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

Estratégias de aplicações sequenciais e paralelas da metaheurística otimização por enxame de partículas ao problema do caixeiro viajante

Particle Swarm Optimization is a metaheuristic that arose in order to simulate the behavior of a number of birds in flight, with its random movement locally, but globally determined. This technique has been widely used to address non-liner continuous problems and yet little explored in discrete problems. This paper presents the operation of this metaheuristic, and propose strategies for implementation of optimization discret problems as form of execution parallel as sequential. The computational experiments were performed to instances of the TSP, selected in the library TSPLIB contenct to 3038 nodes, showing the improvement of performance of parallel methods for their sequential versions, in executation time and results

As sentenças com é ruim que no português brasileiro

Based on studies on the structure of copulates sentences in Brazilian Portuguese (PB), according to grammar theory, it s analyzed on this dissertation, the complex copulate sentences what, in the PB, initiated by the formation é ruim que in the PB, bringing the hypothesis that they can have one predicacional reading (PRED) and other especificacional reading (ESP). It s revealed what, though they are similar slightly, that makes the different that are triggered is structural configuration of sentence and the form as come emerged the its constituents: that of PRED interpretation, that we defined as Common Copulate Sentence (or SCC), it s checked that the constituent ruim, and only it, is predicate of a Small Clause, and appears in the structure on even position wherein is pronounced, not passing by the method of movement, from where introduce wide predication on all subject, that is the CP built-in; those sentences é ruim que understanding ESP, that denominate of Negative Copulate Sentence (or SCN), whereas the fixed expression contradict or right what is asserted in built-in, it s perceived what the ruim is a part of this fixed expression, and surely crystallized, which appears in structure per movement, germinated as adjunct of Inflexional Phrase (IP) and being elevation to specifier to FocP (or SpecFocP), where acquires discursive interpretation of focus. Besides the mode as the ruim or the fixed expression emerge in that sentences, the relation between the copula and main verb likewise contribute to distinguish the sentences: 1) regarding flexion of mode, when is a SCC, the copula must be in the mode indicative, and the main verb, in the subjunctive; when is a SCN, copula and main verb must be always on indicative; 2) regarding flexion of temp, both the copula as main verb of the SCC can be flexed, whereas at the SCN, the main verb can vary in present, past and future, but the copula should appear, necessarily, in third persona of present of indicative, what confirms our hypothesis that there is an fixed expression at the copulate sentences with é ruim que ESP. Other two evidences are pointed as characteristics that distinguish the sentence with é ruim que PRED of sentence with é ruim que ESP: 1) in semantics, the constituent ruim equals not good, that has appreciation, when the reading will PRED; already the pair é ruim equals not, at the ESP; 2) in prosody, there discrete sound elevation the ruim on the other constituents of SCC, PRED, while there is accentuated acoustic elevation on the ruim of SCN, ESP. Our search it is grounded in authors as Zanfeliz (2000), Modesto (2001), Mioto (2003), Kato & Ribeiro (2006), Lobo (2006), Quarezemin (2006, 2009, 2011, 2012) e Resenes (2009), researchers that devoted their attention on studies the formation and organization of the constituents of cleaved sentences and focalization of constituent, basing itself in approach generative of linguistic