Trauma em idosos atendidos pelo serviço pré-hospitalar móvel

O The aim of this study was to characterize the occurrence of trauma in the elderly population served by the mobile pre-hospital service, in Natal, Rio Grande do Norte. This is a descriptive, transversal and quantitative approach and whose population consisted of 2,080 trauma victims. The sample, of systematic random type, consisted of 400 elderly people, aged from 60 years old, assisted by the Office of Mobile Emergency in Natal / RN, between January 2011 and December 2012. Data collection began after consent and assent of the institution of a Research Ethics Committee under No. 309 505. It was proceeded to documentary retrospective analysis of records of this service through a form of self-development, validated by expert judges considered reliable (α> 0.75) and valid (CVI = 0.97) in their clarity and relevance. Data were tabulated by the Statistical Package for Social Sciences, version 20.0. The results show that older victims have an average age of 74.19 years old, with a prevalence of female involvement by chronic diseases, especially hypertension, average usage of 2.2 routine medications with vital signs within normal limits. The trauma prevailed during the daytime, in the residence of the victims, north of the city and on weekends. Among the mechanisms of trauma were falls, traffic accidents and physical aggression, whose most common type was brain-cerebral trauma and the main consequences were suture wounds and closed fractures. Basic Support Units were as more driven to pre-hospital care (87.8%) and the main destination place consisted of a referral hospital for emergency of the state (57.5%). Among the most commonly performed procedures by nursing staff immobilization with rigid board and neck collar and the peripheral venipuncture, and the main component used for volume replacement to saline were highlighted. There was a significant relationship between the deaths and the mechanism of injury, mechanism of injury and procedures, except medication administration procedures carried out, except immobilization and unit for service. It is highlighted the prevalence of trauma in the elderly, poor follow-up Pre-Hospital Trauma Life Support protocol and the paucity of records and nursing procedures performed. There is need for a protocol of care specific to elderly trauma victims and education strategies for the prevention of such events

Avaliação da assistência à saúde dos portadores de úlceras venosas atendidos no programa saúde da família do município de Natal/RN

Descriptive research aimed at evaluating the assistance offered to patients with venous ulcers, on lower limbs, attended by the Family Health Program (FHP) team, from the municipality of Natal/RN. The target population was composed of 74 patients with venous ulcers (VU), attended by the FHP teams in the 31 FHUs. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (protocol n.55/05). The data collection was performed in patients homes and in the FHUs, through structured interviews and physical examinations of patients with VU and non-participant observation during the changing of wound dressings in these Units and in users homes. The data was organized into an Excel electronic table and transported into the SPSS 14.0 program, for descriptive analysis on 2x2 contingency tables and inferential (Qui-Square χ2, Spearman Correlation, Binomial Proportion Test and p-value <0.05). The prevalence of VU (0.36/1000) in the target population (over 20 years of age) was greater than in the population registered in FHP (0.25/1000). We detected a greater prevalence in the age area of over 60 years (2.22/1000), with 2.98/1000 for females and 1.3/1000 for males (p-value=0.008). The sociodemographical and health characteristics of patients with VU revealed predominance of females (74.5%), elders over 60 years of age (67.6%), with fundamental education (74.3%), family earnings of up to 2 minimum wages (68.9%), retired (90.5%), ortostatic position (23.0%), inadequate sleep (59,9%), presence of CVI (100.0%), hypertension (44.6%) and diabetes (25.7%). As for the time of existence of the VU, 64.9% had over 1 year, and 35.1% less than 1 year), with predominance of one wound (67.6%). The changing of wound dressings is performed mostly at home, in and inadequate way, especially with incorrect cleaning techniques, likewise incorrect use of products and substances, and reduced participation of the FHP team on the evaluation and application of the dressing and choosing of products and substances. The compressive therapy is not part of therapeutic conducts for treatment in the FHUs. As for the evaluation of assistance to patients with VU, 90.5% were inadequate and only 9.5% adequate. The main inadequacy factors were the absence of: diagnosis (47.3%), consultation with and angiologist (63.5%), compressive treatment (100.0%), adequate optical therapy (98.62%), adequate dressing kit (70.3%), training for the changing of dressings (67.6%), following by the FHP team (51.4%) and performed exams (55.4%). We ve concluded that patients with VU mostly present now socioeconomical level and associated chronic diseases. Considering that assistance offered by FHP is non-systematic, fragmented, with no diagnosis planning, continual evaluation and evolution, we qualify the assistance as inadequate and with low level of solution, directly interfering on the maintenance of the VUs chronic state

