Os Centros de Especialidades Odontológicas como suporte da atenção básica: uma avaliação na perspectiva da integralidade

The public dental services in Brazil were limited, practically, to the basic care, so that the specialized services acted, up to 2002, no more than 3,5% of the total of clinical procedures. That lower offer reveals the difficulty of continuity of the attention, that is, the comprehensiveness in the assistance, particulary, the reference and counter-reference system. Brasil Sorridente search to supply those needs when proposing Speciality Dental's Centers(CEOs Centros de Especialidades Odontológicas, Brazil) to compose the services of average complexity. In 2005, Ministry of Health enabled the three CEOs of Natal, located in the North II, East and West Sanitary Districts. This investigation evaluated the implantation of these CEOs, as support of the family health care teams, in the perspective of organization of the services in assistencial nets in Natal/RN. It was a study of evaluation, with qualitative approach and some quantitative data as contribution. Dentists, users and managers were interviewed to identify and to understand their perceptions, relationships and experiences in the daily of the services. The conceptual base that orientated the investigation was the principle of comprehensiveness, in its operational sense of the hierarchization in health attention levels. The collection of data was done with documental research, direct observation and semi-structured interview. The analysis was accomplished by triangulation of the extracted content from the used techniques and sources of interviewed groups depositions, looking for theoretical-conceptual support in specific bibliography. The results pointed aspects that go away from the comprehensiveness like: low resolution of problems in the basic net; little valorization of the space in the health units; traditional models of access to health services, insufficient offer for some specialties, compromising the reference and counter-reference system; practices centered in procedures in the CEO; bureaucratic directions from basic care to the specialized service; disintegrated and disjointed system among levels of attention; disrespect to the municipal protocol. On the other hand, there is an approach of compreensiveness in situations like: increase of the access and covering in the Family Health Strategy (ESF Estratégia Saúde da Família, Brazil); larger approach between professional and user; tendency to the quantitative and qualitative growth of specialized actions; punctual initiatives of relationships among levels; existence of protocol to guide professionals

Fatores críticos de sucesso como antecedentes da aceitação de um sistema de informação em uma universidade federal

In recent decades the public sector comes under pressure in order to improve its performance. The use of Information Technology (IT) has been a tool increasingly used in reaching that goal. Thus, it has become an important issue in public organizations, particularly in institutions of higher education, determine which factors influence the acceptance and use of technology, impacting on the success of its implementation and the desired organizational results. The Technology Acceptance Model - TAM was used as the basis for this study and is based on the constructs perceived usefulness and perceived ease of use. However, when it comes to integrated management systems due to the complexity of its implementation,organizational factors were added to thus seek further explanation of the acceptance of such systems. Thus, added to the model five TAM constructs related to critical success factors in implementing ERP systems, they are: support of top management, communication, training, cooperation, and technological complexity (BUENO and SALMERON, 2008). Based on the foregoing, launches the following research problem: What factors influence the acceptance and use of SIE / module academic at the Federal University of Para, from the users' perception of teachers and technicians? The purpose of this study was to identify the influence of organizational factors, and behavioral antecedents of behavioral intention to use the SIE / module academic UFPA in the perspective of teachers and technical users. This is applied research, exploratory and descriptive, quantitative with the implementation of a survey, and data collection occurred through a structured questionnaire applied to a sample of 229 teachers and 30 technical and administrative staff. Data analysis was carried out through descriptive statistics and structural equation modeling with the technique of partial least squares (PLS). Effected primarily to assess the measurement model, which were verified reliability, convergent and discriminant validity for all indicators and constructs. Then the structural model was analyzed using the bootstrap resampling technique like. In assessing statistical significance, all hypotheses were supported. The coefficient of determination (R ²) was high or average in five of the six endogenous variables, so the model explains 47.3% of the variation in behavioral intention. It is noteworthy that among the antecedents of behavioral intention (BI) analyzed in this study, perceived usefulness is the variable that has a greater effect on behavioral intention, followed by ease of use (PEU) and attitude (AT). Among the organizational aspects (critical success factors) studied technological complexity (TC) and training (ERT) were those with greatest effect on behavioral intention to use, although these effects were lower than those produced by behavioral factors (originating from TAM). It is pointed out further that the support of senior management (TMS) showed, among all variables, the least effect on the intention to use (BI) and was followed by communications (COM) and cooperation (CO), which exert a low effect on behavioral intention (BI). Therefore, as other studies on the TAM constructs were adequate for the present research. Thus, the study contributed towards proving evidence that the Technology Acceptance Model can be applied to predict the acceptance of integrated management systems, even in public. Keywords: Technology

