As diretrizes da política pública de saúde bucal e suas inflexões nos serviços da Clínica Odontológica da UFRN

The crisis that the Brazilian State have been crossing throughout the last decades has revealed intense oscillations in the the way of life of the population reality. In the health area, specifically of buccal health, new alternatives of attending to demands for odontological services have been increasing from the 1990 decade. The research had as objective to analyze the demand of the services of the clinic-school of odontology of the UFRN to identify the socio-economic profile of the users and the inflections of the standards of the National Politics of Buccal Health. The methodology is based on a dialectic perspective and a quali-quantitative boarding. It was used as instrument of data collection forms with open and closed questions, applied to two distinguished groups of citizens: 53 users of the services and 12 pupils of 9th and 10th term of the Odontology Course. The results reaffirm that, with the aggravation of the crisis of SUS (Sistema Único de Saúde- Single Health System) grow the difficulties of accessing the odontological services of the users majority. The subjects of the research make use of a regular socio-economic condition, with high school, own house, formal bond to labor and monthly medium income between 1 and 2 minimum wages. The conclusive analyses point to the selective and exculpatory character of the buccal health right, mainly, those users who find themselves in situation of extreme poverty and social vulnerability. Immediate and of lesser cost odontological assistance is what it s aimed, but the standards praised in the Public Politics of Buccal Health walk in another direction, requiring a bigger strongness of the formation bases and implementation of the programmatical actions since the academic field until the effectiveness of Politics of Buccal Health as a right while as a right to attention and care

Arquitetura multiagente baseada em nuvem de partículas para hibridização de metaheurísticas

This thesis proposes an architecture of a new multiagent system framework for hybridization of metaheuristics inspired on the general Particle Swarm Optimization framework (PSO). The main contribution is to propose an effective approach to solve hard combinatory optimization problems. The choice of PSO as inspiration was given because it is inherently multiagent, allowing explore the features of multiagent systems, such as learning and cooperation techniques. In the proposed architecture, particles are autonomous agents with memory and methods for learning and making decisions, using search strategies to move in the solution space. The concepts of position and velocity originally defined in PSO are redefined for this approach. The proposed architecture was applied to the Traveling Salesman Problem and to the Quadratic Assignment Problem, and computational experiments were performed for testing its effectiveness. The experimental results were promising, with satisfactory performance, whereas the potential of the proposed architecture has not been fully explored. For further researches, the proposed approach will be also applied to multiobjective combinatorial optimization problems, which are closer to real-world problems. In the context of applied research, we intend to work with both students at the undergraduate level and a technical level in the implementation of the proposed architecture in real-world problems

Estudo comparativo do bloqueio combinado femoral-isquiático, por punção em sítio único, com anestesia subaracnóidea para cirurgia unilateral do membro inferior

JUSTIFICATIVA E OBJETIVOS: A raquianestesia unilateral pode apresentar vantagens em pacientes ambulatoriais. O objetivo deste trabalho foi comparar a raquianestesia unilateral com o bloqueio combinado femoral-isquiático em cirurgias ortopédicas unilaterais e ambulatoriais. MÉTODO: Sessenta pacientes foram aleatoriamente separados em dois grupos para receber 6 mg de bupivacaína hiperbárica ou hipobárica (grupo RQ) em decúbito lateral esquerdo ou 800 mg de lidocaína 1,6% com epinefrina nos nervos femoral e isquiático (grupo CFI) em decúbito dorsal. O bloqueio dos nervos foi realizado com agulha de 150 mm conectada a um neuroestimulador e inserida no ponto médio entre as duas abordagens clássicas, sendo injetados 15 mL no nervo femoral e 35 mL no nervo isquiático. Avaliados o tempo para realização dos bloqueios e sua duração. Vinte minutos após, os pacientes foram avaliados em relação aos bloqueios sensitivo e motor. RESULTADOS: O tempo para a realização da raquianestesia foi significativamente menor do que o bloqueio combinado femoral-isquiático. O bloqueio unilateral foi obtido em 90% dos pacientes no grupo RQ e 100% no grupo CFI. O tempo para recuperação do bloqueio sensitivo e motor foi significativamente maior no grupo CFI. Não houve bradicardia ou hipotensão. CONCLUSÕES: Este estudo conclui que é tecnicamente fácil realizar bloqueio anterior combinado femoral-isquiático e pode ser uma alternativa para o bloqueio unilateral do membro inferior. A raquianestesia unilateral com baixas doses de bupivacaína resultou em menor tempo para realização, menor número de tentativas e recuperação mais precoce do bloqueio combinado femoral-isquiático, porém com mesma efetividade.