Avaliação de desempenho em mercados reguladores de transporte urbano por ônibus :proposição de um modelo aplicável ao caso de Natal

Increased competition in the market of urban transport, characteristic of the Brazilian cities from years 90, has required actions of the managing agencies to ensure the universality of service, enhancing efficiency and consumer welfare. It grows in the Brazilian municipalities, the need to adopt a systematic performance evaluation in terms of management system of indicators and targets appropriate to the regulatory context, which has the purpose of evaluating the accomplishment and compliance by dealers, of the services granted during the contract period, marked by increasingly long periods. The introduction of an index operational performance in permission contracts/concession in urban buses is intended to establish a regulatory performance, giving the contract a pro-competitive feature and to allow the managing agency the systematic and continuous monitoring of the performance of the delegated service to avoid major deviations from desired performance. A performance assessment model of public transportation companies by bus, and applicable to the case of Natal is proposed. Sought to add the particularities found in the transport system in order to assess the performance of enterprises, contribute to improving the service quality to the population and enable decision-makers a detailed knowledge of the behavior of the licensees

Gestão ambiental na indústria do petróleo : fatores associados ao comportamento pró-ambiental de empregados de uma empresa brasileira de óleo e gás

This survey develops a study about the pro-environment behavior of a brazilian company of oil and gas sector, emphazing the Petróleo Brasileiro S/A PETROBRAS in its Unit of Business of Exploration and Production in the State of Rio Grande do Norte and Ceará − UN-RNCE. The work s development adopt the bibliographic research methodology with the descriptive exploratory analisys, with the purpouse of identifying related points with the knowledge and the analysed enterprise s staff conduct, by the aplication of the interview with a instrument of data colecting with closed variable questions from answers that varies from o to 10.The answers allowed us to know the employees knowledge about the related aspects of environmental responsability, knowing also the involvement of the employees with the politics of environmental managment that has been implemented in the operating area of the company. The research led us to an important verification of the pro-environmental behavior of the people interviewed. The results depends of a wise acting, not only inside the company, but also outside, where the results of this acting will be more perceived for the society. Finally, we conclude that the company has a politics of management with a great importance, emphasinzing that the employees are been in constant training about their behavior resulting in satisfaction

Qualidade em serviços de saúde: uma contribuição à definição de um modelo paramétrico e padrão de qualidade do tempo agendado para consulta ambulatorial

This work presents a study in quality of health care, with focus on consulting appointment. The main purpose is to define a statistical model and propose a quality grade of the consulting appointment time. The time considered is that from the day the patient get the appointment done to the day the consulting is realized. It is used reliability techniques and functions that has as main characteristic the analysis of data regarding the time of occurrence certain event. It is gathered a random sample of 1743 patients in the appointment system of a University Hospital - the Hospital Universitário Onofre Lopes - of the Federal University of Rio Grande do Norte, Brazil. The sample is randomly stratified in terms on clinical specialty. The data were analyzed against the parametric methods of the reliability statistics and the adjustment of the regression model resulted in the Weibull distribution being best fit to data. The quality grade proposed is based in the PAHO criteria for a consulting appointment and result that no clinic got the PAHO quality grade. The quality grade proposed could be used to define priority for improvement and as criteria to quality control

