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.

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

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

Segredos da alma: a dádiva da assistência de Enfermagem

The present study is an analysis of interpersonal relationships between the nursing staff and the patients under their care. Its objectives are to analyze ties/links that may possibly exist in such relationships and to describe, based on the experience of the patients, how they are received by the nursing staff, and what is the extent of their reliability on the nursing staff within the hospital. This investigation is analytical in nature and qualitative in approach, having as its leading thought Marcel Mauss s gift-exchange theory. The study involved eighteen in-patients, eight of them from government institutions, at a large hospital school and ten others from a private specialty hospital; both in the city of Natal, state of Rio Grande do Norte, Brazil. Data were collected between January and March 2006. Results point to ties being created between the nursing staff and patients irrespective of their social status, involving especially the development of friendship and reliability. We have noticed that in both services the interpersonal relationship is associated with the circulation of the symbolic goods mentioned in the patients discourse, such as attention, loving care and concern, among others, marking the formation of ties during hospital stay. Likewise, reliability is also present in close relationship with the technical competence of the professional. Patient hospitality is associated with the manner in which the patients were treated on being admitted to the hospital, although they also refer to hospitality at later moments, during the course of their treatment. Finally, we are in a position to say that there are ties/links between in-patients and nursing staff, irrespective of the patient s social status and class divide. It is thus evident that the antiutilitarian symbolism of gift to give, receive, give back -, which shapes the setting of social ties also takes place in today s utilitarian, individualistic and competitive societies. Thus, human beings whose existence is dependent on mutual relationships try to save their humanity, especially those who are fragile and dependent as is the case of the hospital in-patient

Body lipid deposition in Nile tilapia fed on rations containing tannin

O objetivo deste trabalho foi avaliar o efeito de fontes e níveis de tanino em rações para tilápia-do-nilo (Oreochromis niloticus), durante a engorda, sobre o desempenho produtivo e deposição lipídica corporal. Foram utilizados 342 peixes, distribuídos em 18 tanques. As rações foram preparadas com milho, variedades de sorgo com baixo e alto teor de tanino, e com ácido tânico a 0,08, 0,34, e 0,60%. Ganho de peso, conversão alimentar aparente e taxa de eficiência protéica não foram influenciados pelos tratamentos. A maior deposição lipídica corporal foi observada nas dietas com ácido tânico (14,39%); a dieta de sorgo com alto teor de tanino resultou em carcaças mais magras (12,01%) do que as de sorgo com baixo teor de tanino (13,31%). Dietas com sorgo proporcionaram menores teores de gordura visceral. A presença de tanino nas rações não prejudicou o desempenho produtivo da tilápia-do-nilo.

Uso de aditivos em rações para suínos nas fases de creche, crescimento e terminação

Este trabalho foi conduzido com o objetivo de verificar o efeito da adição de antibiótico, probiótico, prebiótico e gluconato de sódio para suínos no período de 28 a 142 dias de idade, correspondente às fases de creche, crescimento e terminação. Foram utilizados 168 leitões desmamados aos 21 dias de idade, distribuídos em delineamento inteiramente casualizado em 42 baias com quatro suínos machos castrados em cada unidade experimental, com seis repetições e sete dietas: ração basal (controle negativo); ração basal + antibiótico; ração basal + probiótico; ração basal + prebiótico; ração basal + probiótico + prebiótico (simbiótico); ração basal + gluconato de sódio; ração basal + gluconato de sódio + probiótico. O desempenho dos animais diferiu entre as dietas e foi melhor nos animais que receberam ração com aditivos no período de 28 a 142 dias de idade. Entre os aditivos, o simbiótico foi mais eficiente, pois promoveu os melhores resultados de ganho de peso e conversão alimentar. do mesmo modo, a adição de gluconato de sódio + probiótico, prebiótico e probiótico nas rações foi mais eficiente que a adição de antibiótico. A utilização dos aditivos avaliados em substituição ao antibiótico não compromete as características de carcaça e a morfometria intestinal. A associação do probiótico e prebiótico (simbiótico) estudados melhora o desempenho dos suínos nas fases de creche, crescimento e terminação.

Implementação de um sistema embarcado aplicado ao controle de pressão arterial

Hypertension is a dangerous disease that can cause serious harm to a patient health. In some situations the necessity to control this pressure is even greater, as in surgical procedures and post-surgical patients. To decrease the chances of a complication, it is necessary to reduce blood pressure as soon as possible. Continuous infusion of vasodilators drugs, such as sodium nitroprusside (SNP), rapidly decreased blood pressure in most patients, avoiding major problems. Maintaining the desired blood pressure requires constant monitoring of arterial blood pressure and frequently adjusting the drug infusion rate. Manual control of arterial blood pressure by clinical personnel is very demanding, time consuming and, as a result, sometimes of poor quality. Thus, the aim of this work is the design and implementation of a database of tuned controllers based on patients models, in order to find a suitable PID to be embedded in a Programmable Integrated Circuit (PIC), which has a smaller cost, smaller size and lower power consumption. For best results in controlling the blood pressure and choosing the adequate controller, tuning algorithms, system identification techniques and Smith predictor are used. This work also introduces a monitoring system to assist in detecting anomalies and optimize the process of patient care.

