Efeitos de um programa de intervenção precoce baseado no modelo mais que palavras - HANEN, para crianças menores de três anos com risco de autismo

In the last decades, studies on early intervention involving children with autism have suggested that there is no single intervention model capable of addressing the needs of all individuals in the spectrum. The role of parents as active intervention agents is, however, highly recommended. The More Than Words-HANEN Program has been specifically created for parents of children, under five years of age, who are in the autism spectrum. This intervention aims at improving the social competence and language comprehension of the child, as well as their parents empowerment. Until now only three studies have been performed in order to evaluate the effectiveness of the HMTW program. The purpose of this investigation is to evaluate the effects of an early intervention program inspired on HMTW model on the level of caregiver responsiveness and child communication skills. The present study adds to the existing research literature on family-centered early intervention that uses a developmental paradigm. A two year boy in risk for autism, his mother and nanny took part in this investigation, which was carried out in the child´s home in Mossoró, Rio Grande do Norte. The caretakers were given one fifty-two hours of training, divided into thirteen weekly meetings. A quasi-experimental A-B-C design (baselineintervention- follow-up) showed improvement in the caretakers level of responsiveness and meaningful social-communicative gains in the child´s response

Qualidade de vida na perspectiva de idosos institucionalizados no Município de Natal - RN

A descriptive and exploratory Study, quantitative in nature, with the aim to assess the Quality of Life (QL) of the elderly leaving in a Long Residence Institution (LRI) according to their own perception. It was conducted in six Public Institutions of Long Residence for Seniors, in the municipality of Natal - RN, in the period of July to August 2007. The data was collected using two structured interview forms: the first, containing questions about socio-demographic aspects and the second - the WHOQUOL-OLD, prepared by the World Health Organization to assess elderly s quality of life. The reference population was 266 old persons, and a random sample, of 43, being 28 women and 15 men, who account for 30%. The results indicated there is a predominance of older women (65.1%) and the average age is 76.6 years; the predominant religion is the Catholic - 44.2% and, 32.6% are unmarried without children. As for schooling and precedence, 41.9% are illiterate and 67.4% come from the rural area. The time of residency in the institution goes between 1 to 5 years for 69.8% of the elderly, 37.2% of them residing in the institution for not having another option. Most elderly informed using medicines. 51.3% said they are taking anti-hypertensive. As for the other aspects of QL: sensory aspects, autonomy, past, present and future activities, social participation, death and dying and intimacy, the WHOQOL-OLD, showed an average total score of 52.9% (scale of 0 to 100), with a tendency to neutrality, denoting that the elderly, in this study, evaluated their QL as neither satisfactory or unsatisfactory. Of all the facets of the instrument of QL, the sensory facet secured the highest average scores (68,1%), showing that the elderly are "happy" in the situation in which they find themselves, not showing significant disabilities. The facet of autonomy, which refers to the independence and the ability to make decisions on their own life, received the lowest average scores (40.7%), showing the dissatisfaction of the elderly on this aspect. The evaluation of the elderly on other facets were: social participation (48.2%); activities past, present and future (44.6%) and intimacy (50.6%), all perceived as neither unsatisfactory or satisfactory. On the item death and dying, the elderly people declared themselves satisfied, with average score of 65.5%. The analysis of the reliability of the WHOQOL-OLD by the Cronbach Alpha showed 0.57, considering the 24 items that cover the instrument, showing regular internal reliability of the instrument, in our reality. The result is probably due to differences between the regions south and east and the broader sociocultural diversity. We believe that the elderly in this study, tended to realize their QL as neutral, considering it as neither unsatisfactory or satisfactory, result likely related to the resignation with the destine, characterized, at the time, by the finitude of life, feeling very common among elderly, or perhaps, even for an accommodation, often accompanied by discouragement, present in the daily life of many of them

Trajetória do hospital dia Dr. Elger nunes: um recorte histórico da psiquiatria e saúde mental no Rio Grande do Norte