Qualidade em serviços de saúde: uma contribuição à definição de um modelo paramétrico e padrão de qualidade do tempo agendado para consulta ambulatorial

The knowledge management has received major attention from product designers because many of the activities within this process have to be creative and, therefore, they depend basically on the knowledge of the people who are involved in the process. Moreover, Product Development Process (PDP) is one of the activities in which knowledge management manifests in the most critical form once it had the intense application of the knowledge. As a consequence, this thesis analyzes the knowledge management aiming to improve the PDP and it also proposes a theoretical model of knowledge management. This model uses five steps (creation, maintenance, dissemination, utilization and discard) through the verification of the occurrence of four types of knowledge conversion (socialization, externalization, combination and internalization) that it will improve the knowledge management in this process. The intellectual capital in Small and Medium Enterprises (SMEs) managed efficiently and with the participation of all employees has become the mechanism of the creation and transference processes of knowledge, supporting and, consequently, improving the PDP. The expected results are an effective and efficient application of the proposed model for the creation of the knowledge base within an organization (organizational memory) aiming a better performance of the PDP. In this way, it was carried out an extensive analysis of the knowledge management (instrument of qualitative and subjective evaluation) within the Design department of a Brazilian company (SEBRAE/RN). This analysis aimed to know the state-of-the-art of the Design department regarding the use of knowledge management. This step was important in order to evaluate in the level of the evolution of the department related to the practical use of knowledge management before implementing the proposed theoretical model and its methodology. At the end of this work, based on the results of the diagnosis, a knowledge management system is suggested to facilitate the knowledge sharing within the organization, in order words, the Design department

A influência do modelo de triplice hélice no grau de maturidade de inovação: um estudo de caso em empresas participantes do projeto PRÓ-INOVA/NAGI no estado do RIO GRANDE DO NORTE

Public investments in the development of innovation in the country, either through the rigging of public universities, either through public announcements of the promotion, increased dramatically in recent years. To analyze the efficiency and effectiveness of the use of public resources is especially in times of austerity, essential for the development of a country. In this context, this research aims to identify the influence of public investments to promote innovation in the degree of maturity of innovative companies in the state of the RN. Another goal is to identify the regional influence from the installation site - capital or countryside, in the performance of the companies studied in the degree of innovation. The theoretical basis of the understanding of the scope of the concept of innovation and its determination for the purposes of this study. Typology, degree of innovation, evaluation methodologies and mechanisms to support innovation : Still on the theme of innovation additional concepts that help the reader to a greater understanding, such as are presented. Following is approached conceptualization of the triple helix, highlighting the concepts advocated by Etzkowitz and Leydesdorff, Salomon and Silva and Ipiranga, Freitas and Paiva, among others. With regard to methodological aspects, we propose a descriptive, exploratory and explanatory research quantitative and qualitative approach with the target audience group of companies served by INOVA PRO- NAGI design - multi-institutional action from a public resource called FINEP promotes the development of innovative companies in the State of Rio Grande do Norte - in 2013. The research should provide reflection and understanding of the influence of public investment in innovation, which by means of qualitative predictive variables associated with quantitative method to explain which variables are significant variations in the degree of maturity of enterprises studied

Arquitetura inteligente fuzzy para monitoramento de sinais vitais de pacientes: um estudo de caso em UTI

The area of the hospital automation has been the subject a lot of research, addressing relevant issues which can be automated, such as: management and control (electronic medical records, scheduling appointments, hospitalization, among others); communication (tracking patients, staff and materials), development of medical, hospital and laboratory equipment; monitoring (patients, staff and materials); and aid to medical diagnosis (according to each speciality). This thesis presents an architecture for a patient monitoring and alert systems. This architecture is based on intelligent systems techniques and is applied in hospital automation, specifically in the Intensive Care Unit (ICU) for the patient monitoring in hospital environment. The main goal of this architecture is to transform the multiparameter monitor data into useful information, through the knowledge of specialists and normal parameters of vital signs based on fuzzy logic that allows to extract information about the clinical condition of ICU patients and give a pre-diagnosis. Finally, alerts are dispatched to medical professionals in case any abnormality is found during monitoring. After the validation of the architecture, the fuzzy logic inferences were applied to the trainning and validation of an Artificial Neural Network for classification of the cases that were validated a priori with the fuzzy system

