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.

Potencial de erosão da bacia do Rio Uberaba

Este trabalho teve por objetivo identificar qualitativamente as áreas suscetíveis à erosão laminar na bacia do Rio Uberaba, localizada em Uberaba -MG, apoiado no modelo matemático da Equação Universal de Perda de Solo (EUPS). Foram utilizadas cartas de: solos, uso e ocupação das terras, redes de drenagem, declividade e dados pluviográficos, utilizando-se de um Sistema de Informação Geográfica (SIG -IDRISI). A espacialização do potencial de erosão só foi possível a partir da estimativa da tolerância às perdas laminares para cada tipo de solo da bacia, e da profundidade dos solos, por entender que as perdas são mais significativas em solos mais rasos do que em solos muito profundos. Na análise dos resultados, verificou-se que 37% da área total da bacia do Rio Uberaba (905,24 km²) sofrem perdas de solos acima do limite de tolerância, sendo 12% em solos profundos e 25% em muito profundos, e a espacialização deste evento favorece a adoção de ações efetivas quanto à conservação dos solos da bacia.

Vivências compartilhadas de filhos separados pela hanseníase no RN a luz da história oral de vida

Several epidemics marked the lives of individuals and communities in all historical periods, and a prime example is leprosy, infectious disease marked by stigma, prejudice and social exclusion. In the past, the compulsory isolation of patients with leprosy caused serious social and psychological problems, resulting in the separation and the partial or total disruption of the family relationship. Children deprived of this living, removed often inhumanely, were kept and bred in preventoriums / educational establishments. This study aimed to: rescue the oral history of life of the children of leprosy patients that were built in preventorium Osvaldo Cruz, Natal, Rio Grande do Norte; develop a contextual analysis about these children; know the life trajectory of children of leprosy patients institutionalized in preventoriums / educational establishments; produce a documentary on the history of life of children of parents separated by leprosy; forming MORHAN of Rio Grande do Norte state; and implement the I Meeting of MORHAN of Rio Grande do Norte state. This is an exploratory and descriptive study, with a qualitative approach, approved by the ERC No. 024/024/2012 Liga Norteriograndense Contra o Câncer. We used the contributions of the method and technique of oral history of life as methodological reference. We interviewed 10 individuals egress from preventorium Osvaldo Cruz in Natal/RN, sons of former patients proven to be residents in the city, of both sexes, older than 18, with cognitive, intellectual and emotional conditions preserved. The analysis of the histories obtained from collaborators was performed in the light of Thematic Content Analysis. The results and discussions are presented through two articles which meet the proposed objectives. The first, called Contextual Analysis on the children of leprosy patients in preventoriums aimed to record the phenomenon of children of leprosy patients in preventorium through four contextual levels, which identified the need to broaden the debate on public policy in the field of leprosy as a way to enable more effective measures to propagate in the search for harm reduction and direct consequences resulting from stigma and marginalization around patients and their healthy children, egress from preventoriums. The second, Leprosy and the denial of history: the story of separated children , aimed to know the life trajectory of children of leprosy patients who were institutionalized in preventoriums / educational establishments. In this article, we discuss the research question through the establishment of three main themes: 1. Losses and damages: disintegration and reintegration into the family and denied childhood; 2. Unforgettable: remarkable things you do not forget; and 3. Expectancy in living new situations: in search of other paths and destinations. These thematic axis highlighted the negative implications for the lives of the subjects, arising from the separation of their parents, leprosy patients at the time of compulsory isolation; however, has also been shown that this separation was not decisive in their life histories, once they have succeeded in providing a new sense of these experiences and lead their lives with dignity and fortitude. It was concluded that these children demonstrated resilience as form of defense and fighting stigma and prejudice, being able to reinvent themselves and build new paths and destinations

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.

