Uma intervenção educativa para profissionais de saúde na prevenção de pneumonia associada à ventilação mecânica

Quasi-experimental study, prospective with quantitative approach, performed at the Hospital do Coração in Natal, aimed at verified the existence of difference between the care given by health professionals to the patients under mechanical ventilation (MV) in the Intensive Care Unit, before and after an educative intervention. The population was of 31 professionals, with data collected between november 05 of 2007 to march 27 of 2008. The results show a yong population, female gender, middle level of education, nursing technique, working between 05 and 09 years on nursing profession, and 01 to 04 years on Intensive Care Unit; almost all, never had an kind of training over prevent pneumonia associated to mechanical ventilation; from those that had training, occur on the work place with duration from 12 to 24 hours. About endotracheal intubation, the cuff was tested with a sterilized syringe had a positive change after a educative intervention, increased from 75,0% to 100,0%; the sterile guide was used on 75,0% before and 100,0% after an educative intervention. Regarding endotracheal suction procedure, was not informed to the patient on 72,7% before, however was informed on 56,7% after; the hands was not previously washed 68,5% before, however was 63,3% after the procedure; mask was used on 74,2 % opportunities before and 76,7% after; the aspiration catheter had adequated size on 98,9% observation before and 100,0% after; the gaze was sterilized on 95,7% before and 100,0% after; the ventilator was connected to the patient during the aspiration intervals on 94,4% observation before and 100,0% after; the ambu bag was clean and protected on 76,1% before and 85,7% after; the aspiration catheter was discarded after be used on 98,9% before and 100,0% after; FIO2 was turned to the begging value on 32,9% observation before and 12,0% after; before the procedure 71,9% professions washed their hands and 73,3% after; before, notes of aspiration results were performed on 70,8% observation and 86,7% after. Regarding devices used on respiratory tract, aspirator flasks were not swapped on 84,6% observations before and 71,0% after; daily látex extention change was not performed on 93,6% observation before and 87,1% after; the ambu bag change was not performed on 50,0% observation before even if was duty or unprotected and on 75,8% opportunities was changed, after; nebulization was not prepared with sterile fluids or manipulated aseptically on 65,2% observation before, perhaps was on 71,7% after; before nebulizers were not changed on 65,2% observations, perhaps were on 60,9% after. Concerning ventilator breathing circuits, condense fluids cumulated on circuits were removed on 55,0% opportunities before, and 64,0% after; moisturizer was not filled with sterile water when already had small amount of liquid inside on 78,4% observations before, and 90,2% after; MV circuits were changed on 97,0% observations on presence of visible duty or when presents some kind of failure, before and 98,4% after. About body position, on 51,3% observations the decubitus position change were done before and 78,2% after; fowler position was maitened on 95,5% observations before and 98,2% after; Regarding respiratory physiotherapy, enteral diet was not interrupted before respiratory physiotherapy on 94,9% before and 90,0% after; respiratory physiotherapy devices were not disinfected or sterile on 69,6% observations before but they re on 60,0% after; before the cateter was not tested before introduction enteral diet or medications on 100,0% but after was done on 15,2%. About enteral feeding, intestine motility and measure of stomach contents were not done on 100,0% observations before, but was 15,2% after. We conclude that 05 of 07 valuated procedures in relation to MV, had a significant improvement on quality of care given after educative intervention, when compared before intervention

Produtividade do milho relacionada com a resistência mecânica à penetração do solo sob preparo convencional

