not informed to the patient on 72,7% before, however was informed on 56,7% after; the hands was not previously washed 68,5% before, however was 63,3% after the procedure; mask was used on 74,2 % opportunities before and 76,7% after; the aspiration catheter had adequated size on 98,9% observation before and 100,0% after; the gaze was sterilized on 95,7% before and 100,0% after; the ventilator was connected to the patient during the aspiration intervals on 94,4% observation before and 100,0% after; the ambu bag was clean and protected on 76,1% before and 85,7% after; the aspiration catheter was discarded after be used on 98,9% before and 100,0% after; FIO2 was turned to the begging value on 32,9% observation before and 12,0% after; before the procedure 71,9% professions washed their hands and 73,3% after; before, notes of aspiration results were performed on 70,8% observation and 86,7% after. Regarding devices used on respiratory tract, aspirator flasks were not swapped on 84,6% observations before and 71,0% after; daily látex extention change was not performed on 93,6% observation before and 87,1% after; the ambu bag change was not performed on 50,0% observation before even if was duty or unprotected and on 75,8% opportunities was changed, after; nebulization was not prepared with sterile fluids or manipulated aseptically on 65,2% observation before, perhaps was on 71,7% after; before nebulizers were not changed on 65,2% observations, perhaps were on 60,9% after. Concerning ventilator breathing circuits, condense fluids cumulated on circuits were removed on 55,0% opportunities before, and 64,0% after; moisturizer was not filled with sterile water when already had small amount of liquid inside on 78,4% observations before, and 90,2% after; MV circuits were changed on 97,0% observations on presence of visible duty or when presents some kind of failure, before and 98,4% after. About body position, on 51,3% observations the decubitus position change were done before and 78,2% after; fowler position was maitened on 95,5% observations before and 98,2% after; Regarding respiratory physiotherapy, enteral diet was not interrupted before respiratory physiotherapy on 94,9% before and 90,0% after; respiratory physiotherapy devices were not disinfected or sterile on 69,6% observations before but they re on 60,0% after; before the cateter was not tested before introduction enteral diet or medications on 100,0% but after was done on 15,2%. About enteral feeding, intestine motility and measure of stomach contents were not done on 100,0% observations before, but was 15,2% after. We conclude that 05 of 07 valuated procedures in relation to MV, had a significant improvement on quality of care given after educative intervention, when compared before intervention
Resumo:
Analytical study of therapeutic nonrandomized intervention type, intra-group controlled, with the aim of analyzing the cost-effectiveness of compression therapy with manipulated Unna boot in relation to conventional therapy in the healing of venous ulcers (VU) of patients treated in ambulatory clinic. The study population was composed by patients with VU treated by angiologists in Surgical Clinic Ambulatory of the Onofre Lopes University Hospital (HUOL) with a sample of 18 patients. It obtained the assent of the HUOL Ethics in Research Committee (Protocol 276/09). Data collection was performed over a period of four months by the own master's student and 34 nursing students, through the application of the research instrument in the admission of patients to the study and in the ten subsequent evaluations, performed at the time of changing Unna boot, weekly, for a maximum period of 10 weeks. The data were analyzed with SPSS 15.0 software, using descriptive and inferential statistics, and presented as tables, charts and graphs. Among those surveyed, prevailed: females, mean age 57.6 years, low education and income levels, most retired, unemployed or off work, with the standing position more than six hours per day and up to eight hours daily of domestic or occupational activities. In health status profile of respondents there were predominantly sleep, rest and inadequate elevation of the lower limbs, no smoking and/or alcohol use, presence of hypertension and no use of drugs. Most presented the first VU for over 10 years, recurrences, present VU for more than five years, involvement of left leg, in malleolar and / or distal leg region, mild edema, hyperpigmentation, lipodermatosclerosis, telangiectasies, reticular and varicose veins, mild pain, serous exudate in moderate quantity, small lesions (up to 50cm2), with predominance of granulation tissue and / or epithelialization and demarcated, elevated and irregular borders, with crusts and macerated. Most patients reported that in the 10 weeks prior to admission, made bandages at home and / or Basic Health Unit and / or ambulatory, with nursing aides or technicians, daily, and on weekends or holidays, performed by patients themselves, using healing ointment on the lesion, being observed granulation / epithelialization and increase in VU prevalent in the 10 weeks of traditional treatment. After follow up with manipulated Unna boot, was observed a decrease of lesions in all study patients, with complete healing in 27.8% of those between 1 and 5 weeks of treatment, with satisfactory evolution of the lesions, pain and ankle and calf circumferences, and unsatisfactory development of the borders of ulcers, edema, sleep, rest and elevation of the lower limbs, especially in more chronic patients. Furthermore, patients who achieved total healing and exhibited the greatest percentage reduction of lesions had a higher number of wound healing factors (ρ = 0.01 and ρ = 0.027, respectively). The manipulated Unna boot showed better results in those patients with shorter duration of injury, leading them to a satisfactory outcome within a short period of treatment. After the cost-effectiveness analysis, we conclude that the manipulated Unna boot is more effective than conventional therapy in the healing process of VU and is more cost-effective in patients with shorter lesions (ρ = 0.001), shorter treatment (ρ = 0.000) and greater number of wound healing factors (ρ = 0.005).
