O desempenho da Maternidade da Santa Casa de Angra dos Reis face aos critérios de qualidade do Programa Nacional de Avaliação dos Serviços de Saúde - PNASS.

A Santa Casa de Angra dos Reis é uma Instituição Filantrópica inaugurada em 06 de janeiro de 1839. A Unidade passa por Intervenção Municipal, recomendada pelo Ministério Público, no intuito de garantir o restabelecimento adequado de seus serviços, a eficiência desejável e para resgatar a credibilidade e sustentabilidade do Hospital. Da motivação pelos projetos da nova gestão emergiu a necessidade de conhecer a situação do desempenho desta unidade hospitalar, em especial a Maternidade, ponto de partida do projeto. Este estudo é relevante para a institucionalização da avaliação da qualidade nesta Unidade Hospitalar, bem como condição primária para construção de planos de trabalho. O Programa Nacional de Avaliação dos Serviços de Saúde PNASS é uma proposta do Ministério da Saúde, e é visto como uma ferramenta de gestão para monitoramento e avaliação. O programa pode apontar diversas oportunidades de melhorias e auxiliar a tomada de decisão tornando-se adequado seu emprego no levantamento das informações necessárias para o conhecimento do cenário da Maternidade, como base para um futuro plano de ação. Este estudo tem por objetivo aplicar o programa de avaliação normativa proposto pelo PNASS na Maternidade da Santa Casa, a fim de identificar seu desempenho, como primeiro passo para a construção do plano estratégico de ação em busca do aprimoramento da qualidade em saúde neste setor. Como metodologia, é uma pesquisa quantitativa onde foram utilizados padrões de conformidade, questionários fechados direcionados aos usuários e trabalhadores da Maternidade, e análise de indicadores. Resultados: foram entrevistadas 35 mulheres e 47 profissionais de saúde, num total de 85% da amostra desejada; ficou evidente a necessidade de intervenção e implementação de mudanças na área de Gerenciamento de Risco; e melhorias quanto às condições de trabalho relacionadas à infraestrutura e equipamentos. Os indicadores de internação apontam a necessidade de revisão do número de leitos disponíveis; a taxa de parto cesáreo, 59%, é extremamente alta e muito acima do preconizados pela Organização Mundial de Saúde. Este estudo mostrou um resultado positivo quanto à satisfação das parturientes com o serviço prestado, embora existam áreas carentes de melhorias. Melhorias também são necessárias para o dimensionamento efetivo do quadro de profissionais para atendimento à demanda. A interrupção do lançamento de relatórios sobre atuais avaliações feitas pelo PNASS e a pouca divulgação do mesmo são questões levantadas por este estudo. Considera-se que a aplicação do PNASS na Maternidade da Santa Casa de Angra dos Reis proporcionou embasamento para a elaboração de uma oportuna matriz de intervenção.

Investigation of anti-lock braking strategies for heavy goods vehicles

An articulated lorry was instrumented in order to measure its performance in straight-line braking. The trailer was fitted with two interchangeable tandem axle sub-chassis, one with an air suspension and the other with a steel monoleaf four-spring suspension. The brakes were only applied to the trailer axles, which were fitted with anti-lock braking systems (ABS), with the brake torque controlled in response to anticipated locking of the leading axle of the tandem. The vehicle with the air suspension was observed to have significantly better braking performance than the steel suspension, and to generate smaller inter-axle load transfer and smaller vertical dynamic tyre forces. Computer models of the two suspensions were developed, including their brakes and anti-lock systems. The models were found to reproduce most of the important features of the experimental results. It was concluded that the poor braking performance of the steel four-spring suspension was mainly due to interaction between the ABS and inter-axle load transfer effects. The effect of road roughness was investigated and it was found that vehicle stopping distances can increase significantly with increasing road roughness. Two alternative anti-lock braking control strategies were simulated. It was found that independent sensing and actuation of the ABS system on each wheel greatly reduced the difference in stopping distances between the air and steel suspensions. A control strategy based on limiting wheel slip was least susceptible to the effects of road roughness.

