Avaliação das variáveis cardiovasculares, capacidade de caminhar e nível de atividade física de obesos mórbidos antes e depois da cirurgia bariátrica

Morbidly obese patients present an increase in heart rate, blood pressure and perceived exertion besides lower walking ability compared to normal weight people. However, little is known about how these variables are presented after bariatric surgery. Moreover, despite the distance walked during the six-minute walk (6MWT) improve after surgery is not well established if the level of physical activity influences this improvement. Objective: To evaluate cardiovascular performance, perceived effort, ability of walking and physical activity level of patients with morbid obesity before and after bariatric surgery. Methods: The cardiovascular performance, perception of effort, the ability to walk and level of physical activity were assessed in 22 patients before (BMI = 50.4 kg/m2) and after (BMI = 34.8 kg/m2) bariatric surgery through the 6MWT. The heart rate, blood pressure and perceived exertion were assessed at rest, at the end of the 6MWT and in the second minute post-test (HR recovery). The ability to walk was measured by total distance walked at the end of the test while the level of physical activity was estimated by applying the Baecke questionnaire, analyzing domains occupation, leisure and locomotion and leisure and physical activity. Results: The HR at rest and recovery decreased significantly (91.2 ± 15.8 bpm vs. 71.9 ± 9.8 bpm, 99.5 ± 15.3 bpm vs 82.5 ± 11.1 bpm, respectively), as well as all the arterial pressure and perceived exertion after surgery. The distance achieved by the patients increased by 58.4 m (p = 0.001) postoperatively. Time postoperatively had correlation with the percentage of excess weight lost (r = 0.48, p = 0.02), BMI (r =- 0.68, p = 0.001) and the Baecke (r = 0.52, p = 0.01) which did not happen with the distance walked (r = 0.37, p = 0.09). Despite weight loss, patients showed no difference in the level of physical activity in any of the areas before and after surgery. Conclusion: The cardiovascular performance, the perception of effort and ability to walk seem to improve after bariatric surgery. However, despite improvement in the ability to walk by the distance achieved in the 6MWT after weight loss, this is not reflected in an increase in physical activity level of obese patients after surgery

Validação da escala de fatigabilidade percebida para avaliação da fadiga em idosas

The term fatigability concerns the degree of fatigue associated with performing an activity of any type (physical, mental, emotional and / or social). Recently scales for assessing fatigue in the English language were created, however, gaps exist regarding the validity of these scales in relation to oxygen consumption and levels of perceived fatigue. Objective: To investigate the validity of perceived fatigability scale in older women frail and non-frail by the expired gases kinetics. Methods: This is a study of type validation, where were evaluated 48 elderly. The evaluation was conducted at two different sessions. In the first, data were collected demographic partners, as well as assessment of cognitive function, physical health, and the phenotype of frailty. The second was composed by the test 6-minute walk (6MWT) associated the expired gases kinects and assessment of perceived fatigability. Statistical analysis was performed a descriptive analysis and then we used the Pearson correlation test to evaluate the relationship between the measure of perceived fatigue and variables oxygen consumption (VO2), carbon dioxide production (VCO2), respiratory exchange ratio (RER)before and after 6MWT. We used a linear regression model initially considering the following explanatory variable: age, Body Mass Index (BMI), presence of frailty, comorbidities, level of physical activity, distance covered in the 6MWT , the energy cost of walking and severity of fatigability on performance. Results: The final sample consisted of 44 elderly women, 4 elderly were excluded because they didn t complete all phases of this study. The mean age obtained was 75 years (± 7.2 years). There was no significant correlation between fatigability measures and the values of VO2 ( r = .09 , p = .56 ) , VCO2 ( r = .173 , p = .26 ) , RER ( r = - .121 , p = .43 ). The final linear regression model showed that the energy cost of walking, the usual level of physical activity and the performance severity of fatigability explained 83.5 % (R2 = 0.835, p < 0.01) of the variation in the perceived fatigability. Conclusion: Our findings indicate a relationship between greater severity of fatigability and lower levels of physical activity and increased energy cost in walking, suggesting that the fatigability analyses using a simple numeric scale is valid and viable for assessment of fatigue in older women