A resistência mecânica do solo à penetração exerce grande influência sobre o desenvolvimento vegetal, uma vez que o crescimento das raízes e a produtividade das culturas variam de forma inversamente proporcional ao seu valor. O objetivo do trabalho foi estudar a variabilidade espacial e a correlação entre a produtividade do milho (PG) e a resistência mecânica do solo à penetração (RP) de um Latossolo Vermelho sob preparo convencional, em área pertencente à Fazenda Experimental de Ensino e Pesquisa da Faculdade de Engenharia - FE/UNESP - Câmpus de Ilha Solteira. Foram definidos 133 pontos de amostragem no campo, segundo malha com espaçamento regular de 10,0 m, nos quais foram medidas a RP, a umidade gravimétrica (UG), nas camadas de 0-0,10; 0,10-0,20; 0,20-0,30 e 0,30-0,40 m, e a PG. O modelo exponencial mostrou-se adequado para descrever todos os semivariogramas experimentais construídos. A RP e a UG apresentaram moderada dependência espacial, com alcance variando entre 20,2 e 63,0 m. A PG apresentou forte dependência espacial com alcance de 15,3 m. A RP não apresentou correlação espacial com a PG. Valores de RP variando entre 0,9 e 2,0 MPa não restringiram a PG.

Gestão da satisfação e fidelidade do cliente : um estudo dos fatores que influenciam na satisfação e fidelidade dos clientes corporativos de telefonia celular

The competition in the telecommunications industry has grown in Brazil since the privatization, forcing companies that are active in the market to a growing commitment to quality products and services in order to survive. In this context, this work aims to understand the main factors that influence the degree of satisfaction exists in respect of a mobile operator with its corporate customers. The research covered theoretical concepts and analytical models of quality management system and models of indices related to the measurement of customer satisfaction. For the field research was carried out in a practical application of the main approaches based on this thesis by a case study in corporate segment, through a questionnaire applied to 10 consultants and 40 corporate customers of that company. Comparing the results of research with the consultants and corporate clients there is the concern of respondents to the indicators that comprise the constructs of customer satisfaction, commitment calculated, the price index and the handling of complaints, denoting the dissatisfaction of the general assessment for corporate customers with the carrier, against its current expectations. It is concluded that the mobile operator of the telecommunications industry have a big challenge, after ten years of privatization and consequently the period of rapid expansion of customer base and with the depleted, retain corporate customers as highly strategic, thus avoiding that migrate to other companies. We emphasize the need for further research and analysis of different approaches through research and using the same models to specifically evaluate and measure customer satisfaction of mobile enterprise, to adjust the model to the national market. Finally, we suggest the creation of an effective customer loyalty program with a strategy of relationship and specific to the corporate sector of mobile telephony

Aplicando análise de envoltória de dados -DEA à avaliação de desempenho acadêmico: um estudo em programas de pós-graduação em engenharia mecânica e produção no Brasil

This Master of Science Thesis deals with applying DEA (Data Envelopment Analysis) to the academic performance evaluation of graduate programs in Brazil, exploring it on a Mechanical and Production Engineering Program 2001-2003 data. The data used is that of the national assessment carried by CAPES, the governmental body in charge for graduate program assessment and certification. It is used the CCR output oriented DEA model, the CCR-Output with Assurance Region, and Window Analysis. The main findings are first that the CCR has the concerning problem of zero values of weights of outputs that is not appropriate in a sense that a graduate program has the higher efficiency score zeroing some output (e.g., number of academic papers published). Secondly, the Assurance Region method proved useful. Third, the Window Analysis also gave some light to the consistency of the performance in the time frame analysed. Also, the analysis results in the understanding that the Mechanics and Production Engineering should not be assessed jointly like currently applied by CAPES and rather should be assessed in its own field separately. Finally, the result of the DEA analysis showed some serious inconsistencies with the CAPES method. Graduate programs considered excellent has got low performance score and vice versa. This Thesis provides a strong argument in order to use DEA at least as a complimentary methodology for graduate program performance evaluation in Brazil

Fatores da satisfação e fidelidade de clientes: um estudo no setor de telefonia móvel celular

This thesis deals with the factors affecting customer satisfaction and loyalty in the mobile phone telecom sector. It is adapted a model proposed by Johnson et al. (2001) of quality and loyalty antecedent factors. It is conducted a survey with a sample of 385 customers of mobile phone telecom sector in Teresina city, a capital of a Northeastern State of Brazil, and descriptives and multiple regression statistical analysis. The main findings related to satisfaction are that quality and service price are the significant factors affecting it. Regarding loyalty, satisfaction, image, affective commitment, and calculate commitment are the significant factors to explain it. The overall model used fairly explain the satisfaction and loyalty outcomes

