Family health nursing care: weaknesses and strengths in the Unified Health System

OBJECTIVETo analyze the weaknesses and strengths of nursing care in the Family Health Strategy and its interfaces with the Unified Health System network.METHODA qualitative study performed by means of semi-structured interviews and systematic observations, with the participation of a nursing team of 15 people from October of 2012 to January of 2013.RESULTSStrengths that were emphasized: the nurse's versatility in conducting users within the unit and the health system, therefore directly acting upon access to these services. The nurse is the main subject that participates in the care processes for the person, family and social groups. Weaknesses that were highlighted: fragile embracement and low resolution of users' and families' problems.CONCLUSIONThe nursing care process in health units still lacks collective articulation, involvement of the team, and decentralization of the decisions.

Harmonical oscillator and electro-mechanical analogy: an interdiscinary experiment to high precision mass variation measurements

In general, the traditional Physics courses needs examples of the aplications of the Physics concepts in other areas such as Chemistry and Biology. This lacks tend to demotivate Chemistry and Biology students regarding to deal with Physical concepts developed in classroom. In this work, the analogy among mechanic and electric oscillators is investigated to be applied in Chemistry and Biology areas, showing to be valuable due to its aplication in techniques that aims to measure mass variation with high precision. This measure could be made in a direct or indirect way. These techniques are known as electrogravimetric techniques and they are important in biosensor aplications. Thus, this paper explores the electromechanic analogy in an interdisciplinary way involving areas like Physics, Chemistry and Biology. Based on this analogy, it is proposed an experiment that can be applied in different ways, i.e. by an basic approach or more deeper, depending on the students specific formation, in other words, Physics, Chemistry or Biology.

An Investigation into Mechanisms of Loss of Safe Basins in a 2 D.O.F. Nonlinear Oscillator

In this work we consider the transient stability of coupled motions of a 2 D.O.F. nonlinear oscillator that can represent, for example, the motions of a sea vessel under the action of trains of regular lateral waves. Instability is studied as the escape of the system from a safe potential well. The set of initial conditions in phase space that lead to acceptable motions constitutes its safe basin. We investigate the evolution of these safe basins under variation of parameters such as frequency and amplitude of waves, and an internal tuning parameter. Complex nonlinear phenomena are known to play an important role in determining the loss of safe basins as, say, wave amplitude is increased. We therefore investigate those processes, and attempt to classify them in terms of their speed relative to changes in parameter values. "Mechanism basins" are produced depicting regions of parameter space in which rapid or slow losses of safe basin are observed. We propose that a comprehensive understanding of mechanisms of loss of safe basins can be a valuable tool in assessing stability properties of these systems, and we give a conceptual view of how such information could be used.

Chaos in a Two-Degree of Freedom Duffing Oscillator

High dimensional dynamical systems has intricate behavior either on temporal or on spatial evolution properties. Nevertheless, most of the work on chaotic dynamics has been concentrated on temporal behavior of low-dimensional systems. This contribution is concerned with the chaotic response of a two-degree of freedom Duffing oscillator. Since the equations of motion are associated with a five-dimensional system, the analysis is performed by considering two Duffing oscillators, both with single-degree of freedom, coupled by a spring-dashpot system. With this assumption, it is possible to analyze the transmissibility of motion between the two oscillators.

STRATEGIC DECISIONS OF FAMILY FIRMS ON CASH ACCUMULATION

ABSTRACTGiven the particular strengths, weaknesses, and peculiarities of family firms as well as the importance of liquidity in today’s marketplace, we analyze the distinct characteristics and strategies of family businesses related to the amount of cash a firm holds. We look beyond the traditional factors that influence decisions related to cash management to examine factors that are particularly important for family firms. Specifically, we outline the relevance of strategic decisions guided by family firms’ conservatism, flexibility, long-term view, and the active control that they have over family members. To our knowledge, no prior studies exist regarding family firms and their strategic adjustment of cash holding. Therefore, we investigate whether the ownership structure of the firm (through the presence of a controlling family) moderates decisions on cash holding. We found that family firms tend to accumulate cash for strategic reasons and as a result of their own idiosyncrasies. Thus, family firms can achieve optimal cash accumulation more efficiently than non-family firms.

Public hearings as a tool to improve participation in regulatory policies: case study of the National Agency of Electric Energy

The participation of citizens in public policies is an opportunity not only to educate them, but also to increase their empowerment. However, the best way for deploying participatory policies, defining their scope and approach, still remains an open and continuous debate. Using as a case study the Brazilian National Agency of Electric Energy (Aneel), with its public hearings about tariff review, this paper aims at analyzing the democratic aspects of these hearings and challenges the hypothesis of many scholars about the social participation bias in this kind of procedure. This study points out a majority participation of experts, contrasting with the political content of discussions. And, this way, it contributes to a critical analysis of the public hearings as a participatory tool, indicating their strengths and their aspects which deserve a special attention.