Environment monitoring technical report for the SON cage fish culture site at Bugungu, Napoleon Gulf, northern Lake Victoria, November 2013

Source of the Nile Fish farm (SON) is located at Bugungu area in Napoleon Gulf, northern Lake Victoria. The proprietors of the farm and the National Fisheries Resources Research Institute (NaFIRRI) have an established collaborative arrangement where NaFIRRI provides technical back‐stopping to enable quarterly environment monitoring of the cage site as a mandatory requirement of the National Environment Management Authority (NEMA). The agreed study areas are selected physical‐chemical factors (water depth, water transparency/secchi depth, water temperature, dissolved oxygen, pH, conductivity, and nutrient status), algal community (including primary production), aquatic invertebrates (zooplankton and macro‐benthos) and the fish community. This report presents field observations made during the fourth quarter (October‐December) field survey undertaken during December 2013; along with scientific interpretation and discussion of the results in reference to possible impacts of the cage facility to the water environment quality and aquatic biota.

Environment monitoring technical report for the SON cage fish culture site at Bugungu, Napoleon Gulf, northern Lake Victoria, August 2014

Source of the Nile Fish farm (SON) is located at Bugungu area in Napoleon Gulf, northern Lake Victoria. The proprietors of the farm and the National Fisheries Resources Research Institute (NaFIRRI) have an established collaborative arrangement where NaFIRRI provides technical back-stopping to enable quarterly environment monitoring of the cage site; a mandatory requirement of the National Environment Management Authority (NEMA). The agreed study areas are physical-chemical factors (water depth, water transparency/secchi depth, water temperature, dissolved oxygen, BOO, pH, conductivity), and selected nutrients), algal community (including primary production), aquatic invertebrates (zooplankton and macrobenthos) and the fish community. This report presents field observations made during the third quarter (July-September) field survey undertaken during August 2014; along with scientific interpretation and discussion of the results in reference to possible impacts of the cage facility to the water environment quality and aquatic biota.

Environment monitoring technical report for the SON cage fish culture site at Bugungu, Napoleon Gulf, northern Lake Victoria, March 2014

Source of the Nile Fish farm (SON) is located at Bugungu area in Napoleon Gulf, northern Lake Victoria. The proprietors of the farm and the National Fisheries Resources Research Institute (NaFIRRI) have an established collaborative arrangement where NaFIRRI provides technical back‐stopping to enable quarterly environment monitoring of the cage site as a mandatory requirement of the National Environment Management Authority (NEMA). The agreed study areas are selected physical‐chemical factors (water depth, water transparency/secchi depth, water temperature, dissolved oxygen, pH, conductivity, and nutrient status), algal community (including primary production), aquatic invertebrates (zooplankton and macro‐benthos) and the fish community. This report presents field observations made during the first quarter (January‐March) field survey undertaken during March 2014; along with scientific interpretation and discussion of the results in reference to possible impacts of the cage facility to the water environment quality and aquatic biota. The

Three-dimensional effects on sliding and waving wings

Like large insects, micro air vehicles operate at low Reynolds numbers O(1; 000 - 10; 000) in a regime characterized by separated flow and strong vortices. The leading-edge vortex has been identified as a significant source of high lift on insect wings, but the conditions required for the formation of a stably attached leading-edge vortex are not yet known. The waving wing is designed to model the translational phase of an insect wing stroke by preserving the unsteady starting and stopping motion as well as three-dimensionality in both wing geometry (via a finite-span wing) and kinematics (via wing rotation). The current study examines the effect of the spanwise velocity gradient on the development of the leading-edge vortex along the wing as well as the effects of increasing threedimensionalityby decreasing wing aspect ratio from four to two. Dye flow visualization and particle image velocimetry reveal that the leading-edge vortices that form on a sliding or waving wing have a very high aspect ratio. The structure of the flow is largely two-dimensional on both sliding and waving wings and there is minimal interaction between the leading-edge vortices and the tip vortex. Significant spanwise flow was observed on the waving wing but not on the sliding wing. Despite the increased three-dimensionality on the aspect ratio 2 waving wing, there is no evidence of an attached leading-edge vortex and the structure of the flow is very similar to that on the higher-aspect-ratio wing and sliding wing. © Copyright 2010.