Efeitos de fontes nitrogenadas com distintas degradabilidades sobre o aproveitamento da fibra, do nitrogênio e do amido em rações para bovinos

O objetivo do experimento foi avaliar os efeitos da utilização do farelo de soja ou da glutenose sobre a degradabilidade ruminal in situ dos constituintes de dietas compostas por feno, milho e as fontes nitrogenadas fornecidas para bovinos adultos com 650 kg de peso. A glutenose foi considerada fonte nitrogenada de baixa degradabilidade e o farelo de soja, de média degradabilidade ruminal. As degradabilidades potenciais obtidas para o nitrogênio foram 39,7 e 90,3% e as degradabilidades efetivas 35,7 e 62,9%, respectivamente, para glutenose e farelo de soja. Utilizou-se a fibra mordente para determinar a taxa de passagem das dietas e obtiveram-se 6,6%/h para dietas com farelo de soja e 2,4%/h para dietas com glutenose. Não houve diferença na degradabilidade potencial da matéria seca do feno, nas frações A, B, C e na taxa de degradação, mas a degradabilidade efetiva da matéria seca foi inferior para as dietas com farelo de soja (29,3 vs 40,6%). Os demais ingredientes, à exceção do milho, apresentaram acentuadas diferenças entre as dietas nas variáveis de degradabilidade, na taxa de degradação e na degradabilidade efetiva do nitrogênio, com inferioridade na dieta com glutenose. O milho diferiu apenas quanto à degradabilidade efetiva do nitrogênio, superior na dieta com glutenose (68,7 vs 56,3%). O amido do milho apresentou menor degradabilidade efetiva na dieta com farelo de soja (52,5 vs 68,0%), sendo a degradabilidade efetiva da fibra do feno também inferior para essas dietas (27,3 vs 43,2%). Concluiu-se que fontes nitrogenadas com distintas degradabilidades podem afetar tanto a degradabilidade da fibra do volumoso quanto à do amido da própria fonte nitrogenada e do milho das dietas.

Degradabilidade ruminal da matéria seca, da fração fibrosa e da proteína bruta de forrageiras

O objetivo deste trabalho foi avaliar a degradabilidade ruminal da matéria seca, da fibra em detergente neutro, da fibra em detergente ácido e da proteína bruta da alfafa (Medicago sativa), aveia-preta (Avena strigosa), leucena (Leucaena leucocephala) e guandu (Cajanus cajan). Amostras de 3 g das forragens foram incubadas no rúmen de três novilhos por períodos de 0, 6, 12, 24, 36, 48 e 72 horas. As degradabilidades efetivas da matéria seca da alfafa e da aveia, para a taxa de passagem de 5% por hora, foram elevadas (acima de 60%). A leucena e o guandu apresentaram valores inferiores, 50,9 e 56,0%, respectivamente. A partir de 24 horas de incubação, a aveia se destacou com maior desaparecimento da fibra em detergente neutro e da fibra em detergente ácido, e ainda apresentou as mais elevadas taxas de degradação efetiva destas frações. A aveia foi a forragem que apresentou maior degradabilidade da matéria seca, da fibra em detergente neutro, da fibra em detergente ácido e da proteína bruta no rúmen. O guandu, entretanto, foi a forragem com as piores taxas de degradação.

Análise de linhas de fita não-homogêneas com camadas dielétricas anisotrópicas

Abstract

Um sistema para gestão do conhecimento em ameaças, vulnerabilidades e seus efeitos

Attacks to devices connected to networks are one of the main problems related to the confidentiality of sensitive data and the correct functioning of computer systems. In spite of the availability of tools and procedures that harden or prevent the occurrence of security incidents, network devices are successfully attacked using strategies applied in previous events. The lack of knowledge about scenarios in which these attacks occurred effectively contributes to the success of new attacks. The development of a tool that makes this kind of information available is, therefore, of great relevance. This work presents a support system to the management of corporate security for the storage, retrieval and help in constructing attack scenarios and related information. If an incident occurs in a corporation, an expert must access the system to store the specific attack scenario. This scenario, made available through controlled access, must be analyzed so that effective decisions or actions can be taken for similar cases. Besides the strategy used by the attacker, attack scenarios also exacerbate vulnerabilities in devices. The access to this kind of information contributes to an increased security level of a corporation's network devices and a decreased response time to occurring incidents

