A Estratégia Saúde da Família na perspectiva do usuário.

Trata-se de um estudo descritivo, de abordagem qualitativa, do tipo estudo de caso, cujo objetivo é analisar a Estratégia Saúde da Família (ESF) através da perspectiva do seu usuário, verificando o grau de correspondência entre os serviços oferecidos pela ESF e a proposta oficial, norteadora da Estratégia. Neste intuito, realizamos entrevistas com usuários cadastrados na Unidade de Saúde da Família - Centro, no município de Piraí, interior do estado do Rio de Janeiro. Na busca do arcabouço teórico, nos aprofundamos em temas como qualidade dos serviços de saúde, Sistema Único de Saúde, no Programa de Agentes Comunitários de Saúde e Saúde da Família. Ao analisarmos os resultados, dividimos os achados em três categorias. São elas: caracterizando os sujeitos; utilização dos serviços de saúde à luz do acesso, acolhimento e vínculo e, por fim, a percepção do usuário: avaliação, crítica, elogio e sugestão. Ao fim da pesquisa, concluímos que, como todo serviço, necessita ser avaliado e monitorado, levando em consideração as críticas e elogios abordados, buscando melhor qualificação. Acreditamos que repensar o modelo de atenção à saúde, dentro da perspectiva para qual aponta a estratégia saúde da família, implica em assegurar correspondência entre os serviços de saúde e as expectativas e valores socioculturais da população usuária.

Atenção total a adolescentes em risco social: prevenção, acolhimento e integração.

A construção de um atendimento voltado exclusivamente para adolescentes não é fortuita. Infância e adolescência são invenções modernas que delimitaram faixas etárias com características próprias e modelos de intervenção específicos que se transformaram historicamente, bem como sendo atravessadas pela própria criação da noção de risco, perigo e vulnerabilidade. A partir de um estudo junto à equipe de uma instituição criada para garantir um tipo de atenção considerado total, voltado para uma clientela designada adolescentes em risco social, busco compreender o modelo de atenção adotado, privilegiando a perspectiva dos profissionais sobre o mesmo. A metodologia empregada consistiu em análise de documentos institucionais e entrevistas com informantes-chaves, terminando por mostrar a relevância de dois tripés estruturantes das práticas institucionais: tratamento da dependência química, prevenção da violência e cuidados básicos de um lado, prevenção aos fatores de risco, acolhimento do paciente e integração dos atendimentos de outro.

Ler e usar a literatura: alguns artifícios para o envolvimento do leitor

Nesta dissertação investigamos como a ficção envolve o leitor. Para isso, partimos da rejeição a Homero declarada por Calímaco, observando que a suposta diferença entre a literatura preferida pelo público e a literatura preferida pela crítica depende de dois fatores distintos. O primeiro é o simples fato de a crítica ler profissionalmente e o público ler por prazer. O segundo está relacionado à distinção entre recepção e uso da literatura proposta por C.S. Lewis. Na recepção, a obra tende a ser admirada por si; no uso, tende a ser instrumentalizada como suporte para um devaneio em que os desejos do próprio leitor são vicariamente satisfeitos. Observamos que essa devaneio, que Lewis chama de construção egoísta de castelos, e que inclui uma variante mórbida, tem um paralelo na noção girardiana do duplo angélico. Contudo, o devaneio depende da simpatia como definida por Adam Smith, a qual por sua vez depende de certa aprovação moral. Investigamos portanto o tipo de personagem que conquista a aprovação moral do leitor, contrastando os heróis homéricos com os cavaleiros cristãos a fim de verificar como o cristianismo dirige a aprovação moral para as vítimas, fazendo com que os heróis da ficção sejam pessoas perseguidas ou marginalizadas.

