Conhecimento e adesão da prática de higienização das mãos dos profissionais da saúde: revisão de literatura

O presente estudo objetiva conhecer a produção científica da saúde acerca da higienização das mãos realizada pelos profissionais e relacionar o conhecimento e adesão do profissional a essa prática. Trata-se de uma revisão bibliográfica sistemática, realizado na Biblioteca Virtual de Saúde (BVS), nas bases de dados LILACS e SCIELO, com os descritores: pessoal de saúde, lavagem de mãos e adesão. Selecionou-se 13 artigos no período de 2002 a 2012, que foram analisados em categorias. Os critérios de inclusão para a seleção dos artigos foram: artigos publicados em português e estar disponível em texto completo. Os resultados da pesquisa evidenciaram que a grande maioria dos profissionais tem embasamento teórico e prático sobre higienização das mãos. Porém, no campo de trabalho temos resultados contrários, não há adesão esperada nem a técnica correta da lavagem das mãos. Por diversos motivos ainda não realizam por completo essa tarefa. Concluindo assim que as ações de educação que tem função de orientar e motivar esses profissionais devem ser discutidas e implementadas, a fim de sanar todas as dúvidas que ainda existem sobre a técnica de higienização das mãos.

Inference of binding affinity from neuronal receptors in humans

Tese de mestrado, Bioinformática e Biologia Computacional (Bioinformática), Universidade de Lisboa, Faculdade de Ciências, 2016

Avaliação dos efeitos de um programa de caminhada nos fatores de risco de queda em idosos: equilíbrio, força e agilidade.

Dissertação apresentada para a obtenção do grau de Mestre em Desporto com especialização em Condição Física e Saúde

Promover a parentalidade : recomendações perante as birras e momentos de alimentação da criança

Enquadramento: A parentalidade é um tema de saúde com muita relevância na sociedade atual, intervindo o seu exercício na promoção da saúde e bem-estar da criança. A parentalidade envolve acontecimentos stressantes, nomeadamente em situações de problemas de saúde e necessidades básicas e de resposta ao comportamento da criança, como é o caso do choro/birra e no momento de alimentação, procurando a maioria dos cuidadores responder ao problema de forma independente enquanto outros solicitam apoio dos profissionais de saúde. Objetivo: Identificar recomendações concretas, baseadas na evidência científica, de boas práticas e recomendações a transmitir aos pais para lidarem com o choro /birras e no momento da alimentação da criança. Métodos: Realizou-se uma revisão sistemática da literatura de estudos realizados nos idiomas português, inglês e espanhol, publicados entre 2009 e 2014, em bases de dados internacionais CINAHL® Plus with Full-Text, Nursing & Allied Health Collection, Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews (CDSR) e Database of Abstracts of Reviews of Effects (DARE), MedicLatina , MEDLINE, com recurso a diversos descritores e operadores booleanos e recorrendo a dois revisores que avaliaram a qualidade dos estudos metodológicos. Resultados: Após avaliação crítica, foram excluídos 50 estudos e incluídos 7, sendo um de grau de evidência A, dois de evidência B e 4 de evidência D. Os outcomes evidenciaram que para gestão da parentalidade o aconselhamento deve feito pelo profissional de referência, que se necessário deverá acompanhar os pais através de contacto telefónico e visita domiciliária sobretudo se mães inexperientes. Os profissionais devem ampliar os seus conhecimentos sobre as dúvidas e preocupações que os pais têm sobre a educação dos seus filhos consultando os espaços de discussão online. A etnia e nacionalidade das mães tem forte impacto sobre os métodos usados para acalmar o bebé, pelo que os cuidados devem ser culturalmente congruentes. Na abordagem do choro/ birras torna-se necessário conhecer o normal desenvolvimento da criança e em que contextos surgem para minimizá-las, sendo importante que os pais dêem à criança atenção positiva, instituindo rotinas. Para melhorar o momento da alimentação os pais devem reconhecer que até aos dois anos decorre a janela de oportunidade de aprendizagem de rotinas e de novos sabores, salientando-se a importância do ambiente de atenção e reciprocidade durante as refeições. Conclusão: Os enfermeiros devem procurar orientar a sua prática com base nas evidências científicas e tendo como base o estudo efectuado, salienta-se a promoção da parentalidade positiva como central para a abordagem dos comportamentos de choro/birra e no momento da alimentação da criança. Palavras – chaves: educação parental, enfermeiro, aleitamento materno, alimentação, birra, choro, relação pais-filhos.

