Avaliação de intervenção educativa sobre aleitamento materno dirigida a agentes comunitários de saúde

OBJETIVOS: avaliar ação educativa visando à capacitação de agentes comunitários de saúde em promoção e apoio ao aleitamento materno. MÉTODOS: estudo do processo e adequação de intervenção, com comparação de conhecimentos e práticas de 54 agentes, antes e dois meses após a ação. A intervenção, quatro oficinas teórico-práticas com oito horas cada, fundamentou-se em princípios da Educação Crítico-Reflexiva e em dois cursos de capacitação de equipes de maternidade. Os resultados foram expressos pelas diferenças dos escores médios de conhecimentos, práticas e total, adotando-se p<0,05 como nível crítico. RESULTADOS: houve aumento do escore médio de conhecimentos (21,0 para 26,6; p<0,001) e de escores de conhecimentos classificados como bons (37,0% para 88,8%, p<0,001). Não houve mudanças no escore de participação dos agentes em específicas ações de saúde, como grupos. O efeito da intervenção mais apontado pelos agentes foi sentir-se mais aceito e em melhores condições de participar da equipe multiprofissional em situações envolvendo cuidados com crianças. Mais da metade relatou melhora na qualidade e quantidade das orientações prestadas nas visitas domiciliarias. CONCLUSÕES: a intervenção tem efeitos positivos sobre conhecimentos e a prática dos agentes junto às famílias, mas não promove aumento da sua participação em específicas ações de saúde.

Patients' experiences of peritoneal dialysis at home: a phenomenological approach

O objetivo deste estudo foi compreender a experiência da diálise peritoneal domiciliar, a partir da narrativa dos pacientes. A abordagem do estudo inspirou-se na fenomenologia hermenêutica de Paul Ricoeur. Foram entrevistados 19 pacientes na unidade de hemodiálise de um hospital público brasileiro, de março a setembro de 2009. As entrevistas foram orientadas pela questão: descreva sua experiência na diálise peritoneal. Os resultados desvelaram a percepção dos participantes sobre o significado da doença em suas vidas e as drásticas transformações pessoais sofridas nesse processo. Sentimentos de angústia e dor física foram acompanhados por importantes limitações pessoais e sociais, impostas pelo tratamento. Eles esperam por um futuro incerto, reconhecendo sua dependência da ajuda dos familiares e dos profissionais da saúde. Os resultados desvelam as dificuldades e a falta de perspectivas vividas pelos pacientes em diálise, demonstrando o papel crucial que cabe aos profissionais que os acompanham. Ajudá-los a desenvolver o autocuidado e maximizar sua qualidade de vida é prioridade na assistência a esses pacientes.

Between freedom and reclusion: Social support as a quality-of-life component in the family caregiver-dependent person binomial

This is a qualitative study which uses Grounded Theory as its methodological framework and Symbolic Interactionism as a theoretical base to understand the experience of family caregivers for Cerebrovascular Accident (CVA) patients with regard to social support during their rehabilitation process at home. The components (themes and categories) of the phenomenon assuming home care and specifically the themes assuming care with support and assuming care without support were inter-related for the purpose of comparison and analysis, in order to apprehend how the interaction between them occurred, It was observed that, in addition to the recovery of the patient's autonomy, social support is one of the intervenient components in the quality of life for the family caregiver-disabled person binomial, particularly with respect to the caregiver's freedom to resume his/her life plan.

Quality of service control for rt-VBR connections in ATM networks

Nowadays, networks must support applications such as: distance learning, electronic commerce, access to Internet, Intranets and Extranets, voice over IP (Internet Protocol) and many others. These new applications, employing data, voice, and video traffic, require high bandwidth and Quality of Service (QoS). The ATM (Asynchronous Transfer Mode) technology, together with dynamic resource allocation methods, offers network connections that guarantee QoS parameters, such as minimum losses and delays. This paper presents a system that uses Network Management Functions together with dynamic resource allocation for provision of the end-to-end QoS parameters for rt-VBR connections.