O cangaço no cordel e a constituição de uma identidade regionalista pelo migrante nordestino (1950-1980)

Neste trabalho, a partir da recorrência à literatura de cordel como fonte histórica, será apresentada de que forma a reprodução da temática do cangaço nesses folhetos permitem que os migrantes nordestinos constituam uma identidade regionalista baseada no apego aos valores tradicionais da sua região natal. Dentro desse contexto, relacionamos o processo migratório dos nordestinos para as grandes metrópoles situadas no Sudeste, sobretudo Rio de Janeiro e São Paulo, com a difusão e recepção dos cordéis nesses estados entre as décadas de 1950 e 1980. No que concerne a abordagem do cangaço nos versos da literatura de cordel, na qual atribui aos cangaceiros o papel de símbolos regionais, serão pontuadas as principais estratégias adotadas pelos cordelistas que possibilitam a identificação e a empatia dos migrantes vindos do Nordeste com os personagens do cangaço narrados nos folhetos, contribuindo para um maior estreitamento entre Nordeste e nordestino. Nesse sentido, vale ressaltar a ressignificação da imagem dos cangaceiros, deslocando sua representação de homens cruéis e bárbaros para a reprodução de heróis-vilãos, isto é, protagonistas de personalidades ambíguas e contraditórias

Influência dos receptores opioides no efeito hipotensor arterial do propofol em humanos

O propofol é uma droga hipnótico-sedativa, amplamente utilizada em anestesiologia, devido à sua elevada eficácia hipnótica e ao seu despertar rápido e praticamente isento de efeitos residuais. A depressão cardiovascular, que é o efeito adverso mais importante e indesejável do propofol, parece estar intimamente relacionada à dose administrada, à velocidade de injeção do medicamento, à idade e ao estado físico dos pacientes, assim como, às condições de volemia e de reserva cardiovascular dos mesmos, podendo ser intensificada, ainda, pela associação de uma droga opioide ao propofol. A hipotensão arterial induzida pelo propofol parece possuir uma origem multifatorial, pois já foi evidenciada a participação de diversos sistemas nos efeitos produzidos pelo propofol, inclusive, a participação da via opioide no efeito antinociceptivo da droga. Portanto, o objetivo desse estudo foi investigar a participação dos receptores opioides no efeito hipotensor arterial do propofol. A pesquisa foi do tipo randomizada, transversal, aberta e comparativa. Foram estudados 40 pacientes estado físico ASA 1, submetidos a anestesia geral para cirurgias eletivas. Os desfechos avaliados neste estudo foram as pressões arteriais sistólica (PAS), diastólica (PAD) e média (PAM), a pressão venosa central (PVC) e a frequência cardíaca (FC). Portanto, após a monitorização contínua dos pacientes com cardioscopia com análise de ST, pressão arterial invasiva, pressão venosa central, oxicapnometria, análise eletroencefalográfica bispectral (BIS) e gasimetrias arteriais e venosas, estes foram divididos aleatoriamente através de programa de distribuição aleatória gerada por computador, de acordo com os 5 grupos existentes (n = 8 para todos os grupos). Foram 3 grupos de pacientes pré-medicados intravenosamente (iv) com naloxona 1 μg/Kg (PN1) ou 3 μg/Kg (PN3), ou com salina para controle (CP), 2 minutos antes da administração iv de propofol (2,5 mg/Kg). Outros 2 grupos controle da naloxona foram pré-medicados com naloxona 1 μg/Kg (CN1) ou 3 μg/Kg (CN3), mas não receberam propofol. Os resultados demonstraram que há mais de um mecanismo envolvido no efeito hipotensor arterial do propofol, que é composto por uma rápida redução inicial da PAM opioide-independente e uma lenta redução final da PAM, que foi dependente, ao menos parcialmente, de ação opioide. O propofol, na dose de 2,5 mg/Kg, reduziu a PAS, PAD e PAM de forma significativa e independente do efeito hipnótico do anestésico, dos valores iniciais de PVC e de modificações na FC dos pacientes, apesar de ter sido evidenciada a inibição do baroreflexo induzida pelo anestésico. A hipotensão induzida pelo propofol pôde ser parcialmente reduzida, de forma significativa e dose-dependente, pela prévia administração iv de naloxona de 3 μg/Kg, menor dose efetiva. Este efeito da naloxona ocorreu, principalmente, através de um aumento significativo da PAD, sem importar em modificações significativas da PAS, FC, PVC, BIS ou do ECG. Foi concluído que a hipotensão arterial induzida pelo propofol possui uma origem multifatorial, sendo produzida parcialmente por um mecanismo que é opioide-dependente e sensível ao pré-tratamento dos pacientes com a naloxona. Nosso estudo não recebeu nenhum financiamento externo.