Mudanças na ultra-estrutura da parede celular de mangas 'Tommy Atkins' tratadas com cloreto de cálcio na pré-colheita

Mangas 'Tommy Atkins' produzidas na região de Ibirá, São Paulo, foram pulverizadas na pré-colheita com cloreto de cálcio, nas concentrações de 0,0%, 2,5% e 5,0%, em três épocas de seu desenvolvimento (40; 60 e 90 dias após a floração) a fim de verificar a influência do cálcio na estrutura da parede celular destes frutos através de microscopia eletrônica de transmissão, imediatamente após a colheita e depois de 35 dias de armazenamento. Para fixar o material da polpa, utilizou-se metodologia descrita por Jacob e Gowanlock (1995). Nas condições experimentais, verificou-se que os frutos do tratamento-controle (sem cloreto de cálcio), no dia da colheita, já apresentavam desestruturação da parede celular e dissolução da lamela média (LM). A degradação da parede celular ocorre inicialmente na LM, levando à formação de espaços vazios bastante distintos, apresentando uma dissolução ainda maior, com o armazenamento prolongado (35 dias). Os frutos tratados com cloreto de cálcio a 5,0% apresentaram uma LM bem definida e ausência de espaços vazios, mesmo após o armazenamento, mostrando ser uma concentração efetiva na preservação da lamela média.

Análise de Handover inter e intra-célula em um sistema de telefonia celular através de método de medição simplificado

This dissertation has the purpose to present a portable device named PlugData MG100G, equipped with a cellular module, to analyze the radiofrequency coverage in a GSM network situated in João Pessoa city, state of Paraíba, at four distinct regions. The equipment, originally, was developed to be used in fixed environments, so it was adapted so that it could be used in conditions of mobility. From the Mobile Measurement Reports (MMRs) RF coverage and the handover process are analyzed. The MMRs enable the identification of the serving cell and the list of the closest neighboring cells monitored by the mobile. This work analyses only data referent to the serving cell and the two closest neighboring cells. Inter-cell and intra-cell handovers are identified. The frequency planning and quality of service offered by the network related to the regions are discussed as well

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

Remoção mecânica de plantas aquáticas: análise econômica e operacional

A remoção de plantas aquáticas tem sido utilizada como opção ao controle químico e biológico, em razão de restrições ambientais em algumas regiões brasileiras. O objetivo deste trabalho foi desenvolver um modelo para análise econômica e operacional da remoção mecânica de plantas aquáticas, visando realizar estudo econômico comparativo com o controle químico. A operação foi estudada num reservatório de uma usina de bombeamento em Barra do Piraí-RJ. O sistema consiste de retroescavadeiras instaladas em balsas, usadas para cortar as plantas e liberá-las no fluxo de água. Antes da tomada d'água existe uma barreira flutuante que intercepta as plantas, as quais são removidas por um guindaste fixo nas margens. As plantas são armazenadas por algum tempo e depois descartadas. Existe, ainda, um sistema de limpeza das grades da tomada d'água. Dados do volume total de plantas descartadas foram coletados durante 14 meses, assim como foi avaliado o volume de biomassa produzido por área das principais espécies infestantes. A empreiteira que administra o serviço forneceu planilhas de custos e outro parâmetros operacionais. Um modelo foi desenvolvido para calcular custos por hectare de plantas removidas. Os resultados mostraram custo médio mensal de US$ 17.780,28 por hectare. Apesar do alto custo, o sistema de remoção demonstrou capacidade de controlar apenas 4,1% da área infestada no reservatório, na época da coleta dos dados. Simulando dados de uma aplicação de glyphosate, o controle químico custaria apenas 0,23% do custo da remoção. Análises de sensibilidade mostraram que a compactação das plantas para transporte, o volume de plantas produzidas por área e o custo do transporte são os parâmetros principais para a otimização.