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Although the records indicate the involvement of the City Christmas in the feeding system HiperDia, a survey conducted by the Health Ministry in 2004 found that the number of entries made in Natal was well below estimate. In order to understand the functioning of HiperDia, we performed this study to analyze the actions taken by the professionals involved in power system HiperDia in Natal / RN. The research has developed into a quantitative perspective, with the design of exploratory case study conducted in the health services that integrate the various levels of the organization who are directly involved with the process of system power HiperDia in Natal / RN , represented here by SMS, health districts and the Family Health Units in the period from August to October 2008.Study participants were 110 professionals, including nurses, physicians, operators, administrator and a coordinator. The survey results showed that feeding HiperDia in Natal was maintained mainly by health professionals and operators. Activities include carrying out the state registration, monitoring, and updating of data transfer routines. They report that the difficulties in the process of feeding data are related to the work of teams and / or lack of structure of the Program of Hypertension and Diabetes (HA and DM), the discontinuity of federal investments in improving the HiperDia and lack of training. We can see then that the process of feeding system on Christmas HiperDia therefore is developing the three levels (SMS, districts and health units), however is not matching the expectations established by MS, considering that the gaps the flow of information are undermining the end result of this process
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The demographic and epidemiological transition process caused by a declining in birth rates and in mortality, also changes occurred in morbidity and mortality is represented by the increasing of the aging population and the raising of chronic diseases. These diseases are characterized by multiple etiologies, risk factors, long latency period, a prolonged evolution, non-infectious origin and it has association with functional impairment and disability. Thus, elderly with chronic non-communicable disease has priority because they belong to a vulnerable group to get affection of comorbidities in aging, with increased demand and spending on health services. This study is aimed to analyse the understanding of elderly people with chronic non comunicable disease in the medium complexity service as a contribution to the improvement of health care in the city of Natal / RN. This is a descriptive and exploratory study with a quantitative approach, carried out at the Specialized Center for Elderly Health Care and at the Pescadores Hospital. The population was composed of 4,180 persons with a sample of 124 elderly aged above 60 years, attended in these medium complexity services. The instrument, a structured form, adapted from a questionnaire for monitoring risk and protective factors for chronic disease of the Ministry of Health. To collect data was was used the interview form containing demographic data, habits, health status and health care services. The results were processed using the Statistical Package for Social Science, version 18.0, analyzed by simple statistics. It was found that most seniors were female, predominantly between 70 and 74 years old, married, with a brown skin tone and Catholic religion, more than half had incomplete basic education, family income between one to two minimum wages and living with their families. Regarding the interviewers lifestyle, 94.4%, of them ate chicken and 97.6%, fruits, it was observed a reduction in smoking, alcoholism habits and physical activity according to the increasing age, 58.1 and 18.5% had insomnia18,5 % used sleeping pills. The elderly (51.6%) reported using services in times of sickness, seeking primary care at first (30.6%), 52% did not receive referral and was looking for free demand (38.7%). The most reported morbidity was hypertension, followed by musculoskeletal disorders. Regarding the difficulties in seeking health services, the delay in treatment and the waiting line were the most cited by the elderly. Almost all of them reported no activities to promote health in these services and those who received individual counseling on chronic diseases. Almost always, the health professionals who care of them, were mostly doctors followed by nurses. Based on the results presented, it is considered that the health services of medium complexity must undergone a more continuous dialogue with other attention level and focus on actions of health promotion and prevention. It is also recommended the necessity for qualified professionals to delivery health care to elderly and the implementation of protocols by a multidisciplinary health team, intending to provide better and continous care for the elderly with chronic diseases. The healthcare professionals who served them, were mostly physicians, followed by nurses. Through the results presented, it is considered that the medium complexity healthcare services need to perform a more continuous dialogue with the other levels of attention focusing attention to the health promotion and prevention actions. It is also recommended the necessity for qualified professionals to delivery healthcare for the elderly, in addition, a protocol implementation for the multidisciplinary health care team, to provide better care, and also the care continuity to elderly with chronic diseases