Centros de especialidades odontológicas: avaliação da atenção de média complexidade na rede pública da Grande Natal

The Specialized Dental Care Centers (CEO) were developed to provide specialized dental care to the population, given the accumulated needs of health since the past. They must operate as units of reference for the Oral Health Team of the Primary Care, complementing the dental procedures performed at this level of attention. This study aims to assess the performance of CEOs of the Grande Natal Health Region as a strategy of Secondary Care consolidation in oral health through users, dentists and managers. For this to try to identify factors about access, hosting and satisfaction with the service, the actions developed in these centers, integration between the CEOs and the Basic Health Units (UBS), considering the reference and counter reference. Data were collected through semi-structured interview, conducted in four CEOs, among 253 users, 31 dentists and 4 managers. It was submitted to descriptive statistical analysis and to content analysis by software ALCESTE 4.5. The results revealed that the specialties of prosthesis, endodontics and surgery were the most sought by 38.2%, 23.7% and 21.7% of respondents, respectively. It was noticed that among users aged 18 to 30 years-old the greatest demand is for the specialty of endodontics (44.4%) and over 50 years for prosthesis (76.4%). There is a weakness in the reference and counter reference between UBS and CEO, because part of users goes directly to the centers without going before to the Primary Care and the majority does not want to return to the dentist of Health Unit. Satisfaction with care was reported by 90.9% of users, because they resolved the problems needed and were welcomed by the team. But the delay in care was the main factor for not satisfaction. For most dentists, some users could solve their problems completely in Primary Care, which shows the existence of unnecessary referrals to the CEOs, however they consider the existence of limiting factors in UBS that compromise the service. Most dentists revealed that some users do not get to CEOs with the basic dental treatment done, and some of them do not counter reference users. It can be concluded that the studied CEOs are being resolutive for those who access them, offering necessary care for the population, and if they don t account with this service, will encounter obstacles to resolution of problems, ranging seek care service in particular, in another public sector, or even giving up treatment. However, it is perceived the need of professionals training to understand the importance of the reference and counter reference, to that they can better serve and guide users. It is also important that cities offer better conditions to UBS and CEOs, so they can work together, with complementary actions of oral health, seeking full care, aiming for better resolution to the users' health problems

Avaliação longitudinal do impacto da saúde bucal na estratégia saúde da família em Natal

As a result of the financial incentive provided by the GM / MS 1.444, since 2000, Brazil has experienced a substantial increase in the number of oral health services at the Family Health Strategy. There is, however, evidence that these teams have produced qualitatively different experiences which do not translate necessarily into improved quality of life and health. Thus, evaluative research of great importance. This study aims to assess the impact of the Family Health Strategy in oral health in a longitudinal perspective natalense the years 2006 and 2009. This is an intervention study whose design is a community trial in parallel, nearly randomized. The sample consisted of census tracts covered by oral health teams in the Family Health and the Traditional Model (Basic Health Units and non-FHS Program of Community Health Agents and areas not covered.) The sample was determined by drawing ten census tracts to form the experimental group and ten other sectors for the control group by pairing intentional based on socio-economic and geographic. To check the net effect of the intervention was performed multivariate analysis by Poisson regression. As a result of cross-sectional analysis of year 2009, it was found that the effects of the ESF in Natal were satisfactory only for the variables of injuries and for other purposes without and with negative impact on stock coverage reclaimers. However, the longitudinal analysis revealed that the ESB / ESF improved their performance in dealing with grievances, access and coverage of the type of actions and this fact is independent of age, sex and social and economic conditions. In other employees' words are related to the presence of the Family Health Strategy in the region. However it does not say that both models under study (the Family Health Strategy Model and Traditional) are different in terms of performance and it is pertinent to reflect on the need for further development of evaluation studies that use other approaches able to clarify the dynamics of the process whose results can come to the knowledge of the actors responsible for leading the ESF and encourage them to incorporate the assessment in their routine

Avaliação de pastagens tropicais em sistemas de produção de ovinos de corte no nordeste brasileiro

