Diagnósticos de enfermagem em pacientes no pós-operatório imediato de prostatectomia de um Hospital Universitário de Natal-RN

The characterization of the nursing diagnoses in prostatectomized patients is important to provide an unique nursing language, facilitating the communication between professionals and patients. The objective of this study was to analyze the nursing diagnoses of patients in the immediate prostatectomy postoperative period. This is a cross-sectional and descriptive study, developed at the surgical-clinic of Onofre Lopes University Hospital, in the Natal City RN - Brazil. The sample was composed of 50 patients included by the criteria: have presented a diagnosis of a benign prostatic hyperplasia or a prostate cancer, have been subjected to a prostate surgery at the mentioned hospital, and have been in the immediate postoperative period at the moment of the data collection. The exclusion criteria were: haven t been in an appropriate physical and mental condition, have presented a brain vascular disease, a lung disease, an advanced liver disease, a heart disease or a extensive coronary artery disease. The data collection instruments were: the script of an interview and physical examination. The data collection period was between November 2010 and April 2011. The data were organized in two phases: the diagnostic process and the construction of the database. The project was approved by the Ethics Committee of the Federal University of Rio Grande do Norte The results showed that most patients came from the countryside, was living with partners, had an average of 67.78 years, was pensionerthose with low schooling, Catholic and often did not perform preventive examinations of prostatic disease. The patients showed an average of 9.48 nursing diagnoses, defining characteristics 21.70 and 20.72 related or risk factors per patient. We identified 30 nursing diagnoses, of which 7 were above the 75 percentile: Risk of falls, Impaired ambulation, Risk of infection, Self-care deficit bath / hygiene and dress up and Risk for deficient fluid volume. The top six nursing diagnoses were in all patients, and therefore could not apply any statistical test. The others ND were associated with their defining characteristics and related or risk factors. We conclude that the nursing diagnoses identified in this study contribute to the progress of the nursing care to the prostatectomized patients in post-surgery period, allowing the deployment of nursing actions for the effective resolution of identified problems

História oral de vida de pacientes transplantados renais: novos caminhos a trilhar

The therapeutic possibilities for chronic renal failure closely are related to the biological and social condition, and in this perspective the renal transplant is considered the best option, for providing quality of life better. This study it objectified to apprehend, by means of the rescue of the verbal history of life of the kidney transplant patients, the experiences lived since the diagnosis of the renal to the current with the current therapeutic modality. One is about a study of qualitative boarding, exploratory and descriptive, having the verbal history of life as a technique and method. The colony was formed with the ten first kidney transplant patients of the Rio Grande of the North, taken care of in the clinic of the Nephrology in the University Hospital Onofre Lopes-UFRN, located in the city of Christmas-RN. The net was composed for collaborators of both the sex, in the age band between 21 and 56 years of age, submitted it more than has one year to the renal transplant and that, in some cases, together of its familiar ones, they had voluntarily accepted to participate of the study. The first collaborator interviewed for this was excluded not to desire to participate the study more than. After approval for the Committee of Ethics in Search of the UFRN, we carry through the collection of data, by means of a halfstructuralized interview, recorded individually, in environment chosen for the collaborators. We carry through the transcription of the interviews and later we return to the interviewed ones so that the same ones made the conference, what it made possible in them to carry through the transcriation, after consecutive readings. We analyze the stories by means of the analysis of content of Bardin. Guiding the analysis of the stories of the collaborators, we find three axles thematic: Impact in the social relations, Impact in the social condition and Behavior front the illness and treatment. We conclude in this study that the loss of the renal function reed-echo drastically in the life of the collaborators, but that the acceptance of the pathological condition emerged, mainly for the support of the family and in the belief in God. The renal transplant was seen as the chance for a new life, however, so that they reach an improvement in the quality of life, other questions must be optimized, as the guarantee of constitutional laws, the rescue of the citizenship and offer of bigger support of the professionals of the health, family and society for the confrontation of the problems generated for the chronic renal illness and its treatments

Da negatividade a positividade: possível trânsito de saberes, práticas e representações sociais sobre o estigma da hanseníase