Effectiveness and safety of endotracheal tube cuffs filled with air versus filled with alkalinized lidocaine: a randomized clinical trial

CONTEXTO E OBJETIVO: Os tubos traqueais são dispositivos utilizados para manutenção da ventilação. A hiperinsuflação do balonete do tubo traqueal, causada pela difusão do óxido nitroso (N2O), pode determinar lesões traqueais, que se manifestam clinicamente como odinofagia, rouquidão e tosse. A lidocaína, quando injetada no balonete do tubo traqueal, difunde-se através de sua parede, determinando ação anestésica local na traquéia. O objetivo foi avaliar a efetividade e a segurança do balonete do tubo traqueal preenchido com ar comparado com o balonete preenchido com lidocaína, considerando os desfechos: sintomas cardiovasculatórios (HAS, taquicardia); odinofagia, tosse, rouquidão e tolerância ao tubo traqueal. TIPO DE ESTUDO E LOCAL: Estudo clínico prospectivo, realizado no Departamento de Anestesiologia da Faculdade de Medicina da Unesp, campus de Botucatu. MÉTODOS: A pressão do balonete do tubo traqueal foi medida, entre 50 pacientes, antes, 30, 60, 90 e 120 minutos após o início da inalação de N2O anestésico. As pacientes foram distribuídas aleatoriamente em dois grupos: Air, em que o balonete foi inflado com ar para obtenção de pressão de 20 cm H2O, e Lido, em que o balonete foi preenchido com lidocaína a 2% mais bicarbonato de sódio a 8,4% para obtenção da mesma pressão. O desconforto antes da extubação, e manifestações clínicas como dor de garganta, rouquidão e tosse foram registrados no momento da alta da unidade de cuidados pós-anestésicos, e dor de garganta e rouquidão foram avaliadas também 24 horas após a anestesia. RESULTADOS: Os valores da pressão no balonete em G2 foram significativamente menores do que os de Air em todos os tempos de estudo, a partir de 30 minutos (p < 0,001). A proporção de pacientes que reagiu ao tubo traqueal no momento da desintubação foi significantemente menor em Lido (p < 0,005). A incidência de odinofagia foi significantemente menor em Lido no primeiro dia de pós-operatório (p < 0,05). A incidência de tosse e rouquidão não diferiu entre os grupos. CONCLUSÕES: Durante ventilação artificial, empregando-se a mistura de oxigênio e N2O, a insuflação do balonete com lidocaína 2% alcalinizada impede que ocorra aumento significante da pressão no balonete e determina maior tolerância ao tubo traqueal e menor incidência de odinofagia no pós-operatório, podendo então ser considerada mais segura e com maior efetividade.

Estudo comparativo entre cinco diferentes tratamentos sobre as alterações clínicas e laboratoriais do rato diabético induzido pela aloxana

OBJETIVOS: Este estudo visa a analisar os efeitos, a longo prazo, de cinco diferentes tratamentos sobre o controle metabólico de ratos diabéticos aloxânicos. MÉTODOS: Foram analisados 7 grupos experimentais, com 50 ratos cada um, sendo: GN o grupo controle normal; GD o grupo controle diabético, sem tratamento; GI, GA e GIA os grupos tratados, respectivamente, com insulina, acarbose e associação insulina + acarbose; GTIL o grupo tratado com transplante de ilhotas de Langerhans; e o GTPD o grupo tratado com transplante pancreatoduodenal heterotópico. Parâmetros clínicos (peso, ingestão hídrica, ingestão alimentar e diurese) e laboratoriais (glicemia, glicose urinária e insulina plasmática) foram avaliados em todos os animais, no início do experimento, e após 1, 3, 6, 9 e 12 meses de seguimento. RESULTADOS: À exceção do GN, mortalidade foi observada em todos os grupos experimentais no seguimento de 12 meses (GD= 50%; GI= 20%; GA= 26%; GIA= 18%; GTIL= 4%; GTPD= 20%). em GD, GI, GA e GIA os óbitos ocorreram por distúrbios metabólicos ou hidroeletrolíticos e/ou pneumonia, diarréia e caquexia; em GTIL e GTPD todos os óbitos ocorreram por falhas técnicas no pós-operatório até 72h. Animais dos grupos GI, GA e GIA tiveram melhora significativa (p < 0,05) de todos os parâmetros clínicos e laboratoriais observados em ratos diabéticos, sem diferença de efetividade entre os tratamentos. Porém, os resultados observados nestes grupos, biologicamente não foram comparáveis aos observados em GTIL e GTPD, onde observou-se correção completa, aos níveis normais, de todas as variáveis analisadas (p<0,01). CONCLUSÕES: Os tratamentos convencionais com insulina, acarbose e insulina + acarbose melhoraram o estado diabético grave dos ratos tratados, contudo, a eficácia dos tratamentos foi significativamente inferior à oferecida pelo GTIL e GTPD.