He aim of this study was to evaluate the structural characters, herbage accumulation, nutritive value and performance of sheep in different tropical pastures. The treatments were two cultivars and two of the genera Panicum Brachiaria pastures under intermittent stocking and variable stocking rate, in the rainy season. We evaluated the masses and the components of herbage pre grazing in two layers, and after grazing. Chemical analyzes were made of the stems and leaf blades pre grazing in two layers. We used 48 male sheep and whole for the assessment of individual weight gain and area, and anestrous females to adjust the stocking rate. In the cv. Massai showed the highest herbage mass, leaf blades and dead material, and the largest volume density and leaf blade: stem pre grazing. There was no difference among cultivars for the percentage of leaf blade (PLB) in both strata, but the higher the PLB was higher than the bottom. The highest percentage of dead material (PDM) was observed in cvs. Massai and Marandu in the two strata. In cvs. Massai and Piatã were observed lower levels of crude protein in stem and leaf. In stratum 0-25 cm lower nutritional value was observed in the stem in the leaf blades did not grant the nutritional value among the strata. Herbage mass, leaf blade, PLB and proportion of stem in the residue of the Massai pastures were higher than cv. Aruana. There was no difference for efficiencies in harvest leaf and stem between the cultivars. The cv. Massai got the higher accumulation of leaf per cycle per day. Animals kept in grass swards Aruana had the highest average daily gain. The higher stocking rates and earnings per area were observed in grass swards and Marandu Massai. The cultivars are suitable for sheep meat production in the rainy season

Avaliação do padrão do ciclo sono-vigília e a cognição em estudantes de medicina com diferentes esquemas de horários de aulas

The sleep patterns of students entering the university, is accompanied by many factors that can lead to changes in sleep habits, such as academic demands, new social opportunities, reduced parental care and irregular teaching schedules. The irregular pattern of sleep-wake cycle is usually accompanied by several daytime consequences, for example, reduced levels of motivation, performance, concentration, alertness and mood as well as increased fatigue and sleepiness.Thus, there are numerous reasons to support the fact that these students may suffer damage in their academic performance. The aim of this study was to evaluate the sleep-wake cycle (SWC) and cognition in medical students with different schemes teaching schedules. One group started classes at 08am, while the other started at 07am. We analyzed the data from 88 volunteers, 39 from each group. However, only those who participated in both stages of the study (n = 78) underwent cognitive testing. For subjective evaluation of the SWC was used questionnaires to check the quality of sleep, chronotype, daytime sleepiness and sleep habits. For objective evaluation was used actigraphy. For cognitive assessment was used the test MoCA (Montreal Cognitive Assessment). The results indicate that the group has class earlier had a greater irregularity of the SWC and a worse performance in cognitive testing. There was a difference between the schedules the week and weekend in the subjective variables, bedtime, wake up and sleep duration in both groups. The objective variables, time in bed showed difference between the schedules the week and weekend to the group started class at 08am and the variables bedtime, get up time, actual sleep time, time in bed and wake bouts in the class at 07am. In the cognitive test, there were differences between the groups in overall score and in the areas of executive function and memory recall. Thus, it is suggested that the class starting time may cause irregularity of the SWC and the irregularity may cause mild cognitive impairment. Moreover, cognitive testing MoCA was sensitive to detect differences among students, although the difference between the schedules is small

Avaliação da prevenção de falhas em processos utilizando métodos de tomada de decisão

Este trabalho apresenta uma investigação sobre o emprego de FMEA (Failure Mode and Effect Analysis) de Processo com a exposição de irregularidades na sua utilização. O método AHP (Analytic Hierarchy Process) e os Conjuntos Fuzzy são aplicados no estudo das práticas atuais de utilização de FMEA. O AHP é aplicado para a priorização das irregularidades quanto à gravidade de sua ocorrência. Os Conjuntos Fuzzy são aplicados para avaliação do desempenho da utilização de FMEA em algumas empresas do ramo automotivo. Como resultado, tem-se a aceitação de oito e a não aceitação de três dos onze formulários de FMEA averiguados.

