Estudos analíticos dos grafoelementos do eletroencefalograma em sono: fusos do sono, ondas agudas do vértex e o gradiente de freqüência e amplitude, como indicadores de comprometimento neurológico na criança

Innumerable studies have focused been reported on the sleep spindles (SS), Sharp Vertex Waves (SVW) and REM, NREM Sleep as indicators interpreting EEG patterns in children. However, Frequency and Amplitud Gradient (FAG) is rarely cited sleep parameter in children,that occurs during NREM Sleep. It was first described by Slater and Torres, in 1979, but has not been routinely evaluated in EEG reports. The aim of this study was to assess the absence of SS, SVW and FAG, as an indication of neurological compromise in children. The sample consisted of 1014 EEGs of children referred to the Clinical Neurophysiology Laboratory, Hospital Universitário de Brasília (HUB), from January 1997 to March 2003, with ages ranging from 3 months to 12 years old, obtained in spontaneous sleep or induced by choral hydrate. The study was transversal and analytical, in which, visual analysis of EEG traces was perfumed individually and independently by two electroencephalographers without prior knowledge of the EEG study or neurological findings. After EEG selection, the investigators analyzed the medical reports in order to define and correlate neurological pattern was classified according to the presence or absence of neurological compromise, as Normal Neurological Pattern (NNP), and Altered Neurological Pattern (ANP) respectively. From the visual analysis of the EEG(s), it was possible to characterize 6 parameters: 1- FAG present (64,1%); 2- FAG absent (35,9%); 3 - normal SS (87,9%); 4 - altered SS s (12,1%); 5 - normal SVW s (95,7%); 6 - altered SVW s (4,3%). The prevalence of well-formed FAG is found in the 3 months to 5 years age group in the children with NNF. FAG was totally absent from the age of 10 years. When comparing the three sleep graphielements, it was observed that SVW and SS were predominant in children with NNF. However, FAG absent was more prevalent in the ANF than in altered SS an SVW. The statistical analysis showed that there is a strong association of FAG absent, with isolated alteration, in ANF patients, in that the prevalence ratio was 6,60. The association becomes stronger when FAG absent + altered SS(s) is considered (RP= 6,68). Chi-square test, corrected by Yates technique, showed a highly significant relation for FAG ρ= 0,00000001, for error X of 5%, or else the 95% confidence interval (ρ<0,05). Thus, the FAG absent were more expressive in ANF patient than altered SS(s) and SVW(s). The association becomes stronger in order to establish a prognostic relation, when the FAG is combined with the SS. The results os this study allow us to affirm that the FAG, when absent at ages ranging from 3 months to 5 years , is an indication of neurological compromise. FAG is an age-dependent EEG parameter and incorporated systematically, in the interpretation criteria of the EEG of children s sleep, not only in the maturational point of view, but also neurological disturbances with encephalic compromise

Avaliação do desenvolvimento neuropsicomotor em crianças na rede básica de saúde utilizando o teste de Denver II: identificação de fatores de risco materno

Alterations in the neuropsychomotor development of children are not rare and can manifest themselves with varying intensity at different stages of their development. In this context, maternal risk factors may contribute to the appearance of these alterations. A number of studies have reported that neuropsychomotor development diagnosis is not an easy task, especially in the basic public health network. Diagnosis requires effective, low-cost, and easy - to-apply procedures. The Denver Developmental Screening Test, first published in 1967, is currently used in several countries. It has been revised and renamed as the Denver II Test and meets the aforementioned criteria. Accordingly, the aim of this study was to apply the Denver II Test in order to verify the prevalence of suspected neuropsychomotor development delay in children between the ages of 0 and 12 months and correlate it with the following maternal risk factors: family income, schooling, age at pregnancy, drug use during pregnancy, gestational age, gestational problems, type of delivery and the desire to have children. For data collection, performed during the first 6 months of 2004, a clinical assessment was made of 398 children selected by pediatricians and the nursing team of each public health unit. Later, the parents or guardians were asked to complete a structured questionnaire to determine possible risk indicators of neuropsychomotor development delay. Finally the Denver II Developmental Screening Test (DDST) was applied. The data were analyzed together, using Statistical Package for Social Science (SPSS) software, version 6.1. The confidence interval was set at 95%. The Denver II Test yielded normal and questionable results. This suggests compromised neuropsychomotor development in the children examined and deserves further investigation. The correlation of the results with preestablished maternal risk variables (family income, mother s schooling, age at pregnancy, drug use during the pregnancy and gestational age) was strongly significant. The other maternal risk variables (gestational problems, type of delivery and desire to have children) were not significant. Using an adjusted logistic regression model, we obtained the estimate of the greater likelihood of a child having suspected neuropsychomotor development delay: a mother with _75 4 years of schooling, chronological age less than 20 years and a drug user during pregnancy. This study produced two manuscripts, one published in Acta Cirúrgica Brasileira , in which an analysis was performed of children with suspected neuropsychomotor development delay in the city of Natal, Brazil. The other paper (to be published) analyzed the magnitude of the independent variable maternal schooling associated to neuropsychomotor development delay, every 3 months during the first twelve months of life of the children selected.. The results of the present study reinforce the multifactorial characteristic of development and the cumulative effect of maternal risk factors, and show the need for a regional policy that promotes low-cost programs for the community, involving children at risk of neuropsychomotor development delay. Moreover, they suggest the need for better qualified health professionals in terms of monitoring child development. This was an inter- and multidisciplinary study with the integrated participation of doctors, nurses, nursing assistants and professionals from other areas, such as statisticians and information technology professionals, who met all the requirements of the Postgraduate Program in Health Sciences of the Federal University of Rio Grande do Norte

