Custo-efetividade da terapia compressiva no processo de cicatrização de úlceras venosas

Analytical study of therapeutic nonrandomized intervention type, intra-group controlled, with the aim of analyzing the cost-effectiveness of compression therapy with manipulated Unna boot in relation to conventional therapy in the healing of venous ulcers (VU) of patients treated in ambulatory clinic. The study population was composed by patients with VU treated by angiologists in Surgical Clinic Ambulatory of the Onofre Lopes University Hospital (HUOL) with a sample of 18 patients. It obtained the assent of the HUOL Ethics in Research Committee (Protocol 276/09). Data collection was performed over a period of four months by the own master's student and 34 nursing students, through the application of the research instrument in the admission of patients to the study and in the ten subsequent evaluations, performed at the time of changing Unna boot, weekly, for a maximum period of 10 weeks. The data were analyzed with SPSS 15.0 software, using descriptive and inferential statistics, and presented as tables, charts and graphs. Among those surveyed, prevailed: females, mean age 57.6 years, low education and income levels, most retired, unemployed or off work, with the standing position more than six hours per day and up to eight hours daily of domestic or occupational activities. In health status profile of respondents there were predominantly sleep, rest and inadequate elevation of the lower limbs, no smoking and/or alcohol use, presence of hypertension and no use of drugs. Most presented the first VU for over 10 years, recurrences, present VU for more than five years, involvement of left leg, in malleolar and / or distal leg region, mild edema, hyperpigmentation, lipodermatosclerosis, telangiectasies, reticular and varicose veins, mild pain, serous exudate in moderate quantity, small lesions (up to 50cm2), with predominance of granulation tissue and / or epithelialization and demarcated, elevated and irregular borders, with crusts and macerated. Most patients reported that in the 10 weeks prior to admission, made bandages at home and / or Basic Health Unit and / or ambulatory, with nursing aides or technicians, daily, and on weekends or holidays, performed by patients themselves, using healing ointment on the lesion, being observed granulation / epithelialization and increase in VU prevalent in the 10 weeks of traditional treatment. After follow up with manipulated Unna boot, was observed a decrease of lesions in all study patients, with complete healing in 27.8% of those between 1 and 5 weeks of treatment, with satisfactory evolution of the lesions, pain and ankle and calf circumferences, and unsatisfactory development of the borders of ulcers, edema, sleep, rest and elevation of the lower limbs, especially in more chronic patients. Furthermore, patients who achieved total healing and exhibited the greatest percentage reduction of lesions had a higher number of wound healing factors (ρ = 0.01 and ρ = 0.027, respectively). The manipulated Unna boot showed better results in those patients with shorter duration of injury, leading them to a satisfactory outcome within a short period of treatment. After the cost-effectiveness analysis, we conclude that the manipulated Unna boot is more effective than conventional therapy in the healing process of VU and is more cost-effective in patients with shorter lesions (ρ = 0.001), shorter treatment (ρ = 0.000) and greater number of wound healing factors (ρ = 0.005).

Sistematização da assistência de enfermagem (SAE) em um hospital pediátrico de ensino: uma pesquisa-ação