Health financing changes in the context of health care decentralization: the case of three Latin American countries

OBJECTIVE: The results of an evaluative longitudinal study, which identified the effects of health care decentralization on health financing in Mexico, Nicaragua and Peru are presented in this article. METHODS: The methodology had two main phases. In the first, secondary sources of data and documents were analyzed with the following variables: type of decentralization implemented, source of financing, funds for financing, providers, final use of resources, mechanisms for resource allocation. In the second phase, primary data were collected by a survey of key personnel in the health sector. RESULTS: Results of the comparative analysis are presented, showing the changes implemented in the three countries, as well as the strengths and weaknesses of each country in matters of financing and decentralization. CONCLUSIONS: The main financing changes implemented and quantitative trends with respect to the five financing indicators are presented as a methodological tool to implement corrections and adjustments in health financing.

Problemas de saúde mental e tabagismo em adolescentes do sul do Brasil

OBJETIVO: Analisar a associação entre problemas de saúde mental e uso de tabaco em adolescentes. MÉTODOS: Foram analisados 4.325 adolescentes de 15 anos da coorte de nascimentos de 1993 da cidade de Pelotas, RS. Tabagismo foi definido como fumar um ou mais cigarros nos últimos 30 dias. Saúde mental foi avaliada de acordo com o escore total do questionário Strengths and Difficulties Questionnaire e escore maior ou igual a 20 pontos foi considerado como positivo. Os dados foram analisados por regressão de Poisson, com ajuste robusto para variância. RESULTADOS: A prevalência de tabagismo foi 6,0% e cerca de 30% dos adolescentes apresentaram algum tipo de problema de saúde mental. Na análise bruta, a razão de prevalências para tabagismo foi de 3,3 (IC95% 2,5; 4,2). Após ajuste (para sexo, idade, cor da pele, renda familiar, escolaridade da mãe, grupo de amigos fumantes, trabalho no último ano, repetência escolar, atividade física de lazer e uso experimental de bebida alcoólica), diminuiu para 1,7 (IC95% 1,2; 2,3) entre aqueles com problemas de saúde mental. CONCLUSÕES: Problemas de saúde mental na adolescência podem ter relação com o consumo de tabaco.

Professional and community satisfaction with the Brazilian family health strategy

OBJECTIVE: To analyze the strengths and limitations of the Family Health Strategy from the perspective of health care professionals and the community. METHODS: Between June-August 2009, in the city of Vespasiano, Minas Gerais State, Southeastern Brazil, a questionnaire was used to evaluate the Family Health Strategy (ESF) with 77 healthcare professionals and 293 caregivers of children under five. Health care professional training, community access to health care, communication with patients and delivery of health education and pediatric care were the main points of interest in the evaluation. Logistic regression analysis was used to obtain odds ratios and 95% confidence intervals as well as to assess the statistical significance of the variables studied. RESULTS: The majority of health care professionals reported their program training was insufficient in quantity, content and method of delivery. Caregivers and professionals identified similar weaknesses (services not accessible to the community, lack of healthcare professionals, poor training for professionals) and strengths (community health worker-patient communications, provision of educational information, and pediatric care). Recommendations for improvement included: more doctors and specialists, more and better training, and scheduling improvements. Caregiver satisfaction with the ESF was found to be related to perceived benefits such as community health agent household visits (OR 5.8, 95%CI 2.8;12.1), good professional-patient relationships (OR 4.8, 95%CI 2.5;9.3), and family-focused health (OR 4.1, 95%CI 1.6;10.2); and perceived problems such as lack of personnel (OR 0.3, 95%CI 0.2;0.6), difficulty with access (OR 0.2, 95%CI 0.1;0.4), and poor quality of care (OR 0.3, 95%CI 0.1;0.6). Overall, 62% of caregivers reported being generally satisfied with the ESF services. CONCLUSIONS: Identifying the limitations and strengths of the Family Health Strategy from the healthcare professional and caregiver perspective may serve to advance primary community healthcare in Brazil.

Multimodality Imaging of Heart Valve Disease

Unidentified heart valve disease is associated with a significant morbidity and mortality. It has therefore become important to accurately identify, assess and monitor patients with this condition in order that appropriate and timely intervention can occur. Although echocardiography has emerged as the predominant imaging modality for this purpose, recent advances in cardiac magnetic resonance and cardiac computed tomography indicate that they may have an important contribution to make. The current review describes the assessment of regurgitant and stenotic heart valves by multimodality imaging (echocardiography, cardiac computed tomography and cardiac magnetic resonance) and discusses their relative strengths and weaknesses.