Mortalidade da população em idade ativa (PIA) por doença cardiovascular e câncer nas capitais e nas regiões metropolitanas brasileiras: associação com indicadores socioeconômicos

Universidade Estadual do Rio Grande do Norte

Impacto da estratégia saúde da família com equipe de saúde bucal sobre indicadores de saúde bucal: análise em municípios do nordeste com mais de 100 mil habitantes

This study examined in municipalities of Northeast of Brazil with more than one hundred thousand people who incorporation of Oral Health Teams (OHT) into the Family Health Strategy (FHE) the possible impact on oral health indicators. Sought to answer whether implementation OHT brought the best indicators of health problems and coverage, compared to areas without coverage by the FHE through a community trial in parallel, quasi-randomized. In each of the municipalities surveyed were 20 census tracts, 10 were located in areas covered by oral health teams in the ESF and 10 industries in areas not covered. The final sample consisted of 59.221 individuals. We compared oral health indicators related to health problems, access to services and coverage of oral health actions. The analysis strategy was based on the calculation of prevalence ratios and confidence intervals, adjusted for confounding factors through Poisson regression with robust variance. It also has measured the association between an indicator of social inequality for comparison between areas. The best results are associated with indicators of access and coverage of oral health actions at the expense of the indicators of health problems, suggesting a possible maintenance of a traditional model of practice yet. The results also suggest a possible effect of a specific policy in the area of primary care on inequality in access. From the discussions presented throughout this work, we can see that the impact analysis of public policy, obtained by comparing areas with and without the intervention, not only captures the effect on the target population, but other dimensions of organization service and therefore should be understood as one of the analytical possibilities related to the management

Indicadores fisiológicos da interação entre deficit hídrico e acidez do solo em cana-de-açúcar

O objetivo deste trabalho foi avaliar os indicadores fisiológicos da interação entre deficit hídrico e acidez do solo em plantas jovens de cana-de-açúcar. As plantas foram submetidas a três tratamentos de disponibilidade hídrica, medidos em percentagem de capacidade de campo (CC) - sem estresse (70% CC), estresse moderado (55% CC) e estresse severo (40% CC); e três tratamentos de acidez no solo, medidos em termos de saturação por bases (V) - baixa acidez (V = 55%), média acidez (V = 33%) e alta acidez (V = 23%). O experimento foi realizado em casa de vegetação a 29,7±4,3ºC e 75±10% UR. O delineamento experimental utilizado foi o de blocos ao acaso, em esquema fatorial 3x3, com quatro repetições. Após 60 dias, foram determinados os teores de solutos compatíveis - trealose, glicina betaína e prolina - na folha diagnóstico e o crescimento inicial da parte aérea. Os solutos compatíveis trealose, glicina betaína e prolina são indicadores do efeito da interação dos estresses hídrico e ácido no solo. O acúmulo dos solutos compatíveis nos tecidos foliares das plantas não é capaz de impedir a redução na produção de matéria seca da cana-de-açúcar, resultante do agravamento nas condições de disponibilidade hídrica e de acidez no solo.