Avaliação do programa de tutorização da EMATER-RN para servidores em estágio probatório

The present thesis evaluated the contributions and limitations of the tutorship program introduced in EMATER-RN, as a tactic of organizational socialization for civil servants in probationary stage. Tutorship was understood as an intensive and continuous relational process, in which a more experienced person in the organization the tutor offers psychosocial support, stimulates the development of the professional career and enables to the newcomer the tutee learning on job performance. The organizational socialization was considered in the perspective of the symbolic interactionism. The study was characterized as a program evaluation and as an action research. The practical interventions for the program implementation were conducted and, at the same time, the evaluations of process, results and reaction to the program were applied. Among the major contributions of the action research, it stood out: the diagnosis of reasons for the formation of the pair and of expectations of tutors and tutees, the improvement of the tutorship registration tools, the ascertainment of the success of the program in the socialization of the new civil servants, the confirmation of the importance of the compatibility among them and of the adequate performance of tutorship functions for achieving its benefits. Based in constraints of the program, one may quote as essential recommendations: the formation of a technical team supporting the program, the clear establishment of deadlines for each procedure and the reinforcement to its compliance, the investigation of the functions performed by the tutor, the sensitization of the managers to the resolution of problems that affect the program, the voluntary participation of the tutor and the continuous meetings of tutors and tutees. One settles for the relevance of the program and in favor of its continuation, provided that its improvement and systematic management are conducted.

Avaliação hidrodinâmica de unidade piloto de floculação mecanizada

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da floco-decantação de manta de lodo associada à decantação de alta taxa no tratamento de águas de consumo humano

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

Critérios comportamentais utilizados por técnicos na avaliação do desempenho esportivo de futebolista das categorias de base

Currently one of the major concerns in sports is to identify, select, discover and reveal talents in soccer. As principal reasons is perceived the search direct or indirect for resources for players, clubs, media, sports brands and their sponsors. However, high salaries are an exception and not a rule, because the majority of professional players in Brazil receives 1 minimum salary per month. It is also known that on professional clubs, daily, arriving several players to try to be a professional soccer player, however, the majority of clubs - almost all does not present methodological, systematic and analytical aspects to select promising players. The selective processes ("sieves" or "big sieves") developed by technical observers ( olheiros") summarized in the observation of the sportive performance of a big group of players in a period of few minutes given to each player. In this period the target behavior is the ability with the ball. If promising players are identified on that selection, they are referred to the club for a new observation, which will be conducted by the responsible coach of base category in question. It is understood by base categories, the amateur categories (not professional), to serve as a "base" for the formation of the cast of professional clubs. What are sub-13 (under 13 years), sub-15 (under 15 years), sub-17 (under 17 years) and sub-20 (under 20 years). The absence of common criterias and performance indicators of these professionals may hamper the evaluation of promising players, and be a costly activity for the club. This study proposes to identify, characterize and categorize the criterias and methods of behavioral evaluation, used by coaches of base categories of Rio Grande do Norte (RN) to evaluate the sportive performance of young soccer players, with the purpose of to compare the criterias of evaluation of sportive performance of young soccer players, used by coaches with different time of experience in function. The proposal had 2 pilot studies, the first (June and July, 2007) were interviewed 29 coaches, 17 of category sub-13 and 12 of category sub-17. The data were tabulated and organized into spreadsheets in order to describe, and developed a set of descriptors of behavior. And the second (May and June, 2008), with revisions made based on observations, analysis and descriptions found in the first, were interviewed 14 technical of category sub-15. After the results found in pilots, it was possible to outline the study in question, which had 46 coaches base categories of the RN. And from the results show that the characteristic of greatest importance, according to the interviewees was the behavior, the 2nd most important characteristic considered was the motivation, the 3rd was the ability and the 4th was the physical condition and the last was the affiliation. And by analyzing the results to the methods of evaluation of sportive performance used by coaches, it was noted clearly that most uses only the observation to select young soccer players. Therefore, needs a systematization to the selection of soccer players, since there is complexity in the verification of characteristics and aspects involved with purpose to avoid wrong evaluations and selections and the results negligible

