Diagnósticos de enfermagem em pacientes submetidos à hemodiálise: semelhanças entre o modelo de adaptação e a NANDA internacional

The nurses in the hemodialysis has an important role in the nursing process implementation, in the context of a theoretical referential. Among the nursing theories, highlights the Roy´s adaptations model, who considers a person as an holistic adaptive system that aims to adapt customers to different living conditions. Thus, it is believed that the Roy´s nursing process will guide nursing care to patients on dialysis. Therefore, the study aimed to analyze the nursing diagnosis present in patients with chronic kidney disease on hemodialysis based on the theoretical model of Roy and NANDA-International. Descriptive and cros-sectional study, performed at a dialysis center in a city in northeastern Brazil. Sample of 178 patients and consecutive sampling by convenience. Data collection ocurred from October/2011 until February/2012, through interview and physical examination forms. Data analysis was initiated by clinical reasoning, diagnosis judgment and similarity relation. Then, the data were entered into SPSS program, 16.0 version, generating descriptive statistics. The project was approved by the Ethics Research Committee (protocol nº 115/11) with a Presentation Certificate for Ethics Appreciation (in 0139.0.051.000-111) and was funded by the Universal edict MCT / CNPq 14/2010. The results revealed that most patients were male (52.2%), married (62.9%) and residents in the Natal´s metropolitan region (54.5%). The mean age was 46.6 years and the years of study, 8,5. Regarding nursing diagnosis obtained an average of 6.6, especially: Risk of Infection (100%), excessive fluid volume (99.4%) and hypothermia (61.8%). On the other hand the adaptive problems average was 6.4, and the most common: intracellular fluid retention (99.4%); Hyperkalemia (64.6%); Hypothermia (61.8%) and edema (53.9%). Were established 20 similarity relations between the NANDA-International nursing diagnosis and adaptive problems of Roy, namely: risk of falls / injury risk and potential for injury, impaired physical mobility and walking mobility and / or restricted coordination, dressing self-care deficit and loss of self-care ability; hypothermia and hypothermia; impaired skin integrity and impaired skin integrity; excessive fluid volume and intracellular fluid retention / Hyperkalemia / Hypocalcemia / edema; imbalanced nutrition: less than body requirements and Nutrition less than the body's needs; constipation and constipation, acute pain and acute pain, chronic pain and chronic pain, sensorial perception disturbed: visual, tactile and auditory disabilities and a primary sense: sight, hearing and tactile; sleep deprivation and insomnia, fatigue and intolerance to activities; ineffective self health and fails in the role; sexual dysfunction and sexual dysfunction; situational low self-esteem and low self-esteem, and diarrhea and diarrhea. We conclude that there is similarity between the typologies and was required a model´s analysis, because they present different ways to establish the nursing diagnosis. Moreover, the nursing process use, under the context of a theory and a classification system, subsidizes the care and contributes to the strengthening of nursing science