The incessant search if nurse for qualify nursing care makes the Nursing Assistance Systematization, a current topic of discussion throughout the country, not only in order to comply the legal requirements of their practice, but especially by the expected benefits of its application. In this meaning, this research had a qualitative approach, developed for a way of research-action. The general purpose was to analyze the change in the nursing practices in a pediatric teaching hospital, based on construction and implementation of Nursing Assistance Systematization by the nursing team. The results had the thematic analysis of Paulo Freire and were shown in the form of reports. To achieve these purposes, it began by steps pre-trial, to review the charts of the institution and an approach with the managers. In the situational diagnosis of nursing practices without the systematization followed by applying a questionnaire with a nursing team and a focal group with nurses. These ways supported the implementation stage of the Nursing Assistance Systematization which developed actions associate such as focal group with the nurses about the nursing history, capacity with the nursing team about the Nursing Assistance Systematization, development, application and reworking of printed, and discussions in the small groups. The evaluations of the changes after the actions of the research occurred through individual interview with the nurses, to check the results. The charts review confirmed the deficit in the records performed by the nurse on the chart, which reinforced the need for implementation of Nursing Assistance Systematization, an argument used on the meeting with the managers, who promptly agree with the search. The questionnaire and the focal group with the nurses reveal a process of nursing work without systematization, showing gaps in practices, but also obtained relate of expectations of improvements in quality of care as of Nursing Assistance Systematization, furnishing data to the development of ways following-up. The prints were gradually used and modified as the team understood the Nursing Assistance Systematization and its purposes through capacity course. The final evaluation pointed to the partial implementation of the stages of Nursing Assistance Systematization had been institutionalized at the history and the development of nursing, beyond difficulties with diagnosis and prescription of nursing, in later representing a paradigm shift. This search collaborated to change the view about the Nursing Assistance Systematization by nursing team at the institution had been revealed through introduction of new practices in the process of nursing work, as examination of physical exam of the patient, the interview in the admission of customers on service and the daily monitoring by nursing through development of nursing. Before addition, it was noted which the purposes of this search were achieved, since were analyzed the changes in the nursing practices with the systematization. The research-action achieved proposes of the involvement of nursing team in changing their practices. This search contributed to the implementation of the Nursing Assistance Systematization in a pediatric teaching hospital and showed which is possible to seek resolution of problems when the objective is of the group and gave access for further searches within this theme

Liberdade e negação da vontade: análise do ser-livre como representação e na angústia

Common understanding about what freedom means has always been more or less related to the power to realize something intended, desired, a capability. Therefore, being free is commonly interpreted under the concept of free-will and the category of possibility to act. Although there are predecessors in History of Philosophy, Schopenhauer refuses the thesis of free will proposing otherwise the denial of willing (to live) as the ultimate possibility for human freedom, if not the only one left. The thesis that would make him famous was deeply misunderstood and so miscarried somewhat due to the way it was many times presented by the means of exotic examples wrapped in a mystical mood besides exaltations to Eastern traditions, which may satisfy anthropological curiosity instead of being capable to satisfy the reader in a philosophical way. It seems to result from Schopenhauer s thought a kind of pessimism against life. Otherwise, typical readings on the Schopenhauerian thesis are found full of inconsistencies once closely regarded, which blame does not belong to the author but to his interpreters. A new reading about the denial of willing as the ultimate possibility for human freedom demands a criticism on the inconsistencies and prejudgments deep grounded. For this, we firstly clarify the ways of understanding the willing nothing , which cannot be reduced to the mere refusal or conformism, being instead positively understood as a special manner of willing: the admission of oneself for the sake of one is. A few more than a century later The world as will and representation came to light, Heidegger proposes in his fundamental ontology that the proper being-free concerns to originary decision by which, in anguish of being suspended in nothingness, Dasein renders itself singular as the being who is in-a-world and to-death, concluding that the ultimate possibility of freedom is being-free-to-death. Developing the hypothesis that freedom, properly understood, concerns to nothingness as to indeterminate possibilities, we seek for a dialogue between Schopenhauer s thought and existential philosophy aiming to reconstitute and overcome Metaphysics tradition turning the question about freedom into a matter of Ontology. From the factual existence perspective, as we must show, every human activity (or inactivity) is ordinarily mediated by representations, in which me and world appear as distinct entities. So, each one among determininate individuals finds itself connected to the things in the world by interest, which proper concept must be sufficiently explored. Starting from this point, we may proceed to detailed analysis of usual representations of freedom aiming their destruction by Ontology and then reaching existential thesis according to Kierkegaard and Heidegger. Turning back to the analysis of Schopenhauer s work, we conclude existential understanding of freedom as will-to-be can also be found in Schopenhauer. In this way, denial of willing means ultimate freedom once the Will turns back to its own essence by suppressing the world as representation, which means the originary absolute indetermination of the extreme possibility to-be

