Pacientes de alta que permanecem dentro do hospital: quem são e por que permanecem?

A existência de hospitais específicos para pacientes de longa permanência se justifica pela necessidade de profissionais e cuidados especializados na sua assistência. O processo que leva à alta hospitalar nessas instituições tem se mostrado mais complexo do que apenas a estabilização do quadro clínico, incluindo fatores que adiam a saída do paciente. O objetivo desta dissertação é identificar os motivos pelos quais pacientes de alta hospitalar permanecem internados dentro de um hospital público de longa permanência situado na Grande São Paulo, na região do Alto Tiete. Um estudo exploratório descritivo transversal identificou 1.211 internações entre janeiro de 2011 e dezembro de 2014, sendo a média de idade de 53,9 anos e com predomínio do sexo masculino (62,7%). Das 822 internações analisadas, ocorreram “atrasos” na saída em 466 casos (56,7%). A média de atraso foi de 19,1 dias (variação de 1 a 606 dias), gerando um total de 8.895 pacientes-dia que poderiam ter sido evitados. Os principais motivos de atraso foram: transporte familiar (39,7%), aguardo de ambulância (14,8%), suporte da rede (12,7%), resistência familiar para saída (12,4%) e adequação de casa/equipamentos (9,4%). Foram propostas formas que poderiam acarretar em diminuição do período de internação hospitalar, uma vez que essa atuação é resultado de combinações de diversos fatores em diferentes áreas. Entretanto, as medidas que devem ser tomadas fundamentam-se num adequado entendimento do sistema de saúde local, do contexto cultural e da legislação vigente.

Caracterização hidráulica, hidrológica e de transporte sólido do evento de 20 de fevereiro de 2010 na Ribeira de São João – Ilha da Madeira

Após o temporal que se abateu sobre a ilha da Madeira no dia 20 de Fevereiro de 2010 ficou a dúvida se a tragédia podia ter sido evitada ou pelo menos minimizada. A intensa intervenção humana, principalmente na baixa da cidade do Funchal, alterou o normal curso das ribeiras. Esse facto levantou a questão se o homem estará a ser negligente ou irresponsável na maneira como constrói nas suas proximidades. Posto isto, o Governo Regional da Madeira achou que algo mais poderia ser investigado em relação ao comportamento das ribeiras em situações extremas, tal como a sucedida. Com o intuito de responder a estas e outras questões, equipas da UMa (Universidade da Madeira), IST (Instituto Superior Técnico) e LREC (Laboratório Regional de Engenharia Civil) iniciaram, em cooperação, um estudo que foi denominado por Estudo de Avaliação do Risco de Aluviões na Ilha da Madeira. Ao autor deste trabalho foi concedida a oportunidade de fazer parte deste importante estudo para a Ilha da Madeira e de poder realizar esta dissertação no âmbito do mesmo. Foram estudadas as três mais importantes ribeiras do Funchal (João Gomes, Santa Luzia e São João) e as ribeiras da Ribeira Brava e Tabua. O presente trabalho, em particular, incidiu sobre a bacia hidrográfica e Ribeira de São João. Este trabalho inicia-se por uma base teórica, onde é feita uma caracterização biofísica à Ilha da Madeira e mais detalhadamente à bacia hidrográfica da Ribeira de São João. Segue-se uma pequena referência a eventos semelhantes e anteriores ao de 20 de Fevereiro. A parte prática do trabalho consiste no tratamento e interpretação dos dados levantados nas visitas de campo. Estimaram-se os valores sucedidos no dia do evento para caudais máximos e velocidades de escoamento em secções transversais da ribeira previamente seleccionadas. Estimou-se também o volume para o material sólido que foi depositado no leito e nas ruas ou estradas que se situam dentro da área da bacia hidrográfica da Ribeira de São João. Foi feita também uma caracterização granulométrica desse mesmo material sólido. Por fim elaboraram-se listas e mapas com as infra-estruturas danificadas. Finalmente foram propostas algumas medidas preventivas que poderão minimizar as consequências de futuras aluviões.

