Rede de controle em ambiente hospitalar: um protocolo multiciclos para automação hospitalar sobre IEEE 802.3 com IGMP Snooping

VALENTIM, R. A. M. ; MORAIS, A. H. F. ; SOUZA, V. S. V ; ARAUJO JUNIOR, H. B. ; BRANDAO, G. B. ; GUERREIRO, A. M. G. . Rede de Controle em Ambiente Hospitalar: um protocolo multiciclos para automação hospitalar sobre IEEE 802.3 com IGMP Snooping. Revista Ciência e Tecnologia, v. 11, p. 19, 2009

Assistência aos portadores de úlceras venosas: proposta de protocolo

Venous ulcers (VU), recurrent chronic wounds resulting from Chronic Venous Insufficiency (CVI), affect different age groups and would severely affect ambulation of patients. The lesions require treatment lasting and complex and are responsible for significant morbidity and mortality. Thus, this study aims to identify the important aspects covered in the scientific literature protocol for assisting patients with venous ulcers, identifying the issues to be proposed by the judges of the study (nurses, doctors and physiotherapists) to the protocol of care provided to patients venous ulcers and present the structure of protocol proposed by the judges of the study to assist patients with venous ulcers treated at a referral hospital of Rio Grande do Norte. This is a descriptive study using a quantitative approach, carried out at the dressings, located in the outpatient surgical clinic of the Hospital University Onofre Lopes (HUOL), located in East Sanitary District, Natal-RN. The sample consisted of 39 professionals, 30 nurses, seven doctors and two physical therapists, team members HUOL surgical clinic and other public and private institutions of Rio Grande do Norte and Jequié/Bahia. These professionals were the judges responsible for selecting the guidelines already proposed in the literature on VU protocols. Approved by the Ethics in Research HUOL (Report n.o 081/07), began the first stage of the study which consisted of reviewing the scientific literature about the relevant aspects to be included in a protocol for assisting patients with VU. These aspects were organized into a proposed questionnaire to the judges of the study. Following examination, held on the content validation with application of the Kappa (K), accepting a score higher than 0.80 and the Likert Scale, whereas rates from 4.0 to 5.0. The data collected were organized in Microsoft Excel and exported into Statistical Package for Social Sciences (SPSS) 15.0. The literature review included national and international scientific articles, thesis, dissertation and institutional protocols. Regarding the characterization of professional nurses predominated (76.1%), between 34 and 45 years (41.0%), female (79.5%), married/consensual union (46.2%), with specialization in VU care (61.5%), working in the hospital network (46.1%), with up to 5 years experience in VU (69.2%) and claiming to feel prepared to care for these injuries (92.3 %). With regard to aspects that had very good agreement (K ≥ 0.81), remained the items found in the literature with some modifications. In the analysis of the proposed evaluation items had very important, ranging from 4.1 (drug treatment) to 4.9 (patient assessment and care of the injury and the injured and perilesional skin). The proposition of the protocol is arranged in eleven items: A) Evaluation of patient and lesion, B) Registration and documentation, C) the wound and perilesional skin, D) an indication of coverage, E) Use of antibiotic and pain treatment, F) Surgical treatment of CVI, G) Drug treatment, H) Improving venous return and prevetion of recurrence, I) Referral of patients, J) Training and K) Reference and counter reference

Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária

People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconized in the scientific literature, interfering with wound healing and quality of life of affected. In this sense, the construction of a assistance protocol specific to people with venous ulcers (VU) can help professionals of the Family Health Strategy both in patient assessment as and in establishment of quality assistance. Thus, this study aimed to analyse the validity of a multiprofessional assistance protocol for people with venous ulcers in primary care by health professionals using Delphi technique. This is a quantitative study, the methodological type conducted in two steps: first step related to integrative literature review to subsidize the development of the protocol, then these aspects were organized and proposed to the judges of the study through the Delphi technique. The study was initiated after approval by the Research Ethics Committee. The first step was performed between August and September 2012, in the virtual library of health, in the page of the Coordination of Improvement of Higher Education Personnel, of Municipal Health Secretariat and international guidelines of associations and in the subsequent step carried out between September 2012 to January 2013, was performed search by Lattes platform of the National Council of Technological and Scientific Development, in order to identify health professionals in Brazil who act as judges of the instrument and then, via online, the form was submitted to them.The sample for the second step was 51 judges in the first round and 35 for the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach Kappa and CVI established were: request / realization / test results, demographic data, medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion location/ edema and pain treatment. After removal of items which have not obtained Kappa or CVI index established, it was found achieving optimal levels of these index for the categories. In the next step was the ressubmissão of protocol to judges through the Delphi technique in it was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2 phase and the other three categories remained the same Kappa and IVC of the previous phase. As for the average of evaluation requirements of the protocol was found that the scores assigned by the judges were higher in the second phase in nine of the 10 items, remaining the same in only one of the items indicating validity of the instrument before the consensus of the judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The formulation of this assistance protocol valid and reproducible will enable a reorganization and redesign of assistance, with standardization of actions and continuity of care for persons with venous ulcers in primary health care