Otimização Topológica com Termo-elasticidade Utilizando Elementos Tri3

This work proposes a formulation for optimization of 2D-structure layouts submitted to mechanic and thermal shipments and applied an h-adaptive filter process which conduced to computational low spend and high definition structural layouts. The main goal of the formulation is to minimize the structure mass submitted to an effective state of stress of von Mises, with stability and lateral restriction variants. A criterion of global measurement was used for intents a parametric condition of stress fields. To avoid singularity problems was considerate a release on the stress restriction. On the optimization was used a material approach where the homogenized constructive equation was function of the material relative density. The intermediary density effective properties were represented for a SIMP-type artificial model. The problem was simplified by use of the method of finite elements of Galerkin using triangles with linear Lagrangian basis. On the solution of the optimization problem, was applied the augmented Lagrangian Method, that consists on minimum problem sequence solution with box-type restrictions, resolved by a 2nd orderprojection method which uses the method of the quasi-Newton without memory, during the problem process solution. This process reduces computational expends showing be more effective and solid. The results materialize more refined layouts with accurate topologic and shape of structure definitions. On the other hand formulation of mass minimization with global stress criterion provides to modeling ready structural layouts, with violation of the criterion of homogeneous distributed stress

Otimização topológica de estruturas termoelásticas tridimensionais

This work presents an optimization technique based on structural topology optimization methods, TOM, designed to solve problems of thermoelasticity 3D. The presented approach is based on the adjoint method of sensitivity analysis unified design and is intended to loosely coupled thermomechanical problems. The technique makes use of analytical expressions of sensitivities, enabling a reduction in the computational cost through the use of a coupled field adjoint equation, defined in terms the of temperature and displacement fields. The TOM used is based on the material aproach. Thus, to make the domain is composed of a continuous distribution of material, enabling the use of classical models in nonlinear programming optimization problem, the microstructure is considered as a porous medium and its constitutive equation is a function only of the homogenized relative density of the material. In this approach, the actual properties of materials with intermediate densities are penalized based on an artificial microstructure model based on the SIMP (Solid Isotropic Material with Penalty). To circumvent problems chessboard and reduce dependence on layout in relation to the final optimal initial mesh, caused by problems of numerical instability, restrictions on components of the gradient of relative densities were applied. The optimization problem is solved by applying the augmented Lagrangian method, the solution being obtained by applying the finite element method of Galerkin, the process of approximation using the finite element Tetra4. This element has the ability to interpolate both the relative density and the displacement components and temperature. As for the definition of the problem, the heat load is assumed in steady state, i.e., the effects of conduction and convection of heat does not vary with time. The mechanical load is assumed static and distributed

Análise ultraestrutural da interação de Curtobacterium flaccumfaciens pv. flaccumfaciens em genótipos de feijoeiro

Observações com microscopia eletrônica de transmissão em secções ultrafinas de células de caules de feijoeiros (Phaseolus vulgaris L.), inoculados com Curtobacterium flaccumfaciens pv. flaccumfaciens (Cff), mostraram alterações nos vasos de xilema em genótipos de feijoeiros altamente resistentes, como formação de estrutura semelhante a tilose e presença de fibrilas ao redor das células bacterianas. em genótipos suscetíveis, Cff colonizou além de vasos de xilema, células parenquimáticas e metaxilema.

Murcha por Ceratocystis em eucalipto: avaliação de resistência e análise epidemiológica

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

Aplicação de microemulsão na recuperação de petróleo de reservatórios carbonáticos