Amazon Fund: financing deforestation avoidance

The Amazon Fund, created in 2008 by the Brazilian Federal Government, is managed by Banco Nacional de Desenvolvimento Econômico e Social (BNDES). It is a pioneering initiative to fundraise and manage financial resources to cut back deforestation and support sustainable development for 30 million inhabitants in the Amazon Biome. The Amazon Fund has already received more than R$ 1.7 billion in grants (about USD 787 million). This essay analyzes the Amazon Fund's governance and management with focus on its operation and from its stakeholders' perspectives. A combination of research methods includes: documental research, in-depth interviews, and speech analysis. The study offers a comparative analysis of strengths and weaknesses related to its governance. Furthermore, it proposes ways to improve its management towards greater effectiveness. The essay also includes an assessment of the government of Norway, a major donor to the fund. The governments of Norway and Germany, in partnership with Brazil, reveal how important it is to experiment with new means of international cooperation to successfully reduce greenhouse gas emissions through rainforest preservation.

Gas exchange, phisiological indexes and ionic accumulation in Annona emarginata (Schltdl.) H. Rainer seedlings in nutrients solution

"Araticum-de-terra-fria" (Annona emarginata (Schltdl.) H. Rainer) has been consider a good alternative in rootstock production for the main commercial Annonaceae species. Although this species develops in different soil and climate conditions, there is no understanding by the physiological responses of this species at different nutritional levels. Thus, the objective of this study was to evaluate the influence of different ionic strengths on development of vegetative species known as "Araticum-de-terra-fria". It was evaluated in seedlings grown in different ionic strengths (25% I, 50% I, 75% I and 100% I) of the complete nutrient solution Hoagland and Arnon (1950) nº 2, for 140 days, the following characteristics: Gas Exchange (CO2 assimilation rate, stomatal conductance, internal CO2 concentration, transpiration rate, water use efficiency, Rubisco carboxylation efficiency); Vegetative growth characteristics (diameter, leaf number, dry matter); Physiological Indexes (leaf area ratio, specific leaf area, relative growth rate, net assimilation rate, leaf weight ratio) and Ionic Accumulation (nutrients leaf analysis). Seedlings grown under 50% I showed the highest values of Leaf CO2 assimilation rate, water use efficiency, carboxylation efficiency, growth, relative growth rate, net assimilation rate and ionic accumulation in the total dry matter. So it is concluded that "Araticum-de-terra-fria" seedlings grown under intermediate nutrient concentrations of complete nutrient solution Hoagland and Arnon (1950) nº 2, explored more adequately their physiological potential that justify their adaptation in different nutritional conditions and allow reducing the amount of mineral nutrition of seedlings production.

Propriedades espectroscópicas e parâmetros ópticos-eletrônicos dos complexos Ln(NO3)3.2DTPO.4H2O (Ln = Nd e Er)

Complexes with the composition Ln(NO3)3.2DTPO.4H2O (Ln = Nd and Er) were synthesized and characterized by infrared and visible absorption spectra (solid state and solution). The results of the absorption spectra in the solid state suggest that metal-ligand bonds are essentially electrostatic in all complexes. The absorption spectra of the nitrate salt solution presented smaller values of the oscillator strength when compared to the spectra of the complexes in the same solvent.

Production of silica gel from residual rice husk ash

This paper presents a study on the production of silica gel in hydrothermal process using residual rice husk ash. Measurements of the chemical composition, X-ray diffraction, infrared spectroscopy, particle size distribution, and pozzolanic activity were carried out in order to characterize the obtained material, and the optimal silica gel was selected for use as a mineral additive in cement pastes. The compressive strengths were determined for cement pastes containing silica gel (0.0, 2.5 or 5% by mass) in different times. The results indicate that the mixtures containing silica gel showed improved mechanical behavior over all time periods evaluated.

Sintonização de estados quânticos: um estudo numérico do oscilador harmônico quântico

The quantum harmonic oscillator is described by the Hermite equation.¹ The asymptotic solution is predominantly used to obtain its analytical solutions. Wave functions (solutions) are quadratically integrable if taken as the product of the convergent asymptotic solution (Gaussian function) and Hermite polynomial,¹ whose degree provides the associated quantum number. Solving it numerically, quantization is observed when a control real variable is "tuned" to integer values. This can be interpreted by graphical reading of Y(x) and |Y(x)|², without other mathematical analysis, and prove useful for teaching fundamentals of quantum chemistry to undergraduates.