Effects of Compounds from Passiflora edulis Sims f. flavicarpa Juice on Blood Coagulation and on Proteolytic Enzymes

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

A contribuição da asstênia técnica no desenvolvimento desenvolvimento de projetos de assentamento no estado do Rio Grande do Norte

The public policies must have as their aimed the primordial at improving quality of life of families of a given population, however, its performance must be constantly monitored and evaluated scoped to ascertain whether these policies are reaching those goals. This work consisted in search of bibliographies and analysis that addressed the historical evolution of the debate on the subject of agrarian reform in Brazil as public policy and on the policy of technical assistance and rural extension, and collecting data in loco, in order to assess whether the actions implemented under this latter contribute to improvements in local development of settlements projects (PA) land reform in the state of Rio Grande do Norte (RN), this given the constant presented criticisms regarding their effectiveness, considering that it is difficult to empirically differentiate settlements they received of those who did not receive the technical assistance services. In this way, was held the data collection for comparison of characteristics (social organization, relationship with the local environment, form of producing and evaluation of technical assistance services) of two settlements in RN, being one you have received the technical assistance services and another who has not had access to these services in the past five years, at least, to confirm whether those who had access to the above services presents best features of social organization and the relationship with the local environment, mainly, which was confirmed in the results obtained, which still demonstrated that no significant differences on the forma to produce and of commercialization in PA studied. It was also found that the problems faced by families settled in PA studied resemble those seen verified in many other Brazilian states, especially as to how to use natural resources in the areas of land reform and the instability of the availability of technical assistance services. Should be guaranteed at continuity and universality of technical assistance services to settlements, seeking a higher focus on productive issues, which provide the income necessary for families settled can have a better quality of life

Programa de Avaliação de Desempenho: elementos constitutivos e pressupostos na prática avaliativa

This study analyzes the perceptions of technical and administrative UFPA, in relation to the insertion of the components and assumptions of DBP in evaluation practice. Addresses the history, concepts, meanings, about AD methods, skills, evaluation skills, the APF and AD UFPA and Programme itself. The research is characterized as a hypothetical-deductive, descriptive and applied, using the case study. Data were analyzed using a quantitative approach, using the descriptive and inferential statistics. Data were collected through the application of questionnaires to 222 technical and administrative searched IFES, not occupants of FG and CD. The results indicate that the factors perceived in relation to the constituent elements such as: evaluation practice, measurement of competence, program management, timing, individual skills and fundamentals of the program and those related to assumptions such as: democratic process, integrative perspective, character development and pedagogical continuous evaluation practices are perceived in the evaluation process. The study concludes that comparing the results of the constituent elements and assumptions of the PAD of thechnical-administrative UFPA, it can be said about a tendency to change, though subtle, compared to the traditional model of AD, directed only to the granting of career progression for a new logic based on the results, showing an early effectiveness of the program evaluation practice by law and by the Institution. The results are confirmatory of advance evaluation practice in the institution, more so than has previously been expected, which demonstrates the value of scientific criteria of scientific research

Proteção constitucional do consumidor no âmbito da regulação publicitária

The concern with issues related to consumer protection has emerged in North America and then spread throughout the world. In Brazil, consumer‟s rights and interests only gained greater importance after their consolidation in the Constitution of 1988 and the enactment of the 8078/90 Law (Consumer‟s Protection and Defense Code), which established the consumerist microsystem. The understanding of the legal relationship of consumption concept is necessarily connected to knowledge of the elements that compose it. Among these, we can find the consumer and the provider (subjective elements), the product or service (objective elements), and the consumer‟s condition as final receiver of the consumption object (finalistic element). In order to elucidate the configuration of consumer protection before advertising communication, this work will analyze the advertising through the prism of consumerist laws, conceptualizing it and presenting a differentiation of it in relation to practices such as marketing, offer and commercial communication as well as examining its several kinds of manifestation, focusing mainly the ones categorized as misleading or unfair advertising. All kinds of advertising communication against the consumerist microsystem are subject to judicial control exercised by the State. Besides individual protection possibilities, this state-owned control can be collectively exercised as a result of the utilization of public civil action and popular action. Some specific categories of advertising (smoking products, alcoholic beverages, pesticides, medicines and therapies) are still subject to a set of particular restraints provided by the 9294/96 Law, which enables the performance of a special control in relation to them. In addition to state control, there is also a system of advertising communication self-regulation, which develops itself through the actions of the National Council of Advertising Self-Regulation that are based mainly on the laws established by the Brazilian Code of Advertising Self-Regulation and its annexes. However, this system of advertising self-regulation still has some deficiencies that hinder its effectiveness

