Atendimento Pré-hospitalar Móvel. Mapeando Riscos e Prevenindo Erros

The attention with safety of the patients is important in the quality of the nursing and health care. In the pre-hospital care, such care is essential on site with the purpose of avoiding possible consequences to the individual, ensuring a fast and appropriate care, with improvement of the morbidity and reduction of the mortality. This medical attention is equally associated with the significant risks of adverse events and serious mistakes, which can be reduced with the awareness of the professionals, organization and quality management. It is a descriptive, transversal research, of quantitative approach, with the objective of identifying the risks for the safety of the patient during the mobile pre-hospital care under the view of the nurses, in a city of the Brazilian Northeast. The sample was formed by 23 nurses. The inclusion criteria: to have at least two years of experience and accept to participate on the research. The data collection was done in two steps, first photo collection, through the adapted method of photographic analysis, and the second with the application of questionnaire, divide in two parts: socio-professional data and digital photo punctuation instrument of the patient s safety. The majority of the nurses had an average working time in the mobile pre-hospital care of six years and six months, in the age group of 38 to 53 years old (69,56%) and with Lato sensu specialization (73,91%), being (29,41%) emergency and (29,41%) in intensive care. The (74%) have the Advance Cardiac Life Support (ACLS) and (100%) have the Pre-Hospital Trauma Life Support (PHTLS); (91, 30%) know the thematic safety of the patient. On the pictures it was observed a bigger variability of the categories (risks) where 44% of variance emerged on the first picture of the research. The pictures 4 and 9 with the average below 5 were classified as very insecure, while pictures 7 and 3 with an average above 7, very secure. On the results of risks observed for the patient s safety in the mobile pre-hospital care five categories emerged: organization and packaging of the equipment and materials, routines and specificities in the mobile pre-hospital care, risks on the management of medications, for traumas and infections. Starting from the analysis of these risks, it was proposed ten steps for the safety in the mobile pre-hospital care: 1- Identify the patient; 2- Safety related to prevention of infection; 3- Safety in the management of medications; 4- Safety and standardization of the packaging of equipment and materials; 5- Attention to the specificities of the mobile pre-hospital care; 6- Incentive and value the participation of the patient and family; 7- Promote the communication with the central of regulation; 8- Prevention of traumas and falls; 9- Protect the skin from additional injuries; 10- Understand the benefit of all the equipment in the ambulance. The multiple risks and their emerged combinations on the research indicate a variety of actions to be developed and stimulated, like the use of steps for the patient s safety in the mobile pre-hospital care which contributes with the aid and management of risks, reduction of mistakes, disabilities and death

Um estudo da aplicação do conceito de risco na conscientização e conhecimento de estudantes de ensino técnico sobre riscos de segurança e saúde ocupacional em laboratório de soldagem

This dissertation presents a discussion on the level of risk awareness of students who have welding practice in the laboratories at CEFET/PI, both in Teresina and Floriano. Its main goal is to investigate risk factors involving students, teachers and employees that work in these laboratories. It s an empirical survey, held among a certain amount of students from the course in Mechanic Technology. For data analysis, the concept of risk was compared to the students direct measure of perception. The main results suggest the students must be better informed, more risk aware and more competent, in order to avoid accidents. They also point to a strong need for a more formal and effective performance to assure full consciousness about the risks involving the welding practice.

Melhoria da segurança pública: uma proposta para alocação de unidades policiais utilizando o modelo das p-medianas e do caixeiro viajante

The decrease in crime is one of the core issues that cause concern in society today. This study aims to propose improvements to public safety from the choice of points to the location of police units, ie the points which support the car and the police. For this, three models were developed in order to assist decision making regarding the best placement of these bases. The Model of Police Units Routing has the intention to analyze the current configuration of a given region and develop optimal routes for round preventative. The Model of Allocation and Routing for New Police Units (MARNUP) used the model of facility location called p-median weighted and traveling salesman problem (TSP) combined aiming an ideal setting for regions that do not yet have support points or to assess how far the distribution is present in relation to that found in solution. The Model Redefinition and Routing Unit Police (MRRUP) seek to change the current positioning taking into account the budgetary constraints of the decision maker. To verify the applicability of these models we used data from 602 points to instances of police command that is responsible for the capital city of Natal. The city currently has 31 police units for 36 of these 19 districts and police have some assistance. This reality can lead to higher costs and higher response times for answering emergency calls. The results of the models showed that in an ideal situation it is possible to define a distance of 500 km/round, whereas in this 900 km are covered by approximately round. However, a change from three-point lead reduced to 700 km / round which represents a decrease of 22% in the route. This reduction should help improve response time to emergency care, improving the level of service provided by the increase of solved cases, reducing police shifts and routing preventive patrols