In Brazil, the mental health network proposed by the Psychiatric Reform inserts the intermediate and replacement services in the pursuit of alignment or resocialization of patients with mental and behavioral disorder in the community. Was adopted, among other services, the Center for Psychosocial Care, Home Therapy, Sheltered Home, Day Hospital and psychiatric beds in general hospital. In this context, the State of Rio Grande do Norte implanted the Day Hospital Dr. Elger Nunes (HDEN) in Natal / RN in 1996, linked to State Department of Public Health. At HDEN happened a multi and interdisciplinary therapeutic work, besides being the scene of disciplinary practices, and extension projects for graduate courses in Higher Education Institutions in the city. However, with the process of decentralization of local services, the hospital was terminated by an administrative state act in 2006, leaving damage to the activities provided to users, disciplinary practices and extension activities. From this breakdown, the objective was to narrate the trajectory of HDEN through a multidisciplinary team of professionals and teachers who used it as a field of disciplinary practices. It is characterized as a documental and qualitative, backed in the technique of thematic oral history, following the phases: authorization of the interviewee, interview recording, transcription, textualization and transcreation of the material obtained. We used documents, ordinances, general reports of activities, among others, plus interviews to fifteen employees who used this service, being thirteen part of the multidisciplinary team of professionals and two graduation professors of health care area, nursing and medicine. The stories collected were organized according to the technique chosen, respecting its steps. In preparing the body subjected to ALCESTE computer program, priority was given to the vital tone for the formation of categories and classes elected by the program, structured in three thematic areas. In the first axis, called Trajectory of HDEN, were recalled the beginning of its activities, the steps of that time, their activities, and its actors - users, families, professionals, and teaching practices. The second axis has dealt with the process of extinction of HDEN, rescuing the feelings of employees, the main reasons given at the time and immediate postextinction scenario. And the third axis revealed in an articulated form the situation of mental health in Natal / RN, listing to the challenges and prospects for the psychosocial care, starting from the trajectory of HDEN with emphasis on activities. Moreover, the trajectory of HDEN provides recognition of the historical basis outlined in the constitution of the network of substitute services present in the current scenario of psychosocial care in the city of Natal and in RN.

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Efficiency of a constructed wetland for wastewaters treatment

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

Trauma em idosos atendidos pelo serviço pré-hospitalar móvel

O The aim of this study was to characterize the occurrence of trauma in the elderly population served by the mobile pre-hospital service, in Natal, Rio Grande do Norte. This is a descriptive, transversal and quantitative approach and whose population consisted of 2,080 trauma victims. The sample, of systematic random type, consisted of 400 elderly people, aged from 60 years old, assisted by the Office of Mobile Emergency in Natal / RN, between January 2011 and December 2012. Data collection began after consent and assent of the institution of a Research Ethics Committee under No. 309 505. It was proceeded to documentary retrospective analysis of records of this service through a form of self-development, validated by expert judges considered reliable (α> 0.75) and valid (CVI = 0.97) in their clarity and relevance. Data were tabulated by the Statistical Package for Social Sciences, version 20.0. The results show that older victims have an average age of 74.19 years old, with a prevalence of female involvement by chronic diseases, especially hypertension, average usage of 2.2 routine medications with vital signs within normal limits. The trauma prevailed during the daytime, in the residence of the victims, north of the city and on weekends. Among the mechanisms of trauma were falls, traffic accidents and physical aggression, whose most common type was brain-cerebral trauma and the main consequences were suture wounds and closed fractures. Basic Support Units were as more driven to pre-hospital care (87.8%) and the main destination place consisted of a referral hospital for emergency of the state (57.5%). Among the most commonly performed procedures by nursing staff immobilization with rigid board and neck collar and the peripheral venipuncture, and the main component used for volume replacement to saline were highlighted. There was a significant relationship between the deaths and the mechanism of injury, mechanism of injury and procedures, except medication administration procedures carried out, except immobilization and unit for service. It is highlighted the prevalence of trauma in the elderly, poor follow-up Pre-Hospital Trauma Life Support protocol and the paucity of records and nursing procedures performed. There is need for a protocol of care specific to elderly trauma victims and education strategies for the prevention of such events

