Adesão ao tratamento, acesso e qualidade da assistência em Aids no Brasil

A adesão à terapia antirretroviral (TARV) é crucial para a efetividade e o impacto do tratamento da Aids. Este artigo discute as relações entre adesão e qualidade dos serviços de assistência a pessoas vivendo com Aids (PVA), evidenciando a qualidade como elo central entre adesão e acesso. Está baseado nos resultados de pesquisas que conduzimos sobre a atenção a PVA no Brasil. Nossos estudos apontam que os grupos de pacientes acompanhados em serviços com número inferior a 100 pacientes apresentam risco estimado de não adesão maior do que os grupos acompanhados em serviços com mais de 500 pacientes. Apontam também que serviços com menos de 100 pacientes têm risco estimado maior de pertencer a grupos de má qualidade. Isto está relacionado à baixa complexidade observada nos serviços de menor porte caracterizada por: dificuldades em manter uma estrutura mínima de recursos humanos e materiais, simplificação da organização dos processos de trabalho, centramento no trabalho autônomo do profissional médico e gerenciamento sem projeto técnico. Há necessidade de pautar novos estudos sobre adesão e qualidade. As evidências existentes já apontam, porém, a necessidade de revisão na alocação dos serviços de assistência a PVA, bem como a de homogeneizar a qualificação destes serviços, condições necessárias para a manutenção de taxas aceitáveis de adesão à TARV no país.

Radiographic study of distal radial physeal closure in thoroughbred horses

Monthly radiography was performed to study distal radial physeal closure in ten male and ten female Throughbred horses. The height, thoracic circumference and metacarpus circumference were also measured, Distal radial physeal closure time was sooner in females than males, and took 701 +/- 37 and 748 +/- 55 days respectively.

Optimal capacitor placement in radial distribution networks

The capacitor placement (replacement) problem for radial distribution networks determines capacitor types, sizes, locations and control schemes. Optimal capacitor placement is a hard combinatorial problem that can be formulated as a mixed integer nonlinear program. Since this is a NP complete problem (Non Polynomial time) the solution approach uses a combinatorial search algorithm. The paper proposes a hybrid method drawn upon the Tabu Search approach, extended with features taken from other combinatorial approaches such as genetic algorithms and simulated annealing, and from practical heuristic approaches. The proposed method has been tested in a range of networks available in the literature with superior results regarding both quality and cost of solutions.

Optimization of Radial Basis Function neural network employed for prediction of surface roughness in hard turning process using Taguchi's orthogonal arrays

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Performance of low/correct pressure radial ply tires

Extensive field testes were conducted using the UCD single wheel tester employing three large radial ply tractor tires in two different soils, four different soil conditions, two axle load levels, and three levels of tire inflation pressures in order to quantify the benefits of using low/correct inflation pressures. During these tests slip, net traction, gross traction, and dynamic axle load were recorded. Furthermore, soil moisture content, cone index, and dry bulk density data were obtained at test locations. The results of the analysis showed a significant increase in net traction and traction efficiency when low/correct inflation was used. Benefits of using low/correct pressure was higher in tilled soil conditions.

Respostas comportamentais de vacas holandesas, com acesso à sombra constante ou limitada

The experiment was carried out at Piracicaba, São Paulo, Brazil, from January to February 1993, with the objective of evaluating the behavior responses of Holstein cows, with constant or limited access to shade. The experimental design used was completely randomized. Twenty four dairy cows were used, at different lactation stages and production levels, kept in two free stall barns, with or without protection against solar radiation in south-east and north-west edge. The behavior parameters studied were: alimentation, rumination, rest time and frequency and water ingestion frequency. The protection of the free stall barn didn't affect the behavior responses. The alimentation, rumination and rest time, daily, were 3.4, 7.0 e 9.0 hours, respectively. The highest alimentation frequencies were before and after milking. The rumination was mainly during nocturnal period; the rest was more frequent during the period with higher solar radiation. The animals stayed more time in the shelter (13.4 vs 2.5 h/day). The highest daily water ingestion frequencies were in the hot time and next milking, mainly.

Transient flow of the oil-refrigerant mixture through the radial clearance in rolling piston compressors

Unsteady flow of oil and refrigerant gas through radial clearance in rolling piston compressors has been modeled as a heterogeneous mixture, where the properties are determined from the species conservation transport equation coupled with momentum and energy equations. Time variations of pressure, tangential velocity of the rolling piston and radial clearance due to pump setting have been included in the mixture flow model. Those variables have been obtained by modeling the compression process, rolling piston dynamics and by using geometric characteristics of the pump, respectively. An important conclusion concerning this work is the large variation of refrigerant concentration in the oil-filled radial clearance during the compression cycle. That is particularly true for large values of mass flow rates, and for those cases the flow mixture cannot be considered as having uniform concentration. In presence of low mass flow rates homogeneous flow prevail and the mixture tend to have a uniform concentration. In general, it was observed that for calculating the refrigerant mass flow rate using the difference in refrigerant concentration between compression and suction chambers, a time average value for the gas concentration should be used at the clearance inlet.

An analog implementation of radial basis neural networks (RBNN) using BiCMOS technology

This paper describes a analog implementation of radial basis neural networks (RBNN) in BiCMOS technology. The RBNN uses a gaussian function obtained through the characteristic of the bipolar differential pair. The gaussian parameters (gain, center and width) is changed with programmable current source. Results obtained with PSPICE software is showed.