Indicadores zootécnicos e econômicos da tilapicultura em tanques-rede de diferentes dimensões

The present study aimed to compare the main zootechnical and economic indicators of farming tilapia in superintensive system developed in two different net cages dimensions: 6 and 18 m(3). Were used 12,960 juveniles male reversed Nile tilapia (Oreochromis niloticus), strain supreme, with an initial average weight of 32.0 g (+/- 0.85) for 6 m(3) net cages and 88.5 g (+/- 0.96) for 18 m(3) net cages. The fish were fed three times a day with commercial extruded ration, crude protein levels from 40 to 32%, particle size from 2 to 8 mm and daily feeding rate starting with 8% of live weight (LW), decreasing up to 1% LW. It was conclued that, although no statistical difference in most indicators zootechnical (P>0.05), the production of tilapias in bigger net cages resulted in lower average total cost and higher rentability per kg of fish produced, 34.4% higher, resulting in better profitability.

Influência da soma térmica e da chuva durante o desenvolvimento de laranjas-'Valência' e 'Natal' na relação entre sólidos solúveis e acidez e no índice tecnológico do suco

Este trabalho foi realizado com o objetivo de conhecer a influência que algumas variáveis meteorológicas exercem na razão entre sólidos solúveis totais e acidez total titulável (ratio) e no índice tecnológico dos frutos da primeira florada das laranjeiras-'Natal' e 'Valência', na região de Bebedouro-SP, mediante a utilização de métodos estatísticos de regressão. Foram utilizados dados de amostragens de rotina para o processamento industrial durante 4 anos, os quais permitiram desenvolver equações de regressão linear e quadrática, com a soma térmica (graus-dia) como variável independente, e de regressão múltipla, utilizando graus-dia e chuva como variáveis independentes. A equação de melhor ajuste para o índice tecnológico foi a quadrática, enquanto para o ratio a equação linear apresentou o melhor ajuste. A temperatura do ar, representada por graus-dia, foi a variável que exerceu maior influência nos indicadores de qualidade dos frutos.

Uso da krigagem indicatriz na avaliação de indicadores de fertilidade do solo

Este trabalho teve como objetivo identificar zonas diferenciadas de manejo por meio de indicadores de fertilidade em Latossolos cultivados com cana-de-açúcar, utilizando-se a técnica de krigagem indicatriz, com vistas em buscar um aprimoramento na utilização de técnicas de agricultura de precisão. O estudo foi realizado em uma área de 90 ha pertencente a uma área maior de 1.900 ha, localizada em Jaboticabal, Estado de São Paulo, Brasil (21 ° 15 ' S e 48 ° 18 ' W). Na área experimental, foi estabelecida uma malha de amostragem regular de 50 m, com 420 pontos. em cada ponto, coletou-se uma amostra de solo, na qual foram determinados os teores de matéria orgânica, P, K disponíveis e o valor de V. Os dados obtidos para estas características do solo, assim como as combinações entre elas, foram codificados em valores indicadores 0 ou 1, conforme as variáveis apresentassem valores acima ou abaixo do valor de corte estabelecido, escolhido para cada variável, respectivamente. Os resultados propiciaram a confecção de mapas de probabilidade de cada variável (individual e combinada), o que possibilitou identificar regiões com diferentes níveis de fertilidade do solo na área experimental.

O histórico de uma pesca tropical utilizando indicadores ecossistêmicos

When scientists study methods, theory and standards in an inseparable form, he is facing a paradigm. Throughout the development of a determined science, paradigms can change by changing the methods, objective and standards of research. Fisheries science is changing the paradigm moving from the paradigm of maximization in the use of resources, quantified by the index of the catch, which was influenced by evolutionary concepts such as Optimal Foraging Theory, to the sustainability paradigm that seeks its foundation in the fishery ecosystem perspective. The goal of this study was to review methods, theory and the history of ecosystem indexes of fishery science that attempts to determine sustainability of fishery resources from the data capture. Ecosystems indexes by themselves may not be useful to measure the sustainability of fishing because they focus only on the environmental or ecological side of the sustainability tripod. Probably to measure the sustainability of fishing these indexes should include in the future the Payments for Ecosystem Services and Social Resilience. Thus the methods and theories are in constantly changing within science to meet the most current paradigm

Finanças públicas na nova ordem constitucional brasileira: uma análise comportamental dos municípios potiguares, nos anos antecedentes e posteriores à lei de responsabilidade fiscal LRF

