Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente em unidades de terapia intensiva

The reports of adverse events date from 1990 up to the present day. Conceptually, these adverse events are unintentional injuries unrelated to the underlying disease, causing measurable lesions in patients, extending the period of hospitalization, or leading to death. These issues require discussions with regard to patient safety, improved quality of service, and preventing medical errors. In the Intensive Care Units, this concern is greater because these are sectors of intensive care to individuals with hemodynamic changes and imminent risk of death. Therefore, it is essential to conduct evaluation processes to investigate aspects of quality of nursing care and patient safety in these spaces. For that reason, we aimed to propose the Evaluation protocol of nursing care and patient safety in Intensive Care Units. For its achievement, we needed to: 1) analyze the evolution of the patient safety concept used in scientific productions, under Rodgers evolutionary concept; 2) identify the necessary items to build the evaluation protocol of nursing care and patient safety in the Intensive Care Unit, from the available evidence in literature; 3) construct an instrument for content validation of the evaluation protocol of nursing care and patient safety in the Intensive Care Unit; and 4) describe and evaluate the appropriateness of the content for an evaluation protocol of nursing care and patient safety in the Intensive Care Unit. This is a methodological study for the content validation of the abovementioned protocol. To meet the first three specific objectives, we used the integrative literature review in Theses Database of the Coordination for the Improvement of Higher Education Personnel and the portal of the Collaborating Centre for Quality of Care and Patient Safety. The fourth specific objective happened through the participation of judges, located from the Lattes curricula, in the content validation process developed in two stages: Delphi 1 and Delphi 2. As instrument, we used the electronic form of Google docs. We present in tables the answers from the evaluation instruments by Delphi consensus and Content Validity Index (CVI) of the entire protocol. We summarized the results in articles entitled Analysis of the patient safety concept: Rodgers evolutionary concept ; Scientific evidence regarding patient safety in the Intensive Care Unit ; Technological device for the content validation process: experience report ; and Evaluation protocol of nursing care and patient safety in Intensive Care Units. The Embodied Opinion of the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, No. 461,246, under CAAE 19586813.2.0000.5537, approved the study. Thus, we conclude the protocol valid in its content, constituting an important tool for evaluating the quality of nursing care and patient safety in Intensive Care Units

Melhoria da segurança pública: uma proposta para alocação de unidades policiais utilizando o modelo das p-medianas e do caixeiro viajante

The decrease in crime is one of the core issues that cause concern in society today. This study aims to propose improvements to public safety from the choice of points to the location of police units, ie the points which support the car and the police. For this, three models were developed in order to assist decision making regarding the best placement of these bases. The Model of Police Units Routing has the intention to analyze the current configuration of a given region and develop optimal routes for round preventative. The Model of Allocation and Routing for New Police Units (MARNUP) used the model of facility location called p-median weighted and traveling salesman problem (TSP) combined aiming an ideal setting for regions that do not yet have support points or to assess how far the distribution is present in relation to that found in solution. The Model Redefinition and Routing Unit Police (MRRUP) seek to change the current positioning taking into account the budgetary constraints of the decision maker. To verify the applicability of these models we used data from 602 points to instances of police command that is responsible for the capital city of Natal. The city currently has 31 police units for 36 of these 19 districts and police have some assistance. This reality can lead to higher costs and higher response times for answering emergency calls. The results of the models showed that in an ideal situation it is possible to define a distance of 500 km/round, whereas in this 900 km are covered by approximately round. However, a change from three-point lead reduced to 700 km / round which represents a decrease of 22% in the route. This reduction should help improve response time to emergency care, improving the level of service provided by the increase of solved cases, reducing police shifts and routing preventive patrols

Metaheurísticas evolutivas para o problema de roteamento de unidades móveis de pistoneio

This paper presents metaheuristic strategies based on the framework of evolutionary algorithms (Genetic and Memetic) with the addition of Technical Vocabulary Building for solving the Problem of Optimizing the Use of Multiple Mobile Units Recovery of Oil (MRO units). Because it is an NP-hard problem, a mathematical model is formulated for the problem, allowing the construction of test instances that are used to validate the evolutionary metaheuristics developed

Reconhecimento de voz através de unidades menores do que a palavra, utilizando Wavelet Packet e SVM, em uma nova estrutura hierárquica de decisão