Uma abordagem híbrida para o problema de seleção de fornecedores em cadeia de suprimentos

This work presents a hybrid approach for the supplier selection problem in Supply Chain Management. We joined decision-making philosophy by researchers from business school and researchers from engineering in order to deal with the problem more extensively. We utilized traditional multicriteria decision-making methods, like AHP and TOPSIS, in order to evaluate alternatives according decision maker s preferences. The both techiniques were modeled by using definitions from the Fuzzy Sets Theory to deal with imprecise data. Additionally, we proposed a multiobjetive GRASP algorithm to perform an order allocation procedure between all pre-selected alternatives. These alternatives must to be pre-qualified on the basis of the AHP and TOPSIS methods before entering the LCR. Our allocation procedure has presented low CPU times for five pseudorandom instances, containing up to 1000 alternatives, as well as good values for all considered objectives. This way, we consider the proposed model as appropriate to solve the supplier selection problem in the SCM context. It can be used to help decision makers in reducing lead times, cost and risks in their supply chain. The proposed model can also improve firm s efficiency in relation to business strategies, according decision makers, even when a large number of alternatives must be considered, differently from classical models in purchasing literature

Dimensionamento de sistemas de aterramento em linhas de transmissão para escoamento eficiente de correntes de surtos atmosféricos

This work presents in a simulated environment, to analyze the length of cable needed counterweight connected to ground rod, able to avoid the phenomenon of flashover return, back flashover, the insulator chains of transmission lines consisting of concrete structures when they are subjected to lightning standardized regarding certain resistivity values of some kinds of soil and geometric arrangements of disposal of grounding systems structures

Superando os riscos da segurança baseada em perímetro - Uma abordagem com identificação federada através de certificados digitais A3/ICP-Brasil e SAML

The traditional perimeter-based approach for computer network security (the castle and the moat model) hinders the progress of enterprise systems and promotes, both in administrators and users, the delusion that systems are protected. To deal with the new range of threats, a new data-safety oriented paradigm, called de-perimeterisation , began to be studied in the last decade. One of the requirements for the implementation of the de-perimeterised model of security is the definition of a safe and effective mechanism for federated identity. This work seeks to fill this gap by presenting the specification, modelling and implementation of a mechanism for federated identity, based on the combination of SAML and X.509 digital certificates stored in smart-cards, following the A3 standard of ICP-Brasil (Brazilian official certificate authority and PKI)

Implementação paralela escalável e eficiente do algoritmo simplex padrão em arquitetura multicore

This work presents a scalable and efficient parallel implementation of the Standard Simplex algorithm in the multicore architecture to solve large scale linear programming problems. We present a general scheme explaining how each step of the standard Simplex algorithm was parallelized, indicating some important points of the parallel implementation. Performance analysis were conducted by comparing the sequential time using the Simplex tableau and the Simplex of the CPLEXR IBM. The experiments were executed on a shared memory machine with 24 cores. The scalability analysis was performed with problems of different dimensions, finding evidence that our parallel standard Simplex algorithm has a better parallel efficiency for problems with more variables than constraints. In comparison with CPLEXR , the proposed parallel algorithm achieved a efficiency of up to 16 times better

Arquiteturas eficientes para sensoriamento espectral e classificação automática de modulações usando características cicloestacionárias

The increasing demand for high performance wireless communication systems has shown the inefficiency of the current model of fixed allocation of the radio spectrum. In this context, cognitive radio appears as a more efficient alternative, by providing opportunistic spectrum access, with the maximum bandwidth possible. To ensure these requirements, it is necessary that the transmitter identify opportunities for transmission and the receiver recognizes the parameters defined for the communication signal. The techniques that use cyclostationary analysis can be applied to problems in either spectrum sensing and modulation classification, even in low signal-to-noise ratio (SNR) environments. However, despite the robustness, one of the main disadvantages of cyclostationarity is the high computational cost for calculating its functions. This work proposes efficient architectures for obtaining cyclostationary features to be employed in either spectrum sensing and automatic modulation classification (AMC). In the context of spectrum sensing, a parallelized algorithm for extracting cyclostationary features of communication signals is presented. The performance of this features extractor parallelization is evaluated by speedup and parallel eficiency metrics. The architecture for spectrum sensing is analyzed for several configuration of false alarm probability, SNR levels and observation time for BPSK and QPSK modulations. In the context of AMC, the reduced alpha-profile is proposed as as a cyclostationary signature calculated for a reduced cyclic frequencies set. This signature is validated by a modulation classification architecture based on pattern matching. The architecture for AMC is investigated for correct classification rates of AM, BPSK, QPSK, MSK and FSK modulations, considering several scenarios of observation length and SNR levels. The numerical results of performance obtained in this work show the eficiency of the proposed architectures