O corpo no pensamento de Epicuro: limites e possibilidades

The theme that fits the perspective of this thesis comes from the interest of treating, in the Epicurean corpus, about the importance of the body and its manners of realization for understanding the thought of Epicurus of Samos. Based on the inferences contained in the texts that remained from Epicurus, we did an analysis of the aspects that characterize Epicurism as a thought that makes repeated references to the body as an instance of sensitivity. It was necessary, therefore, to discuss how the body is linked to the possibility of thought, and how the latter can be admitted as a body element. It is further understood that the atomistic physics converges to the idea that asserts natural phenomena as likely to be contained and explained by the observations that come from the senses which are manifested through the body. For this reason, it was also pertinent to reflect on the admission of the body as a key element for the interpretation of Epicurean thought, even under the constitution of language. The Epicurean construction about body image was also used for the interpretation and questioning of the dynamics that define the relationships between individuals, characterizing the koinonía of the garden through the notion of corporeal unity. It was defined, therefore, that the characterization of the action field of individuals who lived in the Epicurean garden revolves around the use of logos, with the dialogues coming from the exercise of philosophy for therapeutic purposes, which were able to introduce a specific mode of political action marked by the absence of strange interests of the notion of philía

Cargos comissionados da administração pública direta do Rio Grande do Norte: análise comparativa entre o perfil profissional dos cargos comissionados com vínculo funcional e sem vínculo funcional

The professional profile of public administrators in Brazil is changing very rapidly in recent years, seeking to meet the principle of efficiency by public agencies at all levels. The admission of the permanent government employee under the Public Administration is by competition, however, commissioned positions are free appointment of managers, which allows effective participation of external experts according to their respective standards and norms. In this context, this dissertation seeks to understand the main characteristics of the profile of the occupants of commissioned positions in Direct Public Administration of the State of Rio Grande do Norte, noting the differences between those with functional link with the have nots. For this study, by data collection and content analysis, a mapping of the administrative structure of the Government of the State of Rio Grande do Norte was done, i.e., the organization of the Executive Branch, which is regulated by the Complementary Law no. 163/1999 and its amendments, which consists of 53 (fifty three) entities, these 29 (twenty nine) are agencies of the direct administration and the remaining 24 (twenty four) comprises the indirect administration. With the collected data, analysis on the number of commissioned positions of each organ of the State of Rio Grande do Norte and information on education, age, length of service, gender and functional link with the direct administration was carried out. Data were available from SEARH in June/2013, when they totaled 58,733 (fifty-eight thousand seven hundred thirty-three) servers, these 2.15% (two point fifteen percent) occupy commissioned positions, corresponding to 1,262 commissioned positions under the Direct Administration, below the national average of 4% (four percent). Of total commissioned positions 64.7% (sixty-four point seven percent) have no functional link with the direct administration, while only 35.3% (thirty -five point three percent) have functional link. It was noticed that there are no clear and specific criteria for the appointments of commissioned positions in the State. They occur freely, as provided in the State Constitution. Another conclusion is the importance of Public Administration define and improve their capacity, competence and efficiency in the delivery of public services. For that it is necessary to invest in their workforce composed of permanent employees and commissioned positions to define the appropriate professional profile

Mudanças nas concepções do professor do ensino fundamental em relação à inclusão após a entrada de alunos com deficiência em sua classe