Eutrofização do reservatório Engenheiro Armando Ribeiro Gonçalves, no Rio Grande do Norte: implicações para o abastecimento público e para a piscicultura intensiva em tanques-rede

This study aimed to describe the spatial and temporal patterns of variation in trophic state and its relation with the structure and dynamics of planktonic community of a large reservoir located in semi-arid tropical region of Northeast Brazil. The reservoir Armando Ribeiro Gonçalves is the biggest reservoir of the Rio Grande do Norte State and is responsible for about 53% of all surface water accumulated in the State. The samples of water and plankton were taken monthly in 10 points distributed throughout the longitudinal axis of the reservoir and over a full hydrological cycle. The samples were collected to determine concentrations of total phosphorus, total nitrogen, chlorophyll a and suspended solids (fixed and volatile) and for determining the composition and abundance of phytoplanktonic and zooplanktonic species. During the study period, the reservoir was characterized as eutrophic and there was no trend of increasing the trophic state of the reservoir in the period of drought. The concentrations of total phosphorus and suspended fixed solids decreased towards the dam while the N:P ratios increased in the same direction due to the reduction in the phosphorus concentrations and relative constancy in the nitrogen concentrations. The N:P ratios observed were indicative of greater limitation by phosphorus than by nitrogen. However, as concentrations of both nutrients were high and the water transparency was very low, with secchi depth usually lower than one meter, it seems likely that the planktonic primary production of the reservoir is more limited by the availability of light than the availability of nutrients. High nutrient concentrations coupled with low availability of light may explain the continuing dominance of filamentous cyanobacteria such as Cylindrospermopsis raciborskii in the plankton of the reservoir.These cyanobacteria are potentially toxic and pose a serious environmental problem because it compromises the water quality for public supply, recreation and fishing when present in high densities as in this study. The mesozooplankton of the reservoir was dominated by the calanoid Notodiaptomus cearensis and the cladoceran Diaphanosoma spinulosum. In general, the structure of zooplankton community seems to be particularly influenced by the spatial variation of cyanobacteria. The results of the regression analyses show that both the chlorophyll a concentrations and the cyanobacteria biovolume were more strongly correlated with the nitrogen than with phosphorus and that the water transparency was more strongly correlated with algal biomass than with other sources of turbidity. The maximum load of phosphorus to attain the maximum permissible concentration of total P in the reservoir was estimated in 63.2 tonnes P/ year. The current external P load to the reservoir is estimated in 324 tonnes P / year and must be severely reduced to improve the water quality for water supply and allow the implementation of aquaculture projects that could contribute to the socio-economic development of the region

Modelagem matemática para o transporte de partículas sujeitas a múltiplos mecanismos de retenção

Discrepancies between classical model predictions and experimental data for deep bed filtration have been reported by various authors. In order to understand these discrepancies, an analytic continuum model for deep bed filtration is proposed. In this model, a filter coefficient is attributed to each distinct retention mechanism (straining, diffusion, gravity interception, etc.). It was shown that these coefficients generally cannot be merged into an effective filter coefficient, as considered in the classical model. Furthermore, the derived analytic solutions for the proposed model were applied for fitting experimental data, and a very good agreement between experimental data and proposed model predictions were obtained. Comparison of the obtained results with empirical correlations allowed identifying the dominant retention mechanisms. In addition, it was shown that the larger the ratio of particle to pore sizes, the more intensive the straining mechanism and the larger the discrepancies between experimental data and classical model predictions. The classical model and proposed model were compared via statistical analysis. The obtained p values allow concluding that the proposed model should be preferred especially when straining plays an important role. In addition, deep bed filtration with finite retention capacity was studied. This work also involves the study of filtration of particles through porous media with a finite capacity of filtration. It was observed, in this case, that is necessary to consider changes in the boundary conditions through time evolution. It was obtained a solution for such a model using different functions of filtration coefficients. Besides that, it was shown how to build a solution for any filtration coefficient. It was seen that, even considering the same filtration coefficient, the classic model and the one here propposed, show different predictions for the concentration of particles retained in the porous media and for the suspended particles at the exit of the media