The automatic speech recognition by machine has been the target of researchers in the past five decades. In this period have been numerous advances, such as in the field of recognition of isolated words (commands), which has very high rates of recognition, currently. However, we are still far from developing a system that could have a performance similar to the human being (automatic continuous speech recognition). One of the great challenges of searches for continuous speech recognition is the large amount of pattern. The modern languages such as English, French, Spanish and Portuguese have approximately 500,000 words or patterns to be identified. The purpose of this study is to use smaller units than the word such as phonemes, syllables and difones units as the basis for the speech recognition, aiming to recognize any words without necessarily using them. The main goal is to reduce the restriction imposed by the excessive amount of patterns. In order to validate this proposal, the system was tested in the isolated word recognition in dependent-case. The phonemes characteristics of the Brazil s Portuguese language were used to developed the hierarchy decision system. These decisions are made through the use of neural networks SVM (Support Vector Machines). The main speech features used were obtained from the Wavelet Packet Transform. The descriptors MFCC (Mel-Frequency Cepstral Coefficient) are also used in this work. It was concluded that the method proposed in this work, showed good results in the steps of recognition of vowels, consonants (syllables) and words when compared with other existing methods in literature

Estimação da demanda de instalações elétricas de edificações com múltiplas unidades de consumo

This work aims to predict the total maximum demand of a transformer that will be used in power systems to attend a Multiple Unit Consumption (MUC) in design. In 1987, COSERN noted that calculation of maximum total demand for a building should be different from that which defines the scaling of the input protection extension in order to not overestimate the power of the transformer. Since then there have been many changes, both in consumption habits of the population, as in electrical appliances, so that this work will endeavor to improve the estimation of peak demand. For the survey, data were collected for identification and electrical projects in different MUCs located in Natal. In some of them, measurements were made of demand for 7 consecutive days and adjusted for an integration interval of 30 minutes. The estimation of the maximum demand was made through mathematical models that calculate the desired response from a set of information previously known of MUCs. The models tested were simple linear regressions, multiple linear regressions and artificial neural networks. The various calculated results over the study were compared, and ultimately, the best answer found was put into comparison with the previously proposed model

Estudo e especificação de um sistema de instrumentação para unidades de elevação de petróleo utilizando tecnologia sem fio

Wireless sensor networks are reality nowadays. The growing necessity of connectivity between existing industrial plant equipments pushes the research and development of several technologies. The IEEE 802.15.4 LR-WPAN comes as a low-cost and powersaving viable solution, which are important concerns while making decisions on remote sensoring projects. This study intends to propose a wireless communication system which makes possible the monitoring of analogic and/or digital variables (i. e., the pressure studied) involved on the artificial methods for oil and gas lifting. The main issues are: To develop a software based on SMAC Standard in order to create a wireless network to monitoring analogic and/or digital variables; To evaluate the communication link based on the number of lost packets tested in different environments (indoor and outdoor) and To propose an instrumentation system consisting of wireless devices

Motivação para o trabalho: um estudo com os profissionais de saúde das unidades básicas de saúde do município de Natal RN

This thesis studied the motivation to work among health professionals of the Basic Unities (BUH) in the health network of the city of Natal (RN). It was understood that the work motivation is a process. Then, the expectation theory was applied and motivation components (results of work, expectative, valence, instrumentality, and motivational force) were used to analyses. It s understanding the motivation as multifaceted phenomenon, the psycho sociological perspective was adopted. The research was developed in two phases: one with application of Work Motivation and Meaning Inventory (WMMI), and another with interview. In the first phases, the analysis of results revealed that the major factors contributing to increase the motivational force to health professionals in the BUH´s are: in valence, Self Expression and Personal Realization (VF2), Personal and Family Survival (VF3); in expectative, Self Expression and Work Justice (EF1), Safety and Dignity (EF2) and Responsibility (EF4); in instrumentality, Involvement (IF1) and Recognition and Economic Independence (IF4). In opposition, the factors that more contribute to reduce the motivational force are Wear and Dehumanization factors in valence (VF4), in expectative (EF3), and in instrumentality (IF4), behind the Work Justice Factor (IF2). Basing in content analysis of interviews, it was possible to associate by equivalence, the senses presented by health professionals with obtained results of first phase, indicating that the results of second phase corroborated and complemented those of first one. This possibility broadened the comprehension of the studied phenomenon. In speaking of the respondents, it was visible the presence of contents showing that they perceive the Health System and BUH´s in degradation. In the first phase, the participants´ instruction also predict the results in motivation, and in the interviews can be saw that the instruction is associated with the opportunities in outside of system. As work motivation is a process, the impact of personal and occupational characteristics tend to interact with contextual aspects. It was concluded the majority of health professionals present the moderated motivational force, but it was falling because they experience and perceive a degrading context with work condition increasingly unfavorable.