As concepções dos professores podem determinar as atitudes sociais em relação à inclusão do aluno com deficiência na sala de aula. Dentre dessa temática, pode-se questionar: a concepção de inclusão do professor do ensino regular muda no decorrer do ano letivo após a entrada de alunos com deficiência? Assim, objetivou-se identificar a existência de mudanças de concepções do professor do ensino regular em relação à inclusão. Participaram do estudo cinco professores do ensino regular que atuavam em sala de aula com pelo menos um aluno com deficiência, em três escolas de Município do interior Paulista. Os dados foram coletados durante um ano letivo por meio de três procedimentos: entrevista não-estruturada; segmento bimestral das informações por meio de cadernos de conteúdo e entrevista semi-estruturada, ao final do ano. Os dados foram tratados por meio da técnica designada como análise da enunciação. Dessa análise, foram estabelecidas classes e subclasses, aferidas por juízes para verificar o grau de concordância da análise. Os resultados mostraram mudanças de concepções nas subclasses: expectativa em relação à inclusão do aluno com deficiência no ensino regular, experiência em relação à inclusão, perfil do aluno para ser matriculado no ensino regular; ritmo de aprendizagem do aluno com deficiência na sala de aula regular, avaliação da aprendizagem do aluno com deficiência, dificuldades em lidar com a diversidade, dificuldade em lidar com a disciplina/comportamento do aluno com deficiência e dificuldade para ensinar o aluno com deficiência. Conclui-se que a entrada, por si só, do aluno com deficiência no ensino regular não garantiu a mudança de concepção dos professores.

Chuvas e escorregamentos na região Noroeste da área urbana de Juiz de Fora - MG: uma abordagem genética em climatologia

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

Entre o formal e o real: representações acerca do modelo disciplinar da Fundação CASA de Araraquara

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A brincadeira e as atividades fomais de ensino no primeiro ano do ensino fundamental: uma análise das manifestações das crianças de seis anos

Pós-graduação em Educação - FCT

Avaliação da assistência ao parto no Hospital das Clínicas da Faculdade de Medicina de Botucatu

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

A produção de conhecimento científico da educação física na Sociedade Brasileira para o Progesso da Ciência (SBPC)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Biennial report (2012-2013)

Includes resolutions adopted at the thirty-fifth session of the Commission, held in 2014.

Reserva de vagas no ensino superior: o processo de implementação das cotas raciais nos cursos de graduação da Universidade Federal do Pará

Esta pesquisa é inserida na área de Políticas Públicas do Ensino Superior, nela tivemos três objetivos: 1) Discutir a instituição da política de cotas na Educação Superior brasileira; 2) Verificar seus desdobramentos na Universidade Federal do Pará; e 3) Analisar os impactos que a política de cotas teve no ingresso de alunos pretos e pardos nos seus cursos de graduação. A abordagem metodológica adotada foi de cunho quanti-qualitativo, tivemos como técnicas de coleta de dados a pesquisa documental em diversificadas fontes e a realização de entrevistas com integrantes do Grupo de Trabalho que elaborou a proposta oficial de ação afirmativa da UFPA, a fim de dialogar com os dados documentais. A perspectiva de análise que nos norteou foi a Análise de conteúdo. Os resultados da pesquisa apontam para maior inserção de estudantes negros e alunos de escolas públicas na UFPA, porém, também evidenciam deformidades na adoção das cotas para negros na Instituição.

Parâmetros clínicos e laboratoriais relacionados ao prognóstico em cães com gastroenterite hospitalizados

Pós-graduação em Cirurgia Veterinária - FCAV

Infância e escola: desafios no ingresso da criança no ensino fundamental

In order to expand educational services in the country, were recently approved laws that changed the organization of schools and the population served by them, as was the case of Law No. 11.274/2006 elementary school that extended from eight to nine years, establishing the admission of children to this level of education to 6 years old. The research aimed to analyze the relationship between the legal text and the meanings of schooling and the specifics of childhood with the entry of children in elementary school. We proceeded to carry out theoretical research and documentation and with the main results we can state that: 1) referring to the childhood and school education, we can reflect on the period that includes the ages between 5 and 7 years, periods in which the child Brazil, according to new legislation can be met in kindergarten and compulsory from 6 years in elementary education, refers to the student at a time conducive to the psychological and cognitive investment in the development of imagination, thought through images, perception , logical reasoning, comparison and identification of elements of the property, creativity and playful and symbolic creations, 2) found that the formation of the 1st child. years of elementary school students is directed around the practices of literacy, with emphasis on the acquisition of reading and writing; Find out what this new educational context, schools are presenting great challenges due to the specifics of care for children six years in the first year Elementary School, showing gap between the law and the actual developments in the reorganization of schools.