The large investment in exploration activities offshore Brazil has generated new findings, generally in carbonate reservoirs, with different wettability conditions usually considered in the sandstone, strongly water-wet. In general, the carbonates reservoirs tend to be oil-wet, it difficult to mobilize of oil these reservoirs. These oils can be mobilized by different methods, or it may reverse the wettability of the surface of the reservoir and facilitate the flow of oil, improving production rates. Thus, the objective of this work was to study the influence of inversion on the wettability of the rock in the production and recovery of petroleum from carbonate reservoirs, using microemulsions. Three systems were chosen with different classes of surfactants: a cationic (C16TAB), an anionic (SDS) and nonionic (Unitol L90). Studies of the influence of salinity on the formation of the microemulsion as well as the characterization of fluids using density and viscosity measurements were also performed. To verify the potential of microemulsion systems in changing the wettability state of the chalk oil-wet to water-wet, contact angle measurements were performed using chalk of neutral-wet as surface material. Overall, with respect to the ionic character of the surfactants tested, the cationic surfactant (C16TAB) had a greater potential for reversal in wettability able to transform the rock wettability neutral to strongly water-wet, when compared with the anionic surfactant (SDS) and nonionic (Unitol L90), which showed similar behavior, improving the wettability of the rock to water. The microemulsions of all surfactants studied were effective in oil recovery, resulting in 76.92% for the system with C16TAB, 67.42% for the SDS and 66.30% for Unitol L90 of residual oil

Projeto e Operação em Escala Semi-Industrial de um Equipamento para Tratamento de Águas Produzidas na Indústria do Petróleo Utilizando Nova Tecnologia: misturador-decantador à inversão de fases - MDIF

The aim of this work is to use a new technology in the treatment of produced wastewaters from oil industry. An unit for treat produced waters called UTMDIF, was designed, installed and operated in an industrial plant for treatment of effluents from oil industry. This unit operates by means of the method of separation of phase inversion and can become a promising alternative to solve the problem of oil/water separation. This method constitutes the basis of the working of a new design of mixersettler of vertical configuration which occupies small surface area. The last characteristic becomes specially important when there is limitation on the lay-out of the plant, for example, over maritime platforms to explore oil. This equipment in a semi-industrial scale treats produced wastewaters contaminated with oil at low concentrations (ranging from 30 to 150 mg/L) and throughputs of 320 m3/d (47,4 m3 m-2 h-1). Good results were obtained in oil/water separation which leads to the necessary specification to discharge those wastewaters. Besides, the non dependence of the efficiency of separation in spite of the salinity of the medium becomes the equipment an attractive new technology to treat wastewaters containing oil at low concentrations

Alterações posturais em atletas brasileiros do sexo masculino que participaram de provas de potência muscular em competições internacionais

Os esportes de alto nível determinam padrões corporais que extrapolam barreiras geopolíticas, sociais e culturais. Estas peculiaridades resultam em alterações posturais que estão associadas à eficiência do gesto desportivo, porém, em longo prazo, podem evoluir para processos mórbidos que limitam a prática de atividades físicas regulares. O objetivo da pesquisa foi descrever o perfil postural dos atletas que participam de provas de potência muscular e identificar processos anátomo-cinesiológicos responsáveis pelas principais alterações corporais. A casuística foi composta por 15 atletas do sexo masculino, especializados em provas de potência muscular. O protocolo para coleta de dados foi elaborado com base na proposta de: i) Kendall, para o exame físico e observacional, utilizando simetrógrafo e fio de prumo; ii) Souchard, para a análise postural em cadeia. As informações foram organizadas sob a forma de distribuição de freqüência absoluta e relativa. Os resultados apontaram que: i) o tornozelo em valgo (67%) foi a situação mais comum; ii) a rotação interna da pelve à direita (60%), seguida do lado oposto mais elevado (47%), pode estar relacionada com a corrida em curva que sobrecarrega a estrutura da pelve para a manutenção da velocidade com simultânea mudança de direção em função da força gravitacional; iii) a anteversão de pelve (73%) decorre da retração observada nos músculos flexores do quadril e extensores do joelho; iv) a alteração expressa no item iii contribui para a formação de hiperlordose lombar (73%) e desencadeia mecanismo compensatório de retração da cadeia posterior causando cifose torácica (53%) e cabeça em protrusão (73%). O diagnóstico precoce e a adoção de medidas profiláticas efetivas podem contribuir para o aumento da performance, bem como prevenir a ocorrência de lesões desportivas. Estudos envolvendo intervenção fisioterápica deverão avaliar se há redução dos efeitos crônicos que as alterações posturais decorrentes do treinamento causam ao atleta de alto nível.