Nitrogen and silicon fertilization of upland rice

O silício não é considerado um elemento essencial para o crescimento e desenvolvimento das plantas, entretanto, sua absorção traz inúmeros benefícios, principalmente ao arroz, como aumento da espessura da parede celular, conferindo resistência mecânica a penetração de fungos, melhora o ângulo de abertura das folhas tornando-as mais eretas, diminuindo o auto-sombreamento e aumentando a resistência ao acamamento, especialmente sob altas doses de nitrogênio. O presente trabalho teve por objetivo avaliar os efeitos da adubação nitrogenada e silicatada nos componentes vegetativos, nos componentes da produção, na altura da planta e na produtividade da cultivar de arroz IAC 202. O experimento foi constituído da combinação de três doses de nitrogênio (5, 75 e 150 mg de N kg-1 de solo) aplicado na forma de uréia e quatro doses de silício (0, 200, 400 e 600 mg de SiO2 kg-1 de solo), aplicado na forma de silicato de cálcio. O delineamento experimental utilizado foi o inteiramente casualizado em esquema fatorial 3 ´ 4 (N = 5). A adubação nitrogenada aumentou o número de colmos e panículas por metro quadrado e o número total de espiguetas, refletindo na produtividade de grãos. O perfilhamento excessivo causado pela adubação nitrogenada inadequada causou redução na porcentagem de colmos férteis, na fertilidade das espiguetas e da massa de grãos. A adubação silicatada reduziu o número de espiguetas chochas por panícula e aumentou a massa de grãos sem, contudo, refletir na produtividade de grãos.

Metalização mecânica de ZrO2 com Ti para brasagem ZrO2/Aço com ligas de adição sem metal ativo

Metal/ceramic interfaces using zirconia have dominated the industrial applications in the last decade, due to the high mechanical strength and fracture toughness of zirconia, especially at temperatures below 300 ºC. Also noteworthy is the good ionic conductivity in high temperatures of this component. In this work joining between ZrO2 Y-TZP and ZrO2 Mg-PSZ with austenitic stainless steel was studied. These joints were brazed at high-vacuum after mechanical metallization with Ti using filler alloys composed by Ag-Cu and Ag-Cu-Ni. The influence of the metallization, and the affinity between the different groups (ceramic / filler alloys) was evaluated, in order to achieve strong metal/ceramic joints. Evaluation of joints and interfaces, also the characterization of base materials was implemented using various techniques, such as: x-ray diffraction, leak test, three-point flexural test and scanning electron microscopy with chemical analysis. The microstructural analysis revealed physical and chemical bonds in the metal/ceramic interfaces, providing superior leak proof joints and stress cracking, in order to a good joint in all brazed samples. Precipitation zones and reaction layers with eutetic characteristics were observed between the steel and the filler metal

Estudo e caracterização de matérias-primas para o desenvolvimento de blocos sílico-calcários

The types of products manufactured calcium silicate blocks are very diversified in its characteristics. They include accessory bricks, blocks, products in dense material, with or without reinforcements of hardware, great units in cellular material, and thermal insulating products. The elements calcium silicate are of great use in the prefabricated construction, being formed for dense masses and hardened by autoclaving. This work has for objective develop formulations that make possible the obtaining of calcium silicate blocks with characteristics that correspond the specifications technical, in the State of the Rio Grande of the North, in finality of obtaining technical viability for use in the civil construction. The work studied the availability raw materials from convenient for the production of calcium silicate blocks, and the effect of variations of the productive process on the developed products. The studied raw materials were: the quartz sand from the city of São Gonçalo do Amarante/RN, and two lime, a hydrated lime and a pure lime from the city of Governador Dix-Sept Rosado/RN. The raw materials collected were submitted a testes to particle size distribution, fluorescence of X rays, diffraction of X rays. Then were produced 8 formulations and made body-of-test by uniaxial pressing at 36 MPa, and cured for 7 hours at about 18 kgf/cm2 pressing and temperature of approximately 180 °C. The cure technological properties evaluated were: lineal shrinkage, apparent density, apparent porosity, water absorption, modulus of rupture flexural (3 points), resistance compression, phase analysis (XRD) and micromorphological analysis (SEM). From the results presented the technological properties, was possible say that utilization of hydrated lime becomes more viable its utilization in mass limestone silica, for manufacture of calcium silicate blocks