Evidências de validação de um protocolo para assistência às pessoas com úlceras venosas em serviços de alta complexidade

Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs . After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa ≥ 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity

Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente em unidades de terapia intensiva

The reports of adverse events date from 1990 up to the present day. Conceptually, these adverse events are unintentional injuries unrelated to the underlying disease, causing measurable lesions in patients, extending the period of hospitalization, or leading to death. These issues require discussions with regard to patient safety, improved quality of service, and preventing medical errors. In the Intensive Care Units, this concern is greater because these are sectors of intensive care to individuals with hemodynamic changes and imminent risk of death. Therefore, it is essential to conduct evaluation processes to investigate aspects of quality of nursing care and patient safety in these spaces. For that reason, we aimed to propose the Evaluation protocol of nursing care and patient safety in Intensive Care Units. For its achievement, we needed to: 1) analyze the evolution of the patient safety concept used in scientific productions, under Rodgers evolutionary concept; 2) identify the necessary items to build the evaluation protocol of nursing care and patient safety in the Intensive Care Unit, from the available evidence in literature; 3) construct an instrument for content validation of the evaluation protocol of nursing care and patient safety in the Intensive Care Unit; and 4) describe and evaluate the appropriateness of the content for an evaluation protocol of nursing care and patient safety in the Intensive Care Unit. This is a methodological study for the content validation of the abovementioned protocol. To meet the first three specific objectives, we used the integrative literature review in Theses Database of the Coordination for the Improvement of Higher Education Personnel and the portal of the Collaborating Centre for Quality of Care and Patient Safety. The fourth specific objective happened through the participation of judges, located from the Lattes curricula, in the content validation process developed in two stages: Delphi 1 and Delphi 2. As instrument, we used the electronic form of Google docs. We present in tables the answers from the evaluation instruments by Delphi consensus and Content Validity Index (CVI) of the entire protocol. We summarized the results in articles entitled Analysis of the patient safety concept: Rodgers evolutionary concept ; Scientific evidence regarding patient safety in the Intensive Care Unit ; Technological device for the content validation process: experience report ; and Evaluation protocol of nursing care and patient safety in Intensive Care Units. The Embodied Opinion of the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, No. 461,246, under CAAE 19586813.2.0000.5537, approved the study. Thus, we conclude the protocol valid in its content, constituting an important tool for evaluating the quality of nursing care and patient safety in Intensive Care Units

Protocolo multiciclos para automação hospitalar sobre Multicast com IEEE 802.3 utilizando

The concepts of the industrial automation are being incorporated in the medical area, in other words, they also pass to be applied in the hospital automation. In this sense, researches have been developed and have usually been approached several of the problems that are pertinent to the processes that can be automated in the hospital environment. Considering that in the automation processes, an imperative factor is the communication, because the systems are usually distributed, the network for data transference becomes itself an important point in these processes. Because this network should be capable to provide the exchange of data and to guarantee the demands that are imposed by the automation process. In this context, this doctorate thesis proposed, specified, analyzed and validated the Multicycles Protocol for Hospital Automation (MP-HA), which is customized to assist the demands in these automation processes, seeking to guarantee the determinism in the communications and to optimize the factor of use of the mean of transmission

Um protocolo de comunicação multicast na camada de aplicação com Consciência de Localização