Development of an open case-based decision-support system for diagnosis in oral pathology

Making diagnoses in oral pathology are often difficult and confusing in dental practice, especially for the lessexperienced dental student. One of the most promising areas in bioinformatics is computer-aided diagnosis, where a computer system is capable of imitating human reasoning ability and provides diagnoses with an accuracy approaching that of expert professionals. This type of system could be an alternative tool for assisting dental students to overcome the difficulties of the oral pathology learning process. This could allow students to define variables and information, important to improving the decision-making performance. However, no current open data management system has been integrated with an artificial intelligence system in a user-friendly environment. Such a system could also be used as an education tool to help students perform diagnoses. The aim of the present study was to develop and test an open case-based decisionsupport system.Methods: An open decision-support system based on Bayes' theorem connected to a relational database was developed using the C++ programming language. The software was tested in the computerisation of a surgical pathology service and in simulating the diagnosis of 43 known cases of oral bone disease. The simulation was performed after the system was initially filled with data from 401 cases of oral bone disease.Results: the system allowed the authors to construct and to manage a pathology database, and to simulate diagnoses using the variables from the database.Conclusion: Combining a relational database and an open decision-support system in the same user-friendly environment proved effective in simulating diagnoses based on information from an updated database.

Fitoterapia no sistema de saúde pública (SUS) no Estado de São Paulo, Brasil

Phytotherapy is a form of familiar treatment throughout the world and recommended by the World Health Organisation to be used in all regions, especially in the poorer countries, to improve the state of health of their people. The aim of this study was to describe the use of herbal medicine as an alternative therapy in the public health system in Sao Paulo State. The fieldwork consisted in obtaining information, from all the Regional Health Authorities in the State, about which municipal health areas use this therapy and sending them a questionnaire requesting details about the application of phitotherapy: when the therapy had been adopted, which plants were used, whether the programme had been discontinued or not and if so, for what reason. The cities that use the phytotherapy are: Campinas; Canas; Guaratingueta; Herculandia; Piquete; Pindamonhangaba; Roseira e Sao Jose do Barreiro, Ribeirao Preto, Sao Lourenço da Serra, Cruzeiro e Dobrada. And the three plant more used are: Guaco (Mikania glomerate); Calendula (Calendula officinalis) e Babosa (Aloe vera) The lack of support has led some Authorities to discontinue their active in 08 programmes. Nevertheless, it is concluded that the efficacy and low cost of herbal treatments has engendered a growing interest among health professionals in placing proposals for implanting this therapy in 13 cities in the Municipal Health. Thus, there should be growing practical support for the establishment of such programmes in the future.

Nutritional support and outcome in hospitalized dogs and cats

This study investigated the effect of assisted nutritional support on the outcome and time of hospitalization (TH) of dogs and cats. The study compared two groups of 400 hospitalized animals. The animals in group 1 did not receive assisted nutritional support because they were hospitalized before the clinical nutrition service was implemented; animals in group 2 were nutritionally managed. Animals in group 1 received a low-cost diet with no consumption control. Group 2 animals had their maintenance energy requirement (MER) calculated, received a high-protein and high-energy super-premium diet, had their caloric intake (CI) monitored, and received enteral and parenteral nutritional support when necessary. The statistical analysis of the results included the standard T test (group 1 versus group 2) and chisquare and Spearman's correlation to evaluate group 2 (CI and outcome, body condition score (BCS) and outcome, BCS and CI). For group 2, favorable outcome (FO), defined as the percent responding to therapy and dis-charged from the hospital, was 83%, and the TH was 8.59 days. These values were lower (P < .001) for group 1 (63.2% FO and TH of 5.7 days). For group 2, 65.5% of the animals received voluntary consumption (93.1% outcome), 14.5% received enterai support (67.9% FO), 6.5% received parenteral support (68% FO), and 6.17% did not eat (38.5% FO), demonstrating an association between the type of nutritional support and outcome (P < .01). Group 2 animals that received 0% to 33% of their MER had 62.9% FO, and those receiving more than 67% had 94.3% FO, which shows that lower mortality rates are associated with higher CI (P < .001). TH was higher for animals with higher CI (P < .001). The BCS did not correlate with Cl (P > .05) but did correlate with outcome (P < .01). FO was 68.7% for animals with low BCS, 85.7% for animals with ideal BCS, and 86.6% for overweight animals. Nutritional support could allow for longer therapies, thus increasing the TH and FO rate.