Responsabilidade social e competitividade :um estudo sobre a influência de práticas sociais na decisão de escolha de um destino turístico

The work objective was to investigate the influence of social practices social in the choise decision of a tourist destination. For in such a way, a survey with the aid of a questionnaire, was used as being the research instrument. The study used a simple random sample without replacement, due to elements of the population had a equal probability different of zero, to be selected for forming part of the sample. The used collection method of data was personal interview. The data was collected at Augusto Severo International Airport at the moment in which tourists were embarking in return to the residence place or another tourist destination. For determination of sample size, it was considered the tourist who had visited Natal in November and December, 2004, supplied by the Secretariat of Tourism in the RN. The sample for the research was of 403 people. Results showed that the interviewed express the existence of high level of competitiveness in the tourism industry. It was observed that 42.5% of the interviewed believes to exist a very aggressive competition, and 47.5% believed that the competition is aggressive in the tourism industry. 10.4% of the interviewed expressed much interest in knowing about social practices in the tourism industry and 2.8% had not presented any interest in knowing about social practices in the tourism industry. For the interviewed, the travel agency image is a significant item in the choice for a tourist package, because of 35.6% believed that this factor is very important in the choice. 5% of the interviewed only find that little important or that sometimes the travel agency image can be seen as s decisive factor in the tourist package choice

Desenvolvimento e implementação de um sistema de supervisão e controle residencial

With the technological progress the people are more and more looking for convenience, comfort and safety to your homes. The residential automation is winning space on the market not only by the status and modernity that provide, but also to allow a better use of natural resources, reducing the expense to keep up a residence. This work shows the development of a control system and supervision to be destined to the residential automation. The developed software will be working together with a controller (PLC), acting in the administration, control and supervision all the linked devices, and offering to the user an environment simple and practical for the control residence

Análise do desempenho térmico de um sistema de aquecimento solar utilizando coletor com superfície absorvedora em chapas de PVC

It s presented a solar collector to be used in a system for heating bath water, whose main characteristic is its low cost. The collector consists of five plates of PVC with 10 mm thick, 200 mm in width and 1400mm in length, with an area equal to 1.4 square meters. The plates were connected in parallel to the ends of PVC tubes of  40 mm and 32 mm. The plates were coated on one side with aluminum sheets of soft drinks and beers cans open. The system worked on a thermosiphon and was tested in two configurations: the plates uncoated and coated with aluminum material, to determine the influence of material on the efficiency of the collector. For both configurations was used EPS plates below the surface to minimize heat losses from the botton. The thermal reservoir of the heating system is, also, alternative and low cost, since it was constructed from a polyethylene tank for storing water, with volume of 150 end 200 liters. It will be presented the thermal efficiency, heat loss, water temperature of the thermal reservoir at the end of the process and simulation of baths for a house with four residents. The will be demonstrated thermal, economic and material viability of the proposed collector, whose main innovation is the use of recyclables materials, cans of beer and soft drinks, to increase the temperature of the absorber plate.

Compósito para fabricação de blocos para construção de casas: estudos térmico e de materiais

We present two models of blocks made of composite material obtained from the use of cement, plaster, EPS crushed, shredded tire, mud, sand and water, for the construction of popular housing. Were made metal molds for the manufacture of blocks to be used in the construction of a residence for low-income families. Performed tests of compressive strength of the composite for various formulations that met the specific standard for blocks used in construction. To study the thermal conductivity of the composite for further study of thermal comfort generated in a residence built with the proposed composite. We also determined the mass-specific and water absorption for each formulation studied. Using a home already built with another composite material, made up the closing of a window with the building blocks and found the thermal insulation, measuring external and internal temperatures of the blocks. The blocks had made good thermal insulation of the environment, resulting in differences of up to 12.6°C between the outer and inner faces. It will be shown the feasibility of using composite for the end proposed and chosen the most appropriate wording

