Assistência de enfermagem e o risco para úlceras de pressão medido pela Escala de Braden em unidade de terapia intensiva

The problem facing the incidence of pressure ulcers (UP) in the hospital environment especially in the intensive care unit (ICU), although it is an old and frequent event in our professional practice, it is not notified in the researches as much as it should be. We observed a tendency to invest in therapeutical and in studies about the production of sophisticated new bandages. Few, however, are the investments in research on preventive measures in order to prevent or at least slow down the development of lesions. In this sense, the study aimed to analyze the correlation between nursing care and the risk of developing UP measured by the Braden scale in ICU patients. This is a descriptive study of longitudinal quantitative approach. The project obtained a favourable opinion from the Ethics Committee of HUOL (no 486/10). Data collection was carried out in the Hospital of Unimed in Natal during six months in 2011. The sample was of 32 patients hospitalized in ICU for over four days. The results were processed in SPSS 15.0 for descriptive statistics and inferential statistics. We identified that, only 9.4% of our sample developed UP, being predominantly male, elderly people aged above 60 years, Caucasian, with diagnostic hypothesis at the time of hospitalization of sepsis, were clinical patients, who presented hemodynamic instability, using orotracheal tube (TOT), enteral probe (SNE), vesical probe delay (SVD) and had values of albumin and hemoglobin levels below normal. In addition, these patients had a longer hospital stay, longer usage of TOT, SNE, SVD, increased use of sedation and drain than those who did not develop UP and were all at risk for developing these injuries second Braden scores. 66.7% of the lesions developed were located in the sacral region, limiting the degree I and all patients that developed were considered serious, 100.0% of them have evolved since the death. Small were the differences between the averages of Braden scores between patients with and without UP, 11,9+2,4 against 12,4+2,6 with p = 0.627. The clinical aspects of the patients in the study were instrumental in the development of UP, once, these findings were statistically significant through the Mann-Whitney test, and appropriateness of nursing conduct was decisive for the prevention of pressure ulcers in critical patients, since many were those classified as at risk (28) and few who have developed lesions (03)

Avaliação de economias de escala e escopo no desempenho de equipes de serviços aplicando Análise de Envoltória de Dados DEA: um estudo em Empresa de Telecomunicações no Brasil

This Master s Thesis proposes the application of Data Envelopment Analysis DEA to evaluate economies of scale and economies of scope in the performance of service teams involved with installation of data communication circuits, based on the study of a major telecommunication company in Brazil. Data was collected from the company s Operational Performance Division. Initial analysis of a data set, including nineteen installation teams, was performed considering input oriented methods. Subsequently, the need for restrictions on weights is analyzed using the Assurance Region method, checking for the existence of zero-valued weights. The resulting returns to scale are then verified. Further analyses using the Assurance Region Constant (AR-I-C) and Variable (AR-I-V) models verify the existence of variable, rather than constant, returns to scale. Therefore, all of the final comparisons use scores obtained through the AR-I-V model. In sequence, we verify if the system has economies of scope by analyzing the behavior of the scores in terms of individual or multiple outputs. Finally, conventional results, used by the company in study to evaluate team performance, are compared to those generated using the DEA methodology. The results presented here show that DEA is a useful methodology for assessing team performance and that it may contribute to improvements on the quality of the goal setting procedure.

Influência das condições de cultivo na produção de antígenos recombinantes de Leishmania i. chagasi utilizando Escherichia coli M15 cultivada em incubador rotativo e biorreator

Escherichia coli has been one of the most widely used hosts in recombinant protein production, in both laboratory and industrial scale since the advent of recombinant DNA technology. Despite the substantial progress of studies on the molecular biology and immunology of infections, there is currently no medication-based prophylaxis capable of preventing leishmaniasis. As such, there is a great need to identify specific antigens for the development of vaccines and diagnostic kits against visceral leishmaniasis. Thus, the primary goal of the present study is to assess the influence of cultivation conditions on the production of Leishmania chagasi antigens, carried out in a rotating incubator and bioreactor. To that end, several assays were conducted to evaluate the kinetic behavior of antigens (648, 503) of Leishmania. i. chagasi in two different compositions of media (2xTY, TB), with and without an inducer. In order to improve expression, assays were performed in a benchtop bioreactor using the best conditions obtained in a rotating incubator, in addition to assessing the influence of stirring speed. Results show that high complexity of the cultivation medium favored kinetic growth of clones (648, 503). However, in assays submitted to induction by IPTG, this elevated complexity did not promote the expression of recombinant proteins. Expression of antigens 648 and 503 exhibited behavior associated with growth and, in terms of location, proteins 648 and 503 are intracellularly stored. Lactose may be the most adequate inducer in protein expression, when considering factors, cost, toxicity and stability. Elevated stirring may increase cell growth in clone 53, although it may not result in high concentrations for the protein of interest. On the other hand, positive results were obtained for all recombinant clones (648, 503) tested, confirmed by the electrophoretic profile

Estudo das propriedades psicométricas da escala WHOQOLold em idosos da região Nordeste