Diagnóstico sócio-produtivo-econômico da comunidade de catadores de resíduos sólidos do município de Codó-MA: um estudo de caso

The research was carried out in the urban area in Codó-MA, a small city the east part of Maranhão, which has 4,228.000 km2 (IBGE, 2000) and population of 113,768 hab. (IBGE, 2008). The city is also inside Codó-MA micro-region. The city is located in one of the lacking area in Brazil, where the Human Development Index (IDH) is approximately 0,558. It does not present an adequate model of management when talking about solid residue collecting. All of the solid residue produced and collected in the city is stored in an open area that they call lixão , which is located in a residence area in the suburbs. Because of that, a problem that involves public health and environmental areas, we understand it is necessary to investigate the way the local government treats and manages the solid residue collecting, as well as, the social, economical and productive reality of those who are directly involved in the collecting itself, its productive chain of the material, including the handling, transportation and its final destiny. It means a social, productive, economical diagnosis, that in a such way,the local society and the organs of inspection can act in a better way to control the problems that include solid urban residue and come from a bad administration. That way, this work proposes to carry out a study that has as result a diagnosis with feasible alternatives on management, taking as basis, social and economical aspects that compound this productive chain. This work can bring great contributions to a better local reality through the introduction of an integrated and supported system of management of solid residue that includes a selective collecting and the creation of a sanitary area. Taking that into consideration, we can contribute to minimize the environmental impacts in Codó Novo, caused by the garbage

Análise da sensibilidade do biodiesel B5 em frotas de transporte coletivo com motorização diesel

The aim of this study was investigate the consolidation of the biodiesel fuel used in (a) engines of urban and intercity bus companies, (b) a stationary engine. It was necessary to investigate and analyze, technologically, if the biodiesel fuels were presenting troubleshooting relative to wear of parts lied to fuel and to evaluate the consumption fluctuations of this fuel. The urban and intercity bus companies, localized in Natal, Rio Grande do Norte state, Brazil, had 41 and 12 vehicles, respectively. It were analyzed datasheet of each one vehicle during three years, since 2008 until 2010 and were interviewed the management of the maintenance team of bus companies relative to aspects concerning the substitution of the diesel fuel by the B5 biodiesel. The second aim of this study was visually inspect the wear of the parts directly lied to combustion process. For this reason, it was investigated a stationary engine, manufactured by Branco BD5, 5 HP of power, fueled by (a) diesel, (b) biodiesel B5, (c) biodiesel B20 and (d) diesel or biodiesel, both contaminated by distilled water. In this engine, its power utilizing biodiesel B5 versus diesel was lower about 5.2% and, in the investigated case of B20 versus diesel, it was lower around 11.5%

Otimização de sistema de bombeamento com energia eólica: sistema de bombeamento de São Gabriel/BA

After the Protocol of Kyoto and of the ECHO 92 - Rio de Janeiro, the attentions of the world focus to the preservation of the environment and of the maintainable use of the natural resources. People were looking for preserving environment for the future generations. Ever since, solutions are looked for the supply of energy in its more acquaintances forms and the substitution of the use of fossil fuels for the such alternative forms as: Photovoltaics, solar heat systems for water, wind , bio-diesel, etc. and in this context the Company of Engineering of the State of Bahia - Cerb changed a diesel pumping system by an wind one, It´s the first community system of this nature in Bahia. Facing problems with the model, a Cerb involved the academic segment of the Federal Center of Technological Education of Bahia Cefetba looking for a solution. This work intends to demonstrate the possibilities of optimization of the pumping communit system that supply water to approximately 50 people in the place of Romão, municipal district of São Gabriel-Ba. Technical reports were published in AGRENERGD2004-Unicamp SP and Scientific Magazine ETC,Cefetba, 2005. A simulation of the increase of energy is presented for heights of 15 and 20m, considering the eletromecanical balance from the pumping energy to the wind turbine. From the accomplished bibliographical revision, we emphasized the mechanical aspects of the engineering once in UFRN, those studies concentrate on the Department of Mechanical Engineering while, in others eletroelectronic are more emphasized. Finally, documents that we judged important were enclosed for the perfect understanding of this work