O ecoturismo sob a égide da sociedade do consumo: um estudo das Unidades de Conservação de uso sustentável do RN

Ecotourism, in face to environmental demands and discussions, has achieved prominence in the tourism market and wide global development, occasioning a concern about the need for a scientific deepening through a critical approach of the dynamics of consumption and conservation that permeate this practice. This study addresses the ecotourism under aegis of consumer society, in which is perceived that it constitutes a contester practice of society in which it is embedded, nevertheless has been subjected to the logic of capital through commodification of nature. In order to comprehend the reality presented, this study had as geographical cutting two Conservation Units of Sustainable Use in Rio Grande do Norte state: the Jenipabu Environmental Protection Area (APAJ) and Ponta do Tubarão State Sustainable Development Reserve (RDSEPT). The research sought to investigate the relationship between conservation and consumption and their influences on ecotourism held in the Conservation Units (UCs) of sustainable use selected for this study. To this aim it was made a critical reflection about the relationship conservation versus consumption constant in the practice of ecotourism in UCs in the context of current society, analyzing the historical process of formation of UCs of sustainable use in RN state under the light of the contradictory pair conservation-consumption, as well as looking to apprehend the perception of ecotourism of the actors involved with this practice. It was adopted a qualitative approach under a critical perspective based on bibliographical and documentary research and realization of semi-structured interviews with three groups of actors, namely managers/technician, community and ectourists involved with ecotourism in the selected UCs. The analysis was made using two basic units of analysis (consumption and maintenance) and twelve categories. For definition of units of analysis and categories were taken as reference the authors Santos (1987; 1988; 1994; 2001; 2006), Guerreiro Ramos (1989) and A. B. Rodrigues (1996; 2003), which perform critical to society of consumption and describe the key characteristics of the technical-scientific-informational predominant means, and Diegues (1998; 2000), A. B. Rodrigues (2001), Pires (2002) and Neiman and Rabinovici (2010), which discusse historic and scientifically about the emphasis on conservation present in origins and discourse of ecotourism, describing also its founding characteristics. The main results show that the marketing use of the prefix eco has acted as a new dress for what in reality is in fact ancient, ie, the conservation is used as a justification for another new type of consumption. The results also show that despite the coexistence of commercial and symbolic intentions in both UCs, one can observe the predominance consumer society characteristics in the process of creation and the production activities of APAJ, while in RDSEPT we note the predominance of the conservationist characteristics proclaimed by ecotourism. It can be inferred therefore that tourism held in the APAJ can not be called ecotourism, while the practice found in RDSEPT show an alignment with the guidelines of ecotourism

Geologia, Geocronologia, Geoquímica e Petrogênese das Rochas Ígneas Cretácicas da Província Magmática do Cabo e suas Relações com as Unidades Sedimentares da Bacia de Pernambuco (NE do Brasil)