Prevalência e factores determinantes de desenvolvimento de úlcera por pressão

As Ulceras de Pressão (UP) podem ocorrer em todos os níveis de cuidados particularmente em situações de mobilidade reduzida e actividade diminuídas e a sua prevalência crescente constitui um problema significativo de saúde pública já que tem repercussões importantes na qualidade de vida dos doentes e suas famílias para além da sobrecarga financeira para os mesmos e para os sistemas de saúde. Pode definir-se UP como uma lesão localizada da pele e/ou tecido subjacente, normalmente sobre uma proeminência óssea, em resultado da pressão ou de uma combinação entre esta e forças de torção. Objectivou-se determinar a prevalência e os factores determinantes de desenvolvimento de ulceras de pressão no momento da admissão e alta em utentes institucionalizadas numa UMDR integrada na RNCCI. Estudo retrospectivo, de natureza quantitativa, realizado numa instituição de média duração, sendo a amostra constituída por 300 participantes. Para a colheita de dados elaborou-se um questionário que foi aplicado no período de 1 de Setembro a 31 de Outubro de 2014. Para a análise dos resultados, utilizou-se o programa estatístico SPSS. Na admissão registou-se 34% de prevalência de UP, 16,7% dos casos foi adquirida no domicílio e em 42,0% dos casos a UP é de Grau III, e em 11,7% das situações a UP mais grave localiza-se no sacro. Na alta observaram-se 24% de casos de UP, em que 12,0% das situações a UP é de Grau IV e em 10,0% de Grau III e em 7,7% das situações a UP mais grave se localiza no trocânter e em 6,7% no sacro. Constatou-se que 50% dos utentes são do sexo masculino e 50% do sexo feminino, com uma média de 74,82 anos de idade. Apresentam uma média de tempo de permanência na UMDR de 92,36 dias. 66,3% dos utentes ingressam na UMDR para reabilitação funcional e 29% para tratamento de feridas/UP. A maioria dos utentes revelou perda de autonomia para a realização das atividades de vida diária, com a sua dependência funcional comprometida quer na admissão, quer na alta. Os participantes na admissão apresentam 78,7% de alto risco para desenvolver úlceras de pressão e na alta este valor desceu para 54%. Como conclusão poderá inferir-se que a idade avançada, incontinência urinária e fecal, a presença de sonda vesical, o alto risco de desenvolvimento de UP e a presença de incapacidade aumenta o risco de desenvolver ulceras de pressão. Descritores: Ulceras de Pressão, Factores de Risco, Epidemiologia.

COMUNICAÇÃO EM LINHA E RUÍDOS SEMÂNTICOS NA RECUPERAÇÃO DE INFORMAÇÕES EM PESQUISAS CIENTÍFICAS

O pesquisador científico necessita de informações precisas, em tempo hábil para conclusão de seus trabalhos. Com o advento da INTERNET, o processo de comunicação em linha, homem x máquina, mediado pelos mecanismos de busca, tornou-se, simultaneamente, um auxílio e uma dificuldade no processo de recuperação de informações. O pesquisador teve que adaptar-se ao modo de operar da INTERNET e incluiu conhecimentos de diferenças idiomáticas, de terminologia, além de utilizar instrumentos que lhe forneçam parâmetros para obter maior pertinência e relevância nos dados. O uso de agentes inteligentes para melhoria de resultados e a diminuição de ruídos semânticos têm sido apontados como soluções para aumento da precisão no resultado das buscas. O estudo de casos exploratório realizado analisa a pesquisa em linha a partir da teoria da informação e propõe duas formas de otimizar o processo comunicacional com vistas à pertinência e relevância dos dados obtidos: a primeira sugere a aplicação de algoritmos que utilizem o vocabulário controlado como mediador do processo de comunicação utilizando-se dos descritores para recuperação em linha. , e a segunda ressalta a importância dos agentes inteligentes no processo de comunicação homem-máquina.(AU)