Análise e projeto de superfícies seletivas de frequência com elementos pré-fractais para aplicações em comunicações indoor

In this thesis, a frequency selective surface (FSS) consists of a two-dimensional periodic structure mounted on a dielectric substrate, which is capable of selecting signals in one or more frequency bands of interest. In search of better performance, more compact dimensions, low cost manufacturing, among other characteristics, these periodic structures have been continually optimized over time. Due to its spectral characteristics, which are similar to band-stop or band-pass filters, the FSSs have been studied and used in several applications for more than four decades. The design of an FSS with a periodic structure composed by pre-fractal elements facilitates the tuning of these spatial filters and the adjustment of its electromagnetic parameters, enabling a compact design which generally has a stable frequency response and superior performance relative to its euclidean counterpart. The unique properties of geometric fractals have shown to be useful, mainly in the production of antennas and frequency selective surfaces, enabling innovative solutions and commercial applications in microwave range. In recent applications, the FSSs modify the indoor propagation environments (emerging concept called wireless building ). In this context, the use of pre-fractal elements has also shown promising results, allowing a more effective filtering of more than one frequency band with a single-layer structure. This thesis approaches the design of FSSs using pre-fractal elements based on Vicsek, Peano and teragons geometries, which act as band-stop spatial filters. The transmission properties of the periodic surfaces are analyzed to design compact and efficient devices with stable frequency responses, applicable to microwave frequency range and suitable for use in indoor communications. The results are discussed in terms of the electromagnetic effect resulting from the variation of parameters such as: fractal iteration number (or fractal level), scale factor, fractal dimension and periodicity of FSS, according the pre-fractal element applied on the surface. The analysis of the fractal dimension s influence on the resonant properties of a FSS is a new contribution in relation to researches about microwave devices that use fractal geometry. Due to its own characteristics and the geometric shape of the Peano pre-fractal elements, the reconfiguration possibility of these structures is also investigated and discussed. This thesis also approaches, the construction of efficient selective filters with new configurations of teragons pre-fractal patches, proposed to control the WLAN coverage in indoor environments by rejecting the signals in the bands of 2.4~2.5 GHz (IEEE 802.11 b) and 5.0~6.0 GHz (IEEE 802.11a). The FSSs are initially analyzed through simulations performed by commercial software s: Ansoft DesignerTM and HFSSTM. The fractal design methodology is validated by experimental characterization of the built prototypes, using alternatively, different measurement setups, with commercial horn antennas and microstrip monopoles fabricated for low cost measurements

Otimização de superfícies seletivas de frequência com elementos pré-fractais utilizando rede neural MLP e algoritmos de busca populacional

This thesis describes design methodologies for frequency selective surfaces (FSSs) composed of periodic arrays of pre-fractals metallic patches on single-layer dielectrics (FR4, RT/duroid). Shapes presented by Sierpinski island and T fractal geometries are exploited to the simple design of efficient band-stop spatial filters with applications in the range of microwaves. Initial results are discussed in terms of the electromagnetic effect resulting from the variation of parameters such as, fractal iteration number (or fractal level), fractal iteration factor, and periodicity of FSS, depending on the used pre-fractal element (Sierpinski island or T fractal). The transmission properties of these proposed periodic arrays are investigated through simulations performed by Ansoft DesignerTM and Ansoft HFSSTM commercial softwares that run full-wave methods. To validate the employed methodology, FSS prototypes are selected for fabrication and measurement. The obtained results point to interesting features for FSS spatial filters: compactness, with high values of frequency compression factor; as well as stable frequency responses at oblique incidence of plane waves. This thesis also approaches, as it main focus, the application of an alternative electromagnetic (EM) optimization technique for analysis and synthesis of FSSs with fractal motifs. In application examples of this technique, Vicsek and Sierpinski pre-fractal elements are used in the optimal design of FSS structures. Based on computational intelligence tools, the proposed technique overcomes the high computational cost associated to the full-wave parametric analyzes. To this end, fast and accurate multilayer perceptron (MLP) neural network models are developed using different parameters as design input variables. These neural network models aim to calculate the cost function in the iterations of population-based search algorithms. Continuous genetic algorithm (GA), particle swarm optimization (PSO), and bees algorithm (BA) are used for FSSs optimization with specific resonant frequency and bandwidth. The performance of these algorithms is compared in terms of computational cost and numerical convergence. Consistent results can be verified by the excellent agreement obtained between simulations and measurements related to FSS prototypes built with a given fractal iteration