Concepções de policiais militares sobre cuidados com a saúde

A ausência de cuidados do homem com a saúde representa um fenômeno significativo, pois contribui para o aumento da morbidade e mortalidade masculina por causas evitáveis. Essa realidade torna-se mais relevante quando se trata do policial militar, devido às peculiaridades do seu processo de trabalho. Visto isso, considera-se que os cuidados de saúde adotados por policiais militares atrelam-se ao entendimento de que possuem sobre os agravos à saúde, o qual perpassa por concepções de gênero e da profissão. Isso levou ao seguinte questionamento: Como o policial militar concebe os cuidados com a saúde. Objetivou-se analisar concepções de policiais militares sobre cuidados com a saúde. Trata-se de um estudo exploratório e descritivo, com abordagem qualitativa, desenvolvido junto a um Batalhão Militar do Comando de Policiamento de Natal, Rio Grande do Norte, Brasil. A coleta de dados foi realizada no período de junho a julho de 2013. Essa etapa foi antecedida pela anuência do Comandante Geral da Polícia Militar do Rio Grande do Norte, sob a aprovação do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, com o CAAE nº 15449713.7.0000.5537, e autorização formal dos entrevistados mediante a assinatura do Termo de Consentimento Livre e Esclarecido (TCLE), atendendo às exigências da Resolução 466/2012, do Conselho Nacional de Saúde, no que se refere à pesquisa com seres humanos. Participaram do estudo 21 policiais militares, do sexo masculino, que trabalhavam no policiamento ostensivo, não estavam de licença médica e apresentaram condições psicológicas e/ou físicas favoráveis para responder aos questionamentos. Os dados foram coletados por meio de entrevista semiestruturada mediante um roteiro constituído de duas partes: a primeira com questões sociodemográficas com vistas à caracterização dos participantes da pesquisa e a segunda com duas questões norteadoras relativas ao objeto de estudo. Os depoimentos foram tratados conforme o método de análise de conteúdo na modalidade de análise temática segundo Bardin. Desse processo, emergiram três categorias: hábitos de vida de policiais militares, repercussão do trabalho na saúde de policiais militares e atitudes de policiais militares em frente dos problemas de saúde. A análise dos dados foi subsidiada pelo referencial teórico do Modelo de Crenças em Saúde (Health Belief Model), de acordo com as variáveis vulnerabilidade e barreiras . Para respaldar a discussão dos resultados, buscou-se na literatura conhecimentos acerca da saúde do homem e do policial militar. Os resultados apontaram que os entrevistados procuram cuidar da saúde com práticas de exercícios físicos, alimentos saudáveis e preservação do sono. No entanto, vivenciam dores de coluna, ganho de peso, dificuldades para dormir, estresse e sofrimento psicológico. Diante disso, eles buscam apoio quando acometidos por agravos à saúde e reconhecem a necessidade de medidas de segurança durante o serviço. Portanto, notam a sua condição de vulnerabilidade em decorrência de seu ofício, porém enfrentam dificuldades na adoção de práticas preventivas de agravos a saúde. Mediante os resultados, faz-se necessário que o enfermeiro atuante junto a este público elabore, implemente e acompanhe estratégias de atenção a sua saúde

Avaliação da assistência à saúde dos portadores de úlceras venosas atendidos no programa saúde da família do município de Natal/RN

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

Análise da adesão ao tratamento e da qualidade de vida de pessoas com úlcera venosa

The therapeutic adherence is still a big problem among people with venous ulcers (VU) because the treatment is long, expensive and demand changes in lifestyle. In this context, this study aims to examine treatment adherence and quality of life (QOL) of people with VU assisted at primary health care. This is an analytical, cross-sectional study with a quantitative approach to treatment and data analysis. The study had the scenario 13 Family Health Units and 02 Units Mixed of Natal. The target population consisted of 44 persons with UV indicated by the teams of the Family Health Strategy between February and April 2014. Three instruments were used: an instrument to characterize the sociodemographic, health and care aspects, the Multidimensional Scale of Adherence Therapy composed of the dimensions: healthy lifestyle, compressive therapy and neurovascular monitoring and the Charing Cross Venous Ulcer Questionnaire (CCVUQ) that evaluates QOL in persons with VU composed by the domains: Total Score, Social Interaction, Domestic Activities, Aesthetics and Emotional State. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, CAAE: 07556312.0.0000.5537. The data concerning the sociodemographic characteristics showed that there was a predominance of females (65.9%), age range as of 60 years (59.1%) and income of up to 1 minimum wage (81.8%). With the characterization of health, it was evident that most people reported chronic diseases (63.6%), sleep more than 6 hours (81.8%), present pain (81.8%), denying alcoholism (86 4%) and smoking (77.3%) and showed a number greater than or equal to 1 (77.3%) recurrences. Concerning the therapeutic adherence was found that in the dimension compressive therapy there poor adherence. No associations between the domains of adherence and sociodemographic and health variables were found. Was observed, however, better adherence among individuals without pain and with higher schooling. When analyzed the averages of the dimensions of therapeutic adherence with the care characteristics there was statistical significance between: adherence to compression therapy and guidance for use of compressive therapy (p = 0.002) and guidance for regular exercise (p = 0.026). Considering the mean of total score of CCVUQ (mean 51.47, SD 18.33) it is observed that the overall QOL of respondents has approximate value of the median of the scale (50). The mean of the domain Social Interaction (mean 44.23, SD 21.38) and Domestic Activities (mean 45.70, SD 23.21) were those who reported better QOL. There were weak correlations but significant between adherence to healthy lifestyle and Domains Total Score (p = 0.012), social interaction (p-value = 0.048), Aesthetics (p-value = 0.025) and Emotional State (0.017) of CCVUQ. From the data analysis it is concluded that among people with UV, there poor adherence to compressive therapy. Furthermore, we found no statistically significant association between treatment adherence and sociodemographic and health characteristics. It is added that there was a correlation between the healthy lifestyle dimension and domains CCVUQ