Produção do mestrado profissional em ensino de ciências naturais e matemática da UFRN (física e química/2005-2012): papel dos documentos oficiais e características dos produtos educacionais

The importance of the Professionals Master in the field of science education is revealed by the recognition that they provide, to practicing teachers, in particular, training spaces for reflection and application of knowledge. This work appears in the context of the project "Research and training in teaching science and mathematics: a cutout of academic production in the northeast and overview of formative action in basic education" on the Centre for Education program, which main objective was to conduct studies description, analysis and evaluation of the academic production of Postgraduate Programs in Science Teaching of UFRPE, UFRN and UEPB and investigate the contribution of continuing education in stricto sensu level, of graduated teachers to improve the quality of basic education . We sought to examine a cut of academic production PPGECNM / UFRN, taking as reference dissertations of Natural Sciences, finished between the years 2005 and 2012, which have developed and applied educational products for high school students. More specifically we sought to conduct a general characterization of the dissertations analyzed for basic descriptors, to understand if and how the official documents governing the Brazilian education, especially science education, subsidized development of dissertations and identify current trends for science teaching are addressed and which ones are used in preparing the product of dissertations. The survey was based on documentary analysis, a type of qualitative approach in which the documents are objects of study in themselves. The results revealed that most of the work was developed in public schools, on subjects of physics and chemistry. During analytical reading of the text of the dissertations was observed that, in its construction, most of them addressed somehow, official documents governing the Brazilian educational system, that the products are basically teaching units and teaching approaches that are more focused on Experimentation and History and Philosophy of Science

Análise de conceito do diagnóstico de enfermagem autocontrole ineficaz da saúde em pacientes submetidos à hemodiálise

The concept analysis process carefully examines the description and uses of a word or term, enabling the standardization of language, in addition to providing representation to the profession, and facilitate the work of taxonomies. The aim of the study was to analyze the concept of nursing diagnosis ineffective self-health in patients undergoing hemodialysis. Study concept analysis, based on Walker and Avant model and operationalized through integrative literature review. The databases searched were: SCOPUS, CINAHL, PUBMED, LILACS and COCHRANE, with descriptors: Selfmanagement, Adherence and Hemodialysis. The inclusion criteria were: articles published in the last five years, complete articles are available free in selected databases; articles available in Portuguese, English or Spanish; and articles that address the self-concept of health, the antecedents and the consequent. And Exclusion: editorials, letters to the editor, theses and dissertations. The survey of the articles occurred in the months from January to March 2014. The initial sample of 16785 articles, with 11748 in PUBMED, 4767 in Scopus, 174 in CINAHL, the Cochrane 70 and 26 in LILACS. After applying the criteria, 76 articles were selected, 19 in CINAHL, 18 in PUBMED, 30 in Scopus, and 9 in LILACS. In analyzing the data, given that the concept was sought in the literature was self-health, was held interpretation to ineffective self-health diagnosis through the transposition in the denial of the attributes, antecedents and consequences identified. It is noteworthy that the terms identified in the literature as defining characteristics and related factors of the diagnosis under study were added to the survey, not even the transposition into opposite term is possible. The results show that the concept developed for the inefficient self-health diagnosis was: the patient's inability to control habits and achieve the negotiated with professionals therapeutic targets, resulting in health complications. 33 antecedents relating to social, psychological and therapeutic aspects and 16 consequential, involving physiological, social, psychological and therapeutic aspects were identified. Thus, it is concluded that the ineffective self-health concept is broad and involves individual patient factors and the therapeutic relationship between patient and professionals. It is believed that the study contributed to the improvement of diagnosis in renal clientele, besides being an important base for the growth of the scientific body of nursing, subsidizing the development of own technology area