Estudo da hidrodinâmica de um novo separador líquido-líquido: aplicação ao sistema óleo-bruto/água produzida

This work aims to use a different hydrodynamic condition applied to a new design of mixer-settler on treating wastewater produced by petroleum industry, called MDIF (Misturador-Decantador à Inversão de Fases/ Mixer-Settler based on Phase Inversion MSPI). The use of this different hydrodynamic behaviour is possible due to vertical disposition of the device and the principle of Phase Inversion that controls the MDIF, providing the generation (creation) of a cascade of drops, into an organic layer, that works as micro-decanters, thus making possible the formation of a bed of non-coalesced drops, called Bed Formation . The use of this new hydrodynamics condition allows to increase the residence time of the oil carrier drops, into an organic layer, and the device can treat a greater volume of wastewater. In view of to get this condition it is necessary to operate at high throughput (58,6 m3.m-2.h-1). By results, the condition of Bed Formation is the best one to be used when MSPI operates with throughput up to 58,6 m3.m-2.h-1. The results using the condition of Bed Formation show that increasing the height of the bed of non-coalesced drops and/or decreasing the volumetric ratio (O/A) an increase of the separation efficiency is detected

Recuperação e purificação de quitosanases usando adsorção em leito expandido com streamline DEAE com modelagem e simulação usando redes neurais

Expanded Bed Adsorption (EBA) is an integrative process that combines concepts of chromatography and fluidization of solids. The many parameters involved and their synergistic effects complicate the optimization of the process. Fortunately, some mathematical tools have been developed in order to guide the investigation of the EBA system. In this work the application of experimental design, phenomenological modeling and artificial neural networks (ANN) in understanding chitosanases adsorption on ion exchange resin Streamline® DEAE have been investigated. The strain Paenibacillus ehimensis NRRL B-23118 was used for chitosanase production. EBA experiments were carried out using a column of 2.6 cm inner diameter with 30.0 cm in height that was coupled to a peristaltic pump. At the bottom of the column there was a distributor of glass beads having a height of 3.0 cm. Assays for residence time distribution (RTD) revelead a high degree of mixing, however, the Richardson-Zaki coefficients showed that the column was on the threshold of stability. Isotherm models fitted the adsorption equilibrium data in the presence of lyotropic salts. The results of experiment design indicated that the ionic strength and superficial velocity are important to the recovery and purity of chitosanases. The molecular mass of the two chitosanases were approximately 23 kDa and 52 kDa as estimated by SDS-PAGE. The phenomenological modeling was aimed to describe the operations in batch and column chromatography. The simulations were performed in Microsoft Visual Studio. The kinetic rate constant model set to kinetic curves efficiently under conditions of initial enzyme activity 0.232, 0.142 e 0.079 UA/mL. The simulated breakthrough curves showed some differences with experimental data, especially regarding the slope. Sensitivity tests of the model on the surface velocity, axial dispersion and initial concentration showed agreement with the literature. The neural network was constructed in MATLAB and Neural Network Toolbox. The cross-validation was used to improve the ability of generalization. The parameters of ANN were improved to obtain the settings 6-6 (enzyme activity) and 9-6 (total protein), as well as tansig transfer function and Levenberg-Marquardt training algorithm. The neural Carlos Eduardo de Araújo Padilha dezembro/2013 9 networks simulations, including all the steps of cycle, showed good agreement with experimental data, with a correlation coefficient of approximately 0.974. The effects of input variables on profiles of the stages of loading, washing and elution were consistent with the literature

Recuperação e purificação de proteínas do soro de queijo tipo coalho usando cromatografia de troca iônica e interação hidrofóbica em leito na forma expandida

