Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose

Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.

Qualidade da carne ovina submetida ao processo de salga

Foi estudada a qualidade da carne ovina submetida a diferentes teores de sal no processo de salga, utilizando-se 18 pernas desossadas provenientes de cordeiros ½ Ile de France ½ Ideal, machos inteiros, com peso vivo médio de 30kg. Os tratamentos constituíram-se em: T1 - controle; T2 - salga a 15% e T3 - salga a 20%. As mantas de carne foram lavadas rapidamente em água corrente para remoção do excesso de sal e secadas à sombra. As análises foram realizadas antes da salga e 67 horas após o início da mesma. As perdas de peso ao cozimento, maciez, cor, umidade (2, 4, 16, 28, 40 e 67 horas após o início da salga) e número de TBARS, substâncias reativas ao ácido 2-tiobarbitúrico, foram realizadas no músculo Semimembranosus. Os diferentes teores de sal não influenciaram (P>0,05) na luminosidade da carne, entretanto os teores de vermelho e amarelo, que foram influenciados (P<0,05). As perdas de peso ao cozimento e a umidade foram menores (P<0,05) nas carnes salgadas. A carne dos tratamentos controle e com 15% de salga, apresentou maior (P<0,05) maciez, em relação à carne do tratamento com 20% de salga. A carne que foi submetida a 20% de salga, apresentou maior oxidação lípidica, não diferindo da salga a 15%. A salga a 15% forneceu melhores resultados com valores de perdas de peso ao cozimento, cor, umidade e número de TBARS semelhante a salga a 20%, porém com maior maciez.

Estratégias de intervenção utilizadas por enfermeiros da ESF do município de Natal/RN no controle do câncer do colo de útero

Cancer of the cervix (cervical cancer) is the second most prevalent cancer among Brazilian women. The high rates of cervical cancer in Brazil justify the implementation of effective strategies to control this, which include actions to promote health, primary prevention, early detection, screening, treatment and palliative care. Despite the existence of the National Programme for Control of the CCU there was no reduction in the incidence and mortality of this disease in Brazil. The Family Health Strategy (FHS) has the potential to facilitate such control and, in this context, one should consider that nurses play a central role. The study aimed to know the general intervention strategies used by nurses FHS of Natal / RN in CCU control, and how specific: analyzing the knowledge of these nurses on the CCU, the actions developed in the ESF for the control of CCU and identify the difficulties faced by them to perform it. This is a descriptive exploratory quantitative developed through a structured interview guide with 106 nurses who have experience in controlling the CCU in FHS teams of Natal / RN. Data analysis was performed using descriptive statistic s. The results pointed to actions taken in the FHS to control the CCU, collection of cervical cancer screening, health education activities, nursing consultation, referral of suspected cases for medical monitoring and active women with abnormal test result . The actions that were not mentioned by the nurses included: forming groups of prevention and health promotion; expand coverage of exams and office hours of consultations, establishment of alternatives to end the pent-up demand in the health units, participation in treatment or rehabilitation process users with the CCU; interventions for pain management, alliances and partnerships with schools, in dustry and the use of protocols. This study can be seen that the practice nurses partially shares to the CCU in Natal / RN. The participants of this study, when asked about the CCU, specifically for signs and symptoms of disease and risk factors in general showed important gaps. Difficulties such as lack of materials for collection of Pap smear; inadequate physical space in the Health Units; pent-up demand in the service, delay in arrival of the test results; obstacles in the actions of referral and counter-referral and cultural factors make the CCU control is compromised. It is believed in this research contributed to a reflection on the importance of the role of nurses in the development of the ESF control actions CCU, pointing out the factors that affect these. It is important to involve all nurses who comprise the ESF as knowledgeable of the risk factors, signs and symptoms, and existing tools for the early detection of cervical cancer in the pursuit of quality improvement actions to promote women`s health, contributing in planning future interventions that may reduce mortality from this disease in Natal / RN.