Técnica para segmentação automática de imagens microscópicas de componentes sanguíneos e classificação diferencial de leucócitos baseada em lógica fuzzy

Automatic detection of blood components is an important topic in the field of hematology. The segmentation is an important stage because it allows components to be grouped into common areas and processed separately and leukocyte differential classification enables them to be analyzed separately. With the auto-segmentation and differential classification, this work is contributing to the analysis process of blood components by providing tools that reduce the manual labor and increasing its accuracy and efficiency. Using techniques of digital image processing associated with a generic and automatic fuzzy approach, this work proposes two Fuzzy Inference Systems, defined as I and II, for autosegmentation of blood components and leukocyte differential classification, respectively, in microscopic images smears. Using the Fuzzy Inference System I, the proposed technique performs the segmentation of the image in four regions: the leukocyte’s nucleus and cytoplasm, erythrocyte and plasma area and using the Fuzzy Inference System II and the segmented leukocyte (nucleus and cytoplasm) classify them differentially in five types: basophils, eosinophils, lymphocytes, monocytes and neutrophils. Were used for testing 530 images containing microscopic samples of blood smears with different methods. The images were processed and its accuracy indices and Gold Standards were calculated and compared with the manual results and other results found at literature for the same problems. Regarding segmentation, a technique developed showed percentages of accuracy of 97.31% for leukocytes, 95.39% to erythrocytes and 95.06% for blood plasma. As for the differential classification, the percentage varied between 92.98% and 98.39% for the different leukocyte types. In addition to promoting auto-segmentation and differential classification, the proposed technique also contributes to the definition of new descriptors and the construction of an image database using various processes hematological staining

Segmentação fuzzy de objetos tridimensionais com propriedades texturais

Digital image segmentation is the process of assigning distinct labels to different objects in a digital image, and the fuzzy segmentation algorithm has been used successfully in the segmentation of images from several modalities. However, the traditional fuzzy segmentation algorithm fails to segment objects that are characterized by textures whose patterns cannot be successfully described by simple statistics computed over a very restricted area. In this paper we present an extension of the fuzzy segmentation algorithm that achieves the segmentation of textures by employing adaptive affinity functions as long as we extend the algorithm to tridimensional images. The adaptive affinity functions change the size of the area where they compute the texture descriptors, according to the characteristics of the texture being processed, while three dimensional images can be described as a finite set of two-dimensional images. The algorithm then segments the volume image with an appropriate calculation area for each texture, making it possible to produce good estimates of actual volumes of the target structures of the segmentation process. We will perform experiments with synthetic and real data in applications such as segmentation of medical imaging obtained from magnetic rosonance

A formação do nutricionista para atuação no SUS: um olhar sobre a produção científica obrigatória dos cursos do Rio Grande do Norte

The National Curricular Guidelines for nutrition course predict training directed to the work in the Unified Health System (SUS) and the mandatory completion of course work. The aim of this study was to analyze the formation of dieticians in Rio Grande do Norte state/Brazil to work in the SUS, from the compulsory scientific production provided for training. This is a bibliometric study, quantitative approach, performed with completion of course works of five nutrition undergraduate courses in Rio Grande do Norte state in the years 2013/2013. From the reading of the works, the following variables were collected: nature of the institution, institution administrative category, location, work title, number of authors, work format, titration of the teacher advisor, study type, area of interest, scenery of accomplishment, submission to the ethics committee, suitability of descriptors and, as pertaining to the field of public health, the subfield of public health and the theme. The pedagogical projects of the courses were read and were identified opportunities to develop research in the graduation. For detection of significant categories we applied the Pearson chisquare test. We analyzed 195 works, coming mostly belonging to universities courses (79.0%) and private institutions (56.4%). A higher frequency of articles (68.2%), developed by one student (65.6%), guided by master teachers (57.9%), with cross-sectional study design (49.2%), conducted in laboratory (25%) and without submission to the ethics committee in research (49.2%) was find. The median adequacy of descriptors was 50%. As for the interest of the study, there was a higher frequency of work in the field of public health (p <0.001), within this subfield highlighting the nutritional epidemiology (63.0%) (p <0.001) and the subject nutrition assessment (57, 4%) (p <0.001). In cut on three major areas of dietician performance, was significant performing work in the field of public health in public institutions (p <0.05). The presence of complementary activities was unanimous in the pedagogical projects of the courses. The results of the study showed some methodological weaknesses in the research approaches, as well as a hegemonic positivist training. Despite the emphasis on public health, it was noticed little approximation of policies and nutrition programs in the context of the mandatory recearch of Rio Grande do Norte state nutrition courses.