Avaliação dos modelos de predição de propagação para telefonia móvel celular na cidade do Natal

The development of wireless telecommunication in the last years has been great. It has been taking academics to conceive new ideas and techniques. Their aims are to increase the capacity and the quality of the system s services. Cells that are smaller every time, frequencies that are every time higher and environments that get more and more complex, all those facts deserve more accurate models the propagation prediction techniques are inserted in this context and results with a merger of error that is compatible with the next generations of communication systems. The objective of this Work is to present results of a propagation measurement campaign, aiming at pointing the characteristics of the mobile systems covering in the city of Natal (state of Rio Grande do Norte, Brazil). A mobile laboratory was set up, using the infra-structure available and frequently used by ANATEL. The measures were taken in three different areas: one characterized by high buildings, high relief, presence of trees and towers of different highs. These areas covered the city s central zone, a suburban / rural zone and a section of coast surrounded by sand dunes. It is important to highlight that the analysis was made taking into consideration the actual reality of cellular systems with covering ranges by reduced cells, with the intent of causing greater re-use of frequencies and greater capacity of telephone traffic. The predominance of telephone traffic by cell in the city of Natal occurs within a range inferior to 3 (three) km from the Radio-Base Station. The frequency band used was 800 MHz, corresponding to the control channels of the respective sites, which adopt the FSK modulation technique. This Dissertation starts by presenting a general vision of the models used for predicting propagation. Then, there is a description of the methodology used in the measuring, which were done using the same channels of control of the cellular system. The results obtained were compared with many existing prediction models, and some adaptations were developed by using regression techniques trying to obtain the most optimized solutions. Furthermore, according to regulations from the old Brazilian Holding Telebrás, a minimum covering of 90% of a determined previously area, in 90% of the time, must be obeyed when implanting cellular systems. For such value to be reached, considerations and studies involving the specific environment that is being covered are important. The objective of this work is contribute to this aspect

Sistema de teleoftalmologia para auxílio ao pré-diagnóstico de disfunções oculomotoras

The vision is one of the five senses of the human body and, in children is responsible for up to 80% of the perception of world around. Studies show that 50% of children with multiple disabilities have some visual impairment, and 4% of all children are diagnosed with strabismus. The strabismus is an eye disability associated with handling capacity of the eye, defined as any deviation from perfect ocular alignment. Besides of aesthetic aspect, the child may report blurred or double vision . Ophthalmological cases not diagnosed correctly are reasons for many school abandonments. The Ministry of Education of Brazil points to the visually impaired as a challenge to the educators of children, particularly in literacy process. The traditional eye examination for diagnosis of strabismus can be accomplished by inducing the eye movements through the doctor s instructions to the patient. This procedure can be played through the computer aided analysis of images captured on video. This paper presents a proposal for distributed system to assist health professionals in remote diagnosis of visual impairment associated with motor abilities of the eye, such as strabismus. It is hoped through this proposal to contribute improving the rates of school learning for children, allowing better diagnosis and, consequently, the student accompaniment