Avaliação da relação entre qualidade de sono e uma intervenção com jogos para o desempenho de crianças e adolescentes

The sleep is an active brain process that allows the efficient realization of daily tasks. The changes on sleep patterns may influence the different cognitive processes performance. Many recent studies show the possibility of cognitive performance improvement, through the cognitive training with the use of computer games. The question is if these interventions may be influenced by the sleep quality. Thus, we evaluated the sleep quality effect about the efficacy of an intervention with computers games based on the working memory and attention for a cognitive performance training of elementary school students. The sample was constituted by 42 students with average age of 10,43 years old (SD=1,23), with 22 male participants and 20 female participants. We used to evaluate the sleep with the parents a sleep questionnaire, a sleep diary and the Sleep Behavior Questionnaire. In regard to intervention, the subjectives were distributed in an experimental and in a control group, both with 21 participants. In the first group occurred the intervention that consisted in the working memory and attention training with two cognitive tasks (Safari e Brain Workshop) during 30 daily minutes, for a 6 weeks period. In an equal period, the students from the control group should reproduce an artwork using drawing software. To evaluate the cognitive performance we applied before and after the intervention period the Wechsler Intelligence Scale for Children (WISC-III). The results showed that in both the groups the performance of the intelligence, working memory, attention and visuospatial skills was below of the mean. The cognitive processes evaluated after of intervention in the experimental group had a performance significantly higher in the Perceptual Reasoning Index (t = -6,24; p < 0,01) and in the Full Scale IQ (t = -5,09; p < 0,01) and Performance IQ (t = -6,52; p < 0,01), suggesting a improvement on the visuospatial skills, attention, working memory and processing speed. On the control group, the performance was significantly higher in the Coding subtest (t = -5,38; p< 0,01) and in the Perceptual Reasoning Index (t = -3,66; p = 0,01), suggesting a improvement on the visuospatial skills and attention. The mean obtained with the Sleep Behavior Questionnaire was 53,76 (SD=14,96) for an experimental group and 61,19 (SD=12,82) for a control group, indicating tendency for a bad sleep quality in that last one. Not only during the first days, but also in the last fifteen days of the intervention we verified in the two groups an adequate time to sleep, duration and regularity, in the weekdays and on the weekends. We didn t find significant differences between the two groups in none of the sleep variables. We verified statistically meaningful improvement on the performance of the experimental group with the intervention in the two games. We didn t verify significant correlations between the games performance index and in the sleep variables of the experimental group individuals. We verified significant correlations among the performance on the Brain Workshop and the Cubes subtest, the Perceptual Reasoning Index and the Scale Performance IQ, suggesting that the significant improvement of the visuospatial skills and of the attention was correlated with the performance in the Brain Workshop. Although the absence of correlations with the performance in the Safari, possibly it also has relieved in the improvement of the cognitive performance. The findings support the hypothesis that the computer games might be a satisfactory tool for the improvement of the performance in visuospatial skills and attention. This can be resulted of the insertion of visuospatial stimulations in the task, for example, graphical elements with thematic for children that increase the interest. The IQ below mean the individuals might have influenced the improvement absence on the cognitive processes like the working memory with games. Moreover, it wasn t verified a relation between the sleep quality and the intervention efficacy. It might have been influenced by the n of the sample. Future studies must focalize in the improvement of the effect of the interventions with games

Avaliação das habilidades neurocognitivas em crianças e adolescentes sobreviventes da Leucemia Linfoide Aguda - LLA

