Kvinnors erfarenhet av postoperativ smärta och smärtlindring efter kejsarsnitt

Background: Many women experience high levels of pain after caesarean birth. Adequate postoperative pain treatment is important for the mother to be able to breastfeed, take care of the infant and experience a positive birth. Objective: The overall aim is to study women’s experience of postoperative pain and pain relief after caesarean birth. Method: A quantitative retrospective survey. Data were collected thru a questionnaire from Centralsjukhuset in Karlstad and Falu Larsarett in Sweden. Ninety-eight women participated in the study. Data was analysed with descriptive and comparative statistic. Result: Eighty percent of the women rated the pain with VAS = 4 during the first 24 hours post operative. Those who had to undergo acute caesarean birth rated significant higher levels of pain compared with those who had undergone planned caesarean birth. Despite high level of pain the women were satisfied with the pain relief they received. Both the ability to breastfeed and take care of the infant were affected by pain the first 24 hours post operative. Those who had undergone emergency caesarean birth experienced in greater extend the birth in a negative way. Conclusion: Postoperative pain affects the women’s ability to breastfeed and takes care of here infant. Adequate pain management is therefore important. The women who had to undergo emergency caesarean birth have a more negative birth experience. Midwifes have an important role to inform and support the women in processing here experience.

Uma análise exploratória da indústria de serviços PWLAN Wi-Fi no Brasil: em busca de uma vantagem competitiva sustentável

As telecomunicações no mundo têm avançado a passos largos na oferta de novas tecnologias e padrões que viabilizam e flexibilizam a transmissão / recepção de informações entre pessoas e a Internet. Em especial, no que tange à ubiqüidade, o uso de dispositivos de comunicações móveis sem fio, como telefones celulares e PDAs (Personnal Digital Assistant), tem permitido às empresas alcançarem seus clientes a qualquer hora e em qualquer lugar. Muitos padrões de comunicação wireless têm surgido, inicialmente na indústria de telefonia móvel celular e, em seguida, na indústria de computadores e PDAs, habilitando a comunicação wireless de dados em banda larga e o comércio eletrônico móvel (m-commerce). Em especial, o padrão Wi-Fi tem sido difundido mundialmente através da expansão de redes públicas sem fio (PWLANs). Assim, os fabricantes de equipamentos de telecomunicações, as empresas operadoras de serviços de telefonia fixa e móvel e até provedores de acesso à Internet têm manifestado grande interesse nessa área por perceberem novas oportunidades de aumento de receita através da tecnologia Wi-Fi. Todos estes aspectos da recente história do Wi-Fi têm gerado questionamentos quanto a seu futuro sucesso e real geração de vantagem competitiva sustentável, não obstante o volume de negócios relativos a esta tecnologia estar em franco crescimento. Este trabalho propõe-se a analisar o mercado de serviços PWLAN Wi-Fi brasileiro, identificando os principais atores e os modelos de negócio praticados por eles, comparando esses modelos aos modelos identificados por Shubar e Lechner. O estudo propõe-se, também, a avaliar tais empresas e seus respectivos modelos de negócio segundo o framework VRIO desenvolvido por Barney com base na visão estratégica baseada em recursos (RBV- Resource Based View).

Epidemiologia molecular da tuberculose resistente a múltiplos fármacos no Rio Grande do Sul

A tuberculose resistente a múltiplos fármacos (TB MDR) é definida como uma forma de tuberculose (TB) causada por Mycobacterium tuberculosis resistente a pelo menos isoniazida e rifampicina. A TB MDR é um problema mundial crescente resultante da não adesão dos pacientes ao tratamento e pelo gerenciamento ineficaz da doença pelos sistemas de saúde. Este estudo foi realizado com o objetivo de identificar os fatores de risco e os padrões de transmissão da TB MDR no Estado do Rio Grande do Sul, comparando os resultados obtidos com aqueles casos de TB suscetíveis aos fármacos. Durante os anos de 1999 e 2000 foram identificados 60 isolados MDR no Laboratório Central do RS (LACEN) e 202 isolados suscetíveis aos fármacos anti-TB. Estes isolados foram analisados utilizando a técnica de Polimorfismo do Tamanho dos Fragmentos de Restrição (RFLP) baseado no IS6110. Os dados clínicos e demográficos dos pacientes portadores destas linhagens também foram analisados. Nos isolados que apresentaram seis ou menos cópias de IS6110 foi realizada uma segunda técnica de genotipagem, o Spoligotyping. Os pacientes portadores de linhagens de M. tuberculosis com padrões idênticos foram considerados clusters. Foi observado que entre os 262 isolados, 94 (36%) pertenciam a 20 distintos clusters, e após a análise por Spoligotyping, 89 destes isolados (34%) permaneceram em cluster. Os isolados MDR não diferiram estatisticamente dos isolados suscetíveis na proporção de formação de cluster. Foi observada associação significante entre a ocorrência de TB MDR e tratamento prévio (p < 0,001) e falência no tratamento (p < 0,001). No entanto, os pacientes HIV positivos foram associados com TB suscetível (p = 0,024). Também foi identificado que pacientes não casados desenvolveram mais TB devida à transmissão recente (p < 0,005). A introdução da terapia supervisionada de curta duração (DOTS) no RS será importante, pois auxiliará na diminuição das taxas de falência e abandono de tratamento, evitando o desenvolvimento de novas linhagens MDR.