Representações sociais de familiares sobre o atendimento das emergências psiquiátricas

The reformist movements in the field of mental health have pointed battle flags, among which the prioritization of production of mental health care out of the asylum environment should be highlighted, aiming the reduction of psychiatric beds, greater control over the hospitalization, family co-participation and the rescue of the citizenship of the social players involved. With the progressive reduction of asylum beds, associated with a lot of structural problems in the health services, the occurrence of crises outside the hospital environment has been increasingly frequent, thus giving the family an important therapeutic role. In face of this scenario, there is an urgent need to understand the social construction of the care for psychiatric emergencies, identifying the meanings assigned by family members to their constituent aspects. This study seeks to answer the following research question: what are the social representations of family members about the care of psychiatric emergencies in the city of Mossoró, Rio Grande do Norte? Therefore, the aim is to analyze the social representations of family members about the care of psychiatric emergencies in the city of Mossoró, Rio Grande do Norte. This is an exploratory and descriptive study, with a mixed approach, making use of multimethods: for collection, the semi-structured interview and the Technique of Free Association of Words; for data analysis, the Thematic Analysis of Bardin and its steps was used, with the informational support of the softwares ALCESTE (Analyse Lexicale par Contexte d'un Ensemble de Segments de Texte) and Iramuteq (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires); and the theoretical support of social representations. The study participants totaled 72, and they were selected from the following criteria: older than18 years, with degree of kinship with users suffering from some mental and behavioral disorder, and who have already witnessed a situation of crisis, rescued by the SAMU or other means and taken to the psychiatric hospital or general emergency room. Preliminary results point out: 1.Previous note of the research project with the aim to disseminate it in the scientific community and ensure the intellectual property of the work; 2.The contextual analysis of the care for emergencies in the study place. Reflection about the phenomenon provide a name to the care for the psychiatric emergencies, which is called immediate context; the technical and operational aspects that influence the care, as a specific/ general context; and mental health policies in Brazil are identified as metacontext; 3. The systematic review from randomized clinical trials in the databases PubMed, COCHRANE, LILACS, SciELO and SCIRUS, with the use of the descriptors: ‘Physical restraint’, ‘Psychiatric emergency services’, ‘Restraint’, ‘Physical and Emergency Services’, ‘Psychiatric’. Only one work met the search protocol criteria: a short-term essay that records limited results about the proportion of people who are in restraint and seclusion. It does not show statistically significant results in relation to indications, contraindications and risks of the use of physical restraint; 4. The social representations of the care for psychiatric emergencies. The study results point to the presence of five thematic categories: 1. feeling in the face of the crisis/care; 2. thoughts and perspectives about the crisis/care; 3. centrality of care in the medical- medication-hospitalization triad; 4. the thinking/acting in the face of the use of physical restraint and police force; 5. periodicity of crises. The central core of the representation is in the first category, whilst the peripheral elements are in the third and fifth categories. The contrast zone is in the second and fourth categories. The sadness is the most prominent element of the structure. The social representations about the care for psychiatric crises are at a time of transition between the hegemonic and reformist models, with the traditional aspects being predominant, but already showing peripheral and contrast elements that point to a possible change in the representational field.