Male-infant-male interactions in Tibetan macaques

Event-sampling and scans were used for collecting data on male-infant-male triadic interactions, and their effects on member spacing respectively in a group of Macaca thibetana at Mt. Emei in 1989. The group was partially provisioned by human visitors in seasons other than winter, and could be observed closely. In addition, a stable linear male-hierarchy among five males existed for two years since the end of 1987, providing a good social condition for this topic. The triadic interactions were specific to the birth season, and recognized as three types being on a continuum functionally changing from passive ''agonistic buffering'' (4.8%) to active spatial cohesion, which resulted in a significant decline of intermale distances. Positive correlations were documented between the triad initiation rate and the number of females in consort with the males in the mating season (MS), and between the triad reception rate and the number of infants in proximity to the males in the MS when maternal care was significantly reduced. Thus the male's mating effort and kin/sexual selection may deeply be involved in the triad of this species. Considering that the two triad-species, M. sylvanus and M. thibetana, had different levels of paternity, but shared similar foraging conditions, and showed similar intensities of male-infant caretaking, the triad was very likely a byproduct of male-infant caretaking, which was probably shaped to compensate heavy maternal investment to young offspring in harsh conditions. Accordingly, the long-term arguments about the triad in M. sylvanus can be united to a model of the way in which ''male-infant caretaking'' hypothesis works ultimately, and ''regulating social relations'' hypothesis does proximately.

Automated Detection of Exposed Reinforcement in Post-Earthquake Safety and Structural Evaluations

The world is at the threshold of emerging technologies, where new systems in construction, materials, and civil and architectural design are poised to make the world better from a structural and construction perspective. Exciting developments, that are too many to name individually, take place yearly, affecting design considerations and construction practices. This edited book brings together modern methods and advances in structural engineering and construction, fulfilling the mission of ISEC Conferences, which is to enhance communication and understanding between structural and construction engineers for successful design and construction of engineering projects. The articles in this book are those accepted for publication and presentation at the 6th International Structural Engineering and Construction Conference in Zurich. The 6th ISEC Conference in Zurich, Switzerland, follows the overwhelming reception and success of previous ISEC conference in Las Vegas, USA in 2009; Melbourne, Australia in 2007; Shunan, Japan in 2005; Rome, Italy in 2003; and Honolulu, USA in 2001. Many topics are covered in this book, ranging from legal affairs and contracting, to innovations and risk analysis in infrastructure projects, analysis and design of structural systems, materials, architecture, and construction. The articles here are a lasting testimony to the excellent research being undertaken around the world. These articles provide a platform for the exchange of ideas, research efforts and networking in the structural engineering and construction communities. We congratulate and thank the authors for these articles that were selected after intensive peer-review, and our gratitude extends to all reviewers and members of the International Technical Committee. It is their combined contributions that have made this book a reality.

RFID Tag Interrogation Systems

We describe an RFID tag reading system for reading one or more RFID Tags, the system comprising an RF transmitter and an RF receiver, a plurality of transmit/receive antennas coupled to said RF transmitter and to said RF receiver, to provide spatial transmit/receive signal diversity, and a tag signal decoder coupled to at least said RF receiver, wherein said system is configured to combine received RF signals from said antennas to provide a combined received RF signal, wherein said RF receiver has said combined received RF signal as an input; wherein said antennas are spaced apart from one another sufficiently for one said antenna not to be within the near field of another said antenna, wherein said system is configured to perform a tag inventory cycle comprising a plurality of tag read rounds to read said tags, a said tag read round comprising transmission of one or more RF tag interrogation signals simultaneously from said plurality of antennas and receiving a signal from one or more of said tags, a said tag read round having a set of time slots during which a said tag is able to transmit tag data including a tag ID for reception by said antenna, and wherein said system is configured to perform, during a said tag inventory cycle, one or both of: a change in a frequency of said tag interrogation signals transmitted simultaneously from said plurality of antennas, and a change in a relative phase of a said RF tag interrogation signals transmitted from one of said antennas with respect to another of said antennas.