Alocação de biomassa e nutrientes em Myriophyllum aquaticum sob diferentes níveis de macronutrientes

O objetivo deste trabalho foi verificar o efeito de diferentes concentrações de macronutrientes no crescimento e na alocação de biomassa seca em folha, caule e raiz de Myriophyllulm aquaticum. As plantas foram cultivadas em vasos plásticos preenchidos com areia lavada e emersas em solução nutritiva. O experimento foi conduzido em um delineamento inteiramente ao acaso, com quatro níveis (0, 25, 50 e 75%) da concentração original de N, P, K Ca, Mg e S da solução nutritiva, além de uma testemunha (100% da solução nutritiva), com quatro repetições e por um período de 38 dias. A maior produção de biomassa total foi obtida na testemunha. A ausência de K afetou a alocação de biomassa em raízes. Quanto ao comprimento total dos ramos, a maior resposta ocorreu entre os níveis de Ca a 60 mg L-1. A solução a 100% dos macronutrientes propiciou o maior comprimento das plantas. O número de ramos entre os níveis de N e P seguiu uma tendência linear e crescente com as concentrações desses nutrientes, porém em maior proporção para o fósforo. As condições mais favoráveis ao desenvolvimento das plantas ocorreram a 100% dos macronutrientes da solução base. Entre os níveis de nitrogênio verificaram-se maiores teores de N nas folhas do que nos caules. Já para os demais nutrientes a alocação desses recursos foi destinada em maior proporção para o caule. A maior alocação de biomassa nesta espécie destinou-se ao caule.

Simulação do sistema de esgotamento sanitário de Ponta Negra- Natal: mitigação dos riscos ambientais e estratégia de manutenção preditiva

The simulation of SES-Natal Ponta Negra: mitigation of environmental risks and predictive maintenance strategy was developed in the context of several operational irregularities in the pumping stations and sewage systems in the system Ponta Negra. Thus, the environmental risks and complaints against the company due to overflows of sewage into the public thoroughfare became common. This neighborhood has shown in recent years an increase of resident higher than the initial expectation of growth. In this sense presumed the large population growth and generation of sewers higher than expected, associated to the use of corrective maintenance and misuse of the system may be the main causes of operational failures occurring in the SES. This study aimed at analyzing the hydraulic behavior of SES Ponta Negrathrough numerical simulation of its operation associated to future scenarios of occupation. The SES Ponta Negra has a long lengthof collection networks and 6 pumping stations interconnected, being EE 1, 2, 4 coastal way, and beach Shopping interconnected EE3 to receives all sewers pumped from the rest pumping station and pumped to the sewage treatment station of neighborhood which consists of a facultative pond followed by three maturation ponds with disposal of treated effluent into infiltration ditches. Oncethey are connected with each other, the study was conducted considering the days and times of higher inflow for all lifts. Furthermore, with the aim of measuring the gatherer network failures were conducted data survey of on the networks. Thephysical and operational survey data was conducted between January/2011 and janeiro/2012. The simulation of the SES was developed with the aim ofdemonstrating its functioning, eithercurrently and in the coming years, based in population estimates and sewage flow. The collected data represents the current framework of the pumping stations of the SES Ponta Negra and served as input to the model developed in MS Excel ® spreadsheet which allowed simulating the behavior of SES in future scenarios. The results of this study show thatBeach Shopping Pumping Station is actually undersized and presents serious functioning problemsthatmay compromise the environmental quality of surrounding area. The other pumping stations of the system will reach itsmaximum capacity between 2013 and 2015, although the EE1 and EE3 demonstrateoperation capacity, even precariously, until 2017. Moreover, it was observed that the misuse of the network system, due to the input of both garbage and stormwater, are major factors of failures that occur in the SES. Finally, it was found that the corrective maintenance appliance, rather than predictive,has proven to beinefficient because of the serious failuresin the system, causing damage to the environment and health risks to users

Conexão entre as redes complexas e estatística de Kaniadakis e busca eficiente das propriedades críticas do processo epidêmico difusivo 1D

In this work we study a connection between a non-Gaussian statistics, the Kaniadakis statistics, and Complex Networks. We show that the degree distribution P(k)of a scale free-network, can be calculated using a maximization of information entropy in the context of non-gaussian statistics. As an example, a numerical analysis based on the preferential attachment growth model is discussed, as well as a numerical behavior of the Kaniadakis and Tsallis degree distribution is compared. We also analyze the diffusive epidemic process (DEP) on a regular lattice one-dimensional. The model is composed of A (healthy) and B (sick) species that independently diffusive on lattice with diffusion rates DA and DB for which the probabilistic dynamical rule A + B → 2B and B → A. This model belongs to the category of non-equilibrium systems with an absorbing state and a phase transition between active an inactive states. We investigate the critical behavior of the DEP using an auto-adaptive algorithm to find critical points: the method of automatic searching for critical points (MASCP). We compare our results with the literature and we find that the MASCP successfully finds the critical exponents 1/ѵ and 1/zѵ in all the cases DA =DB, DA DB. The simulations show that the DEP has the same critical exponents as are expected from field-theoretical arguments. Moreover, we find that, contrary to a renormalization group prediction, the system does not show a discontinuous phase transition in the regime o DA >DB.