The present study investigated the impact of the treatment modalities of Acute Lymphoblastic Leukemia on neurocognitive abilities of children and adolescents survivors, aged between 6 and 16 years of age, accompanied in pediatric oncology sectors of public health services in the cities of Campina Grande-PB and Natal-RN. The study included 52 children, 13 of these being children and adolescents diagnosed with leukemia and 39 healthy children matched in relation to the study group considering gender, age, school type and level of maternal education. Later the group of children with leukemia was subdivided into two subgroups depending on treatment modality which were submitted: Group 1A (only chemotherapy) and 1B (chemotherapy and radiotherapy). All participants were subjected to a battery of neuropsychological tests that investigated the following neurocognitive abilities: intellectual ability, memory system, attention, visuospatiality and visuoconstruction, processing speed and executive functions. Data were analyzed using descriptive and inferential measurements with the aid of the U test of Mann-Whitney and T test, considering the influence of the variables: sex, age at diagnosis, time since completion of treatment and level of schooling mothers, on the performance of children. Overall, it is concluded that the illness and the treatment of acute lymphoblastic leukemia significantly favors the emergence of cognitive deficits, particularly in terms of visuospatial skills, and executive skills visoconstrutivas. In turn, the treatment modality of radiotherapy is associated with the presence of more severe deficits, highlighting the significant impact on the speed of information processing. It is hoped that the results presented here will contribute to a better understanding of the nature and extent of neurocognitive effects arising ALL treatment

Uma abordagem anotativa para gerência de variabilidade em linhas de processos de software: concepção, implementação e avaliação

Nowadays, the importance of using software processes is already consolidated and is considered fundamental to the success of software development projects. Large and medium software projects demand the definition and continuous improvement of software processes in order to promote the productive development of high-quality software. Customizing and evolving existing software processes to address the variety of scenarios, technologies, culture and scale is a recurrent challenge required by the software industry. It involves the adaptation of software process models for the reality of their projects. Besides, it must also promote the reuse of past experiences in the definition and development of software processes for the new projects. The adequate management and execution of software processes can bring a better quality and productivity to the produced software systems. This work aimed to explore the use and adaptation of consolidated software product lines techniques to promote the management of the variabilities of software process families. In order to achieve this aim: (i) a systematic literature review is conducted to identify and characterize variability management approaches for software processes; (ii) an annotative approach for the variability management of software process lines is proposed and developed; and finally (iii) empirical studies and a controlled experiment assess and compare the proposed annotative approach against a compositional one. One study a comparative qualitative study analyzed the annotative and compositional approaches from different perspectives, such as: modularity, traceability, error detection, granularity, uniformity, adoption, and systematic variability management. Another study a comparative quantitative study has considered internal attributes of the specification of software process lines, such as modularity, size and complexity. Finally, the last study a controlled experiment evaluated the effort to use and the understandability of the investigated approaches when modeling and evolving specifications of software process lines. The studies bring evidences of several benefits of the annotative approach, and the potential of integration with the compositional approach, to assist the variability management of software process lines

Análise da concordância entre instrumentos de avaliação do equilíbrio corporal em idosos

CONTEXTUALIZAÇÃO: Diagnosticar os parâmetros clínicos associados com as quedas em idosos tornou-se um grande desafio para a comunidade científica. Apesar da existência de diversos instrumentos direcionados à avaliação do equilíbrio corporal em idosos, ainda é escasso o número de trabalhos que investigaram e discutiram a concordância entre os diversos métodos. OBJETIVO: Analisar a correlação entre alguns testes usados para avaliar o equilíbrio corporal no idoso. MÉTODOS: Tratou-se de um estudo transversal, observacional, realizado com 30 voluntárias idosas comunitárias, hígidas, com diferentes níveis de condicionamento físico. Foram utilizados o Teste de Alcance Funcional Anterior (TAF), a Escala de Equilíbrio de Berg (EEB), o teste Timed Up and Go (TUG) e o Teste de Equilíbrio de Tinetti (Performance Oriented Mobility Assessment - POMA). A correlação dos dados foi realizada por meio da aplicação do Coeficiente de Correlação de Spearman, com nível de significância de 5% (p<0,05). RESULTADOS: Observou-se correlação positiva e moderada entre o TAF e a EEB (r=0,4845; p=0,0067), entre o TAF e a POMA (r=0,4136; p= 0,0231), entre a EEB e a POMA (r=0,6088; p=0,0004). CONCLUSÃO: Os testes são complementares, dado que se mostraram com particularidades e limitações distintas. Torna-se razoável, portanto, a aplicação conjunta desses instrumentos para melhor avaliar o equilíbrio de idosas.