Análise do comportamento mecânico de espumas cerâmicas a base de alumina obtidas pelo método da réplica

Ceramics with porous cellular structure, called ceramic foams, have a potential use in several applications, such as: thermal insulation, catalyst supports, filters, and others. Among these techniques to obtain porous ceramics the replication method is an important process. This method consists of impregnation of a sponge (usually polymer) with ceramic slurry, followed by a heat treatment, which will happen the decomposition of organic material and sintering the ceramic material, resulting in a ceramic structure which is a replica of impregnated sponge. Knowledge of the mechanical properties of these ceramics is important for these materials can be used commercially. Gibson and Ashby developed a mathematical model to describe the mechanical behavior of cellular solids. This model wasn´t for describing the ceramics behavior produced by the replica method, because it doesn´t consider the defects from this type of processing. In this study were researched mechanical behavior of porous alumina ceramics obtained by the replica method and proposed modifications to the model of Gibson and Ashby to accommodate this material. The polymer sponge used in processing was characterized by thermogravimetric analysis and scanning electron microscopy. The materials obtained after sintering were characterized by mechanical strength tests on 4-point bending and compression, density and porosity and by scanning electron microscopy. From these results it was evaluated the mechanical strength behavior compared to Gibson and Ashby model for solid cellular structure and was proposed a correction of this model through a factor related to struts integrity degree, which consider fissures present in the structure of these materials besides defects geometry within the struts

Análise térmica e mecânica de um compósito de matriz cerâmica com carga de EPS e raspa de pneu para construção de casas populares

Space Science was built using a composite made of plaster, EPS, shredded tires, cement and water. Studies were conducted to thermal and mechanical resistance. Inside the mold EPS plates were placed in order to obtain a higher thermal resistance on the wall constructed, as well as to give it an end environmentally friendly in view of both the tire and the EPS occupy a large space in landfills and year need to be degraded when released into the environment. Compression tests were performed according to ABNT blocks to seal, measurements of the temperature variation in the external and internal walls using a laser thermometer and check the temperature of the indoor environment using a thermocouple attached to a digital thermometer. The experiments demonstrated the heat provided by the composite values from the temperature difference between the internal and external surfaces on the walls, reaching levels of 12.4 ° C and room temperature in the interior space of the Science of 33.3 ° C, remaining within the zone thermal comfort for hot climate countries. It was also demonstrated the proper mechanical strength of such a composite for sealing walls. The proposed use of the composite can contribute to reducing the extreme housing shortage in our country, producing popular homes at low cost and with little time to work

Avaliação mecânica e microestrutural de compósitos de poliéster com adição de cargas minerais e resíduos industriais

With the current growth in consumption of industrialized products and the resulting increase in garbage production, their adequate disposal has become one of the greatest challenges of modern society. The use of industrial solid residues as fillers in composite materials is an idea that emerges aiming at investigating alternatives for reusing these residues, and, at the same time, developing materials with superior properties. In this work, the influence of the addition of sand, diatomite, and industrial residues of polyester and EVA (ethylene vinyl acetate), on the mechanical properties of polymer matrix composites, was studied. The main objective was to evaluate the mechanical properties of the materials with the addition of recycled residue fillers, and compare to those of the pure polyester resin. Composite specimens were fabricated and tested for the evaluation of the flexural properties and Charpy impact resistance. After the mechanical tests, the fracture surface of the specimens was analyzed by scanning electron microscopy (SEM). The results indicate that some of the composites with fillers presented greater Young s modulus than the pure resin; in particular composites made with sand and diatomite, where the increase in modulus was about 168 %. The composites with polyester and EVA presented Young s modulus lower than the resin. Both strength and maximum strain were reduced when fillers were added. The impact resistance was reduced in all composites with fillers when compared to the pure resin, with the exception of the composites with EVA, where an increase of about 6 % was observed. Based on the mechanical tests, microscopy analyses and the compatibility of fillers with the polyester resin, the use of industrial solid residues in composites may be viable, considering that for each type of filler there will be a specific application