Influência da corrente de pulso, do tempo de pulso e diâmetro de gota sobre a estabilidade da transferência metálica no processo MIG-P

To obtain a process stability and a quality weld bead it is necessary an adequate parameters set: base current and time, pulse current and pulse time, because these influence the mode of metal transfer and the weld quality in the MIG-P, sometimes requiring special sources with synergistic modes with external control for this stability. This work aims to analyze and compare the effects of pulse parameters and droplet size in arc stability in MIG-P, four packets of pulse parameters were analysed: Ip = 160 A, tp = 5.7 ms; Ip = 300 A and tp = 2 ms, Ip = 350 A, tp = 1.2 ms and Ip = 350 A, tp = 0.8 ms. Each was analyzed with three different drop diameters: drop with the same diameter of the wire electrode; droplet diameter larger drop smaller than the diameter of the wire electrode. For purposes of comparison the same was determined relation between the average current and welding speed was determined generating a constant (Im / Vs = K) for all parameters. Welding in flat plate by simple deposition for the MIG-P with a distance beak contact number (DBCP) constant was perfomed subsequently making up welding in flat plate by simple deposition with an inclination of 10 degrees to vary the DBCP, where by assessment on how the MIG-P behaved in such a situation was possible, in addition to evaluating the MIG-P with adaptive control, in order to maintain a constant arc stability. Also high speed recording synchronized with acquiring current x voltage (oscillogram) was executed for better interpretation of the transfer mechanism and better evaluation in regard to the study of the stability of the process. It is concluded that parameters 3 and 4 exhibited greater versatility; diameters drop equal to or slightly less than the diameter of the wire exhibited better stability due to their higher frequency of detachment, and the detachment of the drop base does not harm the maintenance the height of the arc

Utilização do éster de soja como biolubrificante

The lubricants found in the market are of mineral or synthetic origin and harm to humans and the environment, mainly due to their improper discard. Therefore industries are seeking to develop products that cause less environmental impact, so to decrease mainly, operator aggression the Cutting Fluids became an emulsion of oil / water or water / oil. However, the emulsion was not considered the most suitable solution for environmental question, therefore the search for biodegradable lubricants and which no are toxic continues and so vegetable oils are seen, again, as a basis for the production of lubricants. The biggest problem with these oils is their oxidative instability that is intensified when working at high temperatures. The process transesterification decreases the oxidation, however changes some physical and chemical properties. Therefore soybean oil after the transesterification process was subjected to tests of density, dynamic viscosity, kinematic viscosity which is calculated from two parameters mentioned, flash point and acidity. Besides the physico-chemical test the soybean oil was subjected to a dynamic test in a tribometer adapted from a table vise, whose induced wear was the adhesive and ultimately was used as cutting fluid in a process of turning in two different materials, steel 1045 and cast iron. This latter test presented results below the mineral cutting fluid which it was compared in all tests, already in other experiments the result was satisfactory and other experiments not, so that chemical additives can be added to the oil analyzed to try equate all parameters and so formulate a biolubrificante not toxic to apply in machining processes of metalworking industry

Avaliação da remoção de sulfeto de hidrogênio do gás natural em uma coluna de absorção

Natural gas, although basically composed by light hydrocarbons, also presents in its composition gaseous contaminants such as CO2 (carbon dioxide) and H2S (hydrogen sulfide). Hydrogen sulfide, which commonly occurs in oil and gas exploration and production activities, besides being among the gases that are responsible by the acid rain and greenhouse effect, can also cause serious harm to health, leading even to death, and damages to oil and natural gas pipelines. Therefore, the removal of hydrogen sulfide will significantly reduce operational costs and will result in oil with best quality to be sent to refinery, thereby resulting in economical, environmental, and social benefits. These factors highlight the need for the development and improvement of hydrogen sulfide sequestrating agents to be used in the oil industry. Nowadays there are several procedures for hydrogen sulfide removal from natural gas used by the petroleum industry. However, they produce derivatives of amines that are harmful to the distillation towers, form insoluble precipitates that cause pipe clogging and produce wastes of high environmental impact. Therefore, the obtaining of a stable system, in inorganic or organic reaction media, that is able to remove hydrogen sulfide without forming by-products that affect the quality and costs of natural gas processing, transport and distribution is of great importance. In this context, the evaluation of the kinetics of H2S removal is a valuable procedure for the treatment of natural gas and disposal of the byproducts generated by the process. This evaluation was made in an absorption column packed with Raschig ring, where natural gas with H2S passes through a stagnant solution, being the contaminant absorbed by it. The content of H2S in natural gas in column output was monitored by an H2S analyzer. The comparison between the obtained curves and the study of the involved reactions have not only allowed to determine the efficiency and mass transfer controlling step of the involved processes but also make possible to effect a more detailed kinetic study and evaluate the commercial potential of each reagent