The object of the present dissertation is to analyze the behavior of the public finances of the districts of the state of Rio Grande do Norte (RN), taking as reference a period fundamentally previous to the implementation of the Fiscal Responsibility Law LRF, comparatively to the first years, immediately after the advent of the mentioned institutional milestone. The central hypothesis of this study proposes that, from the institutions' viewpoint, the LRF sets securely consistent rules, in the orchestration of the behavior of the municipal revenues and expenses. These regulations, on the other hand, might be effective and reach the districts of the RN indiscriminately, apart from stabilizing tendencies and which are sustainable in the long run. In spite of this, the indicators calculated reveal that the districts researched show, during all the period under analysis, a diminished capacity of self-tax collection , and consequently, a high participation of the intergovernmental transfers in the composition of the current revenues. This behavior indicates that the goal of strengthening the municipal public finances, forecast in the LRF, tends to be only partially accomplished, due to the fiscal decentralism. The analysis and interpretation of the data are conducted from the literature of institutionalist orientation and in descriptive statistical tools applied to the municipal strata of the state of Rio Grande do Norte. Further on, it's used the econometrical method Pooled OLS, which demands the elimination of the municipal strata in order to allow the use of the model, in the attempt to strengthen and/or ratify the results of the research. Finally, the evidence reached in the dissertation show that the LRF brings better conditions to the potiguar municipal public finances, predominantly to the economically stronger districts; whereas the less dynamic municipal entities show rather divergent evidence, that is, their economies seem to be more oriented to a more pronounced state participation; therefore, it generates in the state of RN a certain antithesis in the results reached in the dissertation

Avaliação da qualidade higiênico-sanitária da água de poços rasos localizados em uma área urbana: utilização de colifagos em comparação com indicadores bacterianos de poluição fecal

Foram submetidas às contagens de colifagos, coliformes totais, coliformes fecais e de estreptococos fecais, 104 amostras de água colhidas de 8 poços rasos localizados na área urbana do Município de Jaboticabal, SP, Brasil, com a finalidade de avaliar as condições higiênico-sanitárias e de verificar as correlações existentes entre o número de colifagos e o de bactérias indicadoras de poluição fecal. Os resultados obtidos evidenciaram a ocorrência de 96 (92,3%) amostras fora dos padrões bacteriológicos de potabilidade estabelecidos pelo Ministério da Saúde, monstrando ser precárias as condições higiênico-sanitárias das águas analisadas. Os achados evidenciaram a inexistência de correlação entre o número de colifagos e os números de bactérias indicadoras de poluição fecal.

Acurácia dos indicadores clínicos do diagnóstico de enfermagem volume de líquidos excessivo em pacientes submetidos à hemodiálise

Trasnversal study, with the objective of evaluating the accuracy of clinical indicators of nursing diagnosis excessive fluid volume in patients undergoing hemodialysis. The study occurred in two stages, the first consisted of the evaluation of the diagnostic indicators in study; and the second, the diagnostic inference conducted by nurse diagnosticians. The first stage occurred from december 2012 to april 2013, in a University Hospital and a Hemodialysis Clinic in Northeastern of Brazil, with a sample of 100 chronic renal failure patients on hemodialysis. The data were selected through an interview form and a physical examination, organized into spreadsheets and analyzed as to the presence or absence of the indicators of diagnosis excessive fluid volume. In the second step, the spreadsheets were sent to three nurses diagnosticians, who judged the presence or absence of diagnosis in the clientele searched. This step was conducted from july to september 2013. For analysis of the data, we used descriptive and inferential statistics. In the descriptive analysis, we used measures of central tendency and dispersion. In inferential analysis, we used the tests Chi- square, Fisher and prevalence ratios. The accuracy of the clinical indicators pertaining to the diagnosis were measured as to the specificity, sensitivity, predictive values, likelihood ratios and Diagnostic Odds Ratio. Also developed a logistic regression. The results were organized in tables and discussed with literature. This study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, with Presentation Certificate for Ethics Appreciation nº 08696212.7.0000.5537. The results revealed that the diagnosis studied was present in 82% of patients. The characteristics with prevalence above 50 % that stood out were: azotemia, decreased hematocrit, electrolyte imbalance, intake exceeds output, anxiety, edema, decreased hemoglobin, oliguria and blood pressure changes. Eight defining characteristics were presented statistically significant association with the nursing diagnosis investigated: pulmonary congestion, intake exceeds output, electrolytes imbalance, jugular vein distension, edema, weight gain over short period of time, agitation and adventitious breath sounds. Among these, the 10 characteristics which showed higher prevalence ratios were: edema and weight gain over short period of time. The features with the highest sensitivity were edema, electrolytes imbalance and intake exceeds output and the standing out with greater specificity were: anasarca, weight gain over short period of time, change in respiratory pattern, adventitious breath sounds, pulmonary congestion, agitation and jugular vein distension. The indicators jugular vein distension, electrolytes imbalance, intake exceeds output, increased central venous pressure and edema, together, were identified in the logistic regression model as the most significant predictors. It is concluded that the identification of accurate clinical indicators allow a good prediction of the nursing diagnosis of excessive fluid volume in patients undergoing hemodialysis in order to assist the nurse in the inference process, which will contribute to the success of patient care. In addition, nurses will consider for diagnostic inference not only his clinical experience, but also scientific evidence of the occurrence of excessive fluid volume, contributing to the control of volemia in these patients