Humanização do atendimento à criança na atenção básica: visão dos profissionais

Objetivou-se compreender a humanização do atendimento à criança na Atenção Básica na visão dos profissionais. Estudo qualitativo, realizado em uma Unidade de Saúde da Família de Natal-RN, Brasil. Dezesseis profissionais responderam a um formulário contendo questões referentes ao atendimento à criança, à humanização e às práticas realizadas para humanizar o atendimento. Os dados foram categorizados por temas e analisados a partir dos princípios da Política Nacional de Humanização. Para os profissionais, humanizar o atendimento envolve acolher, escutar, aconselhar sobre o que está sendo realizado com a criança, valorizar a família, e tornar o sujeito ativo no atendimento, mesmo que de forma incipiente. A maioria dos profissionais descreveu atendimento que valorizava parte dos princípios da política de humanização, mesmo com dificuldades para implementá-los na rotina. Requer, portanto, estímulos e atualização dos profissionais para uma postura autocrítica sobre o atendimento

Al-based anodic oxide films structure observation using field emission gun scanning electron microscopy

In the present work, the anodic oxide films of Al, Al-Cu 4.5% and Al-Si 6.5% alloys are formed using direct and pulse current. In the case of Al-Cu and Al-Si alloys, the electrolyte used contains sulfuric acid and oxalic acid, meanwhile for Al the electrolyte contains sulfuric acid only. Al-Cu alloy was submitted to a heat treatment in order to decrease the effect of inter metallic phase theta upon the anodic film structure. Fractured samples were observed using a field emission gun scanning electron microscope JSM-6330F at (LME)/Brazilian Synchrotron Light Laboratory (LNLS), Campinas, SP, Brazil. The oxide film images enable evaluation of the pore size and form with a resolution similar to the transmission electron microscope (TEM) resolution. It is also observed that the anodizing process using pulse current produces an irregular structure of pore walls, and by direct cur-rent it is produced a rectilinear pore wall. (c) 2005 Elsevier B.V. All rights reserved.

Toxicidade diferencial de agrotóxicos utilizados em citros para Neoseiulus californicus, Euseius concordis e Brevipalpus phoenicis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Educação escolar para crianças: o que dizem sujeitos deste direito?

The text aims to discuss the problems that this would be set: - What are the concepts of public school children about their right to primary education, as required step in the Basic Education? - What are conducted by children on the elementary school, in terms of its structure, teaching, and acquisitions provide for their users, especially when it comes to literacy? In order to answer these questions, we conducted within the qualitative a case study within twenty children of the early years of elementary public school, ten of the School Mauricio de Sousa and ten children of the School Monteiro Lobato. with construction procedures of data, we worked with observation, semi-directive interview, questionnaire and document analysis. In analyzing the data, two categories emerged: right to education and school for children. The first focuses on what children think about the legal guarantee to school, seeking to understand if they understand the educational area as a right and relate what the law says and the reality in which they participate. The category for school children, including their purposes, characteristics, space literacy and its relationship with the teacher. In this sense, we comment, taking as its founding, the speech of children in their schools, focusing on how they perceive the school in terms of its structure and functioning, relations with the knowledge and the other children. With regard to child rights, the appreciation of Brazilian children should be the basis of the struggle for a more just, democratic, nondiscriminatory. However, children show not recognize education as a right, but as one who deserves the credit, that is, those children who are always attentive, do not fight and do not complain. In interviews, children express a simple wish child that the school had toys. A school for children should be a place with its own characteristics: cheerful, lively, colorful, which included the same time, security and challenges. Children point to the hope that the course of action the teacher was guided by respect their differences in a more emotional, especially with regard to issues of authority and discipline of the group. The most important learning is for all subjects learning to read / write, differing in the idea of how to learn. Unfortunately, for some students, learning reading and writing appears as a difficult and enjoyable process is not perceived by some subjects up to recognize the instrumental writing. Finally, we point to the actors of the school to launch a more accurate to say that the children and how to outline your main locus of learning

O estágio supervisionado como contexto de formação docente específica para educação infantil: o que dizem os formandos sobre suas aprendizagens?