Leprosy is a chronic infectious-contagious disease, caused by Mycobacterium leprae, manifested by dermatological and neurological signs and symptoms and has great disabling power. It was marked by a strong stigma throughout its history, since its bearers represented a threat, target of fear and social contempt. Currently, leprosy has treatment and cure, and the need to separate the diseased from family and social environment is no more necessary. However, patients still suffer prejudice and discrimination. This study aimed to understand the social representations of leprosy that interfere modifying mental health of the patient with leprosy in relation to stigma and prejudice. This is a descriptive and exploratory study, with qualitative approach, which involved 22 users of the Special Care Clinic in Infectious Diseases at the Hospital Giselda Trigueiro, located in Natal / RN. They were in use of multidrug therapy in the period of data collection, were of both sexes, aged between 16 and 80 years of age and classified as paucibacillary or multibacillary. The study was approved by the UFRN Ethics in Research Committee. Data collection was performed by filling the questionnaire identification and then for conducting the semi-structured interview, which was recorded. After the end of data collection, there was the construction of tables and graphs, using the Microsoft Excel Start 2010 for proper characterization of the research subjects; and for the treatment of the data obtained from the interviews, was used the Content Analysis and based on the Theory of Social Representations. The subjects studied were mostly male (64%), married or in a stable relationship (68%), concentrated in the age group 50-60 years (36%) and 28-38 years (23%), had at most elementary education (65%) and were low-income (59%). Of the total respondents, 64% were classified as multibacillary, with predominantly dimorfous form, and 50% had disability grade I or II, with different periods of diagnosis. The reports originate two categories: 1. The negative meanings of illness and leprosy; and 2. The positive meanings of illness in leprosy, which were subsequently subdivided into subcategories. Thus, it was found that in the group studied, the social representation of leprosy experiences a moment of transition, as regards the understanding of the disease and its way of experiencing the disease process. Such representation is anchored in the quality of information on the disease of its bearers and aimed at an attempt to face the illness of leprosy as a "normal process". It was found in this study that the transition is due to the work of combating stigma and consequences of leprosy, which is able to gradually transform reality, both regarding the team work of reference, and in relation to a broader character, of actions of health education, which favors overcoming of psychosocial disabilities

Estágio supervisionado em enfermagem: visão de preceptores

The present study aimed to analyze the vision of tutors from a university hospital about supervised internship in nursing. It is a descriptive nature research with qualitative approach, developed at the University Hospital Onofre Lopes (HUOL), located in Natal/RN. The population was composed of eleven assisting nurses engaged the precentorship of undergraduate course students in nursing, from the Federal University of Rio Grande do Norte (UFRN). For the empirical research, conducted in the period from September to November 2013, the semi-structured interview involving questions directed to the stage was used, as advocate the national curriculum guidelines, as regards this curricular component. With the consent of the institution where the study has been developed and approved by the Research Ethics Committee of UFRN, as n° 17800613.9.0000.5537, besides CAAE signing an informed consent by participants. The analysis of the information was held from the analysis of content, thematic mode. Thereby four categories were defined a priori, namely: the supervised internship in the vision of nurses; To be preceptor; The internship concerned: contributions and difficulties; Do the institutional actors communicate? The results indicate that in the view of the supervised internship preceptors is a sine qua non for the training of nurses, considering that it prepares for professional life. Besides being a moment conducive to the exercise of management and a greater rapprochement between theory and practice, stimulates the preceptor to upgrade to better exercise the function and also provides an exchange of knowledge between students and tutors, thus contributing to optimize the service. Nevertheless, the respondents indicate the existence of a distancing and little communication with the academic institution. In summary, it is realized that the nurses understand the importance of its function of tutors and supervised stage for vocational training. It is necessary, however, to reflect on the paths to be pinched in the confrontation of difficulties in this process, especially as regards the teaching/service relationship, which, while remaining at a distance, strengthens the existing dichotomy between theory and practice

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

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

Estudo de concretos de diferentes resistências à compressão submetidos a altas temperaturas sem e com incorporação de fibras de politereftalato de etileno (PET)