Geometric modeling from the medical images in the CAD system to support prosthesis design

This paper presents an individual designing prosthesis for surgical use and proposes a methodology for such design through mathematical extrapolation of data from digital images obtained via tomography of individual patient's bones. Individually tailored prosthesis designed to fit particular patient requirements as accurately as possible should result in more successful reconstruction, enable better planning before surgery and consequently fewer complications during surgery. Fast and accurate design and manufacture of personalized prosthesis for surgical use in bone replacement or reconstruction is potentially feasible through the application and integration of several different existing technologies, which are each at different stages of maturity. Initial case study experiments have been undertaken to validate the research concepts by making dimensional comparisons between a bone and a virtual model produced using the proposed methodology and a future research directions are discussed.

Reactive power support pricing of distributed generators with primary energy source uncertainty

In this paper, a novel methodology to price the reactive power support ancillary service of Distributed Generators (DGs) with primary energy source uncertainty is shown. The proposed methodology provides the service pricing based on the Loss of Opportunity Costs (LOC) calculation. An algorithm is proposed to reduce the uncertainty present in these generators using Multiobjective Power Flows (MOPFs) implemented in multiple probabilistic scenarios through Monte Carlo Simulations (MCS), and modeling the time series associated with the generation of active power from DGs through Markov Chains (MC). © 2011 IEEE.

Pricing of reactive power support provided by distributed generators in transmission systems

Distributed Generation, microgrid technologies, two-way communication systems, and demand response programs are issues that are being studied in recent years within the concept of smart grids. At some level of enough penetration, the Distributed Generators (DGs) can provide benefits for sub-transmission and transmission systems through the so-called ancillary services. This work is focused on the ancillary service of reactive power support provided by DGs, specifically Wind Turbine Generators (WTGs), with high level of impact on transmission systems. The main objective of this work is to propose an optimization methodology to price this service by determining the costs in which a DG incurs when it loses sales opportunity of active power, i.e, by determining the Loss of Opportunity Costs (LOC). LOC occur when more reactive power is required than available, and the active power generation has to be reduced in order to increase the reactive power capacity. In the optimization process, three objectives are considered: active power generation costs of DGs, voltage stability margin of the system, and losses in the lines of the network. Uncertainties of WTGs are reduced solving multi-objective optimal power flows in multiple probabilistic scenarios constructed by Monte Carlo simulations, and modeling the time series associated with the active power generation of each WTG via Fuzzy Logic and Markov Chains. The proposed methodology was tested using the IEEE 14 bus test system with two WTGs installed. © 2011 IEEE.

Análise do gerenciamento dos resíduos sólidos domiciliares do município de Ilha Solteira – SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Posso ajudar? Cuidador formal e relação de ajuda: a percepção do idoso acerca do apoio oferecido por um serviço socioassistencial de um município do interior de São Paulo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Saúde mental e trabalho: significados atribuídos pela equipe da saúde da família ao adoecimento dos usuários

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O cotidiano de trabalho dos agentes comunitários de saúde: relações com os usuários e equipe de saúde

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Does public financial support stimulate innovation and productivity? An impact evaluation

This paper contributes to the empirical literature that evaluates the effects of public financial support to innovation on innovation expenditures, innovation itself and productivity in developing countries. Propensity score matching techniques and data from Innovation Surveys are used to analyse the impacts of public financial support to innovation on Uruguayan firms. The results indicate that there is no crowding-out effect of private innovation investment by public funds and that public financial support in Uruguay seems to increase private innovation expenditures. Financial support also appears to induce increased research and development expenditures and innovative sales, with these effects being greatest for service firms. Public funds do not, however, significantly stimulate private expenditures by firms that would have carried out innovation activities even in the absence of financial support.