Uma metodologia para a análise do desempenho sustentável dos postos de revenda de combustível na cidade de Natal/RN, com o uso de data envelopment analysis-DEA

The increasing use of fossil fuels in line with cities demographic explosion carries out to huge environmental impact in society. For mitigate these social impacts, regulatory requirements have positively influenced the environmental consciousness of society, as well as, the strategic behavior of businesses. Along with this environmental awareness, the regulatory organs have conquered and formulated new laws to control potentially polluting activities, mostly in the gas stations sector. Seeking for increasing market competitiveness, this sector needs to quickly respond to internal and external pressures, adapting to the new standards required in a strategic way to get the Green Badge . Gas stations have incorporated new strategies to attract and retain new customers whom present increasingly social demand. In the social dimension, these projects help the local economy by generating jobs and income distribution. In this survey, the present research aims to align the social, economic and environmental dimensions to set the sustainable performance indicators at Gas Stations sector in the city of Natal/RN. The Sustainable Balanced Scorecard (SBSC) framework was create with a set of indicators for mapping the production process of gas stations. This mapping aimed at identifying operational inefficiencies through multidimensional indicators. To carry out this research, was developed a system for evaluating the sustainability performance with application of Data Envelopment Analysis (DEA) through a quantitative method approach to detect system s efficiency level. In order to understand the systemic complexity, sub organizational processes were analyzed by the technique Network Data Envelopment Analysis (NDEA) figuring their micro activities to identify and diagnose the real causes of overall inefficiency. The sample size comprised 33 Gas stations and the conceptual model included 15 indicators distributed in the three dimensions of sustainability: social, environmental and economic. These three dimensions were measured by means of classical models DEA-CCR input oriented. To unify performance score of individual dimensions, was designed a unique grouping index based upon two means: arithmetic and weighted. After this, another analysis was performed to measure the four perspectives of SBSC: learning and growth, internal processes, customers, and financial, unifying, by averaging the performance scores. NDEA results showed that no company was assessed with excellence in sustainability performance. Some NDEA higher efficiency Gas Stations proved to be inefficient under certain perspectives of SBSC. In the sequence, a comparative sustainable performance and assessment analyzes among the gas station was done, enabling entrepreneurs evaluate their performance in the market competitors. Diagnoses were also obtained to support the decision making of entrepreneurs in improving the management of organizational resources and promote guidelines the regulators. Finally, the average index of sustainable performance was 69.42%, representing the efforts of the environmental suitability of the Gas station. This results point out a significant awareness of this segment, but it still needs further action to enhance sustainability in the long term

Qualidade de vida de pessoas com úlcera venosa: associação dos aspectos sociodemográficos, de saúde, assistência e clínicos da lesão