The reinforced concrete structures are largely used in buildings worldwide. Upon the occurrence of fire in buildings, there is a consensus among researchers that the concrete has a high resistance to fire, due mainly to its low thermal conductivity. However, this does not mean that this material is not affected by exposure to high temperatures. Reduction of the compressive strength, modulus of elasticity, discoloration and cracking, are some of the effects caused by thermal exposure. In the case of concretes with higher resistance occurs even desplacamentos explosives, exposing the reinforcement to fire and contributing to reducing the support capacity of the structural element. Considering the above, this study aims to examine how the compressive strength and porosity of concrete are affected when subjected to high temperatures. Were evaluated concrete of different resistances, and even was the verified if addition fibers of polyethylene terephthalate (PET) in concrete can be used as an alternative to preventing spalling. The results indicated that explosive spalling affect not only high strength concrete whose values of this study ranged from 70 to 88 MPa, as well as conventional concrete of medium strength (52 MPa) and the temperature range to which the concrete begins to suffer significant changes in their resistance is between 400 º C and 600 º C, showing to 600 º C a porosity up to 188% greater than the room temperature

Avaliação do desempenho de uma cortina de estacas espaçadas, atirantada, em areia

It is presented the analysis of a retaining wall designed for the basement of a residential building, located in Natal/RN, which consists in a spaced pile wall, anchored by tiebacks, in sand. This structure was instrumented in order to measure the wall s horizontal movements and the load distribution throughout the anchor fixed length. The horizontal movements were measured with an inclinometer, and the loads in the anchors were measured with strain gages, installed in three places throughout the anchor fixed length. Measurements for displacement were done right after the implementation of each stage of the building and right after the conclusion of the building, and the measurements for loads in the anchors were done during the performance test, at the moment of the locking off and, also, right after the conclusion of the building. From the data of displacement were obtained velocity and acceleration data of wall. It was found that the time elapsed on braced installation was decisive in the magnitude of the displacements. The maximum horizontal displacement of wall ranged between 0,18 and 0,66% of the final depth of excavation. The loads in the anchors strongly reduced to approximately half the anchor fixed length, followed an exponential distribution. Furthermore, it was found that there was a loss of load in the anchors over time, reaching 50% loss in one of them

Cultura organizacional e comprometimento dos funcionários do Soleil Suíte Hotel

This study examines the relationship of the types of organizational culture perceived in a business hotel with the nature of the link between individual and organization. This linkage between commitment and organizational culture has been little explored, both national and international, requiring more studies. Thus, the survey was conducted in Soleil Suite Hotel, located on the beach of Ponta Negra, city of Natal, Rio Grande do Norte. The independent variable of the proposed model was represented by the types of organizational culture, while the dependent variable was represented by the four dimensions of commitment. It was used in addition to the correspondence analysis, the arithmetic mean, the Pearson s correlation and the simple regression analysis. The results indicated the existence of relationship of the types of organizational culture with the kind of commitment shown by the officials, where the cultures of Group and Innovative, capable of generating an environment dedicated to the work as a team, the development and professional growth of the employees, as well as the creativity and individual freedom of each one to try new things, encourage the dominance of the dimensions Affective, Affiliative and Normative of the tie person-organization

A Acessibilidade como veículo de inclusão social: proposta de dispositivo computacional para os deficientes visuais da cidade de Natal/RN

This study aims to propose a computing device mechanism which is capable to permit a tactile communication between individuals with visual impairment (blindness or low vision) through the Internet or through a local area network (LAN - Local Network Address). The work was developed under the research projects that currently are realized in the LAI (Laboratory of Integrated Accessibility) of the Federal University of Rio Grande do Norte. This way, the research was done in order to involve a prototype capable to recognize geometries by students considered blind from the Institute of Education and Rehabilitation of Blind of Rio Grande do Norte (IERC-RN), located in Alecrim neighborhood, Natal/RN. Besides this research, another prototype was developed to test the communication via a local network and Internet. To analyze the data, a qualitative and quantitative approach was used through simple statistical techniques, such as percentages and averages, to support subjective interpretations. The results offer an analysis of the extent to which the implementation can contribute to the socialization and learning of the visually impaired. Finally, some recommendations are suggested for the development of future researches in order to facilitate the proposed mechanism.

