Envelhecimento populacional: um diagnóstico dos idosos institucionalizados, em Natal/RN

The aging process lived by the Brazilian population concurred to the transformation in the family models, causing difficulties related to the elderly care on the Family environment, a fact that is one of the main reasons for their institutionalization. Facing this scenario, the need of investigating how the elderly lives on the long-term facilities (ILPI) has aroused. In this study, it has been conducted an analysis of the populational aging process, contrasting the Rio Grande do Norte to Brazil and the Northeast Region, between 1980 to 2010. Faced with the realization of this process, and the rising number of long-term facilities for the elderly (ILPI), it was needed to make a rescue of the abiding laws regarding elderly institutionalization, on the scope of Natal, which surged after the 1988 Federal Constitution, checking what were the impacts on the assistance of the institutionalized elderly. Lastly, it were investigated the possible determinants associated with the institutionalization, in Natal-RN, considering the aspects of the family structure, family relationship, economic, health and well being of the elderly. The results showed that Rio Grande do Norte, particularly Natal, follows the national scene, since between 1980 and 2000 its population passed the intermediate level in the process of population aging for, in 2010, to be considered elderly. Throughout this process, it was observed that Natal has been adapting to the federal legislation, through the creation of the municipal policy, City Council and other relevant standards for the elderly, promoting significant changes in ILPI.However, philanthropic institutions needs better resources for their maintenance. In research with the elderly, it was found that although the majority of the elderly have declared themselves satisfied with life, they had indicators of impairment of functional capacity and cognitive, isolated social behavior and depression, affecting the life quality of these elderly. These results reflect the need for greater investment of public power in the drafting, implementation and monitoring of public policies aimed at promoting changes that raise the level of life quality of this segment of the population

Medição de satisfação e fidelidade do cliente :um estudo com pacientes de clínica particular

This Thesis deals with a study on customer satisfaction and loyalty measurement focusing on a model of factors antecedents of customer satisfaction and loyalty. The model is based on a Satisfaction Index model adopted in Norway developed by Johnson et al.(2001) and the service quality drivers from the literature. It is surveyed a sample of 130 patients of a gynecology clinical. It is used a multiple regression analysis as the main statistical method in order to verify the factors affecting satisfaction and loyalty. The main findings are that the quality model explain 54% of the satisfaction but the whole model explain only 31% of the loyalty. Although the results are consistent with the literature in term of quality as the main driver of the satisfaction and that the satisfaction is not only one factor to explain loyalty, both the quality model to satisfaction and the factors model affecting loyalty should be improved to explain better the satisfaction and loyalty in health care service

Growth curve in Santa Ines sheep

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Gestão de satisfação e fidelidade do cliente: um estudo com turistas em hotéis

This Thesis deals with a study on customer satisfaction and loyalty focusing on a model of factors antecedents of customer satisfaction and loyalty. The model is based on a Satisfaction Index model adopted in Norway developed by Johnson et al.(2001) and the service quality drivers from the literature. It is surveyed a sample of tourist in Natal. It is used a survey questionnaire applied at the airport in the departure moment of the tourist. The final sample results on 198 cases. Is is used a multiple regression analysis as the method to verify the factor affecting satisfaction and loyalty. Two models arise from the analysis. The first model concerning satisfaction results with cleaness and hygiene of the bathroom, leisure facilities, employees promptness, and price as the significant factors affecting satisfaction. The model has a R2 of 0.6430 and the also check in service, cleaness of the apartment and the hotel in general, bedroom setting have colinearity with some factors entering the model. The loyalty model results with satisfaction, affective commitment as the main factors affecting loyalty, with a R2 0.5396, and also image has collinearity with satisfaction. A small part of the sample has complained and this factor was not considered in the models. The results are consistent with the literature in term of quality as the main driver of the satisfaction and that it is not the only one factor to explain loyalty

Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus

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

Association between atherosclerotic aortic plaques and left ventricular hypertrophy in patients with cerebrovascular events