Akrokolioplax, a new genus of Southeast Asian labeonine fishes (Teleostei : Cyprinidae)

Akrokolioplax, new genus, is erected for the reception of Epalzeorhynchos bicornis Wu, 1977. It shares with the remaining species of Epalzeorhynchos what have usually been called "rostral lateral lobes" on the snout, which are non-homologous structures used to distinguish the two genera from all other Labeoninae genera. Akrokolioplax and Epalzeorhynchos differ in the position and structure of these lobes, and also in the morphology of the oromandibular structures. A detailed redescription is also provided for the type species of this monotypic genus, A. bicornis. It is presently known from the upper Salween River (=Nu Jiang in Chinese) basin in Yunnan (South China), Myanmar and Thailand.

云南碧塔海自然保护区生态旅游开发模式研究

Bita lake provincial natural reserve is located in Shangri La region of North western Yunnan,and was set as a demonstrating area for ecotourism exploitation in 1998.After a year's exploitation construction and half a year's operation as a branch of the 99' Kunming International Horticulture Exposition to accept tourists,it was proved that the ecotourism demonstrating area attained four integrated functions of ecotourism,i.e,tourism,protection,poverty clearing and environment education.Five exploitation and management models including function zoned exploitation model, featured tourism communication model signs system designing model,local Tibetan family reception model and environmental monitoring model,were also successful,which were demonstrated and spreaded to the whole province.Bita lake provincial natural reserve could be a good sample for the ecotourism exploitation natural reserves of the whole country.

学习困难儿童智力结构及其与心理语言、视动能力关系的研究

IQ Structure, Psycholinguistic and Visual-motor Abilities Study on Children Learning Disability TONG Fang Directed by professor Zhu Liqi (Developmental and educational psychology) ABSTRACT Objective To comprehensive analyze the IQ structures, and relationships among IQ, psychometric characteristics and visual-motor integration on children disability. At same time, to probe into the family factors that influenced IQ, psycholinguistic abilities and behavior of LD children. Method (1) Downloading the papers on children learning disability from www.cqvip.com and www.wanfangdata.com, in which, the articles were collected by key words from 1985 to 2005. To conduct meta-analysis on IQ construction, compare the case group and the control group, including full IQ, verbal and practice IQ. (2) Designed with model compared and self-compared, 59 diagnosed learning disability children, tested themes with WISC, ITPA and Berry’s VMI. WISC included 10 items, 5 of which subtotal to verbal and practice IQ respectively. IPTA included 10 items, too, 5 process of which subtotal to auditory and visual perception. The first 3 items shared representation level, the other 2 of that shared automatic level.VMI had one score. Analyzed factors and levels with description and Pearson Correlation. To probe to linguistic internal alternately functions of LD children, and compare the scores of groups in different IQ. (3) Analyzed the perspective questionnaire filled by parents. Early development facts compared with model groups. Factors relationships analyzed with Kendall correlation, KOM and Bartlett’s test of sphericity, Promax Rotation. Results: (1) There have been 319 papers related with LD, in which 36 with IQ and 14 valid reports have been analyzed by Meta. FIQ’s 95%CI (confidence interval) is 2.418 ~ 0.172, VIQ between the difficulty and non- difficulty group. C-WISC-R reports were 10 papers, of which, 95%CI of FIQ is 2.424 ~ 0.676, of VIQ is 2.314 ~ 1.196, of PIQ is 2.176 ~ 0.176. The VIQ comparing the PIQ, 95%CI is 1.1 ~ -0.07 in difficulty group and 0.5 ~ -0.0046 in non-difficult group. Nevertheless, in the other 4 tests, FIQ’s 95%CI is 2.00 ~ -0.818 between LD and NLD. (2) Children psycholinguistic abilities had strong relation with Berry’s VMI test excluding auditory reception, and with perceptive factor of intelligence excluding verbal expression. Auditory reception and visual closure had strong relation with FIQ and PIQ. Grammatic closure, visual association and manual expression had strong relation with concept factor. The representational and automatic levels are depended on integration of auditory and visual procession. Lower verbal expression (VE) let to lower expression process and low scores on representational level. Lower visual sequential memory (VSM) let to lower memory process and influenced automatic level. Groups compared by IQ 90 show that LD children with under IQ 90 had lower scores on items of IPTA than with up IQ 90 excluded verbal expression. It was proved that IQ administrated the linguistic ability. Nevertheless, general abilities deficiency didn’t show influencing on the types of the perceptive delay. There was mutual function among linguistic ability on LD children. Auditory and visual level are overlapped each other. Not only show higher Decoding and lower Encoding on Auditory perception, lower Decoding and higher Encoding on Visual perception, in representation, but also higher Sequential remember, lower Closure on Audition, and lower Sequential member, higher Closure on Vision, in Automation. Nevertheless, there was no different between Representational and Automatic level, which may be the relationship of parallel or evolution. (3) Major family factors were father’s education, occupation. Lower auditory perception related to unconcerned, lower visual perception related to premature delivery and written slowly. Threatened–abortion, childbirth-suffocated were known as influencing children’s IQ and later linguistic abilities. It wasn’t shown that dosage relationship with the types of perceptive delay. Conclusion: (1) The FIQ, VIQ and PIQ of Children with LD is lower than that of NLD group. There is no significantly different between VIQ and PIQ in LD and NLD groups. (2) The objectives of ITPA and WISC tests are differently. The psycholinguistic abilities had strong relation with perceptive factor and VMI. Some facts of IPTA related with FIQ. IQ had strong administration on linguistic abilities. There was mutual function among linguistic internal abilities. (3) Family facts on IQ and psycholinguistic abilities were Father’s education, abnormal pregnant and abortion. It would be pre-show development delay in early period.