Um método eficiente para resolução do problema de Despacho Ótimo de Reativos com controle discreto do TAP dos transformadores

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

A Perda Auditiva Induzida pelo Ruído (PAIR) na formação odontológica: conhecimentos e níveis de exposição

The rationalization of work in the Dentistry has been taking the professional to work for ways and systems based in the ergonomics, turning their work efficient and less tiring. Since their academic formation, the dentists surgeons are concerned with the high productivity in clinic and with the final result of the work, neglecting the way as it is executed, which reduce their work capacity and exhibits them to occupational diseases that could be minimized and/or forewarned. This research had as the main objective to investigate the knowledge of the Dentistry academics of Rio Grande do Norte Federal University concerning the Noise-induced Hearing Loss (NIHL), relating them at the noise levels that they are exposed, as well as to the preventive measures taken during the clinical activities. Was observed that 95% of the individuals know that the dentist surgeon is a professional in risk for NIHL. Among the causes of NIHL, the one that obtained the largest frequency citation was the high-speed handpieces, reminded by 92,4% of the academics. Among the students which enumerated protective measures for NIHL, 92% mentioned the use of the ear plugs, although 97% of the researched have told do not use any kind of preventive measure related to the noise. Was also observed that 96% of the academics notice the noise during the clinical attendance, what inconvenience 28,1% of them. Related the noise levels, the high-speed handpieces of the academics presented a medium value of 80,5 dB varying from 72,3 to 88,3 dB. The average of the ambient noise observed at the Integrated Clinic was about 74,8 dB. In spite of the noise levels in this research were observed below the established limits of tolerance by the legislation, they can provoke damages to the Dentistry professionals' health, or that suggests the need of an intervention and use of immediate preventive measures able to generate a healthy atmosphere of work and less risky

Um algoritmo genético especializado aplicado ao planejamento da expansão do sistema de transmissão com alocação de dispositivos de compensação série

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Percepção de riscos ambientais de populações vulneráveis a inundações e deslizamentos de dunas em Natal-RN

In urban, flooding and landslides are among the troubles that most bring human and material loss. Therefore, this study objected to perform an analysis on the risk perception on the population living in social environmental vulnerable places in order to understand what is the way this population realize the risks they are exposed to and what are the outbrave strategies the develop. The first analyzed area was Complexo Passo da Pátria for the flooding risk problematic and then the Cidade Nova neighborhood threatened by the dunes slides. The areas locate, respectively, in the West and East zones of Natal-RN. Using an interview screenplay adapted from risk perception researches from different brazilian cities, it was collected primarily data on the variables: perception, evaluation and choice, safety threshold, adjustment, decision and participation. Due to the studied areas characteristics the qualitative approach adjusted itself to the difficulties for accessing the areas. The studied places characterize for its insecure situation like selling/using drugs, robbery and murder among others. Due to this situation the interviewed individuals were the ones that could be found more accessibly and available in the moment and the interviews were made in the community leader presence of each area. Through the discourse of the respondents analysis it was able to conclude that the interviewed population is exposed to a high vulnerability grade and risks. However it was identified substantial differences between the perception and risks of Complexo Passo da Pátria and bairro Cidade Nova, because in the first area the intervied ones can recognize the high risk they are exposed to in a more emphatic way to the interviewed ones for the Cidade Nova neighborhood. Furthermore, there is a heavy dissatisfaction for the population of the two places about the city hall positions relating to the present problems in the studied areas. It was also identified the strategy development of acquaintanceship with the risk in the research places beyond a feeling of belonging and affection between the dwellers and the places, yet it was more evident for Complexo Passo da Pátria. Though this analysis it was possible to understand and perceptions and the behavior of the individuals or social groups facing the risks as acceptance and rejection of determined risks beyond adaptation measures of living together with the persistence presence of risks. Therefore, qualitative nature researches emphasizing the perception approach are in the fundamental importance in the studies about risks making it possible to offer aids to the urban planning and management in the implement of effective preventive measures and compatible with the population aims