Background and Purpose - the purpose of this research was to evaluate whether an association exists between the presence of atherosclerotic plaque in the thoracic aorta and left ventricular hypertrophy (LVH) in patients with a cerebrovascular event.Methods - We included 116 consecutive patients ( 79 men; mean age, 62 +/- 12.4 years) with previous history of stroke or transient ischemic attack in a cross-sectional study. Transthoracic echocardiogram was performed to diagnose LVH and transesophageal echocardiogram for the detection of atheromas of the thoracic aorta. Continuous variables were analyzed by Student t or Mann-Whitney tests and categorized variables by Goodman test. From the significant association of LVH and age with atheromatous disease of the aorta, an adjustment to the multivariate logistic model was made using high blood pressure history or age as covariates. All of the statistical tests were carried out at a level of 5% significance.Results - Almost half of the patients (43.1%) presented atherosclerotic lesions in the aorta. LVH was present in 90.0% of patients with plaque and in only 30.3% of patients without plaque. Using high blood pressure as a covariate, the risk of patients with LVH presenting atherosclerotic plaque in the aorta was 18.23-fold greater than the risk for patients without LVH (95% CI, 5.68 to 58.54; P < 0.0001). Adding age into the model, the risk increased to 26.36 ( 95% CI, 7.14 to 97.30; P < 0.0001).Conclusions - LVH detected by conventional echocardiogram is associated with high risk of atherosclerotic plaque in the aorta and would be used as a criterion for indication of transesophageal echocardiography in patients with previous stroke or transient ischemic attack LVH.

Eventos adversos após vacinação contra influenza em idosos, Distrito de Campinas, SP, 2000

Há poucos dados sistematizados sobre eventos adversos da vacina contra influenza no Brasil. Este trabalho visou identificar estes eventos em população acima de 60 anos que compareceu à Campanha Nacional de Vacinação do Idoso, em Distrito de Campinas, SP, em 2000. Foi realizada entrevista para relato de sintomas gerais e locais, com nexo temporal após a aplicação do imunobiológico, em amostra aleatória sistemática da população (n=206). Registraram-se 20,38% (IC 14,87-25,88) dos indivíduos com um ou mais sintomas, sendo a dor no local da vacina, a mais freqüente 12,6% (IC 8,09-17,15). Ajustou-se um modelo de regressão logística múltipla, tendo como variável dependente, a ocorrência de pelo menos um evento adverso. A variável independente que se mostrou associada às reações adversas foi o sexo (feminino) (OR=5,89 e IC 2,08-16,68). Os achados deste estudo reafirmam a pequena reatogenicidade da vacina contra a influenza.

Growth curve of Nellore calves reared on natural pasture in the Pantanal

Weight-age and hip height-age relations of Nellore calves, from birth to 10 months old were fitted using a logistic model including sex and year of birth as fixed effects. Calves and their dams were reared on natural pasture using continuous grazing system. The crude protein content and total digestible nutrients were analyzed for pasture selected by the animals. The weights of the calves were adjusted to 205 days and 365 days. There were no significant effects of sex and birth year on the growth curve parameters, but there were significant effects of sex on hip height. The average weight (a parameter) at 10 months of age was 170 kg and the inflection point was observed at 93.5 days old. When weight-age and hip height-age curves were combined in the same graph, the intersection occurred at 142 days. The number of days to gain 160 kg from birth to 205 days of age (adjusted) and number of days to gain 240 kg from 205 days to slaughter was different between the birth years, which were probably due to the quality of the natural pastures. It is necessary to implement nutritional management strategies such as high quality pasture and/or feeding supplementation for calves once they reach three months of age.

Factors affecting conception rates following artificial insemination or embryo transfer in lactating holstein cows

The objective of this study was to evaluate the factors that may affect conception rates (CR) following artificial insemination (AI) or embryo transfer (ET) in lactating Holstein cows. Estrous cycling cows producing 33.1 +/- 7.2 kg of milk/d received PGF(2 alpha) injections and were assigned randomly to 1 of 2 groups (AI or ET). Cows detected in estrus (n = 387) between 48 and 96 h after the PGF2a injection received AI (n = 227) 12 h after detection of estrus or ET (n = 160) 6 to 8 d later (1 fresh embryo, grade 1 or 2, produced from nonlactating cows). Pregnancy was diagnosed at 28 and 42 d after estrus, and embryonic loss occurred when a cow was pregnant on d 28 but not pregnant on d 42. Ovulation, conception, and embryonic loss were analyzed by a logistic model to evaluate the effects of covariates [days in milk (DIM), milk yield, body temperature (BT) at d 7 and 14 post-AI, and serum concentration of progesterone (P4) at d 7 and 14 post-AI] on the probability of success. The first analysis included all cows that were detected in estrus. The CR of AI and ET were different on d 28 (AI, 32.6% vs. ET, 49.4%) and 42 (AI, 29.1% vs. ET, 38.8%) and were negatively influenced by high BT (d 7) and DIM. The second analysis included only cows with a corpus luteum on d 7. Ovulation rate was 84.8% and was only negatively affected by DIM. Conception rates of AI and ET were different on d 28 (AI, 37.9% vs. ET, 59.4%) and 42 (AI, 33.8% vs. ET, 46.6%) and were negatively influenced by high BT (d 7). The third analysis included only ovulating cows that were 7 d postestrus. Conception rates of AI and ET were different on d 28 (AI, 37.5% vs. ET, 63.2%) and 42 (AI, 31.7% vs. ET, 51.7%) and were negatively influenced by high BT (d 7). There was a positive effect of serum concentration of P4 and a negative effect of milk production on the probability of conception for the AI group but not for the ET group. The fourth analysis was embryonic loss (AI, 10.8% vs. ET, 21.5%). The transfer of fresh embryos is an important tool to increase the probability of conception of lactating Holstein cows because it can bypass the negative effects of milk production and low P4 on the early embryo. The superiority of ET vs. AI is more evident in high-producing cows. High BT measured on d 7 had a negative effect on CR and embryonic retention.