Kindergarten teachers training gains the spotlight with the passing of Law number 9.394/96 (Guidelines and Basis Law) that defines this segment as the initial step of basic education, with pedagogical function. In this spectrum, the discussion about teacher training unravels to ensure social quality to education as well as the teacher s specificities towards child singularities. Adding to that, the growing propagation of Pedagogy in an undergraduate level, given that such course has been continually transformed by the National Curriculum Guidelines for Pedagogy (2006), highlighting the addition of curriculum components that are specific to upbringing. The complex debate circa kindergarten teachers training has advancements and hardships that need to be unveiled in order to improve both formation and social quality of education in the 0- 5 years old range. This investigation inserts itself in said context and aims to analyze which knowledge, specific to kindergarten teaching are constructed, according to undergraduate trainees, in Pedagogy s supervised internship. The study was conducted alongside the discipline: Supervised Internship in Child Education ministered by the Advanced Campus of Rio Grande do Norte s State University s in the municipality of Patu-RN (CAP-UERN-Patu) and was conducted through 2012 by accompanying four undergraduate interns. We first assumed that the development of teaching knowledge is a complex process of appropriation of cultural-social practices and is symbolically mediated by interactions that occur in the formation context, and the supervised internship can be understood as a space for the articulation and enlargement of theoretical and practical knowledge, directly related to the specificities of child education. The theoretical-methodological foundation was based upon the historiccultural approach of L. S. Vygotsky and M. Bakhtin s dialogism on human sciences research, as well as his postulates on learning and developmental processes, conceived as both essentially social and discursive. The investigation approached the principles of the qualitative perspective and to the construction and analysis of data, involved documental analysis and, specially, semi-structured interviews, both individual and collective, whose fundamental premise was the production-comprehension of meanings in a dialogical perspective. The participants texts/speeches produced a synthesis that points to the occurrence, within the supervised internship at CAP/UERN, of internalization/appropriation processes and, as such, of formulation of meanings that are pertinent to child education: child, childhood, kindergarten and teacher signification and this stage s specific teaching knowledge. It stood out that the internship, alongside other curriculum components, is, in fact, one of the primeval formation environment for the teachers, in which the interns interact with their colleagues, supervisor professor, collaborator professor, and of course, the children to construct their erudition. Such interactions allow the undergraduate interns to develop attitudes and procedures to reflect on what they know, what they ve done and what they can achieve. We have concluded that the undergraduate internship can constitute itself as an articulatorconsolidator environment in the future teacher s formation process and, since well oriented, can provide the effective initiation, not only to the practice, but to the praxis as a movement of non dissociability between theory and practice

O processo de trabalho e a composição técnica do trabalho do enfermeiro no cuidado à saúde da criança em unidades de saúde da familia

With the trajectory that the problems related to child health are taking in our society, particularly with regard to infant mortality, beyond the process of decentralization of health and the implementation of the Family Health Strategy in the cities, where it has increased considerably performance of nursing staff in Primary Health Care, they can be considered essential factors for reflections on the care of nurse dispenses the health of these children. In order to check how it is organized the working process of the nurse in caring for these children in USFs as well as the difficulties found in the dynamics of this work, this research aimed to analyze the work processes of nurses in care Child Health in USFs, with emphasis on technologies used in producing care. This is a research exploratory and descriptive with qualitative approach, based on the theoretical reference in about Work Process and Composition Technique of Work. The data were collected through semi-structured interviews of 11 nurses who, at the moment, perform their functions for more than 01 year at USF. The guiding questions were based at theoretical reference. To analyze the results, was used the referential of content analysis, and was refer to thematic analysis. In situations that were involved closed questions of the interview, was used the aid of SPSS 15.0 program for Windows. The results indicated that the process of nurse work in health care of children, focuses on the preventive character, whose focus of the actions are healthy children, following the routines and protocols established by the Ministry of Health with a view to maintaining health them. When analyzing the data through theoretical references of Composition Technique of Work found that the core technologies of daily tasks of the nurse are directed for the use of technology soft-hard and hard, and the reason established between the Dead Working and Alive Working, there is prevalence of the first against the second in the production of this care. These situations contribute to the explanation of the emergence problems related to adhesion of mothers / caregivers to monitoring the CD, due to character prescriptive and normalizer of actions. The results also suggested the presence of "vanishing lines" in the make of nurses, confirming the self-governance of health professionals in daily work. These "vanishing lines" express the own execution of the Work Live in action, guided by the use of soft technologies, however, was not characterized as a process of technology transition. So, to get a better resolution to the problems related to child health, the nurse has reorganize your work process by focusing on the execution of work live in action.