The area studied forms a thin NNE-directed belt situated south of Recife town (Pernambuco state), northeastern Brazil. Geologically, it comprises the Pernambuco Basin (PB), which is limited by the Pernambuco Lineament to the north, the Maragogi high to the south and the Pernambuco Alagoas massif to the west, all of them with Precambrian age. This thesis reports the results obtained for the Cabo Magmatic Province (CMP), aiming the characterization of the geology, stratigraphy, geochronology, geochemistry and petrogenesis of the Cretaceous igneous rocks presented in the PB. The PB is composed of the Cabo Formation (rift phase) at the base (polymictic conglomerates, sandstones, shales), an intermediate unit, the Estiva Formation (marbles and argillites), and, at the top, the Algodoais Formation (monomictic conglomerates, sandstones, shales). The CMP is represented by trachytes, rhyolites, pyroclastics (ignimbrites), basalts / trachy-andesites, monzonites and alkali-feldspar granite, which occur as dykes, flows, sills, laccoliths and plugs. Field observations and well descriptions show that the majority of the magmatic rocks have intrusive contacts with the Cabo Formation, although some occurrences are also suggestive of synchronism between volcanism and siliciclastic sedimentation. 40Ar/39Ar and zircon fission tracks for the magmatic rocks indicate an average age of 102 r 1 Ma for the CMP. This age represents an expressive event in the province and is detected in all igneous dated materials. It is considered as a minimum age (Albian) for the magmatic episode and the peak of the rift phase in the PB. The 40Ar/39Ar dates are about 10-14 Ma younger than published palynologic ages for this basin. Geochemically, the CMP may be divided in two major groups; i) a transitional to alkaline suite, constituted by basalts to trachy-andesites (types with fine-grained textures and phenocrysts of sanidine and plagioclase), trachytes (porphyrytic texture, with phenocrysts of sanidine and plagioclase) and monzonites; ii) a alkaline suite, highly fractionated, acidic volcano-plutonic association, formed by four subtypes (pyroclastic flows ignimbrites, fine-to medium-grained rhyolites, a high level granite, and later rhyolites). These four types are distinguished essentially by field aspects and petrographic and textural features. Compatible versus incompatible trace element concentrations and geochemical modeling based on both major and trace elements suggest the evolution through low pressure fractional crystallization for trachytes and other acidic rocks, whereas basalts / trachy-andesites and monzonites evolved by partial melting from a mantle source. Sr and Nd isotopes reveal two distinct sources for the rocks of the CMP. Concerning the acidic ones, the high initial Sr ratios (ISr = 0.7064-1.2295) and the negative HNd (-0.43 to -3.67) indicate a crustal source with mesoproterozoic model ages (TDM from 0.92 to 1.04 Ga). On the other hand, the basic to intermediate rocks have low ISr (0.7031-0.7042) and positive HNd (+1.28 to +1.98), which requires the depleted mantle as the most probable source; their model ages are in the range 0.61-0.66 Ga. However, the light rare earth enrichment of these rocks and partial melting modeling point to an incompatible-enriched lherzolitic mantle with very low quantity of garnet (1-3%). This apparent difference between geochemical and Nd isotopes may be resolved by assuming that the metasomatizing agent did not obliterate the original isotopic characteristics of the magmas. A 2 to 5% partial melting of this mantle at approximately 14 kbar and 1269oC account very well the basalts and trachy-andesites studied. By using these pressure and temperatures estimates for the generation of the basaltic to trachy-andesitic magma, it is determined a lithospheric stretching (E) of 2.5. This E value is an appropriated estimate for the sub-crustal stretching (astenospheric or the base of the lithosphere?) region under the Pernambuco Basin, the crustal stretching probably being lower. The integration of all data obtained in this thesis permits to interpret the magmatic evolution of the PB as follows; 1st) the partial melting of a garnet-bearing lherzolite generates incompatible-enriched basaltic, trachy-andesitic and monzonitic magmas; 2nd) the underplating of these basaltic magmas at the base of the continental crust triggers the partial melting of this crust, and thus originating the acidic magmas; 3rd) concomitantly with the previous stage, trachytic magmas were produced by fractionation from a monzonitic to trachy-andesitic liquid; 4th) the emplacement of the several magmas in superficial (e.g. flows) or sub-superficial (e.g. dykes, sills, domes, laccoliths) depths was almost synchronically, at about 102 r 1 Ma, and usually crosscutting the sedimentary rocks of the Cabo Formation. The presence of garnet in the lherzolitic mantle does not agree with pressures of about 14 kbar for the generation of the basaltic magma, as calculated based on chemical parameters. This can be resolved by admitting the astenospheric uplifting under the rift, which would place deep and hot material (mantle plume?) at sub-crustal depths. The generation of the magmas and their subsequent emplacement would be coupled with the crustal rifting of the PB, the border (NNE-SSW directed) and transfer (NW-SE directed) faults serving as conduits for the magma emplacement. Based on the E parameter and the integration of 40Ar/39Ar and palynologic data it is interpreted a maximum duration of 10-14 Ma for the rift phase (Cabo Formation clastic sedimentation and basic to acidic magmatism) of the PB

Analise dos impactos socioambientais da instalacao das unidades de bombeio de petroleo na area urbana de Mossoro - RN

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Rhodophyta de ambientes lóticos de unidades de conservação da região sul do Brasil

Species of Rhodophyta from 10 Conservation Units from the south region of Brazil were surveyed. The samplings were carried out in 105 stream reaches, consisting of 10 m length transects. The floristic survey involved 80 populations, representing three genera, Batrachospermum, Kumanoa and Hildenbrandia plus the 'Chantransia' stages. Batrachospermum was represented by five species (B. arcuatum Kylin, B. atrum (Hudson) Harvey, B. helminthosum Bory, B. keratophytum Bory and B. puiggarianum Grunow in Wittrock & Nordstedt). The genus Kumanoa was represented by K. abilii (Reis) Necchi Junior & Vis and K. ambigua (Montagne) Entwisle et al., while Hildenbrandia only by H. angolensis W.West & G.S.West. Our results confirm Batachospermum as the best represented genus, in terms of species number, among freshwater Rhdophyta. B. arcuatum was a new record for the south region of Brazil, thus extending its austral distribution range.