Venous ulcer (VU) is a lower limbs injury resulting from inadequate return of venous blood in feet or legs. Although it is not a deadly disease, it causes chronic wounds, which seriously undermine patients´ quality of life (QOL) and sometimes leads to drastic family, social, economic and psychological changes. In this sense, there are several aspects that may influence the venous ulcers patients´ QOL. The study´s objective aimed on the association of socio-demographic and health, health care and clinical injury on UV patients‟ QOL. Analytical studies, which consider the complexity of factors involved in changes in UV patients‟ QOL has a cross-sectional and quantitative approach. The HUOL Ethics Committee approved this project (n.279/09). The collection of data lasted a period of 3 months in 2010 and it took place at the clinic of Angiology at Hospital Universitário Onofre Lopes (HUOL). The data sample consisted of 60 patients treated by UV angiologists in the HUOL Surgical Clinic. The results were analyzed with SPSS 15.0 by descriptive and inferential statistics. The study was based on UV patients that were predominantly female, average age of 61.4 years, that had low education level and low family income, with occupations requiring long periods of standing or sitting, but mostly retired, unemployed or laid off due to the disease and/or due to chronic diseases associated with the UV. The study took also into consideration patients that used inappropriate products, that were improperly treated by a professional caregiver, that lacked of adequate guidance and compression therapy, that performed no lifting of the lower limbs and regular exercise, that the time of injury were greater than or equal to six months, that were missing specific laboratory tests. The study‟s reference were on recurrent lesions, medium to large lesions area, bed of the lesion (injuries) with fibrin and/or necrosis, with amount of exudate with medium to large, odorless and no signs of infection, with tissue loss between 1st and 2nd degree, without collecting swab or biopsy and with pain. In general, QOL of researched individuals were considered low, the maximum score was 69 points, which the areas that were mostly influenced were the total scores of QOL functional capacity (0.021), emotional (0.000) and social functioning (0.080). Of the 60 individuals, 53.3% had scores between 40 and 69 points in SF-36, and they had the best scores in sociodemographic and health variables (ρ = 0.049). In respect to the assistance and injury characteristics, patients who scored between 40 and 69 points in SF-36 had better scores on these characteristics. By combining the socio-demographic variables, health, and handling characteristics of the injury, we observed a significant difference (ρ = 0.032) when linking them with the QOL total scores. When analyzing separately the domains of the SF-36 scores on the quality of life, we find that the areas that showed statistical significance were functional ability (ρ = 0.035), appearance (ρ = 0.019), emotional (ρ = 0.000), and mental health (ρ = 0.050). Among the socio-demographic characteristics studied, gender and marital status contributed more to the reduction of QOL and among the variables of assistance and the injury, orientation, reference and area of UV contributed the most. By analyzing these five variables all together in accordance with the overall score obtained in the quality of life, we found a significant correlation (ρ = 0.002); with 6.23 times more chances of patients have better QOL in the presence of these five positive factors. By conducting the Mann Whitney U test between all the five demographic variables, health, and clinical care, we found that this combination also proved to be significant (ρ = 0.006). Therefore, patients with these five variables positive tend to have a better QOL. Based on these results, we reject the null hypothesis (H0) and accept the alternative hypothesis (H1) proposed in this study because we noted that the QOL of patients with UV is associated with sociodemographic and health, health care and clinical aspects of the injury

Extração do óleo e caracterização dos resíduos da borra de petróleo para fins de reuso

The petroleum industry, in consequence of an intense activity of exploration and production, is responsible by great part of the generation of residues, which are considered toxic and pollutants to the environment. Among these, the oil sludge is found produced during the production, transportation and refine phases. This work had the purpose to develop a process to recovery the oil present in oil sludge, in order to use the recovered oil as fuel or return it to the refining plant. From the preliminary tests, were identified the most important independent variables, like: temperature, contact time, solvents and acid volumes. Initially, a series of parameters to characterize the oil sludge was determined to characterize its. A special extractor was projected to work with oily waste. Two experimental designs were applied: fractional factorial and Doehlert. The tests were carried out in batch process to the conditions of the experimental designs applied. The efficiency obtained in the oil extraction process was 70%, in average. Oil sludge is composed of 36,2% of oil, 16,8% of ash, 40% of water and 7% of volatile constituents. However, the statistical analysis showed that the quadratic model was not well fitted to the process with a relative low determination coefficient (60,6%). This occurred due to the complexity of the oil sludge. To obtain a model able to represent the experiments, the mathematical model was used, the so called artificial neural networks (RNA), which was generated, initially, with 2, 4, 5, 6, 7 and 8 neurons in the hidden layer, 64 experimental results and 10000 presentations (interactions). Lesser dispersions were verified between the experimental and calculated values using 4 neurons, regarding the proportion of experimental points and estimated parameters. The analysis of the average deviations of the test divided by the respective training showed up that 2150 presentations resulted in the best value parameters. For the new model, the determination coefficient was 87,5%, which is quite satisfactory for the studied system

Ensaios de tratabilidade aplicados a determinação de parâmetros para dimensionamento de processos de tratamento de água de manancial eutrofizado