Internet applications such as media streaming, collaborative computing and massive multiplayer are on the rise,. This leads to the need for multicast communication, but unfortunately group communications support based on IP multicast has not been widely adopted due to a combination of technical and non-technical problems. Therefore, a number of different application-layer multicast schemes have been proposed in recent literature to overcome the drawbacks. In addition, these applications often behave as both providers and clients of services, being called peer-topeer applications, and where participants come and go very dynamically. Thus, servercentric architectures for membership management have well-known problems related to scalability and fault-tolerance, and even peer-to-peer traditional solutions need to have some mechanism that takes into account member's volatility. The idea of location awareness distributes the participants in the overlay network according to their proximity in the underlying network allowing a better performance. Given this context, this thesis proposes an application layer multicast protocol, called LAALM, which takes into account the actual network topology in the assembly process of the overlay network. The membership algorithm uses a new metric, IPXY, to provide location awareness through the processing of local information, and it was implemented using a distributed shared and bi-directional tree. The algorithm also has a sub-optimal heuristic to minimize the cost of membership process. The protocol has been evaluated in two ways. First, through an own simulator developed in this work, where we evaluated the quality of distribution tree by metrics such as outdegree and path length. Second, reallife scenarios were built in the ns-3 network simulator where we evaluated the network protocol performance by metrics such as stress, stretch, time to first packet and reconfiguration group time

Uma arquitetura para detecção online de transientes em sinais de eletrocardiograma sobre o protocolo IEEE 802.3 com PM-AH

The occurrence of transients in electrocardiogram (ECG) signals indicates an electrical phenomenon outside the heart. Thus, the identification of transients has been the most-used methodology in medical analysis since the invention of the electrocardiograph (device responsible for benchmarking of electrocardiogram signals). There are few papers related to this subject, which compels the creation of an architecture to do the pre-processing of this signal in order to identify transients. This paper proposes a method based on the signal energy of the Hilbert transform of electrocardiogram, being an alternative to methods based on morphology of the signal. This information will determine the creation of frames of the MP-HA protocol responsible for transmitting the ECG signals through an IEEE 802.3 network to a computing device. That, in turn, may perform a process to automatically sort the signal, or to present it to a doctor so that he can do the sorting manually

Desenvolvimento de um protocolo de comunicação para automação de subestações móveis via satélite

One of the most important decisions to turn a substation automatic and no attended it relates to the communication media between this substation and Operation Center. Generally energy companies uses radio or optic fiber, depending of distances and infrastructure of each situation. This rule applies to common substations. Mobile substations are a particular case, therefore they are conceived for use at provisional situations, emergencies, preventive or corrective maintenance. Thus the telecommunication solution used at common substations are not applied so easily to mobile substations, due absence of infrastructure (media) or difficulty to insert the mobile substation data in existing automation network not long. The ideal media must supply covering in a great geographic area to satisfy presented requirements. The implantation costs of this big infrastructure are expensive, however a existing operator may be used. Two services that fulfill that requirements are satellite and cellular telephony. This work presents a solution for automation of mobile substations through satellite. It was successfully implanted at a brazilian electric energy concessionaire named COSERN. The operation became transparent to operators. Other gotten benefits had been operational security, quality in the supply of electric energy and costs reduction. The project presented is a new solution, designed to substations and general applications where few data should be transmitted, but there is difficulties in relation to the media. Despite the satellite having been used, the same resulted can be gotten using celullar telephony, through Short Messages or packet networks as GPRS or EDGE.

Implementação da infra-estrutura e protocolo de comunicação para tratamento e disponibilização de dados do projeto ePoste

The study consists in the structure elaboration and the ePoste project communicationprotocol, which is a system of monitoring by wireless communication with the aim tosensor and act with one or many public lighting points, and also the treatment of data todetect the activity in the sensors located on the posts. Previously the communication withsensors were made in locus and when data collect was necessary or the performance inthe devices, the operator had to move until the net place. Accordingly, the purpose has theconcern to increase the system dynamic, achieving the possible integrations with the systemsalready available to the lighting management. The same technology of communicationbetween the sensors are considerate, using the ZigBee protocol running on the meshnet, the communication with this net is made be internet through a gateway by GPRS,device with two basics functionalities, which bypass for data and the firmware update inthe sensor. This functionality test of data management is being tested; integrate way withlocal net of sensors and the internet data server operates. The protocol developed, besidesincorporating the ZigBee, that it is formation of framework in lower level, where definesbeginning, size and errors check, as well as the communication of sensor with the concentrator,which it is encapsulated in ZigBee; also the protocol of upper level, where thatit is the names, it was developed a platform of service to meet GET and POST requestsbeneath HTTP protocol, this service is implemented in the data server, which availablethe communication with the clients systems, in case, lighting management systems.