Germinação das unidades de dispersão de gervão-roxo

Foram conduzidos dois experimentos com o objetivo de estudar a germinação das unidades de dispersão de gervão-roxo [Stachytarpheta cayennesis (L.C. Rich) Vahl], removidas de espigas que haviam sido armazenadas após terem sido colhidas em dois estádios de maturação. As unidades de dispersão foram removidas de espigas que se encontravam armazenadas por seis ou 18 meses e que haviam sido colhidas com a coloração verde ou palha. No primeiro experimento, as unidades de dispersão, incubadas no interior de caixas plásticas tipo gerbox, foram distribuídas em folhas de papel germitest umedecidas com água destilada, sob temperatura de 20ºC(noite) e 30ºC (dia), na presença ou ausência de fotoperíodo de 12 horas, por 28 dias. No segundo experimento, as unidades de dispersão, incubadas no interior de caixas plásticas, foram distribuídas em folhas de papel germitest umedecidas com água destilada ou com solução de KNO3, sob temperatura de 20ºC(noite) e 30ºC (dia), na presença ou ausência de fotoperíodo de 12 horas, por 28 dias. A maior germinação foi obtida a partir de unidades de dispersão provenientes de espigas colhidas com a coloração palha e que se encontravam armazenadas por seis meses. A presença da luz, e o emprego de nitrato na ausência de luz, favoreceram a germinação das unidades de dispersão retiradas da parte apical e basal de espigas colhidas com a coloração verde ou palha e, armazenadas por seis ou 18 meses.

Desenvolvimento de um Questionário Quantitativo de Freqüência Alimentar (QQFA) para gestantes usuárias de Unidades Básicas de Saúde de Ribeirão Preto, São Paulo, Brasil

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

Dimensão pessoal do processo de trabalho para enfermeiras de Unidades de Terapia Intensiva

OBJETIVO: Compreender os aspectos da dimensão pessoal do processo de trabalho para enfermeiras que atuam em Unidades de Terapia Intensiva (UTI) de um hospital universitário do interior do Estado de São Paulo. MÉTODOS: Estudo de abordagem qualitativa utilizando o método fenomenológico. Foram entrevistadas 12 enfermeiras que trabalhavam nas UTI de adulto, pediátrica e coronariana dessa instituição hospitalar e para análise dos relatos, utilizou-se o referencial da estrutura do fenômeno situado. RESULTADOS: A análise dos relatos permitiu identificar a categoria: dimensão pessoal do trabalho na UTI, com os temas - trabalho gratificante, trabalho desgastante e (des) valorização do trabalho. CONCLUSÃO: Os resultados do estudo revelam que as enfermeiras das UTI selecionadas identificam-se com o trabalho, porém vivenciam situações desmotivadoras decorrentes da elevada carga de trabalho, que dificulta o desenvolvimento do processo de trabalho e compromete a qualidade do cuidado.

Terapêutica com doses profiláticas de sulfato ferroso como medida de intervenção no combate à carência de ferro em crianças atendidas em unidades básicas de saúde

Objetivou-se testar a terapêutica com doses profiláticas de sulfato ferroso no combate à anemia carencial ferropriva, em 620 crianças de 4 a 36 meses de idade, atendidas em duas unidades de saúde do Município de São Paulo, Brasil. As crianças foram submetidas a coleta de sangue para dosagem de hemoglobina. em seguida, foi prescrito dosagem de 12 mg/dia de ferro elementar, por 30 dias. Observou-se que 25% dos menores de 6 meses apresentaram níveis de hemoglobina inferiores a 11,0 g/dl. As maiores ocorrências de anemia foram detectadas entre os 9 e 23 meses de idade (50,0%). Decorrido o prazo, apenas 37,4% das crianças com anemia e 52,4% das não anêmicas retornaram para reavaliação. Das 299 que foram reavaliadas, somente 157 (52,5%) receberam a medicação corretamente. A freqüência de hemoglobinas inferiores a 9,5 g/dl caiu de 17,1% no início, para 8,1% ao final da intervenção. Por outro lado, o percentual de crianças com hemoglobinas superiores a 12,0 g/dl subiu de 13,4%, para 33,4%. As que receberam a suplementação férrica de forma correta registraram queda nos índices de anemia sensivelmente maior que a observada naquelas suplementadas de forma incorreta. Concluiu-se que a terapêutica com doses profiláticas de sulfato ferroso, apesar de se mostrar eficiente na recuperação dos níveis de hemoglobina, apresenta sérios entraves do ponto de vista operacional.