Distribuição regional da ventilação pulmonar em indivíduos com insuficiência cardíaca crônica após serem submetidos a um programa de treinamento da musculatura inspiratória e sua correlação com dados funcionais

Introduction: Chagas Disease is a serious public health problem, with 5 million infected individuals in Brazil. Of these, approximately 30% develop chronic Chagas cardiomyopathy (CCC), where the main symptoms are fatigue and dyspnea. Objective: To correlate maximal exercise capacity with pulmonary function, inspiratory muscle strength and quality of life in patients with CCC. Methodology: Twelve individuals suffering from CCC were evaluated (7 men), with a mean age of 54.91± 8.60 years and the following inclusion criteria: functional class II and III according to the New York Heart Association (NYHA); left ventricle ejection fraction below 45%; clinical stability (> 3 months); symptom duration > 1 year, body mass index (BMI) < 35Kg/m2 and non-smokers or ex-smokers with a history of smoking <10 packs/day. All subjects were submitted to spirometry, manometer testing, maximal cardiopulmonary exercise testing (CPX) and a quality of life questionnaire (Minnesota). Results: A negative correlation was observed between VO2máx and MLHFQ scores (r=-0.626; p=0.03) and a positive association with MIP (r=0.713; p=0.009). Positive correlations were also recorded between MIP and spirometric variables [FEV1(r=0.825;p=0.001 ), FVC(r=0.66;p=0.01 and FEF25-75%(r=0.639;p=0.02)]. Conclusion: The present study demonstrated that in patients with CCC: VO2MAX is directly related to inspiratory muscle strength and quality of life, while deteriorating lung function is directly associated with respiratory muscle weakness

A influência do tempo de diálise e do paratormônio sobre as condições clínico-radiográficas bucais de indivíduos com insuficiência renal crônica em diálise

Universidade Estadual do Rio Grande do Norte

Convergência ou divergência no desenvolvimento? um estudo multidimensional para o sudeste e o nordeste do Brasil, 1990-2010

The analysis of some aspects of development in Brazil in the past three decades reveals an improvement on a range of indicators isolated in the south east the richest region and north east the poorest region. From a database of twenty variables, the main purpose the study was to verify if there are indications of convergence or divergence in five dimensions of development between the two regions from 1990 to 2010. Aiming to identify the states more similar and different, and to verify changes in the composition of low development groups and high development in the adressed period, was used the analysis of groupings (Cluster Analysis). Additionally, to test equality of distance between states all the time, was used the non-parametric Test of Wilcoxon. This makes it possible to verify IF the distance between the states of two regions has been increasing or has been falling, showing signs of divergence or convergence. The results of Cluster s analysis suggest that there are indications of convergence inside the cluster of north east, but the distance between two regions has not changed. The results of test of Wilcoxon suggests that there have been no changes statistically significant in the distance between the states, in the two regions the standards of development became more homogenous, but the two regions will be far apart

Algoritmos genéticos: uso de lógica nebulosa e análise de convergência por cadeia de Markov

In this work, the Markov chain will be the tool used in the modeling and analysis of convergence of the genetic algorithm, both the standard version as for the other versions that allows the genetic algorithm. In addition, we intend to compare the performance of the standard version with the fuzzy version, believing that this version gives the genetic algorithm a great ability to find a global optimum, own the global optimization algorithms. The choice of this algorithm is due to the fact that it has become, over the past thirty yares, one of the more importan tool used to find a solution of de optimization problem. This choice is due to its effectiveness in finding a good quality solution to the problem, considering that the knowledge of a good quality solution becomes acceptable given that there may not be another algorithm able to get the optimal solution for many of these problems. However, this algorithm can be set, taking into account, that it is not only dependent on how the problem is represented as but also some of the operators are defined, to the standard version of this, when the parameters are kept fixed, to their versions with variables parameters. Therefore to achieve good performance with the aforementioned algorithm is necessary that it has an adequate criterion in the choice of its parameters, especially the rate of mutation and crossover rate or even the size of the population. It is important to remember that those implementations in which parameters are kept fixed throughout the execution, the modeling algorithm by Markov chain results in a homogeneous chain and when it allows the variation of parameters during the execution, the Markov chain that models becomes be non - homogeneous. Therefore, in an attempt to improve the algorithm performance, few studies have tried to make the setting of the parameters through strategies that capture the intrinsic characteristics of the problem. These characteristics are extracted from the present state of execution, in order to identify and preserve a pattern related to a solution of good quality and at the same time that standard discarding of low quality. Strategies for feature extraction can either use precise techniques as fuzzy techniques, in the latter case being made through a fuzzy controller. A Markov chain is used for modeling and convergence analysis of the algorithm, both in its standard version as for the other. In order to evaluate the performance of a non-homogeneous algorithm tests will be applied to compare the standard fuzzy algorithm with the genetic algorithm, and the rate of change adjusted by a fuzzy controller. To do so, pick up optimization problems whose number of solutions varies exponentially with the number of variables