Atuação e o conhecimento dos profissionais de enfermagem quanto a morte encefálica e manutenção do potencial doador de órgãos e tecidos para transplantes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Ergonomia e Odontologia: determinantes da postura corporal dos estudantes da clínica-escola de uma Universidade Federal

Posture is one of the most worrying problems dentists face. That is because of the high incidence of low back pathologies regarding the professional activity, despite the development on the field of Dental Ergonomics. This work took place at the dental schoolclinic at a Federal University, and it was grounded on the Ergonomic Principles in the workplace. Its main objective was to analyze the determinants of inadequate posture adopted by students inasmuch as the adoption of non ergonomic methods at the school-clinic may influence them to develop inadequate postures in their working environment. The analysis of the activity showed us that it requires some complex procedures in the patient s mouth. Thus, when the students carry out the activity, they start to adopt, although unconsciously, inadequate postures which will make easier the visual accuracy and the access to the operation focus. In case there is no internal (body awareness) or external warning mechanisms (the professor s or the partner s counseling) regarding posture or possible risks which lead them to self-correction, the students become vulnerable to osteomuscle disorders. The time pressure, because the students are expected to perform their task in a predetermined clinical time. The facts related to each patient s variability as well as the stress caused by the expectations to get their work done in time make the students to advance it believing they will waste time if they help their partners or using an indirect view. We could also notice that there was no assistant to perform the job of minor ones, as well as there was no professor who could actually connect the knowledge on Ergonomics to its working practice. The conclusions of this work stand out the need of widen the discussion at the academic environment regarding health professionals in places such as universities. The ergonomic principles in the workplace aim a multidisciplinary analysis based on the experience of students, professors, staff members and janitors that can contribute to some reflection upon the issue and consequently actions which will bring positive changes at the working environment

Produção pesqueira artesanal: diagnóstico ergonômico e bases para um planejamento nutricional situado e a promoção da saúde dos jangadeiros

The traditional fishing with rafts is characterized by unpredictability, high stakes and inadequate work conditions. The extensive working hours, physical wear, inadequate nutrition, unsanitary conditions, lack of salvage equipment and instruments suitable working, added by the presence of changes in the nutritional status of fisherman, that contribute to the picture of insecurity in high seas, injuries and health. This study aimed to analyze the activity of the fisherman s from Ponta Negra, Natal / RN, and check the conditions of supply of these fishermen and their implications on health and development of their work. To this finality, was used a methodology based on the ergonomic work analysis employing techniques such as observational and interactional conversational action, listening to the answers, observation protocols, photographic and video records. The script conversational dynamic action was developed from literature searches about the artisanal fisheries, culture and food habits of this population, and analyzes the overall situation of focus and two reference situations. To collect data on the usual diet of fisherman as well as quantitative and qualitative analysis that was used for data analysis and 24h recall the Food Frequency Questionnaire (FFQ). The impact of this power to the health of fisherman was evaluated performing a nutritional assessment. The results revealed that the fishermen carry out their activities with poor working conditions, health and nutrition. Feeding practices of these fishermen undertake development work, making it even more stressful, as well contributing to the emergence of Chronic Noncommunicable Diseases. The management of the activity, as well as the current structure of the vessel, also contributes to the adoption of inappropriate feeding practices during the shipment of catch. The results of this indicate the need for adequate interventions in order to assist in recovery and / or maintenance of health of fisherman minimizing reflections of nutritional disorders for the development activity by improving the quality of life in this population

Modelagem e controle de um microveículo aéreo: uma aplicação de estabilidade robusta com a técnica backstepping em uma estrutura hexarrotor

In this Thesis, the development of the dynamic model of multirotor unmanned aerial vehicle with vertical takeoff and landing characteristics, considering input nonlinearities and a full state robust backstepping controller are presented. The dynamic model is expressed using the Newton-Euler laws, aiming to obtain a better mathematical representation of the mechanical system for system analysis and control design, not only when it is hovering, but also when it is taking-off, or landing, or flying to perform a task. The input nonlinearities are the deadzone and saturation, where the gravitational effect and the inherent physical constrains of the rotors are related and addressed. The experimental multirotor aerial vehicle is equipped with an inertial measurement unit and a sonar sensor, which appropriately provides measurements of attitude and altitude. A real-time attitude estimation scheme based on the extended Kalman filter using quaternions was developed. Then, for robustness analysis, sensors were modeled as the ideal value with addition of an unknown bias and unknown white noise. The bounded robust attitude/altitude controller were derived based on globally uniformly practically asymptotically stable for real systems, that remains globally uniformly asymptotically stable if and only if their solutions are globally uniformly bounded, dealing with convergence and stability into a ball of the state space with non-null radius, under some assumptions. The Lyapunov analysis technique was used to prove the stability of the closed-loop system, compute bounds on control gains and guaranteeing desired bounds on attitude dynamics tracking errors in the presence of measurement disturbances. The controller laws were tested in numerical simulations and in an experimental hexarotor, developed at the UFRN Robotics Laboratory