Desenvolvimento de um sistema de planejamento, gestão de serviços e controle de custos em obras de construção civil

The increasing competitiveness of the construction industry, set in an economic environment in which the offer is now greater than the demand , causes the prices of many products and services, are strongly influenced by the processes of production and the final consumer. Thus, to become more competitive in the market and construction companies are seeking new alternatives to reduce and control costs, production processes and tools that allow for close monitoring of the construction schedule, with the consequent compliance deadline with the client. Based on this scenario, the creation of control tools, service management and planning work emerges as an investment opportunity and an area that can promote great benefits to construction companies. The goal of this work is to present a system of planning, service management and costs control that through worksheets provide information relating to the production phase of the work, allowing the visualization of possible irregularities in the planning and cost of the enterprise, enabling the company to take steps to achieve the goals of the enterprise in question, and correct them when necessary. The developed system has been used in a piece of real estate in Rio Grande do Norte, and the results showed that its use together allowed the construction company to accompany their results and take corrective and preventive actions during the production process, efficiently and effective

Controle on-line do número de não-conformidades por itens em uma produção finita

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Controle on-line por atributos para o número de não-conformidades no item inspecionado com base em uma sequência de inspeção

This paper proposes a procedure to control on-line processes for attributes, using an Shewhart control chart with two control limits (warning limit and control limit) and will be based on a sequence of inspection (h). The inspection procedure is based on Taguchi et al. (1989), in which to inspect the item, if the number of non-conformities is higher than an upper control limit, the process needs to be stopped and some adjustment is required; and, if the last inspection h, from all items inspected present a number of non-conformities between the control limit and warning limit. The items inspected will suffer destructive inspection, being discarded after inspection. Properties of an ergodic Markov chain are used to get the expression of average cost per item and the aim was the determination of four optimized parameters: the sampling interval of the inspections (m); the constant W to draw the warning limit (W); the constant C to draw the control limit (C), where W £ C, and the length of sequence of inspections (h). Numerical examples illustrate the proposed procedure

Controle de estoques de sal: uma inovação da quantificação e no gerenciamento dos recursos naturais da indústria mineral

The strengthening of the domestic industry in Brazil required the modernization, mechanization and expansion of salt production. Thereafter the production of sea salt started to be made in a process of continuous flow, where the product is constantly stored in yards, with daily movements in and out of salt. Thus far, the major bottleneck found in this production process is the control of production, because due to the large amount produced and variety of losses existing in the various stages of production there are not a regulated and safe way to control inventories with accuracy and speed demanded. In a typical case with a salt marsh company of Rio Grande do Norte state, salt produced is stored in two open courtyards and inventory control of salt made by carrying input / output relationship of salt in each storage yard. This work developed a conceptual model of inventory control, based on topography, adopting surveys into one of the courtyards of the company. There were 25 biweekly survey measurements over a year book to generate digital models representing the stock. For each measurement, results were compared with the values of inventory accounting provided by the salt marsh in order to identify existing losses and mark out the sales department on the actual stock available at each measurement date. Inventories calculated by the model indicated losses of 6,349 tonnes for the period of one year book and 3,279 tonnes for the period between harvests, when compared to the accounting control

Uma aplicação de análise de decisão com o método AHP Processo de hierarquia analítica: um estudo sobre adoção de Sistema eletrônico de cobrança no Transporte público urbano

This thesis carries through an application of Analysis of Multicriterion Decision with use of the method of Analytical Hierarchy Process (AHP) in the problematic one of taking of decision of the adoption of electronic collecting in the system of urban transport in the country, a subject that has been controversial. A modeling of criteria and alternatives is carried through and applied a questionnaire based on method AHP the excellent actors in the system of urban transport - Leading of the Managing Agency Public Municipal theatre of Urban Transports, Controller of Company of Bus, Controller of Labor union, Controller of Union of Companies, Communitarian Leader. The considered alternatives were: the maintenance of the current state with collectors, the implementation of electronic collection without collectors, and the implementation of electronic collection with collectors. The used criteria were: job, impact in the fare, control of the system, easiness of use, information. The study was carried through in the city of Natal, RN, where if the adoption of electronic collection argues and where this implementation in some bus lines between Natal and Parnamirim exists, city that integrates the region of the great Natal. The main results of the method evidence in a dimension, the viability of use of method AHP with questionnaire by means of validation of the judgments with analysis of variance beyond proper the normal mechanisms of analysis of consistency to the method, and in another one, the contribution of the analysis boarding multicriterion to become the judgments more clearly. The main results of the analysis help to show that although to models of criteria and distinct judgments of the actors, the method evidenced that it has inclination the adoption of the electronic collection on the current situation, even so with divergences between the maintenance or not of the collector. The research points to the possibility of accomplishment of the application of the AHP in successive rounds of judgments

Controle preditivo robusto baseado em desigualdades matriciais lineares aplicado a um sistema de tanques acoplados