Estudo comparativo de vias de acesso cirúrgico na contracepção cirúrgica feminina: Microlaparoscopia versus minilaparotomia

Purpose: to compare in a retrospective way, 51 women who underwent tubal ligation, 30 through microlaparoascopy (Gmicrol) and 21 through minilaparotomy (Gminil). Methods: the analyzed parameters were: total time for accomplishment of the procedure and the surgical technique, time of hospital stay and return to the habitual activities after the surgery, postoperative pain, morbidity, satisfaction degree and esthetic effect, considering values of p<0,05 as significant, and also standard cost. Results: Gmicrol took less time to accomplish the surgery than the Gminil (43 against 57 minutes respectively, p<0,05), less time to accomplish the surgical technique (6.48 against 30.32 minutes respectively, p<0,05), and lower hospital stay (9,90 hours as against 41,7 hours respectively, p <0,05). There was no significant difference between the two groups regarding time to return to the habitual activities after surgery. To evaluate postoperative pain, a scale of 0-10 it was applied. Gmicrol present a lower pain score on the 1st and 2nd postoperative days (1.13 and 0.26 to Gmicrol and 4.52 and 1.14 to Gminil, respectively, p<0,05). There was no significant difference between immediate postoperative the most common complaint being pain at the site of pain and that on the 3rd postoperative day. Gminil presented a higher morbidity rate incision. To evaluate the satisfaction degree and esthetic effect, numeric values were attributed to as good, regular, poor and very bad as answered by the patiets. Gmicrol presented a higher satisfaction degree (p<0,05) and better esthetic effect as compared to Gminil (p <0,05). The microlaparoscopy standard cost was R$ 109.30 being lower than that of minilaparotomy. Conclusions: tubal ligation by microlaparoscopy, under local anesthesia and conscious sedation presented some advantages compared to minilaparotomy.

An approach based on neural networks for identification of fault sections in radial distribution systems

The main objective involved with this paper consists of presenting the results obtained from the application of artificial neural networks and statistical tools in the automatic identification and classification process of faults in electric power distribution systems. The developed techniques to treat the proposed problem have used, in an integrated way, several approaches that can contribute to the successful detection process of faults, aiming that it is carried out in a reliable and safe way. The compilations of the results obtained from practical experiments accomplished in a pilot radial distribution feeder have demonstrated that the developed techniques provide accurate results, identifying and classifying efficiently the several occurrences of faults observed in the feeder.

Artificial immune systems applied to optimal capacitor placement in radial distribution networks

The capacitor placement problem for radial distribution networks aims to determine capacitor types, sizes, locations and control scheme. This is a combinatorial problem that can be formulated as a mixed integer nonlinear program. The paper presents an algorithm inspired in artificial immune systems and developed for this specific problem. A good performance was obtained through experimental tests applied to known systems. © 2006 IEEE.

Radial basis function network applied to the linearization of a voltage controlled oscillator

An analog circuit that implements a radial basis function network is presented. The proposed circuit allows the adjustment of all shape parameters of the radial functions, i.e., amplitude, center and width. The implemented network was applied to the linearization of a nonlinear circuit, a voltage controlled oscillator (VCO). This application can be classified as an open-loop control in which the network plays the role of the controller. Experimental results have proved the linearization capability of the proposed circuit. Its performance can be improved by using a network with more basis functions. Copyright 2007 ACM.

Radial basis function networks with quantized parameters

A RBFN implemented with quantized parameters is proposed and the relative or limited approximation property is presented. Simulation results for sinusoidal function approximation with various quantization levels are shown. The results indicate that the network presents good approximation capability even with severe quantization. The parameter quantization decreases the memory size and circuit complexity required to store the network parameters leading to compact mixed-signal circuits proper for low-power applications. ©2008 IEEE.

Acesso a medicamentos essenciais em farmácias e drogarias do Município de Araraquara

A survey to determine the availability of 20 essential medicines for the diseases with highest prevalence in primary health care was conducted in the city of Araraquara. The presence and the price of these medicines in private sector pharmacies and drugstores of the city were recorded. Two forms, recommended by the WHO, were used in the survey, one for availability and the other for prices. The drugs most commonly available in pharmacies and drugstores were: propranolol (90.5%), captopril (96%) and ranitidine (96%), while the least available were ferrous sulfate (27%), beclomethasone (33.8%) and ibuprofen (41.9%). The drugs that showed the greatest variation among the prices charged were: propranolol (97.1%), hydrochlorothiazide (96.4%) and glibenclamide (95.0%), while the least variable were salbutamol (30.8%) and trimethoprim-sulfamethoxazole (30.2%). Generic drugs, which were half (10) of those assessed, had the lowest prices. The indicators of access, referring to the ability of patients to acquire drugs for the treatment of major diseases at the primary health care level, showed that no establishment stocked all 20 essential drugs and that wide variations existed in their prices, undermining their availability to drug users, whose only sources are pharmacies and drugstores. These data demonstrate the importance of the popular pharmacy to improve the access to medicines, by lowering the cost and increasing the availability of the items selected for the National List of Essential Drugs (RENAME).