Decision tree-based context clustering based on cross validation and hierarchical priors

The standard, ad-hoc stopping criteria used in decision tree-based context clustering are known to be sub-optimal and require parameters to be tuned. This paper proposes a new approach for decision tree-based context clustering based on cross validation and hierarchical priors. Combination of cross validation and hierarchical priors within decision tree-based context clustering offers better model selection and more robust parameter estimation than conventional approaches, with no tuning parameters. Experimental results on HMM-based speech synthesis show that the proposed approach achieved significant improvements in naturalness of synthesized speech over the conventional approaches. © 2011 IEEE.

The dynamics of hippocampal sensory gating during the development of morphine dependence and withdrawal in rats

The effects of morphine on hippocampal sensory gating (N40) during the development of morphine dependence and withdrawal were investigated in the double click auditory evoked potential (EP) suppression paradigm. Rats were made dependent upon morphine hydrochloride by a series of injections (every 12h) over 6 days, followed by withdrawal after stopping morphine administration. Hippocampal gating was examined during the development of dependence and withdrawal. Moreover, the DA antagonist haloperidol was used to assess the contribution of dopamine to hippocampal gating induced by morphine. Our results showed that the morphine-treated rats exhibited significantly disrupted hippocampal gating during the development of morphine dependence and this disrupted gating was partially reversed by haloperidol pretreatment. In contrast, there was significantly enhanced hippocampal gating at the fifth and sixth days of withdrawal. The dynamics of hippocampal gating during the development of morphine dependence and withdrawal suggests the interaction between the hippocampus and opioids. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

The survey of sexual maturity in Mugil cephalus so measuring sex hormones and histologic studies

In this study the process of female gray mullet brooders was carried out by using histological study and masurment of sex steroids. Results of histological studies showed that oocyte of gray mullet brooders in Gomishan Rearing Center conditions of develop to the end of yolk globule stage. The results were observed with oocyte in chromatin nucleolar stage (first stage) with means of diameter of 20 p m, in August, perinucleolar stage (second stage) in September with mean diameter of 87 p m, yolk vesicle stage (third stage) in October with mean diameter 200 p m and yolk granules stage (forth stage) from October to November with average diameter of 180 — 650 p m. For the reason of stopping oocyte develop at the end of fourth stage, hormonal induction to final oocyte maturation and ovulation was used. For this purpose, carp pituitary , HCG and LRH-A2 with different combinations were used in two stages, second injection was used 24 hours after first injection. 15 females brooders were divided in 5 groups, different hormonal combinations were injected to four groups and to fifth group as control, only saline, was injected. The process of female brooder rippening in hormonal induction was studied via masurment of sex steroids including 17 a - hydroxy progestrone, estradio1-17)6 and testosterone. Blood samples were collected from caudal vein during first injection, 24, 30 and 48 hours after the first injection. At the same time, for distinguishing histological changes the sample has been attained from the gonads Sex stroid fluctuation patterns in different brooder groups that injected hormon were similar, however hormonal composition had similar effects. All brooder that their oocyte in the beginning of hormonal injection were At the end of fourth stage with oocyte diameter average of 600 p m received to final maturation and ovulation. The brooder that its oocytes were At the begining or mid-fourth stage did not show ovulation but hormonal induction caused oocyte develop at the beginning of fifth stage. Study of 17-hydroxy progestrone fluctuation showed that the maximum level of this steroid (0.347 ng/ml) measured 30 hours after the first injection and was significantly higher (p< 0.05) than those of control group. So, 17-hydroxy progestrone is probably precursor of maturation inducing steroid (MIS). However the maximum level of that observed was coincident with germinal vesicle breakdown, oil droplets coalescence and dissolution of yolk granuls The maximum levels of esteradiol— 17/0 and testosterone (3.778 and 16.801ng/ml,respectively) in spawned brooders,were observed 24 hours after the first injection. levels of those steroids were significantly higher (p<0.05) than control group. Maximum level of sex steroids in the brooders that did not spawn to the end of treatment was observed with more delay than those in spawned brooders. Therefor maximum level of 17a-hydroxy progestrone (0.264 ng/ml) in those brooders observed in fourth sampling time and the maximum levels of estradio1-17a and testosterone (2.944 and 18.993 ng/ml, respectivly)observed in third sampling time that was significantly higher (p<0.05) than those of control group. For the study of stress effect on brooders during the hormonal induction, level of cortisol was measured in every sampling time. level of cortisol had high fluctuation that showed handling level and stress effect on brooders. However maximum level of cortisol in majority of brooders was dominant in third sampling time that was coincident with final maturation.