Uso de técnicas de otimização baseadas em derivadas como suporte do planejamento operacional de redes de distribuição de energia elétrica

The usual programs for load flow calculation were in general developped aiming the simulation of electric energy transmission, subtransmission and distribution systems. However, the mathematical methods and algorithms used by the formulations were based, in majority, just on the characteristics of the transmittion systems, which were the main concern focus of engineers and researchers. Though, the physical characteristics of these systems are quite different from the distribution ones. In the transmission systems, the voltage levels are high and the lines are generally very long. These aspects contribute the capacitive and inductive effects that appear in the system to have a considerable influence in the values of the interest quantities, reason why they should be taken into consideration. Still in the transmission systems, the loads have a macro nature, as for example, cities, neiborhoods, or big industries. These loads are, generally, practically balanced, what reduces the necessity of utilization of three-phase methodology for the load flow calculation. Distribution systems, on the other hand, present different characteristics: the voltage levels are small in comparison to the transmission ones. This almost annul the capacitive effects of the lines. The loads are, in this case, transformers, in whose secondaries are connected small consumers, in a sort of times, mono-phase ones, so that the probability of finding an unbalanced circuit is high. This way, the utilization of three-phase methodologies assumes an important dimension. Besides, equipments like voltage regulators, that use simultaneously the concepts of phase and line voltage in their functioning, need a three-phase methodology, in order to allow the simulation of their real behavior. For the exposed reasons, initially was developped, in the scope of this work, a method for three-phase load flow calculation in order to simulate the steady-state behaviour of distribution systems. Aiming to achieve this goal, the Power Summation Algorithm was used, as a base for developing the three phase method. This algorithm was already widely tested and approved by researchers and engineers in the simulation of radial electric energy distribution systems, mainly for single-phase representation. By our formulation, lines are modeled in three-phase circuits, considering the magnetic coupling between the phases; but the earth effect is considered through the Carson reduction. It s important to point out that, in spite of the loads being normally connected to the transformer s secondaries, was considered the hypothesis of existence of star or delta loads connected to the primary circuit. To perform the simulation of voltage regulators, a new model was utilized, allowing the simulation of various types of configurations, according to their real functioning. Finally, was considered the possibility of representation of switches with current measuring in various points of the feeder. The loads are adjusted during the iteractive process, in order to match the current in each switch, converging to the measured value specified by the input data. In a second stage of the work, sensibility parameters were derived taking as base the described load flow, with the objective of suporting further optimization processes. This parameters are found by calculating of the partial derivatives of a variable in respect to another, in general, voltages, losses and reactive powers. After describing the calculation of the sensibility parameters, the Gradient Method was presented, using these parameters to optimize an objective function, that will be defined for each type of study. The first one refers to the reduction of technical losses in a medium voltage feeder, through the installation of capacitor banks; the second one refers to the problem of correction of voltage profile, through the instalation of capacitor banks or voltage regulators. In case of the losses reduction will be considered, as objective function, the sum of the losses in all the parts of the system. To the correction of the voltage profile, the objective function will be the sum of the square voltage deviations in each node, in respect to the rated voltage. In the end of the work, results of application of the described methods in some feeders are presented, aiming to give insight about their performance and acuity

Uso de técnicas de otimização baseadas em derivadas como suporte do planejamento operacional de redes de distribuição de energia elétrica