As fontes de desgaste físico e emocional e a Síndrome de Burnout no setor de transporte coletivo urbano de Natal

Recognizing the importance the workplace has on mental health of the individual, the objective of this study was to investigate the relationship between the burnout syndrome and the sources of physical and emotional wear which permeate the work conditions of the urban public transport system of the city of Natal. Although existent in international literature, research on burnout in the professional transport category and studies directed to this category are not a tradition in Brazil. The research was carried out using 412 drivers and money-changers of two transport companies of Natal. To collect the data, two questionnaires and a semi-structured interview were used. The first instrument, developed and validated during the research, investigated the sources of wear and the second, the syndrome of burnout. As its main results, two sources of empirical wear were identified as follows: (1) the Conflict of Values and the Lack of Justice at the Workplace, (2) Union and Reward. Besides these, it was observed that there is an incidence of the syndrome of burnout among the drivers and money-changers of urban transport by bus, not only in the caring occupations studied before in Natal and Brazil and that this incidence is related to the sources of wear which permeate the work conditions of these professionals

Estudo da mobilidade molecular das blendas aPA/SAN/MMA-MA usando relaxação dielétrica

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Análises técnica e econômica da cultura da bananeira 'Maçã' (Musa spp.) na região noroeste do Estado de São Paulo

Este trabalho foi realizado no Escritório de Desenvolvimento Rural - Jales, região noroeste do Estado de São Paulo, com o objetivo de efetuar um levantamento do potencial da cultura da banana 'Maçã' na região, determinando-se indicadores técnicos e econômicos de dois sistemas de produção, os quais utilizam, no plantio, mudas micropropagadas e convencional. O levantamento de dados necessários à realização da pesquisa nos aspectos ligados à elaboração das matrizes de coeficientes técnicos, base para estimativas de custos de produção, foi obtido diretamente junto a produtores da região, e a metodologia de custos foi baseada no custo total de produção. Os resultados econômicos mostraram-se satisfatórios na região para os dois sistemas de produção, mas a receita líquida obtida com a utilização de mudas micropropagadas foi 34% maior que a obtida no sistema convencional.

Caracterização geológica, geoquímica e geocronológica da suíte plutônica enoproterozóica da região de Serrinha, porção centro-leste do maciço São José de Campestre, sudeste do RN