Fatores que afetam a satisfação de pacientes em serviços de saúde :um estudo em setor ambulatorial de hospital

This thesis shows concepts and models related to customer satisfaction measurement, focusing in detail on patients satisfaction evaluations in a policlinic sector of a hospital located in Natal RN. To reach this aim, two hundred and fifty one patients of this hospital were interviewed. The methodology approach includes a theoretical basis through a review and study of previous research on the topic, governmental initiatives and management systems which deal with excellence and need more reports concerning customers perceptions about satisfaction. Furthermore, it was included some models of nationals index about customer satisfaction. The Norwegian model was used in this thesis. The use of this approache, together with a multiple regression analysis, led to results that shows the factors which affect patients satisfaction in a policlinic sector. They are four as following: The evaluation of physician attendance; its results; simplicity of accessibility when health services are needed; and both support and tranquility given by the hospital. The study results can support researches of a conceptual model to determinate the aspects which affect the patient s satisfaction and could be a contribution to a development of a national costumer satisfaction index

Uma avaliação comparativa de estratégias de arranjos físicos para estaleiros de construção de embarcações metálicas de pequeno porte

The present study aims to analyse, in different levels of demand, what is the best layout strategy to adopt for the small metallic shipbuilding. To achieve this purpose, three simulation models are developed for analyze these production strategies under the positional, cellular and linear layouts. By the use of a simulation tool for compare the scenarios, Chwif and Medina (2010) and Law (2009)´s methodologies were adapted that includes three phases: conception, implementation and analysis. In conception real systems were represented by process mapping according to time, material resources and human resources variables required for each step of the production process. All of this information has been transformed in the cost variable. Data were collected from three different production systems, two located in Natal RN with cellular and positional layouts and one located in Belém-PA with linear layout. In the implementation phase, the conceptual models were converted in computacional models through the tool Rockwell Software Arena ® 13.5 and then validated. In the analysis stage the production of 960 ships in a year vessels were simulated for each layout noting that, for a production of until 80 units positional layout is the most recommended, between 81 and 288 units the cellular layout and more than 289 units the linear layout

Análise comparativa dos métodos de fatores ponderados na seleção de áreas para aterros sanitários

This study presents a comparative analysis of methodologies about weighted factors considered in the selection of areas for deployment of Sanitary Landfills, applying the methodologies of classification criteria with scoring bands Gomes, Coelho, Erba & Veronez (2000); Waquil et al, 2000. That means, we have the Scoring System used by Union of Municipalities of Bahia and the Quality Index Landfill Waste (IQR) which are applyed for this study in Massaranduba Sanitary Landfill located in the municipality of Ceará Mirim /RN, northeastern of Brazil. The study was conducted in order to classify the methodologies and to give support for future studies on environmental management segment, with main goal to propose suited methodologies which allow safety and rigor during the selection, deployment and management of sanitary landfill, in the Brazilian municipalities, in order to help them in the process to extinction of their dumps, in according of Brazilian Nacional Plan of Solid Waste. During this investigation we have studied the characteristics of the site as morphological, hydrogeological, environmental and socio-economic to permit the installation. We consider important to mention the need of deployment from Rio Grande do Norte State Secretary of Environment and Water (SEMARH), Institute of Sustainable Development and Environment of RN (IDEMA), as well, from Federal and Municipal Governments a public policies for the integrated management of urban solid waste that address environmental preservation and improvement of health conditions of the population of the Rio Grande do Norte

Agentes Inteligentes com Foco de Atenção Afetivo em Simulações Baseadas em Agentes