Ação de impugnação de mandato eletivo: análise constitucional e novas perspectivas

This study is developed in setting in which the Federal Constitution of 1988 completed 22 years of validity, as well as in general elections (national and state) in country. From this perspective, there are multiple reflections, especially on the constitutional mechanisms of popular sovereignty consolidation, the integrity and legitimacy of elections and democracy itself. It has appeared timely, therefore, to examine the development of ensured instrument of these precepts. Thus, it is approached as an object of research to Action of Impugnation to the Elective Mandate- AIEM, under Art.14, § 10 and § 11 of the Constitution of 1988, considering its constitutional and electoral reasons. It is then aimed to review the second AIEM conceptions of scale, systematic interpretation, preservation of constitutional rights and its effectiveness. Specifically, it is analyzed the Action as to the forms of power that relate to this. then it is examined the democracy principal aspects related to the issue. Without being followed, it is the democratic situation in which it is operated. They are also examined the political rights, especially regarding restraint applied to ineligibility and the possibility of integrating the effects of an impugnatory origin. Following, it has been discussed the formation of an early panorama, consisting of constitutional principles applied to electoral constituencies and eminently procedural principles and, according to which subsidizes the operations of such Action. After that, addressing the Election Law, including its concept, its sources, the Electoral Court and its peculiarities and functions. It is also considered the elective office as to its definition, characteristics and ways of accessing and extinguishing it. Afterwards, the Action of Impugnation is studied from its historical evolution of laws, legal, concept and goals. Expanding on the theme, it s highlighted about their chances of traditional appropriateness (economic power abuse, corruption and fraud) and modern (abuse of economic power intertwined with political) business, including the suggestion of suitability in case of abuse of unique political power. It was also identified the injurious potential demand affecting these illicit to enable the Action. Subsequently, other relevant aspects were explored, such as the legitimacy ad causam, competence, secrecy, procedure, recklessness, bad faith, the purpose of the merits and manageable resources. In the end, it is demonstrated an evolution of AIEM, however, still insufficient to reach full intentions that rise it. It is proposed therefore to re-read the action from news perspectives, based on constitutional and electoral precepts, as well as wider interpretation of the appropriateness of their assumptions of suitability and effects, according to a systematic interpretation, all aimed at the preservation of constitutional rights and their own effectiveness

Outras verdades, muito extraordinárias, do grande sertão

This study explores the symbolism of evil way in the novel Grande sertão: veredas, by Guimarães Rosa, regarding faustian pact by Goethe, and so tries to understand how the rosiana language are present to the strategies which put in suspense the effectiveness of the demonic agreement and enable, with poetic intensity, different interpretations, especially as regards the anguish of the human condition. This research thus has drawn upon the Mythical Symbolism, in Literary Criticism and aspects of Metaphysics, in addition to analyzing classic literary essays in approaching of Rosa s masterpiece structure. It has also demonstrated that the incorporation of the Faust legend in Grande sertão reflects the same desire for happiness that is not done completely, and in this manner, instigates a discussion about the limits to the satisfaction of being human. Therefore, it has observed that epic narrative of ex-gangster Riobaldo to the doctor of city speculates on human man, in the continuous learning of his passing

Confirmação de presença de usuário à cirurgia eletiva por telefone como estratégia para reduzir absenteísmo

O presente trabalho trata-se de pesquisa quase experimental para avaliar o impacto na redução do absenteísmo de usuários agendados para cirurgia eletiva, quando submetidos à confirmação de presença por telefone. O estudo foi conduzido no Centro Cirúrgico do Hospital das Clínicas da Faculdade de Medicina de Botucatu, durante trinta dias, perfazendo 89 usuários. Os resultados indicaram a efetividade da intervenção, que reduziu o absenteísmo em 30%. Recomenda-se sua implementação na antevéspera da cirurgia, possibilitando novas tentativas para encontrar o usuário no domicílio e convocação de outro. A criação de um núcleo de atendimento poderia constituir um canal de comunicação entre instituição e usuário, permitindo a confirmação da presença da pessoa e a oportunidade de sanar dúvidas sobre o tratamento e comunicar eventuais impedimentos à cirurgia. O núcleo demandaria um profissional com habilidade e conhecimento do serviço, uma vez que os usuários requerem orientações sobre o tratamento durante o contato telefônico.