Algoritmos genéricos para otimização de uma arquitetura de controle inteligente híerárquico

A hierarchical fuzzy control scheme is applied to improve vibration suppression by using an electro-mechanical system based on the lever principle. The hierarchical intelligent controller consists of a hierarchical fuzzy supervisor, one fuzzy controller and one robust controller. The supervisor combines controllers output signal to generate the control signal that will be applied on the plant. The objective is to improve the performance of the electromechanical system, considering that the supervisor could take advantage of the different techniques based controllers. The robust controller design is based on a linear mathematical model. Genetic algorithms are used on the fuzzy controller and the supervisor tuning, which are based on non-linear mathematical model. In order to attest the efficiency of the hierarchical fuzzy control scheme, digital simulations were employed. Some comparisons involving the optimized hierarchical controller and the non-optimized hierarchical controller will be made to prove the efficiency of the genetic algorithms and the advantages of its use

Desenvolvimento de software para simulação de motores com dispositivos de partida baseada na integração do atp com o toprede

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Regulador automático de tensão robusto utilizando técnicas de controle adaptativo

The stability of synchronous generators connected to power grid has been the object of study and research for years. The interest in this matter is justified by the fact that much of the electricity produced worldwide is obtained with the use of synchronous generators. In this respect, studies have been proposed using conventional and unconventional control techniques such as fuzzy logic, neural networks, and adaptive controllers to increase the stabilitymargin of the systemduring sudden failures and transient disturbances. Thismaster thesis presents a robust unconventional control strategy for maintaining the stability of power systems and regulation of output voltage of synchronous generators connected to the grid. The proposed control strategy comprises the integration of a sliding surface with a linear controller. This control structure is designed to prevent the power system losing synchronism after a sudden failure and regulation of the terminal voltage of the generator after the fault. The feasibility of the proposed control strategy was experimentally tested in a salient pole synchronous generator of 5 kVA in a laboratory structure

O imaginário da mediunidade no processo de escritura em Fernando Pessoa

The answer to creating a fictional world? Repulsion or form of reaction to an outside world? Mental illness, whose brand can be symbolic simulation or depersonalization? Hard to take a stand when the deed is a poet Fernando Pessoa as what is at stake. Notes Schlafman Léo (1998) who, at the age of 20 years, Fernando Pessoa wrote in English, in his diary, "One of my mental complications is the fear of madness, which in itself already is crazy." What rid of madness, notes Robert Bréchon (1986), was the taste of the game and was playing it for your writing. Even though it has rid the madness, the poet does not quit seeking explanations - or provide it - for the phenomena much bother him, or defined.'s where we come across the alignment of Fernando Pessoa within philosophical as occultism and reading about psychological and mental disorders treated. paths were pursued by him to explain the existence of his heteronyms and its entry process. This work therefore presents main objective: to analyze the personal papers of Fernando Pessoa, whose outstanding feature is the presence of occult and alleged mediumship demonstrations held in response to non-literary and heteronímicas. Therefore, I focused on specific goals, which are: a) to study the speech of Fernando Pessoa on his mediumship / occult b) analyzing specific texts that are, for the poet, psychic demonstrations, c) study of a series of excerpts personal letters in which Fernando Pessoa suggested to be a medium. Admittedly, this essay will touch many arguments already made by scholars and experts of Fernando Pessoa, but consider the possibility of developing issues and contribute to the critical fortune of the poet. We assume that announces the Portuguese scholar Jerome Pizarro (2006), one of the greatest scholars of the work Pessoan: those interested in Fernando Pessoa be lost in the maze created by him. It is the image of a person-Minotaur, devouring all but, holding us in its labyrinthine tessitura, as marked by mystery. Will draw on our analysis, a theory aligned themselves to objects of research, whose main authors are Sigmund Freud (1908) Carl Jung (1991.1996). Gaston Bachelard (1996), Helena Blavatsky (2008), among others