This work deals with an on-line control strategy based on Robust Model Predictive Control (RMPC) technique applied in a real coupled tanks system. This process consists of two coupled tanks and a pump to feed the liquid to the system. The control objective (regulator problem) is to keep the tanks levels in the considered operation point even in the presence of disturbance. The RMPC is a technique that allows explicit incorporation of the plant uncertainty in the problem formulation. The goal is to design, at each time step, a state-feedback control law that minimizes a 'worst-case' infinite horizon objective function, subject to constraint in the control. The existence of a feedback control law satisfying the input constraints is reduced to a convex optimization over linear matrix inequalities (LMIs) problem. It is shown in this work that for the plant uncertainty described by the polytope, the feasible receding horizon state feedback control design is robustly stabilizing. The software implementation of the RMPC is made using Scilab, and its communication with Coupled Tanks Systems is done through the OLE for Process Control (OPC) industrial protocol

Ambiente de simulação híbrido integrando hysys e rede industrial Foundation Fieldbus aplicado ao controle de uma coluna de destilação

The main purpose of this work is to develop an environment that allows HYSYS R chemical process simulator communication with sensors and actuators from a Foundation Fieldbus industrial network. The environment is considered a hybrid resource since it has a real portion (industrial network) and a simulated one (process) with all measurement and control signals also real. It is possible to reproduce different industrial process dynamics without being required any physical network modification, enabling simulation of some situations that exist in a real industrial environment. This feature testifies the environment flexibility. In this work, a distillation column is simulated through HYSYS R with all its variables measured and controlled by Foundation Fieldbus devices

Implementação de um sistema embarcado aplicado ao controle de pressão arterial

Hypertension is a dangerous disease that can cause serious harm to a patient health. In some situations the necessity to control this pressure is even greater, as in surgical procedures and post-surgical patients. To decrease the chances of a complication, it is necessary to reduce blood pressure as soon as possible. Continuous infusion of vasodilators drugs, such as sodium nitroprusside (SNP), rapidly decreased blood pressure in most patients, avoiding major problems. Maintaining the desired blood pressure requires constant monitoring of arterial blood pressure and frequently adjusting the drug infusion rate. Manual control of arterial blood pressure by clinical personnel is very demanding, time consuming and, as a result, sometimes of poor quality. Thus, the aim of this work is the design and implementation of a database of tuned controllers based on patients models, in order to find a suitable PID to be embedded in a Programmable Integrated Circuit (PIC), which has a smaller cost, smaller size and lower power consumption. For best results in controlling the blood pressure and choosing the adequate controller, tuning algorithms, system identification techniques and Smith predictor are used. This work also introduces a monitoring system to assist in detecting anomalies and optimize the process of patient care.

Controle de Temperatura do Sistema de Refrigeração a água de uma tocha plasmática Indutiva Utilizando Lógica fuzzy

Este projeto propõe desenvolver e implementar um controlador para o sistema de refrigeração da tocha indutiva a plasma térmico. Este processo é feito a partir da medição da temperatura através de um sensor do sistema de refrigeração. O sinal produzido será enviado para uma entrada analógica do microcontrolador da família PIC, que utilizando os conceitos de lógica fuzzy, controla a velocidade de um motor bomba. Este é responsável por diminuir ou aumentar o fluxo circulante de água que passa pela bobina, pelo corpo da tocha e pelo flange de fixação, deixando-os na temperatura desejada. A velocidade desta bomba será controlada por um inversor de frequência. O microcontrolador, também, acionará um ventilador caso exceda a temperatura de referência. A proposta inicial foi o desenvolvimento do controle da temperatura da bobina de uma tocha indutiva a plasma, mas com algumas adequações, foi possível também aplicar no corpo da tocha. Essa tocha será utilizada em uma planta de tratamento de resíduos industriais e efluentes petroquímicos. O controle proposto visa garantir as condições físicas necessárias para tocha de plasma, mantendo a temperatura da água em um determinado nível que permita o resfriamento sem comprometer, no entanto, o rendimento do sistema. No projeto será utilizada uma tocha de plasma com acoplamento indutivo (ICPT), por ter a vantagem de não possuir eletrodos metálicos internos sendo erodidos pelo jato de plasma, evitando uma possível contaminação, e também devido à possibilidade do reaproveitamento energético através da cogeração de energia. O desenvolvimento da tecnologia a plasma na indústria de tratamento de resíduos vem obtendo bons resultados. Aplicações com essa tecnologia têm se tornado cada vez mais importantes por reduzir, em muitos casos, a produção de resíduos e o consumo de energia em vários processos industriais