An investigation of the effects of pneumatic actuator design on slip control for heavy vehicles

Progress in reducing actuator delays in pneumatic brake systems is opening the door for advanced anti-lock braking algorithms to be used on heavy goods vehicles. However, little has been published on slip controllers for air-braked heavy vehicles, or the effects of slow pneumatic actuation on their design and performance. This paper introduces a sliding mode slip controller for air-braked heavy vehicles. The effects of pneumatic actuator delays and flow rates on stopping performance and air (energy) consumption are presented through vehicle simulations. Finally, the simulations are validated with experiments using a hardware-in-the-loop rig. It is shown that for each wheel, pneumatic valves with delays smaller than 3ms and orifice diameters around 8mm provide the best performance. © 2013 Copyright Taylor and Francis Group, LLC.

A theory of slow feature analysis for transformation-based input signals with an application to complex cells

We develop a group-theoretical analysis of slow feature analysis for the case where the input data are generated by applying a set of continuous transformations to static templates. As an application of the theory, we analytically derive nonlinear visual receptive fields and show that their optimal stimuli, as well as the orientation and frequency tuning, are in good agreement with previous simulations of complex cells in primary visual cortex (Berkes and Wiskott, 2005). The theory suggests that side and end stopping can be interpreted as a weak breaking of translation invariance. Direction selectivity is also discussed. © 2011 Massachusetts Institute of Technology.

Designing and testing an advanced pneumatic braking system for heavy vehicles

Heavy goods vehicles exhibit poor braking performance in emergency situations when compared to other vehicles. Part of the problem is caused by sluggish pneumatic brake actuators, which limit the control bandwidth of their antilock braking systems. In addition, heuristic control algorithms are used that do not achieve the maximum braking force throughout the stop. In this article, a novel braking system is introduced for pneumatically braked heavy goods vehicles. The conventional brake actuators are improved by placing high-bandwidth, binary-actuated valves directly on the brake chambers. A made-for-purpose valve is described. It achieves a switching delay of 3-4 ms in tests, which is an order of magnitude faster than solenoids in conventional anti-lock braking systems. The heuristic braking control algorithms are replaced with a wheel slip regulator based on sliding mode control. The combined actuator and slip controller are shown to reduce stopping distances on smooth and rough, high friction (μ = 0.9) surfaces by 10% and 27% respectively in hardware-in-the-loop tests compared with conventional ABS. On smooth and rough, low friction (μ = 0.2) surfaces, stopping distances are reduced by 23% and 25%, respectively. Moreover, the overall air reservoir size required on a heavy goods vehicle is governed by its air usage during an anti-lock braking stop on a low friction, smooth surface. The 37% reduction in air usage observed in hardware-in-the-loop tests on this surface therefore represents the potential reduction in reservoir size that could be achieved by the new system. © 2012 IMechE.

Assessment of dry weight by monitoring changes in blood volume during hemodialysis using Crit-Line.