The population aging process increases the number of elderly people worldwide. In Brazil, a country of continental size, this process began in the 40s and happens with specific features in each of the different region s realities. This way, this thesis aimed to evaluate the psychometric properties of a elderly s quality of life (QOL) scale, the WHOQOL-old, in a population of the Northeast of Brazil. We sought to investigate the congruence between the content covered by the scale and the ones deemed as relevant by the participants. It aimed also study the validity evidences of the instrument s internal structure. To achieve the research objectives we adopted the design of multiple methods. The research was organized in two studies. For data collection, both studies used a sociodemographic questionnaire to obtain a profile of the participants and the Mini Mental State Exam (MMSE), used as exclusion criterion. A number of 18 elderly residents of the cities of Natal-RN and Campina Grande-PB, mean age of 73.3 years (SD = 5.9) took part od the study, They were organized into three focal groups (FG) in witch they discussed about the concept of QOL, what enhance and what hinders QOL. For Study II, a quantitative approach, 335 elderly from Campina Grande responded scale WHOQOL-old. They are between 65 and 99 years (M = 74.17, SD = 6.5). The FG data were analyzed by categorical thematic content. For the data analysis of the WHOQOL-old scale were used exploratory factor analysis and calculation of the Akaike and Bayesian information criteria. The results of both studies were triangulated. According to the discussions in the FG, health and social participation have central roles in quality of life. Social participation is related to all the other QOL s influences raised. The participants indicated the relevance of religiosity and were divided about the importance of sexual activity. Exploratory factor analysis (EFA) extracted a model of six factors. Two items (OLD_3 and OLD_9), not loaded on any factor and were excluded. The other items had factor loadings > 0.3. The response categories were reduced from five to three. After the scale changes, the empirical model showed better fit (-2loglikelihood = 8993.90, BIC and AIC = 9183.90 = 9546.24) than the theoretical model (-2loglikelihood = 18390.88, AIC = 18678.88 and BIC = 19228.11). Despite the best information criterion values, the RMESA remained above the ideal (0.06). We conclude that the WHOQOL-old presents psychometric parameters below the ideal when used with the Northeast population, but the improvements made the scale s use acceptable. The WHOQOL-old uses observable variables that matches with the participants' perceptions on quality of life. However, new strategies must be tested for a better sacale refinement

Estudos de distúrbios ionosféricos propagantes de larga escala (LSTID’S) na região equatorial durante grandes tempestades magnéticas: estudo de casos

The Ionospheric Disturbances – TIDs – are irregularities on the ionospheric plasma propagating in speeds in the order of tens to a few hundreds of meters per second. This present study detected and characterized the TIDs of LSTIDs (Large Scale Travelling Ionospheric Disturbance) type at low latitudes during intense geomagnetic storms and its propagation over the Brazilian sector. This work also shows as being the first to report systematically propagation of gravity waves over Natal. For this purpose, we used ionospheric records obtained from type of digisonde CADI (Canadiam Advanced Digital Ionosonde) located in Natal and the type DSP (Digisonde Portable Souder) located in Cachoeira Paulista, Fortaleza and São Luis, whereupon we used a dataset of 12 years collected by INPE (National Institute of Space Research). In this study, both calm days, that preceded the storms, and the geomagnetically disturbed days were related during the years 2000 and 1012, which cover a period of maximum and minimum solar activity. And it is presented the variations that happened in the electron density from region F of the ionosphere over the Brazilian sector, especially near the Equator (Natal, Fortaleza and São Luis), caused by ionospheric disturbances in the equatorial region during intense geomagnetic storms, because, as we know of the literature in this area, this phenomenon contributes positively to the emergence of LSTIDs in the auroral region, which may move to the equatorial region where a few cases have been documented and studied systematically. From the observation of signatures if TIDs in ionogram records, a study of the morphology of these events was performed and compared with the main characteristics of the wave of this phenomenon during great magnetic storms, i.e., DST <(-200 nT) and KP > 6. Thus, we obtained the main characteristics of TIDs over our region, i.e., period, vertical wavelength, phase and propagation speed, as well as the delay of these disturbances compared to the beginning of the magnetic storms to the Brazilian Sector.

Um estudo sobre a variabilidade do vento no nordeste do Brasil através de métodos estatísticos e via modelos dinâmicos de meso e micro escala

The objective of this study was to determine the seasonal and interannual variability and calculate the trends of wind speed in NEB and then validate the mesoscale numerical model for after engage with the microscale numerical model in order to get the wind resource at some locations in the NEB. For this we use two data sets of wind speed (weather stations and anemometric towers) and two dynamic models; one of mesoscale and another of microscale. We use statistical tools to evaluate and validate the data obtained. The simulations of the dynamic mesoscale model were made using data assimilation methods (Newtonian Relaxation and Kalman filter). The main results show: (i) Five homogeneous groups of wind speed in the NEB with higher values in winter and spring and with lower in summer and fall; (ii) The interannual variability of the wind speed in some groups stood out with higher values; (iii) The large-scale circulation modified by the El Niño and La Niña intensified wind speed for the groups with higher values; (iv) The trend analysis showed more significant negative values for G3, G4 and G5 in all seasons and in the annual average; (v) The performance of dynamic mesoscale model showed smaller errors in the locations Paracuru and São João and major errors were observed in Triunfo; (vi) Application of the Kalman filter significantly reduce the systematic errors shown in the simulations of the dynamic mesoscale model; (vii) The wind resource indicate that Paracuru and Triunfo are favorable areas for the generation of energy, and the coupling technique after validation showed better results for Paracuru. We conclude that the objective was achieved, making it possible to identify trends in homogeneous groups of wind behavior, and to evaluate the quality of both simulations with the dynamic model of mesoscale and microscale to answer questions as necessary before planning research projects in Wind-Energy area in the NEB