Simulations based on cognitively rich agents can become a very intensive computing task, especially when the simulated environment represents a complex system. This situation becomes worse when time constraints are present. This kind of simulations would benefit from a mechanism that improves the way agents perceive and react to changes in these types of environments. In other worlds, an approach to improve the efficiency (performance and accuracy) in the decision process of autonomous agents in a simulation would be useful. In complex environments, and full of variables, it is possible that not every information available to the agent is necessary for its decision-making process, depending indeed, on the task being performed. Then, the agent would need to filter the coming perceptions in the same as we do with our attentions focus. By using a focus of attention, only the information that really matters to the agent running context are perceived (cognitively processed), which can improve the decision making process. The architecture proposed herein presents a structure for cognitive agents divided into two parts: 1) the main part contains the reasoning / planning process, knowledge and affective state of the agent, and 2) a set of behaviors that are triggered by planning in order to achieve the agent s goals. Each of these behaviors has a runtime dynamically adjustable focus of attention, adjusted according to the variation of the agent s affective state. The focus of each behavior is divided into a qualitative focus, which is responsible for the quality of the perceived data, and a quantitative focus, which is responsible for the quantity of the perceived data. Thus, the behavior will be able to filter the information sent by the agent sensors, and build a list of perceived elements containing only the information necessary to the agent, according to the context of the behavior that is currently running. Based on the human attention focus, the agent is also dotted of a affective state. The agent s affective state is based on theories of human emotion, mood and personality. This model serves as a basis for the mechanism of continuous adjustment of the agent s attention focus, both the qualitative and the quantative focus. With this mechanism, the agent can adjust its focus of attention during the execution of the behavior, in order to become more efficient in the face of environmental changes. The proposed architecture can be used in a very flexibly way. The focus of attention can work in a fixed way (neither the qualitative focus nor the quantitaive focus one changes), as well as using different combinations for the qualitative and quantitative foci variation. The architecture was built on a platform for BDI agents, but its design allows it to be used in any other type of agents, since the implementation is made only in the perception level layer of the agent. In order to evaluate the contribution proposed in this work, an extensive series of experiments were conducted on an agent-based simulation over a fire-growing scenario. In the simulations, the agents using the architecture proposed in this work are compared with similar agents (with the same reasoning model), but able to process all the information sent by the environment. Intuitively, it is expected that the omniscient agent would be more efficient, since they can handle all the possible option before taking a decision. However, the experiments showed that attention-focus based agents can be as efficient as the omniscient ones, with the advantage of being able to solve the same problems in a significantly reduced time. Thus, the experiments indicate the efficiency of the proposed architecture

WI-BIO: redes de monitoramento de pacientes em ambientes de automação hospitalar utilizando o padrão IEEE 802.11

The monitoring of patients performed in hospitals is usually done either in a manual or semiautomated way, where the members of the healthcare team must constantly visit the patients to ascertain the health condition in which they are. The adoption of this procedure, however, compromises the quality of the monitoring conducted since the shortage of physical and human resources in hospitals tends to overwhelm members of the healthcare team, preventing them from moving to patients with adequate frequency. Given this, many existing works in the literature specify alternatives aimed at improving this monitoring through the use of wireless networks. In these works, the network is only intended for data traffic generated by medical sensors and there is no possibility of it being allocated for the transmission of data from applications present in existing user stations in the hospital. However, in the case of hospital automation environments, this aspect is a negative point, considering that the data generated in such applications can be directly related to the patient monitoring conducted. Thus, this thesis defines Wi-Bio as a communication protocol aimed at the establishment of IEEE 802.11 networks for patient monitoring, capable of enabling the harmonious coexistence among the traffic generated by medical sensors and user stations. The formal specification and verification of Wi-Bio were made through the design and analysis of Petri net models. Its validation was performed through simulations with the Network Simulator 2 (NS2) tool. The simulations of NS2 were designed to portray a real patient monitoring environment corresponding to a floor of the nursing wards sector of the University Hospital Onofre Lopes (HUOL), located at Natal, Rio Grande do Norte. Moreover, in order to verify the feasibility of Wi-Bio in terms of wireless networks standards prevailing in the market, the testing scenario was also simulated under a perspective in which the network elements used the HCCA access mechanism described in the IEEE 802.11e amendment. The results confirmed the validity of the designed Petri nets and showed that Wi-Bio, in addition to presenting a superior performance compared to HCCA on most items analyzed, was also able to promote efficient integration between the data generated by medical sensors and user applications on the same wireless network

Uma abordagem comportamental para inserção de robôs em ambientes culturais

In this work, we propose methodologies and computer tools to insert robots in cultural environments. The basic idea is to have a robot in a real context (a cultural space) that can represent an user connected to the system through Internet (visitor avatar in the real space) and that the robot also have its representation in a Mixed Reality space (robot avatar in the virtual space). In this way, robot and avatar are not simply real and virtual objects. They play a more important role in the scenery, interfering in the process and taking decisions. In order to have this service running, we developed a module composed by a robot, communication tools and ways to provide integration of these with the virtual environment. As welI we implemented a set of behaviors with the purpose of controlling the robot in the real space. We studied available software and hardware tools for the robotics platform used in the experiments, as welI we developed test routines to determine their potentialities. Finally, we studied the behavior-based control model, we planned and implemented alI the necessary behaviors for the robot integration to the real and virtual cultural spaces. Several experiments were conducted, in order to validate the developed methodologies and tools