A convergência digital na produção da notícia: reconfigurações na rotina produtiva dos jornais Tribuna do Norte e Extra

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Jornalismo e narrativas transmidias: a reportagem no contexto da convergência

The transmedia storytelling is a phenomenom recently conceptualized theoretically (JENKINS, 2009), arising from ficcional mediatic products and disseminated as well by the use on other fields. This search aims to analyze how the transmedia storytellings can be applied to journalism on the basis of an specific genre, the reporting. To that, take as reference theoretical developments performed by brazilian authors (FECHINE et al., 2011, 2012, 2013), on the basis of televisive fiction, which culminated on concepts as transmediation and transmedia contents and deepened the comprehension and the research in this area. Thenceforth, this study propone a problematization and apropriation of this theoretic support for the journalism field, using, for that, a comprehension of journalistic production on a speech level, as well as its social practices (newsmaking). The empiric research also take two different paths. First, analyze a group of reportings, in which there is transmediation, in order to verifying the configuration of the transmedia phenomenom - more specifically of the transmedia storytelling - and its particularities to journalism. Then, develops an investigation, based on the etnographic method, of the productive routine on the special reporting section of the Jornal do Commercio (Recife/PE), aiming to investigate the conditions of transmediation in this range and the practices that favor and difficult the employment of transmedia storytelling. The result are, therefore, compared and related, with the goal of providing multidimensional view of the phenomenom

Influência do tratamento periodontal sobre os níveis da proteína c-reativa ultrassensível em pacientes com insuficiência renal crônica em fase de prétransplante

The present study evaluated the influence of non-surgical periodontal treatment on the levels of C- reactive protein (hsCRP) in patients with chronic renal failure (CRF) in pretransplant. We conducted a controlled and randomized trial to evaluate the periodontal condition and plasma concentrations of hsCRP, albumin and transferrin in 56 dialysis patients divided into two groups: experimental and control. The study was conducted at the dental clinic of Family and Community Health s Unit (USFC), located in Onofre Lopes University Hospital (HUOL), Federal University of Rio Grande do Norte (UFRN), from December 2010 to November 2011. Severe periodontitis was the type of periodontal disease more common, affecting 78.6% of patients. Periodontal conditions, evaluated through the means of probing depth, clinical attachment level, bleeding index and plaque index, proved to be uniform for both groups at the initial examination. There were no differences in levels of inflammatory markers between the two groups. The analysis of the concentrations of hsCRP allowed classifying study participants as at high risk of developing cardiovascular disease. After completion of periodontal treatment in the experimental group, there was a statistically significant reduction of the mean of all periodontal parameters assessed; however this improvement of periodontal health was not accompanied by changes in the levels of hsCRP, albumin and transferrin in the evaluation time. Given this, the periodontal treatment did not promote the reduction of systemic inflammatory burden and risk of cardiovascular complications in patients with CRF

Evidências de validade do Millon Behavioral Medicine Diagnostic na avaliação de aderência terapêutica em pacientes com insuficiência cardíaca crônica

Chronic heart failure (CHF) is the final common pathway of most diseases affecting the heart, being responsible for a high level of mortality and hospitalization, as well as significant reduction in quality of life of those affected. Interventions that claim to optimize patient adherence to their medical regimen, and improve self-care behavior, have proven effective in preventing unplanned admissions and improves the outcome for patients, however, studies have shown the problem of non-adherence, and some psychological instruments have been used to show that traces indicate difficulties with treatment adherence. Having shown this, the aim of this work is to evaluate the evidence of validity of the Millon Behavioral Medicine Diagnostic (MBMD) in a population of patients with CHF. The study included individuals with CHF, males and females, between the age of 18 and 85 years, treated in a reference hospital in the city of NatalRN. A total of 120 patients answered, in addition to the MBMD, another questionnaire structured with sociodemographic aspects and clinical itens. The results indicated that the parameter of the MBMD reliability was satisfactory the most of extracted factors, and some scale. In terms of the population studied, we could verify that the disease was more prevalent in men, but women had the highest average in indicators related to negative health habits and depressed mood. Younger pacients and those who had no partner had the highest averages in groups of items that dealt with feelings of sadness and discouragement. Hasn’t been observed differences related to negative health habits and problematic adherence among patients in different functional classes. More studies in this research line, with a larger population and from other regions of the country, are needed in order to expand the data presented here

Novas formas de governança pública: um estudo do arranjo articulado para Implementação da política pública nacional de aprendizagem profissional