Análise dos indicadores de qualidade versus taxa de abandono utilizando método de regressão múltipla para serviço de banda larga

Telecommunication is one of the most dynamic and strategic areas in the world. Many technological innovations has modified the way information is exchanged. Information and knowledge are now shared in networks. Broadband Internet is the new way of sharing contents and information. This dissertation deals with performance indicators related to maintenance services of telecommunications networks and uses models of multivariate regression to estimate churn, which is the loss of customers to other companies. In a competitive environment, telecommunications companies have devised strategies to minimize the loss of customers. Loosing customers presents a higher cost than obtaining new ones. Corporations have plenty of data stored in a diversity of databases. Usually the data are not explored properly. This work uses the Knowledge Discovery in Databases (KDD) to establish rules and new models to explain how churn, as a dependent variable, are related to a diversity of service indicators, such as time to deploy the service (in hours), time to repair (in hours), and so on. Extraction of meaningful knowledge is, in many cases, a challenge. Models were tested and statistically analyzed. The work also shows results that allows the analysis and identification of which quality services indicators influence the churn. Actions are also proposed to solve, at least in part, this problem

Uma contribuição à definição de indicadores de desempenho de instituições federais de educação tecnológica do Brasil na abordagem do balanced scorecard

This Master of Science Thesis deals with a study on applying the BSC Balanced Scorecard to assess the performance of Federal Centers for Technological Education Institution in Brazil, the CEFET s (Centro Federal de Educação Tecnológica), government organizations non for profit. It s accomplished a literature review in order to understand the BSC and its application to non for profit organizations and as a main result it is proposed a BSC conceptual model with an inversion of the main BSC perspective from financial to customer/society. Taking the FORPLAN/CONCEFET performance indicators matrix it is developed a set of performance indicators for the two tops perspective in the conceptual model proposed five for customer/society perspective and three for financial/budget perspective. A field survey with ten CEFET s General Directors is conducted to validate the indicators and assess the perception of the Directors on the hierarchy of the conceptual model, and a hierarchy among the indicators as well. The main results suggests that the indicators are validated, that most of the Directors support the hierarchy presented in the conceptual model but 30% of them have a traditional model with financials coming first. In terms of indicator hierarchy, there s a slight priority for the student unitary cost among the financial perspective indicators, and a relative balance among the customer/society perspective indicators

Avaliação dos indicadores de desempenho de instituições federais de educação tecnológica doBrasil na abordagem do balanced scorecard

This Master of Science Thesis deals with a study on applying the BSC Balanced Scorecard to assess the performance of Federal Institution for Technological Education Institution in Brazil, a government organizations non for profit. It s accomplished a literature review in order to understand the BSC and its application to non for profit organizations and as a main result it is proposed a BSC conceptual model with an inversion of the main BSC perspective from financial to customer/society. It is used the annual management report of thirteen Institutions and applied a Pearson correlation analysis in order to verify a cause-effect situation between indicators. The main findings suggest that the model teachers qualification in terms of degree earned, quantity of teachers in full time job, and rate of students by teacher in full time job having good pearson correlation with the results expected of quality, throughput, social and demand response. However, the student unit cost use as the sole financial indicator did not get any reasonable correlation with the results, as so the quality and quantity of books in the libraries. Although it suggests a need for improvement in the model, the general model adopted appears to be satisfactory as a starting point to a BSC-like performance measuring system to this kind of Institutions