BACKGROUND: Routine assessment of dry weight in chronic hemodialysis patients relies primarily on clinical evaluation of patient fluid status. We evaluated whether measurement of postdialytic vascular refill could assist in the assessment of dry weight. METHODS: Twenty-eight chronic, stable hemodialysis patients were studied during routine treatment sessions using constant dialysate temperature and dialysate sodium concentration, and relative changes in blood volume were monitored using Crit-Line III monitors throughout this study. The study was divided into three phases. Phase 1 studies evaluated the time-dependence of vascular compartment refill after completion of hemodialysis. Phase 2 studies evaluated the relationships in patient subgroups between intradialytic changes in blood volume and the presence of postdialytic vascular compartment refill during that last 10 minutes of hemodialysis after stopping ultrafiltration. Phase 3 studies evaluated the extent of dry weight changes following the application of a protocol for blood volume reduction, postdialytic vascular compartment refill, and correlation with clinical evidence of intradialytic hypovolemia and/or postdialytic fatigue. Phase 3 included anywhere from three to five treatments. RESULTS: Phase 1 studies demonstrated that despite interpatient variability in the magnitude of postdialytic vascular compartment refill, when significant refill was evident, it always continued for at least 30 minutes. However, the majority of refill took place within 10 minutes postdialysis. Phase 2 studies identified 3 groups of patients: those who exhibited intradialytic reductions in blood volume but not postdialytic vascular compartment refill (group 1), those who exhibited intradialytic reductions in blood volume and postdialytic vascular compartment refill (group 2), and those whose blood volume did not change substantially during hemodialysis treatment (group 3). In phase 3 studies, use of an ultrafiltration protocol for blood volume reduction and monitoring of postdialytic vascular compartment refill combined with clinical assessment of hypovolemia and postdialytic fatigue demonstrated that patients often had a clinical dry weight assessment which was too low or too high. In all 28 patients studied, dry weight was either increased or decreased following use of this protocol. CONCLUSION: Determination of the extent of both intradialytic decreases in blood volume and postdialytic vascular compartment refill, combined with clinical assessment of intradialytic hypovolemia and postdialytic fatigue, can help assess patient dry weight and optimize volume status while reducing dialysis associated morbidity. The number of hospital admissions due to fluid overload may be reduced.

Determination of the rheological parameters of self-compacting concrete matrix using slump flow test

The classification of a concrete mixture as self-compacting (SCC) is performed by a series of empirical characterization tests that have been designed to assess not only the flowability of the mixture but also its segregation resistance and filling ability. The objective of the present work is to correlate the rheological parameters of SCC matrix, yield stress and plastic viscosity, to slump flow measurements. The focus of the slump flow test investigation was centered on the fully yielded flow regime and an empirical model relating the yield stress to material and flow parameters is proposed. Our experimental data revealed that the time for a spread of 500 mm which is used in engineering practice as reference for measurement parameters, is an arbitrary choice. Our findings indicate that the non-dimensional final spread is linearly related to the non-dimensional yield-stress. Finally, there are strong indications that the non-dimensional viscosity of the mixture is associated with the non-dimensional final spread as well as the stopping time of the slump flow; this experimental data set suggests an exponential decay of the final spread and stopping time with viscosity. © Appl. Rheol.

Influence of implantation energy on the characteristics of Mn-implanted nonpolar a-plane GaN films

Nonpolar GaN Mn films have been fabricated by implanting Mn-ion into nonpolar a-plane (MO) GaN films at room temperature. The influence of implantation energy on the Structural, morphological and magnetic characteristics of samples have been investigated by means of stopping and range of ions in matter (SRIM) Simulation software, high-resolution X-ray diffraction (HRXRD), atomic force microscopy (AFM), and superconducting quantum interference device (SQUID). According to the SQUID analysis, obvious room temperature ferromagnetic properties of samples were detected. Moreover, the implantation energy has little impact on the ferromagnetic properties of samples. The XRD and AFM analyses show that the structural and morphological characteristics of samples were severely deteriorated with the increase of implantation energy. (C) 2008 Elsevier B.V. All rights reserved.