The configuration assumed by the institutional governance arrangement established in the cities of Fortaleza and Natal, and its influence on the implementation of the National Public Policy of Professional Learning that promotes the formation and integration into the labor market of teens and young people aged 14 to 24 years old and people with disabilities is the aim of this thesis. The interactive governance approach, proposed by Kooiman (2003.2008) was the mainstay of the epistemological construction of the investigative process, also supported by contributions from Draibe (2001) concerning the stages of implementation of public policies. In methodological terms, the approach used was qualitative, being performed descriptive bibliographical and documentary research, applying semi-structured interviews with 44 subjects. Data were based on Bardin (2011), having been pre-established two categories of analysis: governance and implementation. The results pointed, among other things, to greater diversity and dynamics of the arrangement in Fortaleza, highlighting the much larger number of accessions of Nonprofit Entities (ESFLs) to politics, more frequent interactions between stakeholders from different organizational levels of governance, better alignment between guiding governance images and spaces designed to encourage interactions among actors and also greater local government involvement. In both cities studied, on the other hand, the study indicated that the failure of institutional capacities adversely affect the interactions stimulation and the exercise of meta-governance. The thesis concluded that the shape and intensity of the interactions between the actors involved in the implementation of the National Public Policy of Professional Learning and the way images are shared results in greater understanding and dissemination of the policy and create a favorable environment for cooperation and dialogue needed to collective work and favors the modeling of a governance structure able to handle the demands and characteristics of organizations and their participants in order to accommodate the divergent interests, make room for the creation of innovations and convergence of actions to achieve the objectives of the policy. Thus, the results of the Professional Learning Policy in the cities of Natal and Fortaleza, in terms of levels of entering the labor market, can be understood from the differences found in the governance structure of the institutional arrangement used for its implementation.

Algoritmo modificado de PSO matricial aplicado a identificação de sistemas com análise de convergência

Recentemente diversas técnicas de computação evolucionárias têm sido utilizadas em áreas como estimação de parâmetros de processos dinâmicos lineares e não lineares ou até sujeitos a incertezas. Isso motiva a utilização de algoritmos como o otimizador por nuvem de partículas (PSO) nas referidas áreas do conhecimento. Porém, pouco se sabe sobre a convergência desse algoritmo e, principalmente, as análises e estudos realizados têm se concentrado em resultados experimentais. Por isso, é objetivo deste trabalho propor uma nova estrutura para o PSO que permita analisar melhor a convergência do algoritmo de forma analítica. Para isso, o PSO é reestruturado para assumir uma forma matricial e reformulado como um sistema linear por partes. As partes serão analisadas de forma separada e será proposta a inserção de um fator de esquecimento que garante que a parte mais significativa deste sistema possua autovalores dentro do círculo de raio unitário. Também será realizada a análise da convergência do algoritmo como um todo, utilizando um critério de convergência quase certa, aplicável a sistemas chaveados. Na sequência, serão realizados testes experimentais de maneira a verificar o comportamento dos autovalores após a inserção do fator de esquecimento. Posteriormente, os algoritmos de identificação de parâmetros tradicionais serão combinados com o PSO matricial, de maneira a tornar os resultados da identificação tão bons ou melhores que a identificação apenas com o PSO ou, apenas com os algoritmos tradicionais. Os resultados mostram a convergência das partículas em uma região delimitada e que as funções obtidas após a combinação do algoritmo PSO matricial com os algoritmos convencionais, apresentam maior generalização para o sistema apresentado. As conclusões a que se chega é que a hibridização, apesar de limitar a busca por uma partícula mais apta do PSO, permite um desempenho mínimo para o algoritmo e ainda possibilita melhorar o resultado obtido com os algoritmos tradicionais, permitindo a representação do sistema aproximado em quantidades maiores de frequências.

Reabilitação cardíaca na insuficiência cardíaca crônica: efeitos de 12 semanas de treinamento intervalado x contínuo na função cardiopulmonar e qualidade de vida

Background: Cardiac Rehabilitation (CR) has effect on mortality in patients with heart failure (HF) chronic, and the exercise of the treatment of this patient. The most common exercise is ongoing training. Recently we have been studying the effects of interval training, but there is no consensus on the optimal dose of exercise. Objective: To evaluate the effects of interval aerobic training are superior to continuous aerobic training in patients with chronic HF. Methods: The clinical trial evaluated patients through cardiopulmonary test (CPX) and quality of life before and after the RC (3 times / 12 weeks). Patients were randomized into Group Interval Training (GTI - 85% of heart rate reserve - FCR), Continuous Training Group (GTC - 60% of HRR) and control group (CG) who received guidelines. Results: 18 patients were evaluated (mean age 44.7 ± 13.2 years and 35.2 ± 8.9% of left ventricular ejection fraction [LVEF]). Both groups were efficient to increase the peak VO2 and 15.1% (P = 0.02) in GTI and 16.1% (P = 0.01) GTC. As for the quality of life the GTI GTC showed improvement compared to the control group (P = 0.006). Hemodynamic mismatch events during the CPX were reduced after training in more GTC (patients 1 to 4) than in the GTI (5 to 3). Cardiac risk also decreased in the GTC (3 patients left the severe risk to take after training). Conclusion: Continuous training becomes more appropriate for improving fitness with little chance of developing cardiac event patients with chronic HF.