Segmentação fuzzy de imagens coloridas com características texturais: uma aplicação a rochas sedimentares

Image segmentation is the process of labeling pixels on di erent objects, an important step in many image processing systems. This work proposes a clustering method for the segmentation of color digital images with textural features. This is done by reducing the dimensionality of histograms of color images and using the Skew Divergence to calculate the fuzzy a nity functions. This approach is appropriate for segmenting images that have colorful textural features such as geological, dermoscopic and other natural images, as images containing mountains, grass or forests. Furthermore, experimental results of colored texture clustering using images of aquifers' sedimentary porous rocks are presented and analyzed in terms of precision to verify its e ectiveness.

Estratégias de enfrentamento da incontinência urinária por mulheres

Este artigo é parte de uma pesquisa qualitativa mais abrangente que utilizou como referencial teórico-metodológico a Grounded Theory e o Interacionismo Simbólico, resultando no modelo teórico denominado Entre o sofrimento e a esperança: a reabilitação da incontinência urinária como componente interveniente. Com a intenção de comunicar todo o conhecimento produzido, apresenta-se parte desse modelo, referente ao processo de enfrentamento da incontinência urinária por mulheres sem perspectivas de acesso ao tratamento cirúrgico, após falha dos procedimentos conservadores. Ao inter-relacionar os componentes (categorias e subcategorias) relativos à experiência dessas mulheres, buscando compará-los e analisá-los para compreender a interação entre eles, notou-se vulnerabilidade moral e psicossocial no movimento da experiência do grupo, suscetibilizando-o a riscos à saúde e ao comprometimento da qualidade de vida. Pesquisas são necessárias para aprofundar a compreensão de experiências em que haja barreira ao tratamento cirúrgico por descrédito do profissional médico sobre sua efetividade.

Mapa dos programas sociais: transferência de renda e dinâmicas sociais no Rio Grande do Norte (2000-2007)

The question of evaluating the fight against poverty in a given society is very complex task, considering the range of factors that permeate, such as education, culture and economy itself. Come hence the relevance of the theme and its constant presence in discussions on the fruits of public policies, institutional structure and economic development which are the guiding elements of this work, and noted that seeks to highlight the social demographics and most important, the most significant trends and issues pertaining to her. The assessment was initially made in all the municipalities of Rio Grande do Norte doing a verticalilzação to the municipalities Caicó, Pau dos Ferros, Ipueira and Taboleiro Grande. Highlighting the role of a social policy through government programs, such as the Bolsa Familia Program (PBF), which creates the possibility of changes in the socio demographic profile given the importance that the action of this public policy has in shaping the regional economic reality As well as social programs and actions of the government here reported that generate mobility of people and new social demands, such as rural retirements, the benefit of continuing provision (BPC), the Program for the Eradication of Child Labor (PETI) that put on the market of population living on the margins of various forms of consumption. Accordingly, the socio economic profile of the state shows a significant improvement in their social indicators, vital education and redistribution of income, due to the significant improvement in life expectancy in the fall of school drop-out rate and the drop in indicators of Proportion Poor and destitute of the state. Where the fall in the proportion of poor and indigent is strongly associated with an increase in income, from social programs. With this transfer and redistribution of income can be gauged that occurs a strengthening of local economies and an engagement of families with the conditionalities of social programs and PETI Bolsa Familia. Our research concludes that simply raising the rents caused by transfers, presents relevant impacts on the education of young people in beneficiary families. There is no doubt that the programs of transfer income, no facing the social field, representing a mechanism to decrease the most perverse ills of poverty, social and economic inequality that is hungry. For a significant portion of the Brazilian population living below the poverty line, programs for the transfer of income are expressed directly in improving the material conditions of life and indirectly in improving self-esteem of women and all family members receiving encouraging yet the integration family. Experiments have shown that improvements in health and nutrition can be obtained through the implementation of adequate social policies like the programs of transfer income, while social inclusion and economic does not become full