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The venous ulcer is an epidemiological problem of high prevalence, causing disability and dependence. Assess the tissue impairment level of patients with venous lesions, within a nursing referential, is relevant for the implementation of a directed assistance to specific clientele. Thus, this work aims to characterize the health status regarding the integrity the lower limbs skin of patients with venous ulcers, according to the of tissue integrity outcome indicators from the Nursing Outcomes Classification. A cross-sectional study conducted in a university hospital in Natal - Rio Grande do Norte. The sample consisted of 50 participants, selected through consecutive sampling. Data collection occurred through a interview and physical examination form and a operational definitions tool for indicators of the nursing Tissue Integrity outcome directed to patients with venous ulcer, applied from February to June 2012. Data analysis was done by descriptive statistics and nonparametric tests (Spearman, Kruskal-Wallis and Mann-Whitney tests). The project was approved by the Research Ethics Committee with protocol 608/11 and Presentation Certificate to Ethical Consideration No. 0038.0.294.000-11. The results were presented using three scientific articles derivatives of research. It was found that the indicators show moderate impairment, light and not impaired, as the median. The respondents had an average of 59.72 years, 66% female, 50% were retired, 60% with a partner, 44% had arterial hypertension, 26% allergies, 20% diabetes mellitus, 96% were sedentary, 14% drank alcohol and 6% were smokers. There was a statistically significant correlation of low intensity between age and hydration (p=0.032; rs=-0.304) and skin desquamation (p=0.026; rs=-0.316), family income and necrosis (p=0.012; rs=-0.353); Ankle Brachial Index and tissue perfusion (p=0,044; rs=-0,329); Diabetes Mellitus and texture (p=0.015) and tissue perfusion (p=0.026); allergy and texture (p=0.034), physical activity and hydration (p=0.034), smoking and thickness (p=0.018), and alcohol consumption and exudate (p=0.045). We conclude that the patients had light to moderate impairment, indicating a good state of health on the integrity of the skin of the lower limbs, according to the indicators of the outcome of tissue integrity Classification Nursing Outcomes valued in the present study. It is believed that the evaluation of impairment tissue using a self-nursing system and its relation with socioeconomic, clinical and risk factors are unique tools in the care planning and in the wound healing
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One of the Primary Health Care strategies for adolescent health is the growth and development follow-up and the early detection of overweight adolescents. Even though the School Health Program in Brazil proposes to evaluate the nutritional state of the school population in the corresponding community health units, not all cities have adhered to the Program and many nurses do not recognize overweight as a problem in their territory. The objective of the study was to identify the nurse´s participation in the screening of overweight adolescent students in their work territory. Cross sectional study conducted in eight state supported schools of the municipality of Natal/RN and in four Primary Health Units. The total student population was 27.277. A stratified sample was statistically calculated based on the student population of the four city geographical zones: 112 North , 74 West; 108 East; and 78 South, totalizing 372 adolescents. The students were selected by a probability process where eight schools were first selected, two per district, until the number per subsample in each district was reached. Four primary health nurses, responsible for the health units were included. Two instruments were used for data collection, a screening questionnaire and a semi-structured interview form for questioning of the nurses. The content of both instruments was validated. Anthropometric and health data were collected from the students and analyzed with descriptive and analytical statistics. Interview data were transcribed and submitted to content analysis. The nursing diagnosis of overweight was identified in 50 (13,5%) of the adolescents and its association with consumption of foods that have cardiovascular risk (canned foods, pasta and fried food). An association of the nursing diagnosis was identified with family history (diabetes, hypertension, obesity, and kidney disease). The nurses judged that care of overweight adolescents was important but noted difficulties because of the absence of this population in the health units, because of their work overload, and the lack of school articulation. The nurses do not have impacting actions with this population and delegate the responsibility to other professionals. It is concluded that overweight is a nutritional problem relevant to the adolescent school population in Natal/RN, with a 13,5% prevalence and that it is related to food consumption with cardiovascular risk and family health history. The nurses consider overweight as an important public health problem but do not envision ways to maintain linkage with adolescents and with the school to promote the needed care