Controlador preditivo não linear aplicado ao controle de golfadas em processos de produção de petróleo

Slugging is a well-known slugging phenomenon in multiphase flow, which may cause problems such as vibration in pipeline and high liquid level in the separator. It can be classified according to the place of its occurrence. The most severe, known as slugging in the riser, occurs in the vertical pipe which feeds the platform. Also known as severe slugging, it is capable of causing severe pressure fluctuations in the flow of the process, excessive vibration, flooding in separator tanks, limited production, nonscheduled stop of production, among other negative aspects that motivated the production of this work . A feasible solution to deal with this problem would be to design an effective method for the removal or reduction of the system, a controller. According to the literature, a conventional PID controller did not produce good results due to the high degree of nonlinearity of the process, fueling the development of advanced control techniques. Among these, the model predictive controller (MPC), where the control action results from the solution of an optimization problem, it is robust, can incorporate physical and /or security constraints. The objective of this work is to apply a non-conventional non-linear model predictive control technique to severe slugging, where the amount of liquid mass in the riser is controlled by the production valve and, indirectly, the oscillation of flow and pressure is suppressed, while looking for environmental and economic benefits. The proposed strategy is based on the use of the model linear approximations and repeatedly solving of a quadratic optimization problem, providing solutions that improve at each iteration. In the event where the convergence of this algorithm is satisfied, the predicted values of the process variables are the same as to those obtained by the original nonlinear model, ensuring that the constraints are satisfied for them along the prediction horizon. A mathematical model recently published in the literature, capable of representing characteristics of severe slugging in a real oil well, is used both for simulation and for the project of the proposed controller, whose performance is compared to a linear MPC

Influência da corrente de pulso, do tempo de pulso e diâmetro de gota sobre a estabilidade da transferência metálica no processo MIG-P

To obtain a process stability and a quality weld bead it is necessary an adequate parameters set: base current and time, pulse current and pulse time, because these influence the mode of metal transfer and the weld quality in the MIG-P, sometimes requiring special sources with synergistic modes with external control for this stability. This work aims to analyze and compare the effects of pulse parameters and droplet size in arc stability in MIG-P, four packets of pulse parameters were analysed: Ip = 160 A, tp = 5.7 ms; Ip = 300 A and tp = 2 ms, Ip = 350 A, tp = 1.2 ms and Ip = 350 A, tp = 0.8 ms. Each was analyzed with three different drop diameters: drop with the same diameter of the wire electrode; droplet diameter larger drop smaller than the diameter of the wire electrode. For purposes of comparison the same was determined relation between the average current and welding speed was determined generating a constant (Im / Vs = K) for all parameters. Welding in flat plate by simple deposition for the MIG-P with a distance beak contact number (DBCP) constant was perfomed subsequently making up welding in flat plate by simple deposition with an inclination of 10 degrees to vary the DBCP, where by assessment on how the MIG-P behaved in such a situation was possible, in addition to evaluating the MIG-P with adaptive control, in order to maintain a constant arc stability. Also high speed recording synchronized with acquiring current x voltage (oscillogram) was executed for better interpretation of the transfer mechanism and better evaluation in regard to the study of the stability of the process. It is concluded that parameters 3 and 4 exhibited greater versatility; diameters drop equal to or slightly less than the diameter of the wire exhibited better stability due to their higher frequency of detachment, and the detachment of the drop base does not harm the maintenance the height of the arc

Controle inteligente de sistemas eletroidráulicos utilizando redes neurais artificiais

This work describes the development of a nonlinear control strategy for an electro-hydraulic actuated system. The system to be controlled is represented by a third order ordinary differential equation subject to a dead-zone input. The control strategy is based on a nonlinear control scheme, combined with an artificial intelligence algorithm, namely, the method of feedback linearization and an artificial neural network. It is shown that, when such a hard nonlinearity and modeling inaccuracies are considered, the nonlinear technique alone is not enough to ensure a good performance of the controller. Therefore, a compensation strategy based on artificial neural networks, which have been notoriously used in systems that require the simulation of the process of human inference, is used. The multilayer perceptron network and the radial basis functions network as well are adopted and mathematically implemented within the control law. On this basis, the compensation ability considering both networks is compared. Furthermore, the application of new intelligent control strategies for nonlinear and uncertain mechanical systems are proposed, showing that the combination of a nonlinear control methodology and artificial neural networks improves the overall control system performance. Numerical results are presented to demonstrate the efficacy of the proposed control system