A experiência do enfermeiro com educação permanente no Hospital das Clinicas Unidade Materno Infantil de Marília

Pós-graduação em Saúde Coletiva - FMB

As relações públicas em parceria com a ouvidoria e Ombudsman: gestão e ajuste para um relacionamento eficaz

This work presents as the central theme the management conducted by the Public Relations' professional regarding the custom relations' channels, focusing on Ombudsman. Its main objective is to discuss, reflect and establish a parallel between these activities, highlighting the importance of these channels on the organization’s communication and relationship process with their customers. Split in three chapters, it begins the discussion about the terminology in Ombudsman, from the meaning and concept of the terms to the comparison with other relationship means with the customer. It is a part of the study a brief history about organizations and their changes over the years, emphasizing the importance of customers and relations for the success of the modern day organizations, considering the Public Relations in this context. The discussion concludes establishing a parallel between the Ombudsman channels and the meaning of public relations in its management, regarding the relevancy of the subject in a highly competitive scenario, in which the customer/person, as a change agent, can be the responsible for the success or failure of organizations. The study tries to focus on showing the importance of the skills and competencies of the Public Relations for the fore mentioned channels, which are not well defined yet.

Experience generalization for multi-agent reinforcement learning

On-line learning methods have been applied successfully in multi-agent systems to achieve coordination among agents. Learning in multi-agent systems implies in a non-stationary scenario perceived by the agents, since the behavior of other agents may change as they simultaneously learn how to improve their actions. Non-stationary scenarios can be modeled as Markov Games, which can be solved using the Minimax-Q algorithm a combination of Q-learning (a Reinforcement Learning (RL) algorithm which directly learns an optimal control policy) and the Minimax algorithm. However, finding optimal control policies using any RL algorithm (Q-learning and Minimax-Q included) can be very time consuming. Trying to improve the learning time of Q-learning, we considered the QS-algorithm. in which a single experience can update more than a single action value by using a spreading function. In this paper, we contribute a Minimax-QS algorithm which combines the Minimax-Q algorithm and the QS-algorithm. We conduct a series of empirical evaluation of the algorithm in a simplified simulator of the soccer domain. We show that even using a very simple domain-dependent spreading function, the performance of the learning algorithm can be improved.

Microhardness change of enamel due to bleaching with in-office bleaching gels of different acidity

Objective. The aim of this study was to assess the enamel microhardness treated with three in-office bleaching agents, containing 35% hydrogen peroxide with different acidity. Materials and methods. Bovine incisors were divided into three groups that received the following bleaching agents: Whiteness HP, Total Bleach and Opalescence Xtra. Three gel applications/10-min each, totaling 30-min of bleaching treatment, were made on the teeth and activated with a blue LED (1000 mW/470 nm) combined to a LASER (120 mW/795 nm) device (Easy Bleach-Clean Line). Vickers hardness (VH) was evaluated at baseline and after the bleaching procedure. The values of Hardness loss [HNL] (% reduction) were calculated. The two-sample t-test was used for comparison of the HNL of the three bleaching products (5% level of significance). Results. The Opalescence Xtra, which had the lowest pH value (pH = 4.30), showed a significant increase of HNL when compared with Total Bleach bleaching agent, which had the highest pH value (pH = 6.62). Conclusions. The 35% hydrogen peroxide bleaching agents resulted in a reduction in surface enamel microhardness and bleaching with the most acid agent resulted in a significant enamel hardness loss compared to the less acid agent (4.30 vs 6.62). Strategies proposed to reduce the enamel loss after bleaching treatment may include the use of daily fluoride therapy, mouth rinsing (fluoride, milk and sodium bicarbonate solution), fluoride/bicarbonate dentifrices without abrasives, do not toothbrush immediately after bleaching, fluorides and calcium add to bleaching agents.

Evaluation of dimensional change and detail reproduction in silicones for facial prostheses.

The aim of this study was to evaluate the dimensional stability and detail reproduction of two silicones used for facial prosthesis, under the influence of chemical disinfection and storage time. Twenty-eight test specimens were obtained, half made of Silastic MDX 4-4210 silicone, and the other half of Silastic 732 RTV silicone. The test specimens were divided into 4 groups: Silastic 732 RTV and Silastic MDX 4-4210, with disinfection 3 times a week with Efferdent and without disinfection. Dimensional change was analyzed using an electronic comparison microscope and detail reproduction was observed under a stereo microscope, immediately and 2 months after the test specimens were made. Once the results were obtained, an analisis of variance (ANOVA) was applied, followed by the Tukey's Test with 1% confidence. The storage time factor had a statistical influence on dimensional stability: Silastic MDX 4-4210 had less contraction than Silastic 732 RTV. Chemical disinfection did not significantly alter the dimensional stability of the materials used. Regarding detail reproduction, no alteration of values was observed in any of the materials analyzed, regardless of storage period or disinfection.

Clinical Trial Evaluating Color Change and Tooth Sensitivity Throughout and Following In-office Bleaching

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)