The of Serrinha plutonic suite, northeastern portion of the Borborema Province (NE Brazil), is characterized by a voluminous and diversified magmatism of Neoproterozoic age, intrusive in the Archean to Paleoproterozoic gneissic-migmatitic basement of the São José de Campestre massif. Field relations and petrographic and geochemical data allowed us to individualize different lithologic types among this plutonic suite, which is represented by intermediate to mafic enclaves, porphyritic diorites, porphyritic granitoids, porphyritic granodiorites, microporphyritic granites and dykes/sheets of microgranite. The intermediate-to-mafic enclaves occur associated with porphyritic granitoids, showing mixture textures. The porphyrytic diorites occur as isolated bodies, generally associated with intermediate-to-mafic enclaves and locally as enclaves within porphyritic granites. The granodiorites represent mixing between an intermediate to mafic magma with an acidic one. The micropophyritic granites occur as isolated small bodies, generally deformed, while the microgranite dykes/sheets crosscut all the previous granitoids. A U-Pb zircon age of 576 + 3 Ma was obtained for the Serrinha granite. This age is interpreted as age of the peak of the regional ductile deformational event (D3) and of the associated the E-W Rio Jacu shear zone, which control the emplacement of the Neoproterozoic syntectonic plutons. The porphyrytic granitoids show monzogranitic composition, transitional between peraluminous and metaluminous types, typically of the high potassium subalkaline-calc-alkaline series. The intermediate-to-mafic enclaves present vary from quartz diorite to tonalite/granodiorite, with metaluminous, shoshonitic affinity. The diorites are generally quartz-monzodiorite in composition, with metaluminous, subalkaline affinity. They display coarse-grained, inequigranular, porphyrytic texture, with predominance of plagioclase phenocrystals immersed in a matrix composed of biotite and pyroxenes. The microporphyrytic granites are essentially monzogranites of fine- to medium-grained texture, whereas microgranite dikes/sheets varying from monzogranites to syenogranites, with fine to media texture, equigranular. The diversified magmatism occurring at a relatively small surface associated with shear zones, suggests lithospheric dimensions for such structures, with magma extractions from different depths within the lower crust and upper mantle. The geological, geochemical and geochronological characteristics of the Serrinha plutonic suite suggest a pos-collisional geodynamic context for the Neoproterozoic magmatism. Thermobarometric data show emplacement conditions in the range 5-6 kbar (AlTamphibole) and 730-740°C (plagioclase-amphibole) for the porphyrytic granitoids (Serrinha body) and the intermediate-to-mafic enclaves

Comportamento voltamétrico da redução de 2-furfuraldeído em etanol utilizando eletrodo de carbono vítreo

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

Concentração de flúor nas águas de abastecimento público de municípios da região noroeste do estado de São Paulo, Brasil

It may be difficult for small and medium cities to obtain information about the fluoride content of public water, because of the lack of equipments and technicians. This study aimed to analyze the fluoride levels of the water supplied by the public treatment stations of 40 cities situated in the northwest region of São Paulo State, during a period of 6 months, to verify if fluoridation occurs in a continuous manner and if the fluoride levels are within the recommended. Maps of the water distribution system were obtained from the water treatment companies and utilized to randomize the addresses of the collection sites, so that they included all regions with treated water sources. One water sample by month was collected and analyzed in duplicate using an ion-specific-electrode. Samples with 0.6 to 0.8 mgF/L were considered acceptable. In the 38 cities that regularly provided the samples in the 6 months of the study, water from 144 collection sites was collected and a total of 864 samples were analyzed, of which 61.81 percent were classified as unacceptable. It was observed that 33 cities performed fluoridation but in 78.79 percent of these cities there were variations in the fluoride level among the sites and in the same site during the period of study. One can conclude that most of these cities do not control the fluoride levels in the public water, since fluoridation occurs in a discontinuous manner and in most of the situations not within the recommended concentrations.

Variação genética, interação genótipo solo e ganhos na seleção em teste de progěnies de Corymbia citriodora Hook em Luiz Antonio, São Paulo

The aim of this study was to investigate the genetic variation, the genotype × soil interaction and the selection among and within Corymbia citriodora progenies in three different kinds of soils (Red Latossol, Quartz Sand and Purple Latossol), which occur in the Luiz Antônio Experimental Station, São Paulo State, Brazil. The progeny test was established 1983, using 56 open-pollinated families of C. citriodora. Twenty fve years after planting the following traits were measured: height, diameter at breast height (Dbh), stem form and survival. Best growth occurred in Purple Latossol. Significant differences among progenies were detected for most traits in all sites, suggesting the possibility of improvement by selection. In the analysis with sites, Significant differences among locals, progenies and genotypes × soil interaction were detected, confiming that the tested material has sufficient genetic variation to be explored by selection in all sites. The analysis of genotype × soil interaction indicates that growth traits present single interaction and the same progenies can be selected in each site. On the order hand, genotype × soil interaction for stem form and survival was complex; and specifc progenies need to be selected for each kind of soil. The population, due to its high genetic variation and strong genetic control of traits, permits to obtain considerable genetic gains by selection among and within progenies.