Extração de ferro da cera de carnaúba utilizando sistemas microemulsionados

The constant search for biodegradable materials for applications in several fields shows that carnauba wax can be a viable alternative in the manufacturing of biolubricants. Carnauba wax is the unique among the natural waxes to have a combination of properties of great importance. In previous studies it was verified the presence of metals in wax composition that can harm the oxidative stability of lubricants. Considering these factors, it was decided to develop a research to evaluate iron removal from carnauba wax, using microemulsion systems (Me) and perform the optimization of parameters, such as: extraction pH, temperature, extraction time, among others. Iron concentration was determined by atomic absorption and, to perform this analysis, sample digestion in microwave oven was used, showing that this process was very efficient. It was performed some analysis in order to characterize the wax sample, such as: attenuated total reflectance infrared spectroscopy (ATR-IR), thermogravimetry (TG), differential scanning calorimetry (DSC), energy dispersive X-ray fluorescence (EDXRF), scanning electron microscopy (SEM) and melting point (FP). The microemulsion systems were composed by: coconut oil as surfactant, n-butanol as cosurfactant, kerosene and/or heptanes as oil phase, distilled water as water phase. The pH chosen for this study was 4.5 and the metal extraction was performed in finite experiments. To evaluate Me extraction it was performed a factorial design for systems with heptane and kerosene as oil phase, also investigating the influence of temperature time and wax/Me ratio, that showed an statistically significant answer for iron extraction at 95% confidence level. The best result was obtained at 60°C, 10 hours contact time and 1: 10 wax/Me ratio, in both systems with kerosene and heptanes as oil phase. The best extraction occurred with kerosene as oil phase, with 54% iron removal

Modelagem da transferência de massa na remoção do óleo da água produzida por flotação em coluna com uso de tensoativos de origem vegetal

The treatment of oil produced water and its implications are continually under investigation and several questions are related to this subject. In the Northeast Region Brazil, the onshore reservoirs are, in its majority, mature oil fields with high production of water. As this oil produced water has high levels of oil, it cannot be directly discarded into the environment because it represents a risk for contamination of soil, water, and groundwater, or even may cause harm to living bodies. Currently, polyelectrolytes that promote the coalescence of the oil droplets are used to remove the dispersed oil phase, enhancing the effectiveness of the flotation process. The non-biodegradability and high cost of polyelectrolytes are limiting factors for its application. On this context, it is necessary to develop studies for the search of more environmentally friendly products to apply in the flotation process. In this work it is proposed the modeling of the flotation process, in a glass column, using surfactants derived from vegetal oils to replace the polyelectrolytes, as well as to obtain a model that represents the experimental data. In addition, it was made a comparative study between the models described in the literature and the one developed in this research. The obtained results showed that the developed model presented high correlation coefficients when fitting the experimental data (R2 > 0.98), thus proving its efficiency in modeling the experimental data.

Extração enzimática de óleo e produção in situ de biodiesel a partir da Moringa oleífera Lam

With the growth and development of modern society, arises the need to search for new raw materials and new technologies which present the "clean" characteristic, and do not harm the environment, but can join the energy needs of industry and transportation. The Moringa oleifera Lam, plant originating from India, and currently present in the Brazilian Northeast, presents itself as a multi-purpose plant, can be used as a coagulant in water treatment, as a natural remedy and as a feedstock for biodiesel production. In this work, Moringa has been used as a raw material for studies on the extraction and subsequently in the synthesis of biodiesel. Studies have been conducted on various techniques of Moringa oil extraction (solvents, mechanical pressing and enzymatic), being specially developed an experimental design for the aqueous extraction with the aid of the enzyme Neutrase© 0.8 L, with the aim of analyzing the influence variable pH (5.5-7.5), temperature (45-55°C), time (16-24 hours) and amount of catalyst (2-5%) on the extraction yield. In relation to study of the synthesis of biodiesel was initially carried out a conventional transesterification (50°C, KOH as a catalyst, methanol and 60 minutes reaction). Next, a study was conducted using the technique of in situ transesterification by using an experimental design variables as temperature (30-60°C), catalyst amount (2-5%), and molar ratio oil / ethanol (1:420-1:600). The extraction technique that achieved the highest extraction yield (35%) was the one that used hexane as a solvent. The extraction using 32% ethanol obtained by mechanical pressing and extraction reached 25% yield. For the enzymatic extraction, the experimental design indicated that the extraction yield was most affected by the effect of the combination of temperature and time. The maximum yield obtained in this extraction was 16%. After the step of obtaining the oil was accomplished the synthesis of biodiesel by the conventional method and the in situ technique. The method of conventional transesterification was obtained a content of 100% and esters by in situ technique was also obtained in 100% in the experimental point 7, with a molar ratio oil / alcohol 1:420, Temperature 60°C in 5% weight KOH with the reaction time of 1.5 h. By the experimental design, it was found that the variable that most influenced the ester content was late the percentage of catalyst. By physico-chemical analysis it was observed that the biodiesel produced by the in situ method fell within the rules of the ANP, therefore this technique feasible, because does not require the preliminary stage of oil extraction and achieves high levels of esters