Memórias da prisão: literatura e liberdade m estudo sobre Graciliano Ramos e Antonio Gramsci

La tese avvicina le Memorie dal carcere, di Graciliano Ramos e i Quaderni dal carcere di Antonio Gramsci, in una prospettiva in cui essi erano uniti per lo stesso ideale politico della prima metá del XX secolo e rappresentavano la resistenza intellettuale di fronte alla repressione. Entrambi furono vittime dell autoritarismo dei poteri fascisti e registrarono il periodo di prigione in differenti forme memorialistiche. Questi scrittori sono uniti anche per il contesto nazionale molto simile per la differenza economica tra le regioni. Condividono, inoltre, anche il concetto di arte e la certezza che l alienzazione dell intelligenza può essere superata solamente attraverso la ricostruzione delle basi nazionali per mezzo della conoscenza, dell educazione e della cultura. Si vuole mostrare come i concetti di Gramsci sono presenti non solo nella convinzione politica di Graciliano, ma in tutto il suo stile letterario memorialístico. Il lavoro, ancora, paragona le Memorie del carcere con due testi memorialistici di prigione in Italia, che sono Le mie prigioni, di Silvio Pellico, e Se questo è un uomo, di Primo Levi, per dimostrare che la proposta della letteratura gramsciana è molto più vicina allo scrittore brasiliano che ai due suoi conazionali.

Veredas infinitas, Recepção italiana de Grandes sertões: veredas

L'obiettivo principale di questo lavoro è valutare le difficoltà di comprensione e di identificazione nella ricezione da parte della cultura italiana dell'opera Grande sertão: veredas, da quelle trovate, in modo pionieristico, dal traduttore italiano, a quelle che sono state percepite e indicate al momento della lettura dai critici, dagli accademici, dall'autore di questo lavoro e, soprattutto, dai lettori comuni, mostrando, allo stesso tempo, che i problemi avuti dagli italiani nella traduzione esistono, sotto certi aspetti, anche per i brasiliani urbani, poiché la dimensione linguistico-geografica presente nel romanzo è così peculiare, che perfino molti lettori di lingua portoghese ignorano il mondo plasmato dal linguaggio di Guimarães Rosa rivelando una esacerbazione della questione universale espressa nella formula "traduttori, traditori". Partendo da tutto ciò, abbiamo cercato di dimostrare che, sebbene la traduzione di Edoardo Bizzarri abbia raggiunto un eccellente risultato, l'opera rosiana, così come nella poesia e di più di qualsiasi altra narrativa, comporta, nel passaggio da un idioma all'altro, perdite irrimediabili, tanto relative all'armonia musicale e ritmica, quanto alla richezza semantica che si occulta nel testo originale

Influência da fadiga no comportamento neuromuscular do quadríceps femoral, após reconstrução do ligamento cruzado anterior

Muscle fatigue is a phenomenon that promotes physiological and biomechanical disorders and their changes in healthy subjects have been widely studied and have significant importance for care in preventing injuries, but we do not have many information about its effects in patients after ACL reconstruction. Thus, this study is to analyze the effects of fatigue on neuromuscular behavior of quadriceps after ACL reconstruction. To reach this objective, participants were forty men, twenty healthy (26,90 ± 6,29 years) and twenty after ACL reconstruction (29,75 ± 7,01 years) with a graft of semitendinosus and gracilis tendons, between four to six months after surgery. At first, there was an assessment of joint position sense (JPS) at the isokinetic dynamometer at a speed of 5°/s and target angle of 45° to analyze the absolute error of JPS. Next, we applied the a muscle fatigue protocol, running 100 repetitions of isokinetic knee flexion-extension at 90°/s. Concurrently with this protocol, there was the assessment of muscle performance, as the peak torque (PT) and fatigue index, and electromyographic activity (RMS and median frequency). Finally, we repeated the assessment of JPS. The statistical analysis showed that patients after ACL reconstruction have, even under normal conditions, the amended JPS compared with healthy subjects and that after fatigue, both have disturbances in the JPS, but this alteration is significantly exacerbated in patients after ACL reconstruction. About muscle performance, we could notice that these patients have a lower PT, although there are no differences between the dynamometric and EMG fatigue index. These findings show the necessity about the cares of pacients with ACL reconstruction in respect of the risks of articulate instability and overload in ligamentar graft