The usual programs for load flow calculation were in general developped aiming the simulation of electric energy transmission, subtransmission and distribution systems. However, the mathematical methods and algorithms used by the formulations were based, in majority, just on the characteristics of the transmittion systems, which were the main concern focus of engineers and researchers. Though, the physical characteristics of these systems are quite different from the distribution ones. In the transmission systems, the voltage levels are high and the lines are generally very long. These aspects contribute the capacitive and inductive effects that appear in the system to have a considerable influence in the values of the interest quantities, reason why they should be taken into consideration. Still in the transmission systems, the loads have a macro nature, as for example, cities, neiborhoods, or big industries. These loads are, generally, practically balanced, what reduces the necessity of utilization of three-phase methodology for the load flow calculation. Distribution systems, on the other hand, present different characteristics: the voltage levels are small in comparison to the transmission ones. This almost annul the capacitive effects of the lines. The loads are, in this case, transformers, in whose secondaries are connected small consumers, in a sort of times, mono-phase ones, so that the probability of finding an unbalanced circuit is high. This way, the utilization of three-phase methodologies assumes an important dimension. Besides, equipments like voltage regulators, that use simultaneously the concepts of phase and line voltage in their functioning, need a three-phase methodology, in order to allow the simulation of their real behavior. For the exposed reasons, initially was developped, in the scope of this work, a method for three-phase load flow calculation in order to simulate the steady-state behaviour of distribution systems. Aiming to achieve this goal, the Power Summation Algorithm was used, as a base for developping the three phase method. This algorithm was already widely tested and approved by researchers and engineers in the simulation of radial electric energy distribution systems, mainly for single-phase representation. By our formulation, lines are modeled in three-phase circuits, considering the magnetic coupling between the phases; but the earth effect is considered through the Carson reduction. Its important to point out that, in spite of the loads being normally connected to the transformers secondaries, was considered the hypothesis of existence of star or delta loads connected to the primary circuit. To perform the simulation of voltage regulators, a new model was utilized, allowing the simulation of various types of configurations, according to their real functioning. Finally, was considered the possibility of representation of switches with current measuring in various points of the feeder. The loads are adjusted during the iteractive process, in order to match the current in each switch, converging to the measured value specified by the input data. In a second stage of the work, sensibility parameters were derived taking as base the described load flow, with the objective of suporting further optimization processes. This parameters are found by calculating of the partial derivatives of a variable in respect to another, in general, voltages, losses and reactive powers. After describing the calculation of the sensibility parameters, the Gradient Method was presented, using these parameters to optimize an objective function, that will be defined for each type of study. The first one refers to the reduction of technical losses in a medium voltage feeder, through the installation of capacitor banks; the second one refers to the problem of correction of voltage profile, through the instalation of capacitor banks or voltage regulators. In case of the losses reduction will be considered, as objective function, the sum of the losses in all the parts of the system. To the correction of the voltage profile, the objective function will be the sum of the square voltage deviations in each node, in respect to the rated voltage. In the end of the work, results of application of the described methods in some feeders are presented, aiming to give insight about their performance and acuity

Um ambiente integrado para manipulação de tráfego multicast

In the two last decades of the past century, following the consolidation of the Internet as the world-wide computer network, applications generating more robust data flows started to appear. The increasing use of videoconferencing stimulated the creation of a new form of point-to-multipoint transmission called IP Multicast. All companies working in the area of software and the hardware development for network videoconferencing have adjusted their products as well as developed new solutionsfor the use of multicast. However the configuration of such different solutions is not easy done, moreover when changes in the operational system are also requirede. Besides, the existing free tools have limited functions, and the current comercial solutions are heavily dependent on specific platforms. Along with the maturity of IP Multicast technology and with its inclusion in all the current operational systems, the object-oriented programming languages had developed classes able to handle multicast traflic. So, with the help of Java APIs for network, data bases and hipertext, it became possible to the develop an Integrated Environment able to handle multicast traffic, which is the major objective of this work. This document describes the implementation of the above mentioned environment, which provides many functions to use and manage multicast traffic, functions which existed only in a limited way and just in few tools, normally the comercial ones. This environment is useful to different kinds of users, so that it can be used by common users, who want to join multimedia Internet sessions, as well as more advenced users such engineers and network administrators who may need to monitor and handle multicast traffic

Análise comparativa da região codificadora para a proteína capsidial de isolados de PepYMV e PVY coletados em pimentão

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

Análise do modelo troposférico empregado na geração de uma estação de referência virtual utilizando o posicionamento por ponto preciso

In the past few years the interest is accomplishing a high accuracy positioning increasing. One of the methods that has been applied by the scientific community is the network based on positioning. By using multiple reference station data, it is possible to obtain centimetric positioning in a larger coverage area, in addition to gain in reliability, availability and integrity of the service. Besides, using this concept, it is possible to model the atmospheric effects (troposphere refraction and ionosphere effect). Another important question concerning this topic is related to the transmission of the network corrections to the users. There are some possibilities for this fact and an efficient one is the Virtual Reference Station (VRS) concept. In the VRS concept, a reference station is generated near to the rover receiver (user). This provides a short baseline and the user has the possibility of using a single frequency receiver to accomplish the relative positioning. In order to test this kind of positioning method, a software has been developed at São Paulo State University. In this paper, the methodology applied to generate the VRS data is described and the VRS quality is analyzed by using the Precise Point Positioning (PPP) method.

Classic and molecular study of Giardia duodenalis in children from a daycare center in the region of Presidente Prudente, São Paulo, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)