Fertilidade do solo e nutrição de tangerineiras Ponkan manejados com resíduos sólidos e adubação química

The objective of this research was to evaluate some soil chemical attributes and the nutritional status of 'Ponkan' mandarin managed with organic residues and chemical fertilization. The experiment was carried out at the Natural Resource Department-Soil Science Area, in the College of Agronomic Sciences -UNESP/Botucatu, SP. 'Ponkan' Mandarin seedlings were cropped and managed using the organic residues sewage sludge, cattle manure and chemical fertilization. The results allow the conclusion that there was an increase in the CEC, OM, N-total, P and K values in the soil managed with organic residues. The sewage sludge application did not harm the soil quality because the input of elements As, Cd, Cr and Hg present in its constitution were not significant. The soil management with organic residues increased significantly contents of N, P, Ca and S in 'Ponkan' leaves but did not contribute to increase significantly the elements B, Cu, Fe, Mn, Zn, As, Cd, Cr and Pb. The soil management with sewage sludge did not result in significant increase in the As, Cd, Cr and Hg content of leaves and fruits.

Condições de saúde bucal e capacidade funcional em idosos

Population aging is one of the greatest challenges to contemporary public health and, in this perspective, the functional capacity emerges as an important feature in geriatric assessment. The oral health of elderly, in turn, deserves special attention because, historically, in the dental services, this population group was not considered a priority for attention, which is verified by high rates of edentulism found even among these individuals. The present study proposes to examine the relationship between oral health status and functional capacity in an elderly population. To this end, intra-oral epidemiological examination was performed to assess the degree of dental caries, periodontal status, use and need of prosthesis and the presence of lesions. Functional capacity was assessed by the Independence in Activities of Daily Living, which considers the independence or not in the performance of six self-care functions. Socioeconomic and demographic characteristics and general health status were also investigated, in view of the possibility of intervention of these variables in the investigated relation. An factor analysis of the principal components was conducted which resulted four indicators of oral health conditions, representative of the population studied. 441 seniors were enrolled with mean age of 71.7 (± 8.7) years, the majority being female (68%). Functional capacity was dichotomized into completely independent individuals (89.6%) and dependent on at least one of the functions considered (10.4%). There was an association between functional capacity and the indicators related to the presence of many teeth and dental caries, and to that associated with the use and need of prostheses. These associations in turn, lost statistical significance when adjusting for confounding variables, combined in separate models for each indicator. Some of these variables, however, remained associated with functional capacity. It is considered that the study of oral health status of elderly, associeted with the search for an association with functional capacity is important in the construction of indicators necessary for planning preventive and therapeutic interventions that reduce the risk for loss of ability in daily physical functions and their consequences, as the harm in the oral self-care

Ecological efficiency in thermoelectric power plants

This work evaluates the environmental impact resulting from the natural gas and diesel combustion in thermoelectric power plants that utilize the combined cycle technology (CC), as regarding to Brazilian conditions according to Thermopower Priority Plan JPP). In the regions where there are not natural gas the option has been the utilization of diesel and consequentily there are more emission of pollutants. The ecological efficiency concept, which evaluates by and large the environmental impact, caused by CO2, SO2, NOx and particulate matter (PM) emissions. The combustion gases of the thermoelectric power plants working with natural gas (less pollutant) and diesel (more pollutant) cause problems to the environment, for their components harm the human being life, animals and directly the plants. The resulting pollution from natural gas and diesel combustion is analyzed, considering separately the CO2, SO2, NO2 and particulate matter gas emission and comparing them with the in use international standards regarding the air quality. It can be concluded that it is possible to calculate thermoelectric power plant quantitative and qualitative environment factor, and on the ecological standpoint, for plant with total power of 41441 kW, being 27 170 kW for the gas turbine and 14271 kW for the steam turbine. The natural gas used as fuel is better than the diesel, presenting ecological efficiency of 0.944 versus 0.914 for the latter, considering a thermal efficiency of 54% for the combined cycle. (c) 2006 Elsevier Ltd. All rights reserved.