Escalabilidade Paralela de um Algoritmo de Migração Reversa no Tempo (RTM) Pré-empilhamento

The seismic method is of extreme importance in geophysics. Mainly associated with oil exploration, this line of research focuses most of all investment in this area. The acquisition, processing and interpretation of seismic data are the parts that instantiate a seismic study. Seismic processing in particular is focused on the imaging that represents the geological structures in subsurface. Seismic processing has evolved significantly in recent decades due to the demands of the oil industry, and also due to the technological advances of hardware that achieved higher storage and digital information processing capabilities, which enabled the development of more sophisticated processing algorithms such as the ones that use of parallel architectures. One of the most important steps in seismic processing is imaging. Migration of seismic data is one of the techniques used for imaging, with the goal of obtaining a seismic section image that represents the geological structures the most accurately and faithfully as possible. The result of migration is a 2D or 3D image which it is possible to identify faults and salt domes among other structures of interest, such as potential hydrocarbon reservoirs. However, a migration fulfilled with quality and accuracy may be a long time consuming process, due to the mathematical algorithm heuristics and the extensive amount of data inputs and outputs involved in this process, which may take days, weeks and even months of uninterrupted execution on the supercomputers, representing large computational and financial costs, that could derail the implementation of these methods. Aiming at performance improvement, this work conducted the core parallelization of a Reverse Time Migration (RTM) algorithm, using the parallel programming model Open Multi-Processing (OpenMP), due to the large computational effort required by this migration technique. Furthermore, analyzes such as speedup, efficiency were performed, and ultimately, the identification of the algorithmic scalability degree with respect to the technological advancement expected by future processors

Fabricação de malha de trama utilizada como pré-formas na indústria de compósitos e avaliação das propriedades mecânicas

In the manufacture of composite, textile materials are being used as reinforcement. Generally, the combination of the matrix with the textile material in the form of fibres or yarns is used depending on their distribution in the web. In the present work, in place of fibres or yarns, a knitted structure in the form of the final product which is defined as preform. The preform is weft knit manufactured with polyester filaments. In the manufacture of composite, polyester resin was used as matrix. The physical and mechanical properties as well as the formability of the weft knit were analysed. The physical and mechanical properties as well as the formability of the knitted structure were analysed. The results obtained on the analysis show that the courses and wales of the weft knit structure and the tensile properties help the formability of the structure and the impregnation of the resin. It could be clearly observed that composite structure in the direction of the courses support more tension than in the direction of the wales. In relation to the three points flexural tests it was possible to note that there was more flexion in the direction of wales, what was expected. It was also possible to note that there are other advantages such as reduction in the loss of materials used, homogeneity in the distribution of the knitted structure in the mould, reduction in the preparation time and also in the reduction in the cost of manufacture

Sistema de destilação solar com pré-aquecimento em concentrador cilindro parabólico

Due to the increasing need to promote the use of resources that support the environment and the clean industry, the science has developed in the area of natural resource use as well as enhanced use of the renewable energy sources. Considering also the great need for clean water and wide availability of salt or brackish water, added to the great solar energy potential in northeastern of the Brazil, it was developed a solar distiller whose main difference is its system of pre-solar heating also. From experimental adjustments, the system was developed by the use of a cylindrical solar concentrator coupled to a conventional distiller. The system is designed such that attempt to facilitate the process termination trap to ensure constant movement of the fluid mass and thus enable higher temperatures to the system and thus fetch a higher amount of distillate collected. In a stage of the experiment were used a forced circulation to try to further increase the amount of energy exchange system. To develop the study were set up four settings for comparison in which one was only distiller simple as basic parameter, the second proposed configuration were with the coupling of the concentration triggered manually every 30 minutes to monitor the sun, the third configuration occurred with automatic triggering of a timer, and the fourth configuration was also used a pumping system that tried to improve the circulation of the fluid. With the comparative analysis of the results showed a gain in the amount of distillate system, especially in the forced model