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O The aim of this study was to characterize the occurrence of trauma in the elderly population served by the mobile pre-hospital service, in Natal, Rio Grande do Norte. This is a descriptive, transversal and quantitative approach and whose population consisted of 2,080 trauma victims. The sample, of systematic random type, consisted of 400 elderly people, aged from 60 years old, assisted by the Office of Mobile Emergency in Natal / RN, between January 2011 and December 2012. Data collection began after consent and assent of the institution of a Research Ethics Committee under No. 309 505. It was proceeded to documentary retrospective analysis of records of this service through a form of self-development, validated by expert judges considered reliable (α> 0.75) and valid (CVI = 0.97) in their clarity and relevance. Data were tabulated by the Statistical Package for Social Sciences, version 20.0. The results show that older victims have an average age of 74.19 years old, with a prevalence of female involvement by chronic diseases, especially hypertension, average usage of 2.2 routine medications with vital signs within normal limits. The trauma prevailed during the daytime, in the residence of the victims, north of the city and on weekends. Among the mechanisms of trauma were falls, traffic accidents and physical aggression, whose most common type was brain-cerebral trauma and the main consequences were suture wounds and closed fractures. Basic Support Units were as more driven to pre-hospital care (87.8%) and the main destination place consisted of a referral hospital for emergency of the state (57.5%). Among the most commonly performed procedures by nursing staff immobilization with rigid board and neck collar and the peripheral venipuncture, and the main component used for volume replacement to saline were highlighted. There was a significant relationship between the deaths and the mechanism of injury, mechanism of injury and procedures, except medication administration procedures carried out, except immobilization and unit for service. It is highlighted the prevalence of trauma in the elderly, poor follow-up Pre-Hospital Trauma Life Support protocol and the paucity of records and nursing procedures performed. There is need for a protocol of care specific to elderly trauma victims and education strategies for the prevention of such events
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Descriptive research aimed at evaluating the assistance offered to patients with venous ulcers, on lower limbs, attended by the Family Health Program (FHP) team, from the municipality of Natal/RN. The target population was composed of 74 patients with venous ulcers (VU), attended by the FHP teams in the 31 FHUs. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (protocol n.55/05). The data collection was performed in patients homes and in the FHUs, through structured interviews and physical examinations of patients with VU and non-participant observation during the changing of wound dressings in these Units and in users homes. The data was organized into an Excel electronic table and transported into the SPSS 14.0 program, for descriptive analysis on 2x2 contingency tables and inferential (Qui-Square χ2, Spearman Correlation, Binomial Proportion Test and p-value <0.05). The prevalence of VU (0.36/1000) in the target population (over 20 years of age) was greater than in the population registered in FHP (0.25/1000). We detected a greater prevalence in the age area of over 60 years (2.22/1000), with 2.98/1000 for females and 1.3/1000 for males (p-value=0.008). The sociodemographical and health characteristics of patients with VU revealed predominance of females (74.5%), elders over 60 years of age (67.6%), with fundamental education (74.3%), family earnings of up to 2 minimum wages (68.9%), retired (90.5%), ortostatic position (23.0%), inadequate sleep (59,9%), presence of CVI (100.0%), hypertension (44.6%) and diabetes (25.7%). As for the time of existence of the VU, 64.9% had over 1 year, and 35.1% less than 1 year), with predominance of one wound (67.6%). The changing of wound dressings is performed mostly at home, in and inadequate way, especially with incorrect cleaning techniques, likewise incorrect use of products and substances, and reduced participation of the FHP team on the evaluation and application of the dressing and choosing of products and substances. The compressive therapy is not part of therapeutic conducts for treatment in the FHUs. As for the evaluation of assistance to patients with VU, 90.5% were inadequate and only 9.5% adequate. The main inadequacy factors were the absence of: diagnosis (47.3%), consultation with and angiologist (63.5%), compressive treatment (100.0%), adequate optical therapy (98.62%), adequate dressing kit (70.3%), training for the changing of dressings (67.6%), following by the FHP team (51.4%) and performed exams (55.4%). We ve concluded that patients with VU mostly present now socioeconomical level and associated chronic diseases. Considering that assistance offered by FHP is non-systematic, fragmented, with no diagnosis planning, continual evaluation and evolution, we qualify the assistance as inadequate and with low level of solution, directly interfering on the maintenance of the VUs chronic state