Tactual Display of Consonant Voicing to Supplement Lipreading

This research is concerned with the development of tactual displays to supplement the information available through lipreading. Because voicing carries a high informational load in speech and is not well transmitted through lipreading, the efforts are focused on providing tactual displays of voicing to supplement the information available on the lips of the talker. This research includes exploration of 1) signal-processing schemes to extract information about voicing from the acoustic speech signal, 2) methods of displaying this information through a multi-finger tactual display, and 3) perceptual evaluations of voicing reception through the tactual display alone (T), lipreading alone (L), and the combined condition (L+T). Signal processing for the extraction of voicing information used amplitude-envelope signals derived from filtered bands of speech (i.e., envelopes derived from a lowpass-filtered band at 350 Hz and from a highpass-filtered band at 3000 Hz). Acoustic measurements made on the envelope signals of a set of 16 initial consonants represented through multiple tokens of C1VC2 syllables indicate that the onset-timing difference between the low- and high-frequency envelopes (EOA: envelope-onset asynchrony) provides a reliable and robust cue for distinguishing voiced from voiceless consonants. This acoustic cue was presented through a two-finger tactual display such that the envelope of the high-frequency band was used to modulate a 250-Hz carrier signal delivered to the index finger (250-I) and the envelope of the low-frequency band was used to modulate a 50-Hz carrier delivered to the thumb (50T). The temporal-onset order threshold for these two signals, measured with roving signal amplitude and duration, averaged 34 msec, sufficiently small for use of the EOA cue. Perceptual evaluations of the tactual display of EOA with speech signal indicated: 1) that the cue was highly effective for discrimination of pairs of voicing contrasts; 2) that the identification of 16 consonants was improved by roughly 15 percentage points with the addition of the tactual cue over L alone; and 3) that no improvements in L+T over L were observed for reception of words in sentences, indicating the need for further training on this task

Uso de imagens digitais na avaliação do crescimento da taxa de cobertura do solo.