Modeling grouped survival data with time-dependent covariates

In this article, proportional hazards and logistic models for grouped survival data were extended to incorporate time-dependent covariates. The extension was motivated by a forestry experiment designed to compare five different water stresses in Eucalyptus grandis seedlings. The response was the seedling lifetime. The data set was grouped since there were just three occasions in which the seedlings was visited by the researcher. In each of these occasions also the shoot height was measured and therefore it is a time-dependent covariate. Both extended models were used in this example, and the results were very similar.

Comparação de modelos não-lineares para descrever o crescimento de fêmeas da raça Guzerá

Dados de crescimento e reprodução de 573 vacas da raça Guzerá, nascidas entre 1961 e 1985, na Fazenda Canoas, em Curvelo, MG, foram analisados com o objetivo de estabelecer um padrão médio de crescimento, mediante o uso de um modelo matemático que se ajuste adequadamente aos dados. Os modelos Brody, Bertalanffy, Logístico, Gompertz e Richards foram ajustados aos dados de peso/idade, coletados até 1992, e comparados quanto à qualidade de ajustamento. Os pesos assintóticos e as taxas de maturidade estimadas foram, respectivamente: para o modelo Brody, 464,49 e 0,046; para o Bertalanffy, 453,18 e 0,065; para o Logístico, 447,05 e 0,085; para o Gompertz, 449,89 e 0,075, e para o Richards, 458,26 e 0,055. O modelo Richards apresentou dificuldades computacionais para ajustamento aos dados. Os outros modelos se revelaram adequados para descrever o crescimento nesses animais, apresentando pequenas variações na qualidade de ajustamento, de acordo com os critérios utilizados. O modelo Bertalanffy foi escolhido para representar a curva média de crescimento dos animais, por apresentar um ajustamento superior no conjunto dos critérios.

Methods to verify parameter equality in nonlinear regression models

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Determination of a point sufficiently close to the asymptote in nonlinear growth functions

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise de dados de gastroenterite hemorrágica canina para identificar fatores de risco por regressão logística

No presente estudo, ajustou-se um modelo de regressão logística para prever a probabilidade de óbito de cães acometidos por gastroenterite hemorrágica. O modelo Logístico é recomendado para variáveis-resposta dicotômicas em estudo de Coorte. Registraram-se 176 animais censitariamente atendidos com gastroenterite hemorrágica em quatro clínicas veterinárias da cidade de Lavras, sul de Minas Gerais, entre os anos de 1992 e 1999. Após terem sido selecionadas por meio do teste de Pearson ou teste exato de Fisher, ajustou-se o modelo considerando-se as variáveis sexo, idade, diárias de internação e número de atendimentos. A estimação dos parâmetros foi feita pelo método da máxima verossimilhança. Conclui-se que quando os cães acometidos por gastroenterite hemorrágica são atendidos apenas uma vez, aqueles com idade superior a 6 meses possuem 15,45 vezes mais chances de morrerem (P<0,05) do que aqueles com menos de 6 meses de idade. Quando os animais que apresentam a enfermidade possuem mais de 6 meses de idade, a chance de morrerem, se forem atendidos apenas uma vez, é 20,251 vezes maior (P<0,05) do que se recebessem de 2 a 7 atendimentos.

Polinômios fracionários em modelos de regressão

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)