FTE-LEACH: um protocolo energeticamente eficiente e tolerante a falhas aplicado às redes industriais de sensores sem fio

A Wireless Sensor Network (WSN) consists of distributed devices in an area in order to monitor physical variables such as temperature, pressure, vibration, motion and environmental conditions in places where wired networks would be difficult or impractical to implement, for example, industrial applications of difficult access, monitoring and control of oil wells on-shore or off-shore, monitoring of large areas of agricultural and animal farming, among others. To be viable, a WSN should have important requirements such as low cost, low latency, and especially low power consumption. However, to ensure these requirements, these networks suffer from limited resources, and eventually being used in hostile environments, leading to high failure rates, such as segmented routing, mes sage loss, reducing efficiency, and compromising the entire network, inclusive. This work aims to present the FTE-LEACH, a fault tolerant and energy efficient routing protocol that maintains efficiency in communication and dissemination of data.This protocol was developed based on the IEEE 802.15.4 standard and suitable for industrial networks with limited energy resources

Economy of the island of eco-tourism: the role of shark-diving and shark harvesting

Beyond its importance in maintaining ecosystems, sharks provide services that play important socioeconomic roles. The rise in their exploitation as a tourism resource in recent years has highlighted economic potential of non-destructive uses of sharks and the extent of economic losses associated to declines in their population. In this work, we present estimates for use value of sharks in Fernando de Noronha Island - the only ecotouristic site offering shark diving experience in the Atlantic coast of South America. Through the Travel Cost Method we estimate the total touristic use value aggregated to Noronha Island by the travel cost was up to USD 312 million annually, of which USD 91.1 million are transferred to the local economy. Interviewing people from five different economic sectors, we show shark-diving contribute with USD 2.5 million per year to Noronha’s economy, representing 19% of the island’s GDP. Shark-diving provides USD 128.5 thousand of income to employed islanders, USD 72.6 thousand to government in taxes and USD 5.3 thousand to fishers due to the increase in fish consumption demanded by shark divers. We discover, though, that fishers who actually are still involved in shark fishing earn more by catching sharks than selling other fish for consumption by shark divers. We conclude, however, that the non-consumptive use of sharks is most likely to benefit large number of people by generating and money flow if compared to the shark fishing, providing economic arguments to promote the conservation of these species.

Protocolo para assistência do enfermeiro ao paciente séptico em terapia intensiva: construção e validação de conteúdo

Tratar-se-á de um estudo metodológico, com abordagem quantitativa; baseado no referencial metodológico da técnica Delphi, com objetivo de construir e validar um protocolo clínico para assistência do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva. A proposta metodológica seguiu duas etapas: elaboração do instrumento por meio da revisão integrativa da literatura e validação de conteúdo do protocolo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, mediante o Parecer CAAE 41873314.5.0000.5537. O universo amostral foi composto por profissionais enfermeiros, considerados peritos, doutores ou mestres na área da saúde, com experiência em alta complexidade e/ ou estudos de validação de instrumento/protocolo, selecionados por meio da Plataforma Lattes. Referente à primeira etapa elaborou-se um instrumento composto pela caracterização profissional dos peritos; e baseado em evidência científica e nas diretrizes do Surviving Sepsis Campaign, contemplando três tópicos assistenciais ao paciente com sepse, a saber: Triagem para Sepse- Reconhecimento das Manifestações Clínicas; Pacote de Ressuscitação Inicial (Controle das Primeiras 6 Horas); Tratamento de Suporte. A segunda etapa caracterizou-se na validação de conteúdo do instrumento para elaboração final do protocolo, utilizando à técnica Delphi, em duas fases. No que concernem as variáveis referentes ao estudo, na 1ª fase de Delphi, 34 peritos avaliaram o instrumento composto por 18 itens, no período de maio a julho de 2015, e os dados foram analisados pela estatística descritiva (frequência, média, mediana e desvio padrão) e pelo Índice de Validade de Conteúdo (IVC), demonstrando um IVC extremamente satisfatório para 15 itens, com total de 0,79, obtendo assim, a reformulação e refinamento do conteúdo do instrumento. Na segunda fase de Delphi, entre julho e agosto de 2015, participaram 26 peritos, e utilizou-se o percentual de concordância acima de 75% para as variáveis consideradas pertinentes ao protocolo de cuidados ao paciente séptico em UTI, obtendo nesta fase, o percentual de concordância de 95%. O protocolo foi concluído com 15 itens, sendo respaldado e modificado, baseado em evidência científica, nas diretrizes internacionais e nas sugestões dos peritos. A utilização do protocolo proposto poderá contribuir para a prática clínica do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva.