Expanded Bed Adsorption plays an important role in the downstream processing mainly for reducing costs as well as steps besides could handling cells homogenates or fermentation broth. In this work Expanded Bed Adsorption was used to recover and purify whey proteins from coalho cheese manufacture using Streamline DEAE and Streamline SP both ionic resins as well as a hydrophobic resin Streamline Phenyl. A column of 2.6 cm inner diameter with 30 cm in height was coupled to a peristaltic pump. Hydrodynamics study was carried out with the three resins using Tris-HCl buffer in concentration of 30, 50 and 70 mM, with pH ranging from 7.0 to 8.0. In this case, assays of the expansion degree as well as Residence Time Distribution (RTD) were carried out. For the recovery and purification steps, a whey sample of 200 mL, was submitted to a column with 25mL of resin previously equilibrated with Tris/HCl (50 mM, pH 7.0) using a expanded bed. After washing, elution was carried out according the technique used. For ionic adsorption elution was carried out using 100 mL of Tris/HCl (50 mM, pH 7.0 in 1M NaCl). For Hydrophobyc interaction elution was carried out using Tris/HCl (50 mM, pH 7.0). Adsorption runs were carried out using the three resins as well as theirs combination. Results showed that for hydrodynamics studies a linear fit was observed for the three resins with a correlation coefficient (R2) about 0.9. In this case, Streamline Phenyl showed highest expansion degree reaching an expansion degree (H0/H) of 2.2. Bed porosity was of 0.7 when both resins Streamline DEAE and Streamline SP were used with StremLine Phenyl showing the highest bed porosity about 0.75. The number of theorical plates were 109, 41.5 and 17.8 and the axial dipersion coefficient (Daxial) were 0.5, 1.4 and 3.7 x 10-6 m2/s, for Streamline DEAE, Streamline SP and Streamline Phenyl, respectively. Whey proteins were adsorved fastly for the three resins with equilibrium reached in 10 minutes. Breakthrough curves showed that most of proteins stays in flowthrough as well as washing steps with 84, 77 and 96%, for Streamline DEAE, Streamline SP and Streamline Phenyl, respectively. It was observed protein peaks during elution for the three resins used. According to these peaks were identified 6 protein bands that could probably be albumin (69 KDa), lactoferrin (76 KDa), lactoperoxidase (89 KDa), β-lactoglobulin (18,3 KDa) e α-lactoalbumin (14 KDa), as well as the dimer of beta-lactoglobulin. The combined system compound for the elution of Streamline DEAE applied to the Streamline SP showed the best purification of whey proteins, mainly of the α-lactoalbumina

Ephemeroptera, Plecoptera and Trichoptera assemblages in litter in a mountain stream of the Atlantic Rainforest from Southeastern Brazil

A fauna de Ephemeroptera, Plecoptera e Trichoptera associadas ao folhiço em um riacho do sudeste do Brasil foi estudada com o objetivo de responder às seguintes questões: 1) A riqueza e a composição faunística de EPT difere entre os dois mesohabitats (corredeira-remanso) mesmo quando associadas ao mesmo substrato, folhiço? 2) A similaridade da fauna de EPT entre os dois mesohabitas muda temporalmente? 3) A estrutura funcional de EPT difere entre os dois mesohabitats (corredeira-remanso)? Para responder essas questões, coletas mensais, de novembro de 1999 a junho de 2000, foram feitas no Ribeirão Bocaina com rede D (10 acúmulos de folhas em remanso e 10 em corredeira). A fauna de EPT do Ribeirão Bocaina foi mais diversificada e mais abundante no folhiço em corredeira do que no folhiço em remanso, no entanto, quando a riqueza foi padronizada para o mesmo número de indivíduos essa se tornou similar para as duas condições. A fauna de EPT foi bastante diferente entre os dois mesohabitats, tanto em termos da composição faunística quanto em termos funcionais. Isso provavelmente ocorreu devido às diferenças de velocidade da água, no tempo de residência do folhiço e na taxa de oxigênio da água entre os dois mesohabitats.

Simulações da ação do vento e da dispersão de contaminantes no estuário do Rio Potengi/ Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior