Saúde mental: concepções e práticas profissionais de um campo em tensão

A Reforma Psiquiátrica, atual política de saúde mental, redireciona os recursos da assistência psiquiátrica para o modelo de base comunitária, substituindo o modelo asilar. A abordagem proposta pela Reforma Psiquiátrica procura conjugar o esforço teórico e prático para a construção da Rede de Atenção Psicossocial. O presente trabalho objetivou desvelar concepções e práticas de trabalhadores da saúde mental, construídas na práxis de suas trajetórias profissionais e contextos de vida, em relação à incorporação do modelo de atenção psicossocial ou manutenção de princípios asilares, caracterizadores da tradicional prática profissional em saúde mental. Objetivou também identificar pontos de tensão, que caracterizam interesses de diferentes naturezas, como obstáculos e desafios à implementação da Reforma Psiquiátrica. A pesquisa, de natureza qualitativa, contou com 10 entrevistas de profissionais atuando na área, baseada na técnica de depoimento oral e em roteiro do tipo temático, sendo 3 enfermeiros, 3 psicólogos, 3 psiquiatras e 1 terapeuta ocupacional. Os relatos dos profissionais foram organizados em categorias gerais e específicas tendo em vista a interpretação das narrativas à luz da literatura especializada. Através dos discursos dos profissionais do campo da saúde mental é possível observar que um tensionamento ideológico marca fortemente o espaço da saúde. Alguns profissionais relataram a busca por construir práticas em equipe interdisciplinar, pautadas pelo modelo psicossocial; porém, referem à resistência de outros profissionais da equipe. Praticamente todos os profissionais apresentam discursos de humanização no campo da saúde mental, mas alguns não enunciam visões críticas aos modelos asilares. Alguns trabalhadores revelam a crença na possibilidade de coexistência integrada entre o Modo Asilar e Modo Psicossocial. Para estes trabalhadores de CAPS, é desejável a permanência dos hospitais psiquiátricos e é possível a humanização dos mesmos. Essa questão indica, ao que parece, que as práticas em saúde mental ainda operam sobre premissas epistemológicas diferenciando sujeitos que podem ou não circular no meio social. A existência dos hospitais psiquiátricos, considerados como instituições totais, é problematizada e questionada pela Luta Antimanicomial, indica a permanência da lógica asilar que respalda a continuidade dos hospitais, exclusivamente psiquiátricos, entre os serviços de atendimento, com o apoio de parte dos profissionais da rede de saúde mental. Concordantes com a possibilidade de coexistência do modelo asilar e modelo psicossocial, estes profissionais permitem-nos demonstrar que mesmo uma visão clínica pretensamente humanizadora, que defenda em seu discurso um tratamento digno, pode operar no modelo teórico-metodológico positivista e não está necessariamente vinculada a uma postura política de sujeitos de direitos e de cidadania. Os profissionais que apresentaram em suas narrativas a não concordância com a permanência dos hospitais psiquiátricos, defendem que as transformações sejam clínicas e políticas nos saberes e nas práticas em Saúde Mental. Estes trabalhadores já fizeram ou fazem parte de movimentos sociais, apontados como lugares de reflexão crítica sobre ideias instituídas contribuindo, ao que parece, para o processo de desnaturalização de concepções construídas culturalmente e orientadoras de práticas profissionais. Diante de tais constatações podemos indagar e refletir se a desinstitucionalização, concreta e simbólica, encontra-se no horizonte de uma política pública de atenção em Saúde Mental que realmente tenha como projeto a sua real implementação e se a permanência dos hospitais psiquiátricos e das comunidades terapêuticas estaria descaracterizando as propostas iniciais da construção da Atenção Psicossocial, considerando os interesses privados e a manutenção da lógica asilar, contrários aos princípios do SUS.

Reengenharia de sistemas na recuperação e modernização de produtos: proposta de um modelo baseado em risco.

Produtos com um tempo considerável de utilização podem ser objeto de um processo de manutenção mais amplo e profundo, que visa prolongar a sua vida útil. O termo recuperação é aplicado a este tipo de manutenção, que visa à substituição de peças defeituosas, desgastadas, e/ou com a vida útil encerrada. O surgimento de novos paradigmas e de um novo conjunto de doutrinas operacionais pode mudar as expectativas e necessidades das partes interessadas de modo que o produto pode ser proposto para uma modernização. Assim, o produto pode ser reengenheirado durante a sua recuperação. Para realizar um projeto de recuperação e modernização, propõe-se uma abordagem em seis passos centrada numa decisão baseada no risco para classificar os componentes de acordo com a ação a ser realizada. A análise do produto é desenvolvida com base em técnicas de desmontagem e uma análise da fase operacional é realizada para as tomadas de decisões. Deste modo, um componente pode sofrer manutenção, ser modernizado, ser excluído, ser inserido ou permanecer fora do escopo dos trabalhos. O processo da gestão baseada em risco também inclui duas fases de monitoramento de risco continuado: durante a produção e na fase de operação. As decisões podem ser revistas pelo uso da análise bayesiana. Um estudo de caso é proposto para ilustrar o modelo num programa de recuperação e modernização de veículos blindados realizada numa unidade do Exército Brasileiro. A aplicação da metodologia permitiu a seleção de uma alternativa de modernização, considerando riscos e benefícios. O desdobramento das análises no projeto detalhado permitiu a definição final do escopo de recuperação e modernização, observando efeitos de propagação de alterações de engenharia. A principal contribuição deste trabalho é a formalização de um estudo da recuperação e modernização como projeto específico, descrevendo suas características de uma forma a permitir a aplicação de um modelo baseado em risco.

Controlador integrado baseado em conceito híbrido e controle geométrico para embarcações posicionadas dinamicamente.

O conceito de controle híbrido é aplicado à operação de alívio entre um FPWSO e um navio aliviador. Ambos os navios mantêm suas posições e aproamentos pelo resultado da ação do seu Sistema de Posicionamento Dinâmico (SPD). O alívio dura cerca de 24 horas para ser concluído. Durante este período, o estado de mar pode se alterar e os calados estão sendo constantemente alterados. Um controlador híbrido é projetado para permitir modificacões dos parâmetros de controle/observação se alguma alteração significante do estado de mar e/ou calado das embarcações ocorrer. O principal objetivo dos controladores é manter o posicionamento relativo entre os navios com o intuito de evitar perigosa proximidade ou excesso de tensão no cabo. Com isto em mente, uma nova estratégia de controle que atue integradamente em ambos os navios é proposta baseda em geometria diferencial. Observadores não lineares baseados em passividade são aplicados para estimar a posição, a velocidade e as forças externas de mares calmos até extremos. O critério para troca do controle/observação é baseado na variação do calado e no estado de mar. O calado é assumido conhecido e o estado de mar é estimado pela frequência de pico do espectro do movimento de primeira ordem dos navios. Um modelo de perturbação é proposto para encontrar o número de controladores do sistema híbrido. A equivalência entre o controle geométrico e o controlador baseado em Multiplicadores de Lagrange é demonstrada. Assumindo algumas hipóteses, a equivalência entre os controladores geométrico e o PD é também apresentada. O desempenho da nova estratégia é avaliada por meio de simulações numéricas e comparada a um controlador PD. Os resultados apresentam muito bom desempenho em função do objetivo proposto. A comparação entre a abordagem geométrica e o controlador PD aponta um desempenho muito parecido entre eles.

Simulation Results of AgriPoliS about Diminishing Capital Subsidies and Restrictions. Factor Markets Working Document No. 55, June 2013

This paper investigates the impacts of high interest rates for borrowed capital and credit restrictions on the structural development of four European regions. The method used is the model AgriPoliS which is a spatial-dynamic agent-based model. It is able to provide aggregated results at the regional level, but very individual results as well by considering farms as independent entities. Farms can choose between different investment options during the simulation. Several scenarios with different interest rates for borrowed capital on the one hand as well as with different levels of credit restrictions on the other hand are tested and compared. Results show that higher interest rates have less impact on declining production branches than on expanding ones. If they have the possibility farms invest in the most profitable production branch which relative profitability might have changed with high interest rates. Credit restrictions lead farms to choose smaller and cheaper investments than expensive and large ones. Results also show that income losses in both cases due to under-investment compared to the reference situation are partially compensated by lower rental prices. The impacts on structural change also differ depending on the region and the initial situation. In summary, credit subsidies or imperfections on credit markets might have indirect impacts on the type of dominant investment and therefore on the whole regional agricultural sector as well.

Near Real-Time Detection Of Pipe Bursts in Water Distribution Systems

The research work presented in the thesis describes a new methodology for the automated near real-time detection of pipe bursts in Water Distribution Systems (WDSs). The methodology analyses the pressure/flow data gathered by means of SCADA systems in order to extract useful informations that go beyond the simple and usual monitoring type activities and/or regulatory reporting , enabling the water company to proactively manage the WDSs sections. The work has an interdisciplinary nature covering AI techniques and WDSs management processes such as data collection, manipulation and analysis for event detection. Indeed, the methodology makes use of (i) Artificial Neural Network (ANN) for the short-term forecasting of future pressure/flow signal values and (ii) Rule-based Model for bursts detection at sensor and district level. The results of applying the new methodology to a District Metered Area in Emilia- Romagna’s region, Italy have also been reported in the thesis. The results gathered illustrate how the methodology is capable to detect the aforementioned failure events in fast and reliable manner. The methodology guarantees the water companies to save water, energy, money and therefore enhance them to achieve higher levels of operational efficiency, a compliance with the current regulations and, last but not least, an improvement of customer service.

Conservation of freshwater thermal habitats for Pacific salmon in a changing climate

Thesis (Ph.D.)--University of Washington, 2016-06

Do harvest refuges buffer kangaroos against evolutionary responses to selective harvesting?

There is a wealth of literature documenting a directional change of body size in heavily harvested populations. Most of this work concentrates on aquatic systems, but terrestrial populations are equally at risk. This paper explores the capacity of harvest refuges to counteract potential effects of size-selective harvesting on the allele frequency,of populations. We constructed a stochastic, individual-based model parameterized with data on red kangaroos. Because we do not know which part of individual growth would change in the course of natural selection, we explored the effects of two alternative models of individual growth in which alleles affect either the growth rate or the maximum size. The model results show that size-selective harvesting can result in significantly smaller kangaroos for a given age when the entire population is subject to harvesting. In contrast, in scenarios that include dispersal from harvest refuges, the initial allele frequency remains virtually unchanged.

Consumption habit and international stock returns

We use the consumption-based asset pricing model with habit formation to study the predictability and cross-section of returns from the international equity markets. We find that the predictability of returns from many developed countries' equity markets is explained in part by changing prices of risks associated with consumption relative to habit at the world as well as local levels. We also provide an exploratory investigation of the cross-sectional implications of the model under the complete world market integration hypothesis and find that the model performs mildly better than the traditional consumption-based model. the unconditional and conditional world CAPMs and a three-factor international asset pricing model. (C) 2004 Elsevier B.V. All rights reserved.

Using extreme value theory to measure value-at-risk for daily electricity spot prices

The recent deregulation in electricity markets worldwide has heightened the importance of risk management in energy markets. Assessing Value-at-Risk (VaR) in electricity markets is arguably more difficult than in traditional financial markets because the distinctive features of the former result in a highly unusual distribution of returns-electricity returns are highly volatile, display seasonalities in both their mean and volatility, exhibit leverage effects and clustering in volatility, and feature extreme levels of skewness and kurtosis. With electricity applications in mind, this paper proposes a model that accommodates autoregression and weekly seasonals in both the conditional mean and conditional volatility of returns, as well as leverage effects via an EGARCH specification. In addition, extreme value theory (EVT) is adopted to explicitly model the tails of the return distribution. Compared to a number of other parametric models and simple historical simulation based approaches, the proposed EVT-based model performs well in forecasting out-of-sample VaR. In addition, statistical tests show that the proposed model provides appropriate interval coverage in both unconditional and, more importantly, conditional contexts. Overall, the results are encouraging in suggesting that the proposed EVT-based model is a useful technique in forecasting VaR in electricity markets. (c) 2005 International Institute of Forecasters. Published by Elsevier B.V. All rights reserved.

Modelling photo-detectors in quantum optics

Photo-detection plays a fundamental role in experimental quantum optics and is of particular importance in the emerging field of linear optics quantum computing. Present theoretical treatment of photo-detectors is highly idealized and fails to consider many important physical effects. We present a physically motivated model for photo-detectors which accommodates for the effects of finite resolution, bandwidth and efficiency, as well as dark counts and dead-time. We apply our model to two simple well-known applications, which illustrates the significance of these characteristics.

Simulation of a complete reflected shock tunnel showing a vortex mechanism for flow contamination

Simulations of a complete reflected shock tunnel facility have been performed with the aim of providing a better understanding of the flow through these facilities. In particular, the analysis is focused on the premature contamination of the test flow with the driver gas. The axisymmetric simulations model the full geometry of the shock tunnel and incorporate an iris-based model of the primary diaphragm rupture mechanics, an ideal secondary diaphragm and account for turbulence in the shock tube boundary layer with the Baldwin-Lomax eddy viscosity model. Two operating conditions were examined: one resulting in an over-tailored mode of operation and the other resulting in approximately tailored operation. The accuracy of the simulations is assessed through comparison with experimental measurements of static pressure, pitot pressure and stagnation temperature. It is shown that the widely-accepted driver gas contamination mechanism in which driver gas 'jets' along the walls through action of the bifurcated foot of the reflected shock, does not directly transport the driver gas to the nozzle at these conditions. Instead, driver gas laden vortices are generated by the bifurcated reflected shock. These vortices prevent jetting of the driver gas along the walls and convect driver gas away from the shock tube wall and downstream into the nozzle. Additional vorticity generated by the interaction of the reflected shock and the contact surface enhances the process in the over-tailored case. However, the basic mechanism appears to operate in a similar way for both the over-tailored and the approximately tailored conditions.

The temporal and spatial limits of compensation for fixational eye movements

High-fidelity eye tracking is combined with a perceptual grouping task to provide insight into the likely mechanisms underlying the compensation of retinal image motion caused by movement of the eyes. The experiments describe the covert detection of minute temporal and spatial offsets incorporated into a test stimulus. Analysis of eye motion on individual trials indicates that the temporal offset sensitivity is actually due to motion of the eye inducing artificial spatial offsets in the briefly presented stimuli. The results have strong implications for two popular models of compensation for fixational eye movements, namely efference copy and image-based models. If an efference copy model is assumed, the results place constraints on the spatial accuracy and source of compensation. If an image-based model is assumed then limitations are placed on the integration time window over which motion estimates are calculated. (c) 2006 Elsevier Ltd. All rights reserved.

Intake rates and the functional response in shorebirds (Charadriiformes) eating macro-invertebrates

As field determinations take much effort, it would be useful to be able to predict easily the coefficients describing the functional response of free-living predators, the function relating food intake rate to the abundance of food organisms in the environment. As a means easily to parameterise an individual-based model of shorebird Charadriiformes populations, we attempted this for shorebirds eating macro-invertebrates. Intake rate is measured as the ash-free dry mass (AFDM) per second of active foraging; i.e. excluding time spent on digestive pauses and other activities, such as preening. The present and previous studies show that the general shape of the functional response in shorebirds eating approximately the same size of prey across the full range of prey density is a decelerating rise to a plateau, thus approximating the Holling type 11 ('disc equation') formulation. But field studies confirmed that the asymptote was not set by handling time, as assumed by the disc equation, because only about half the foraging time was spent in successfully or unsuccessfully attacking and handling prey, the rest being devoted to searching. A review of 30 functional responses showed that intake rate in free-living shorebirds varied independently of prey density over a wide range, with the asymptote being reached at very low prey densities (< 150/m(-2)). Accordingly, most of the many studies of shorebird intake rate have probably been conducted at or near the asymptote of the functional response, suggesting that equations that predict intake rate should also predict the asymptote. A multivariate analysis of 468 'spot' estimates of intake rates from 26 shorebirds identified ten variables, representing prey and shorebird characteristics, that accounted for 81 % of the variance in logarithm-transformed intake rate. But four-variables accounted for almost as much (77.3 %), these being bird size, prey size, whether the bird was an oystercatcher Haematopus ostralegus eating mussels Mytilus edulis, or breeding. The four variable equation under-predicted, on average, the observed 30 estimates of the asymptote by 11.6%, but this discrepancy was reduced to 0.2% when two suspect estimates from one early study in the 1960s were removed. The equation therefore predicted the observed asymptote very successfully in 93 % of cases. We conclude that the asymptote can be reliably predicted from just four easily measured variables. Indeed, if the birds are not breeding and are not oystercatchers eating mussels, reliable predictions can be obtained using just two variables, bird and prey sizes. A multivariate analysis of 23 estimates of the half-asymptote constant suggested they were smaller when prey were small but greater when the birds were large, especially in oystercatchers. The resulting equation could be used to predict the half-asymptote constant, but its predictive power has yet to be tested. As well as predicting the asymptote of the functional response, the equations will enable research workers engaged in many areas of shorebird ecology and behaviour to estimate intake rate without the need for conventional time-consuming field studies, including species for which it has not yet proved possible to measure intake rate in the field.

Accounting for management costs in sensitivity analyses of matrix population models

Traditional sensitivity and elasticity analyses of matrix population models have been used to p inform management decisions, but they ignore the economic costs of manipulating vital rates. For exam le, the growth rate of a population is often most sensitive to changes in adult survival rate, but this does not mean that increasing that rate is the best option for managing the population because it may be much more expensive than other options. To explore how managers should optimize their manipulation of vital rates, we incorporated the cost of changing those rates into matrix population models. We derived analytic expressions for locations in parameter space where managers should shift between management of fecundity and survival, for the balance between fecundity and survival management at those boundaries, and for the allocation of management resources to sustain that optimal balance. For simple matrices, the optimal budget allocation can often be expressed as simple functions of vital rates and the relative costs of changing them. We applied our method to management of the Helmeted Honeyeater (Lichenostomus melanops cassidix; an endangered Australian bird) and the koala (Phascolarctos cinereus) as examples. Our method showed that cost-efficient management of the Helmeted Honeyeater should focus on increasing fecundity via nest protection, whereas optimal koala management should focus on manipulating both fecundity and survival simultaneously, These findings are contrary to the cost-negligent recommendations of elasticity analysis, which would suggest focusing on managing survival in both cases. A further investigation of Helmeted Honeyeater management options, based on an individual-based model incorporating density dependence, spatial structure, and environmental stochasticity, confirmed that fecundity management was the most cost-effective strategy. Our results demonstrate that decisions that ignore economic factors will reduce management efficiency.

Using integrated metamodeling to define OO design patterns with object-z and UML

Three important goals in describing software design patterns are: generality, precision, and understandability. To address these goals, this paper presents an integrated approach to specifying patterns using Object-Z and UML. To achieve the generality goal, we adopt a role-based metamodeling approach to define patterns. With this approach, each pattern is defined as a pattern role model. To achieve precision, we formalize role concepts using Object-Z (a role metamodel) and use these concepts to define patterns (pattern role models). To achieve understandability, we represent the role metamodel and pattern role models visually using UML. Our pattern role models provide a precise basis for pattern-based model transformations or refactoring approaches.