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The occurrence of transients in electrocardiogram (ECG) signals indicates an electrical phenomenon outside the heart. Thus, the identification of transients has been the most-used methodology in medical analysis since the invention of the electrocardiograph (device responsible for benchmarking of electrocardiogram signals). There are few papers related to this subject, which compels the creation of an architecture to do the pre-processing of this signal in order to identify transients. This paper proposes a method based on the signal energy of the Hilbert transform of electrocardiogram, being an alternative to methods based on morphology of the signal. This information will determine the creation of frames of the MP-HA protocol responsible for transmitting the ECG signals through an IEEE 802.3 network to a computing device. That, in turn, may perform a process to automatically sort the signal, or to present it to a doctor so that he can do the sorting manually
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Hypertension is a dangerous disease that can cause serious harm to a patient health. In some situations the necessity to control this pressure is even greater, as in surgical procedures and post-surgical patients. To decrease the chances of a complication, it is necessary to reduce blood pressure as soon as possible. Continuous infusion of vasodilators drugs, such as sodium nitroprusside (SNP), rapidly decreased blood pressure in most patients, avoiding major problems. Maintaining the desired blood pressure requires constant monitoring of arterial blood pressure and frequently adjusting the drug infusion rate. Manual control of arterial blood pressure by clinical personnel is very demanding, time consuming and, as a result, sometimes of poor quality. Thus, the aim of this work is the design and implementation of a database of tuned controllers based on patients models, in order to find a suitable PID to be embedded in a Programmable Integrated Circuit (PIC), which has a smaller cost, smaller size and lower power consumption. For best results in controlling the blood pressure and choosing the adequate controller, tuning algorithms, system identification techniques and Smith predictor are used. This work also introduces a monitoring system to assist in detecting anomalies and optimize the process of patient care.
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En plein XIXe siècle, Nísia Floresta Brasileira Augusta a écrit sur deux voyages faits en Europe. Quelques années plus tard, cette norte-rio-grandense a livré au public ses récits de voyage : Itinéraire d un voyage en Allemagne (1857) et Trois ans en Italie Suivis d un Voyage en Grèce (1864/1872). Malgré les particularités qui entourent chacun de ces récits, un aspect y est fortement présent : les marques autobiographiques. Notre travail a comme principal objectif enquêter comment se manifeste ce discours autobiographique. A partir de l‟Analyse du Discours, nous avons travaillé quelques positionnements sur certaines oeuvres littéraires, comme par exemple, le fait qu‟elles aient plus d‟un genre. Ce qui se passe dans les récits de voyage de Nísia Floresta est semblable, car au-délà de raconter le passage de Nísia par ces lieux, nous pouvons trouver des caractéristiques qui appartiennent à l‟écriture fragmentaire, autobiographique et épistolaire. Devant les propositions indiquées par Philippe Lejeune, nous avons pu confirmer que ces récits de Nísia font partie de l‟écriture autobiographique. Sous l‟optique de quelques théories, nous avons parcouru des points intéressants qui enveloppent ces récits et, de cette façon, nous avons voyagé avec Nísia Floresta par l‟Allemagne et ultérieurement par l‟Italie et Grèce, en connaissant ainsi, pas seulement un peu plus sur ces lieux, mais beaucoup de confidences sur cette écrivain potiguar, qui a ouvert son coeur au plublic