RESUMO: Existem vários métodos para avaliar o crescimento da vegetação e a taxa de cobertura do solo. Medidas precisas e rápidas podem ser obtidas do tratamento digital de imagens geradas de câmeras fotográficas ou de vídeo. Há disponível, no mercado, diversos processadores de imagens que apresentam funções básicas semelhantes, mas com certas particularidades que poderão trazer maior benefício para o usuário, dependendo da aplicação. O SPRING, desenvolvido pelo INPE, é de domínio público, sendo mais abrangente do que um processador de imagens, incluindo funções de geoprocessamento. O ENVI foi desenvolvido para a análise de imagens multiespectrais e hiperespectrais, podendo também ser utilizado para o processamento de imagens obtidas de câmeras de vídeo, por exemplo. O KS-300 é um conjunto de hardware e de software destinado ao processamento e à quantificação de imagens microscópicas, permitindo a captação direta das imagens geradas por meio de lupas, microscópios eletrônicos ou câmeras de vídeo. O SIARCS foi desenvolvido pela Embrapa Instrumentação Agropecuária para tornar mais ágil o processo de captação de dados de um sistema. Este trabalho apresenta os fundamentos teóricos básicos envolvidos na técnica de análise de imagens, com as principais características dos softwares citados acima e sua aplicação na quantificação da taxa de crescimento e da cobertura do solo por espécies vegetais. ABSTRACT: Several methods exist to evaluate the growth of the vegetation and the tax of covering of the soil. Necessary and fast measures can be obtained of the digital treatment of generated images of photographic cameras or of video. There is available, in the market, several processors of images that you/they present similar basic functions, but with certain particularities that can bring larger benefit for the user, depending on the application. SPRING, developed by INPE, it is public domain, being including than a processor of images, including functions. ENVI was developed for the analysis of images multiespectrais and hiperespectrais, could also be used for the processing of obtained images of video cameras, for instance. The KS-300 it is a hardware group and software destined to the processing and quantification of microscopic images, allowing the direct reception of the images generated through magnifying glasses, eletronic microscopes or video cameras. SIARCS was developed by Embrapa Agricultural Instrumentation to turn more agile the process of reception of data of a system. This work presents the basic theoretical foundations involved in the technique of analysis of images, with the main characteristics of the softwares mentioned above and his application in the quantification of the growth tax and of the covering of the soil for vegetable species.

Centenarians and their hearts: a prospective registry with comprehensive geriatric assessment, electrocardiogram, echocardiography, and follow-up

Background Data on the cardiac characteristics of centenarians are scarce. Our aim was to describe electrocardiogram (ECG) and echocardiography in a cohort of centenarians and to correlate them with clinical data. Methods We used prospective multicenter registry of 118 centenarians (28 men) with a mean age of 101.5 ± 1.7 years. Electrocardiogram was performed in 103 subjects (87.3%) and echocardiography in 100 (84.7%). All subjects underwent a follow-up for at least 6 months. Results Centenarians with abnormal ECG were less frequently females (72% vs 93%), had higher rates of previous consumption of tobacco (14% vs 0) and alcohol (24% vs 12%), and scored lower in the perception of health status (6.8 ± 2.0 vs 8.3 ± 6.8). Centenarians with significant abnormalities in echocardiography were less frequently able to walk 6 m (33% vs 54%). Atrial fibrillation/flutter was found in 27 subjects (26%). Mean left ventricular (LV) ejection fraction was 60.0 ± 10.5%. Moderate or severe aortic valve stenosis was found in 16%, mitral valve regurgitation in 15%, and aortic valve regurgitation in 13%. Diastolic dysfunction was assessed in 79 subjects and was present in 55 (69.6%). Katz index and LV dilation were independently associated with the ability to walk 6 m. Age, Charlson and Katz indexes, and the presence of significant abnormalities in echocardiography were associated with mortality. Conclusions Centenarians have frequent ECG alterations and abnormalities in echocardiography. More than one fifth has atrial fibrillation, and most have diastolic dysfunction. Left ventricular dilation was associated with the ability to walk 6 m. Significant abnormalities in echocardiography were associated with mortality.