Eutrophication is a growing process present in the water sources located in the northeast of Brazil. Among the main consequences of these changes in trophic levels of a water source, stands out adding complexity to the treatment to achieve water standards. By these considerations, this study aimed to define, on a laboratory scale, products and operational conditions to be applied in the processing steps using raw water from Gargalheiras dam, RN, Brazil. The dam mentioned shows a high number of cyanobacteria, with a concentration of cells / ml higher than that established by Decree No. 518/04 MS. The same source was also considered by the state environmental agency in 2009 as hypereutrophic. The static tests developed in this research simulated direct filtration (laboratory filters) and pre-oxidation with chlorine and powdered activated carbon adsorption. The research included the evaluation of the coagulants aluminum hydrochloride (HCA) and alum (SA). The development of the research investigated the conditions for rapid mixing, the dosages of coagulants and pHs of coagulation by the drawing of diagrams. The interference of filtration rate and particle size of filtering means were evaluated as samples and the time of contact were tested with chlorine and activated carbon. By the results of the characterization of the raw water source it was possible to identify the presence of a high pH (7.34). The true color was significant (29 uH) in relation to the apparent color and turbidity (66 uH and 13.60 NTU), reflecting in the measurement of organic matter: MON (8.41 mg.L-1) and Abs254 (0.065 cm-1). The optimization of quick mix set time of 17", the speed gradient of 700 s-1 in the coagulation with HCA and the time of 20" with speed gradient of 800 s-1 for SA. The smaller particle sizes of sand filtering means helped the treatment and the variation in filtration rate did not affect significantly the efficiency of the process. The evaluation of the processing steps found adjustment in standard color and turbidity of the Decree nº 518/04 MS, taking in consideration the average values found in raw water. In the treatment using the HCA for direct filtration the palatable pattern based on the apparent color can be achieved with a dose of 25 mg L-1. With the addition of pre-oxidation step, the standard result was achieved with a reduced dose for 12 mgHCA.L-1. The turbidity standard for water was obtained by direct filtration when the dose exceeds 25 mg L-1 of HCA. With pre-oxidation step there is the possibility of reducing the dose to 20 mg L-1.The addition of CAP adsorption, promoted drinking water for both parameters, with even lower dosage, 13 mg L-1 of HCA. With coagulation using SA removal required for the parameter of apparent color it was achieved with pre-oxidation and 22 mgSA.L-1. Despite the satisfactory results of treatment with the alum, it was not possible to provide water with turbidity less than 1.00 NTU even with the use of all stages of treatment

Estrutura genética de populações de Amphobotrys ricini, agente causal do mofo cinzento da mamoneira

The gray mold, causal organism Amphobotrys ricini, is one of the major diseases of castor bean. Difficulties in managing plant disease arises form the limited understanding of the genetic structure of A. ricini, their complexity and variability make it difficult to control. Genetic structure can be used to infer the relative impact of different forces that influence the evolution of pathogen populations, that allow to predict the potencial for pathogen populations to envolve in agricultural ecosystems. Growers protect their crop by applying fungicides, but there aren t fungicides to provide significant control of gray mold of castor bean. The objectives of this work were use RAPD to determine the genetic structure of A. ricini subpopulations in Paraíba and assay the sensitivity of A. ricini isolates to azoxystrobin and carbendazim. To determine the genetic structure of A. ricini subpopulations in Paraíba, 23 isolates were colleted from two different geographic location (subpopulation). These isolates were analysed by RAPD using 22 random decamer primers, purchased from OPERON, produced a total of 80 markers polimorphics. The resulting matrixes were analysed using PopGene version 1.32. Sensitivity to azoxystrobin and carbendazim of 30 isolates, colleted form Paraíba and Alagoas, was estimated based on spore germination and colony growth inhibition. The stock solutions were added toV8 medium after sterilization to produce final concentrations of 0, 0.01, 0.1, 1, 10, and 100 µg/ml of carbendazim and 0, 0.001, 0.01, 0.1, 1, and 10 µg/ml of azoxystrobin. All statistical analyses were performed using SAS to estimate the dose that inhibited fungal growth by 50% (ED50 values). The genetic diversity within subpopulations (Hs=0,271) accounted for 92% of the total genetic diversity (Ht=0,293), while genetic diversity between subpopulations (Gst = 0,075) represented only 7,5%. The estimated number of migrants per generation (NM ) was 6,15. Nei s average gene identity across 80 RAPD loci was 0,9468. Individual ED50 values, for the 30 isolates screened for their sensitivity to azoxystrobin, ranged From a maximum of 0,168 µg/ml to a minimum of 0,0036 µg/ml. The ED50 values for carbendazim varied within the range of 0,026 to 0,316 µg/ml