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Esta tesis trata de cómo se desarrolla en la obra de la escritora contemporánea Nélida Piñon una especie de pensamiento cartográfico, presente desde su primer romance Guia-mapa de Gabriel Arcanjo, publicado en 1961. Para que se interprete el universo literario nelidiano, formulamos nuestro trabajo estableciendo un confronto con el texto del mito iluminado por las reflexiones de Eliade (2007; 2007b; 2008) y Meletínski (2002); con el discurso filosófico pos-estructuralista, representado principalmente por las contribuciones de Deleuze y Guattari (1995; 1996; 1997) a respecto de una geografía del nomadismo; y de Foucault (1996; 2006) sobre el orden del discurso, o nacimiento de la literatura y el ser del lenguaje. Examinadas por la lectura crítica y comparativista de esta investigación, las cartografías mito-póeticas de Piñon son presentadas al lector asociándose a una geografía de los sentimientos y al que Maffesoli (2001) denomina deseo de errância y de perdición, particularmente en las obras Tebas do Meu Coração, A República dos Sonhos, O Presumível Coração da América e Fundador. Esa última novela, publicada en 1969, por lo tanto anterior a los otros textos mencionados, servirá como corpus principal de nuestro análisis, que objetiva demostrar como la narrativa de Piñon se conecta a un linaje literario estructurado a partir de las acciones de un determinado tipo de personaje conocido como inaugurador de ciudades o héroe civilizador o cultural. En la reedición de ese arquetipo de personaje, la autora instaura el elemento de la seducción, en un juego que se establece entre los sujetos masculino y femenino y que pone de manifiesto cuestiones relacionadas al erotismo, a la transgresión y al sagrado, abordadas en nuestro discurso por las consideraciones de Baudrillard (2008) y Bataille (1987). Para que se explicite la constitución de esos puntos, realizaremos un viaje de las visiones del mundo arcaico al contemporáneo por las páginas de Fundador, apuntando de qué manera la escritora brasileña retoma las imágenes del mito cosmogónico, del mito del eterno retorno y del paraíso terreal, que se inscriben como fundamento do su texto literario
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A abordagem da visão da literatura nacional dentro do contexto cultural brasileiro da segunda metade do século XIX e do posicionamento crítico de José de Alencar fez, de sua produção romanesca, especialmente a indianista, representada aqui por sua obra Iracema, um símbolo do conjunto de intenções nacionalistas que invadiu a alma e o coração de todo o povo, no que diz respeito ao sentimento de brasilidade , condizente com a estética romântica da qual faz parte seu autor. Seu posicionamento, quer seja crítico ou artístico, faz de Alencar o maior polemista em defesa da liberdade cultural e literária do Brasil, enquanto alguém bem consciente de sua função social, e por que não dizer, crítica, identificando a metalinguagem como um diferencial fomentador de uma teorização de poética na defesa de sua ficção, abrindo caminho, assim, para a pesquisa da poética explícita na sua produção artística. A referida análise buscará, a partir de uma análise estrutural das partes formais que o compõem esteticamente, como também de uma compreensão temática dos ditos e interditos utilizados pelo narrador alencariano na composição de seu discurso, identificar Iracema enquanto um romance que disputa o título de obra fundacional do Brasil. Para isso se faz necessário empreender uma abordagem do como e do quanto os elementos da Natureza, num romance romântico que tem a Natureza enquanto uma de suas temáticas mais significativas, podem constituir e interferir na percepção e construção de um personagem, que é todo Natureza, e no meio natural em que ele vive; até mesmo ser, por causa disso, o elemento mais representativo dessa nação que se deseja criar, trazendo para o cenário cultural brasileiro do século XIX uma versão de instituição baseada no revigoramento da memória da cultura selvagem. Faz-se lícito também animar forças da natureza e da terra-paisagem que poderiam ser tidas, apenas, como exóticas, mas que na obra em questão funcionam como protagonistas, mesmo fantasmas, de um pacto social e político que, mesmo quando rompe, recusa-se em deixar romper, mergulhando no espaço romanesco da magnitude das águas ou na frieza tumular da terra. Tomar-se-á, também, como ponto de estudo, a análise da fusão da experiência histórica com a experiência ficcional, observando o imbricamento de um discurso no outro, como também as fronteiras que se estabelecem a partir dessa tentativa; tomando o erotismo e a alegoria como pontos de convergência na obra em questão. Por meio da verificação de uma relação que se constrói a partir da solidão, da memória e do esquecimento em que acabam por mergulhar todos os seus personagens, que são, por vezes, tragados em algum dilúvio bíblico da purificação, dentro de um projeto audacioso de invenção de uma nação, que se quer de identidade cultural, e também política, mas que termina condenado ao silêncio, não gozando de liberdade em relação ao espaço a que pertence e, no entanto representa, só cabendo a eles regressarem para dentro da terra-mãe, ou se submeterem a um ritual de profunda aculturação, verificar-se-á, através desse discurso historicamente construído, o ideário de uma nação que se almejava projetar. O conflito de Iracema, personagem protagonista de sua obra homônima, a negação e a perda de si mesma, de tudo aquilo que poderia representar a sua identidade social e cultural, e, conseqüentemente, a morte e a vida dessa mãe genti(o)l, simbolizam a vida e a arte de um povo que, passando pelos embates da colonização, através de seus artistas rebeldes e românticos da Independência, que ilustraram, em grande síntese, a visão através da qual o homem do Novo Mundo foi vislumbrado, rabiscou a imagem da americanidade pelo discurso da História