Protocolo para assistência do enfermeiro ao paciente séptico em terapia intensiva: construção e validação de conteúdo

Tratar-se-á de um estudo metodológico, com abordagem quantitativa; baseado no referencial metodológico da técnica Delphi, com objetivo de construir e validar um protocolo clínico para assistência do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva. A proposta metodológica seguiu duas etapas: elaboração do instrumento por meio da revisão integrativa da literatura e validação de conteúdo do protocolo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, mediante o Parecer CAAE 41873314.5.0000.5537. O universo amostral foi composto por profissionais enfermeiros, considerados peritos, doutores ou mestres na área da saúde, com experiência em alta complexidade e/ ou estudos de validação de instrumento/protocolo, selecionados por meio da Plataforma Lattes. Referente à primeira etapa elaborou-se um instrumento composto pela caracterização profissional dos peritos; e baseado em evidência científica e nas diretrizes do Surviving Sepsis Campaign, contemplando três tópicos assistenciais ao paciente com sepse, a saber: Triagem para Sepse- Reconhecimento das Manifestações Clínicas; Pacote de Ressuscitação Inicial (Controle das Primeiras 6 Horas); Tratamento de Suporte. A segunda etapa caracterizou-se na validação de conteúdo do instrumento para elaboração final do protocolo, utilizando à técnica Delphi, em duas fases. No que concernem as variáveis referentes ao estudo, na 1ª fase de Delphi, 34 peritos avaliaram o instrumento composto por 18 itens, no período de maio a julho de 2015, e os dados foram analisados pela estatística descritiva (frequência, média, mediana e desvio padrão) e pelo Índice de Validade de Conteúdo (IVC), demonstrando um IVC extremamente satisfatório para 15 itens, com total de 0,79, obtendo assim, a reformulação e refinamento do conteúdo do instrumento. Na segunda fase de Delphi, entre julho e agosto de 2015, participaram 26 peritos, e utilizou-se o percentual de concordância acima de 75% para as variáveis consideradas pertinentes ao protocolo de cuidados ao paciente séptico em UTI, obtendo nesta fase, o percentual de concordância de 95%. O protocolo foi concluído com 15 itens, sendo respaldado e modificado, baseado em evidência científica, nas diretrizes internacionais e nas sugestões dos peritos. A utilização do protocolo proposto poderá contribuir para a prática clínica do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva.

Protocolo clínico para confecção de próteses removíveis

Este protocolo objetiva esclarecer dúvidas existentes a respeito dos passos necessários para a reabilitação com próteses totais e parciais removíveis convencionais. Essas alternativas de tratamento são modalidades terapêuticas consagradas na literatura e podem devolver função mastigatória, estética, fonação e conforto ao paciente quando confeccionadas de maneira satisfatória. Elas representam também uma ótima opção para aqueles pacientes que não podem se submeter ao tratamento com implantes, por apresentarem limitações biológicas ou financeiras. A abordagem do protocolo clínico está dividida em duas partes. A primeira parte ilustra a reabilitação com próteses totais convencionais e a segunda, a reabilitação com próteses parciais removíveis convencionais em arcos inferiores com extremidade livre bilateral. Por meio da demonstração do passo a passo com fotos, dicas clínicas e resumos sistemáticos do conteúdo teórico contido nesse material, o aluno de Odontologia e o cirurgião-dentista poderão conhecer os passos necessários para executar estes tipos de reabilitações, desde o momento clínico de diagnóstico até o de controle e manutenção. Esperamos que essa obra desperte o interesse dos cirurgiões-dentistas por executar esses tipos de próteses e que os ajude a desenvolverem práticas e habilidades que melhorem o desempenho clínico dessas alternativas de tratamento.