Análise e comparação entre algoritmos de percolação

In this work, we study and compare two percolation algorithms, one of then elaborated by Elias, and the other one by Newman and Ziff, using theorical tools of algorithms complexity and another algorithm that makes an experimental comparation. This work is divided in three chapters. The first one approaches some necessary definitions and theorems to a more formal mathematical study of percolation. The second presents technics that were used for the estimative calculation of the algorithms complexity, are they: worse case, better case e average case. We use the technique of the worse case to estimate the complexity of both algorithms and thus we can compare them. The last chapter shows several characteristics of each one of the algorithms and through the theoretical estimate of the complexity and the comparison between the execution time of the most important part of each one, we can compare these important algorithms that simulate the percolation.

Satisfação dos usuários e qualidade dos tratamentos protéticos realizados nos centros de especialidades odontológicas da grande Natal RN

Aim: To evaluate user satisfaction and quality of prosthetic treatments performed in specialized dental clinics (CEOs) of Natal Metropolitan Region - RN. Methods: Cross-sectional study with subjects who underwent prosthetic CEOs in the cities of Natal, Macaíba, Parnamirim and Sao Goncalo do Amarante in the period 2007 to 2009. Data collection was performed by questionnaire, clinical examination of the oral cavity and examination of fabricated denture. This analysis involved the following aspects: retention, stability, aesthetics and prosthesis fixation. The variables are presented by means of absolute numbers and proportions. The determination of the association between the independent and dependent variables was conducted by the association of Chi-square test and Fisher exact test. Results: A total of 149 users, totaling 233 conventional dentures (148 upper and 85 lower). Most patients (56.4%) were rehabilitated with conventional complete dentures. The technical quality of the denture was regarded as satisfactory in the majority (52.7%), whereas the inferior dentures were rated as unsatisfactory in 90.5% of cases. Satisfaction with the prosthesis was 69.1% (N = 103). The average time to begin treatment was 3 months to receive while the prosthesis was 4 months old. The presence of injury from the upper prosthesis occurred in 21.5% of cases (N = 32), candidiasis being the most frequent (N = 18). The technical quality of the upper prosthesis (p=0,041), as well as retention (p=0,002) and stability (p<0,001) were significantly associated with user satisfaction. Conclusions: The specialized Dental clinics has been fulfilling its role of providing treatment of intermediate complexity for low-income population with the majority of satisfield patients, even when their dentures have problems of technical quality

Avaliação de arquitetura de agentes emocionais : uma abordagem baseada em métrica de qualidade e na influência das emoções sobre usuários

There is a need for multi-agent system designers in determining the quality of systems in the earliest phases of the development process. The architectures of the agents are also part of the design of these systems, and therefore also need to have their quality evaluated. Motivated by the important role that emotions play in our daily lives, embodied agents researchers have aimed to create agents capable of producing affective and natural interaction with users that produces a beneficial or desirable result. For this, several studies proposing architectures of agents with emotions arose without the accompaniment of appropriate methods for the assessment of these architectures. The objective of this study is to propose a methodology for evaluating architectures emotional agents, which evaluates the quality attributes of the design of architectures, in addition to evaluation of human-computer interaction, the effects on the subjective experience of users of applications that implement it. The methodology is based on a model of well-defined metrics. In assessing the quality of architectural design, the attributes assessed are: extensibility, modularity and complexity. In assessing the effects on users' subjective experience, which involves the implementation of the architecture in an application and we suggest to be the domain of computer games, the metrics are: enjoyment, felt support, warm, caring, trust, cooperation, intelligence, interestingness, naturalness of emotional reactions, believabiliy, reducing of frustration and likeability, and the average time and average attempts. We experimented with this approach and evaluate five architectures emotional agents: BDIE, DETT, Camurra-Coglio, EBDI, Emotional-BDI. Two of the architectures, BDIE and EBDI, were implemented in a version of the game Minesweeper and evaluated for human-computer interaction. In the results, DETT stood out with the best architectural design. Users who have played the version of the game with emotional agents performed better than those who played without agents. In assessing the subjective experience of users, the differences between the architectures were insignificant