Influência da seca extrema na dinâmica fitoplanctônica de um reservatório da região tropical semiárida: uma abordagem morfofuncional

Droughts are climatic phenomena whose frequency has increased in the last decades and also compromised drinkable water supplies in semiarid regions. The lack of rain combined with high evaporation rates promotes a significant reduction of the volume of reservoirs in these regions. Shallower conditions favors nutrients concentration and phytoplankton overgrowth, including potentially toxic cyanobacteria blooming. Therefore, there is a tendency to the intensification of eutrophication in those reservoirs during drought periods. Phytoplankton can respond quickly to environmental conditions related to light and nutrient availability by changes in algal biomass and composition, therefore it is considered a good predictor of environmental variables. Two functional approaches - Reynolds’s Functional Groups (FG) and Kruk’s Morphologically Based Functional Groups (MBFG) - were used to assess which environmental variables were responsible for phytoplankton dynamics, in addition to compare which functional approach explains environmental changes better. This study highlights that the reduction of 90% in the volume of a tropical reservoir of Brazilian semi-arid region, as well as light limitation and nutrient increase, can promote phytoplankton overgrowth. Multivariate analyses using both functional approaches indicated a clear separation between high volumes and low volumes conditions, showing that light and nutrient availability were the main variables that better explained the combination of functional groups. The composition of phytoplankton assemblage changed from species of meso-eutrophic habitats (FG: F and J; MBFG: VI), to organisms of eutrophic and turbid environments (FG: SN and M; MBFG: VIII and VII) during shallower conditions. Both ecological approaches described properly the phytoplankton dynamics according to light and trophic state alterations related to the water volume reduction, therefore they can be considered as equivalent approaches for using in similar environments.

Análise de desempenho de algoritmos de compressão de dados com perda para aplicações industriais

The great amount of data generated as the result of the automation and process supervision in industry implies in two problems: a big demand of storage in discs and the difficulty in streaming this data through a telecommunications link. The lossy data compression algorithms were born in the 90’s with the goal of solving these problems and, by consequence, industries started to use those algorithms in industrial supervision systems to compress data in real time. These algorithms were projected to eliminate redundant and undesired information in a efficient and simple way. However, those algorithms parameters must be set for each process variable, becoming impracticable to configure this parameters for each variable in case of systems that monitor thousands of them. In that context, this paper propose the algorithm Adaptive Swinging Door Trending that consists in a adaptation of the Swinging Door Trending, as this main parameters are adjusted dynamically by the analysis of the signal tendencies in real time. It’s also proposed a comparative analysis of performance in lossy data compression algorithms applied on time series process variables and dynamometer cards. The algorithms used to compare were the piecewise linear and the transforms.

Uso de correntropia na generalização de funções cicloestacionárias e aplicações para a extração de características de sinais modulados

Information extraction is a frequent and relevant problem in digital signal processing. In the past few years, different methods have been utilized for the parameterization of signals and the achievement of efficient descriptors. When the signals possess statistical cyclostationary properties, the Cyclic Autocorrelation Function (CAF) and the Spectral Cyclic Density (SCD) can be used to extract second-order cyclostationary information. However, second-order cyclostationary information is poor in nongaussian signals, as the cyclostationary analysis in this case should comprise higher-order statistical information. This paper proposes a new mathematical tool for the higher-order cyclostationary analysis based on the correntropy function. Specifically, the cyclostationary analysis is revisited focusing on the information theory, while the Cyclic Correntropy Function (CCF) and Cyclic Correntropy Spectral Density (CCSD) are also defined. Besides, it is analytically proven that the CCF contains information regarding second- and higher-order cyclostationary moments, being a generalization of the CAF. The performance of the aforementioned new functions in the extraction of higher-order cyclostationary characteristics is analyzed in a wireless communication system where nongaussian noise exists.