733 resultados para Missed appointments


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Understanding habitat selection and movement remains a key question in behavioral ecology. Yet, obtaining a sufficiently high spatiotemporal resolution of the movement paths of organisms remains a major challenge, despite recent technological advances. Observing fine-scale movement and habitat choice decisions in the field can prove to be difficult and expensive, particularly in expansive habitats such as wetlands. We describe the application of passive integrated transponder (PIT) systems to field enclosures for tracking detailed fish behaviors in an experimental setting. PIT systems have been applied to habitats with clear passageways, at fixed locations or in controlled laboratory and mesocosm settings, but their use in unconfined habitats and field-based experimental setups remains limited. In an Everglades enclosure, we continuously tracked the movement and habitat use of PIT-tagged centrarchids across three habitats of varying depth and complexity using multiple flatbed antennas for 14 days. Fish used all three habitats, with marked species-specific diel movement patterns across habitats, and short-lived movements that would be likely missed by other tracking techniques. Findings suggest that the application of PIT systems to field enclosures can be an insightful approach for gaining continuous, undisturbed and detailed movement data in unconfined habitats, and for experimentally manipulating both internal and external drivers of these behaviors.

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Individual cues to deception are subtle and often missed by lay people and law enforcement alike. Linguistic statement analysis remains a potentially useful way of overcoming individual diagnostic limitations (e.g. Criteria based Content Analysis; Steller & Köhnken, 1989; Reality monitoring; Johnson & Raye, 1981; Scientific Content Analysis; Sapir, 1996). Unfortunately many of these procedures are time-consuming, require in-depth training, as well as lack empirical support and/or external validity. The current dissertation develops a novel approach to statement veracity analysis that is simple to learn, easy to administer, theoretically sound, and empirically validated. Two strategies were proposed for detecting differences between liars' and truth-tellers' statements. Liars were hypothesized to strategically write statements with the goal of self-exoneration. Liars' statements were predicted to contain more first person pronouns and fewer third person pronouns. Truth-tellers were hypothesized to be motivated toward being informative and thus produce statements with fewer first person pronouns and more third person pronouns. Three studies were conducted to test this hypothesis. The first study explored the verbal patterns of exoneration and informativeness focused statements. The second study used a traditional theft paradigm to examine these verbal patterns in guilty liars and innocent truth tellers. In the third study to better match the context of a criminal investigation a cheating paradigm was used in which spontaneous lying was induced and written statements were taken. Support for the first person pronoun hypothesis was found. Limited support was found for the third person pronoun hypothesis. Results, implications, and future directions for the current research are discussed.

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Despite research showing the benefits of glycemic control, it remains suboptimal among adults with diabetes in the United States. Possible reasons include unaddressed risk factors as well as lack of awareness of its immediate and long term consequences. The objectives of this study were to, using cross-sectional data, 1) ascertain the association between suboptimal (Hemoglobin A1c (HbA1c) ≥7%), borderline (HbA1c 7-8.9%), and poor (HbA1c ≥9%) glycemic control and potentially new risk factors (e.g. work characteristics), and 2) assess whether aspects of poor health and well-being such as poor health related quality of life (HRQOL), unemployment, and missed-work are associated with glycemic control; and 3) using prospective data, assess the relationship between mortality risk and glycemic control in US adults with type 2 diabetes. Data from the 1988-1994 and 1999-2004 National Health and Nutrition Examination Surveys were used. HbA1c values were used to create dichotomous glycemic control indicators. Binary logistic regression models were used to assess relationships between risk factors, employment status and glycemic control. Multinomial logistic regression analyses were conducted to assess relationships between glycemic control and HRQOL variables. Zero-inflated Poisson regression models were used to assess relationships between missed work days and glycemic control. Cox-proportional hazard models were used to assess effects of glycemic control on mortality risk. Using STATA software, analyses were weighted to account for complex survey design and non-response. Multivariable models adjusted for socio-demographics, body mass index, among other variables. Results revealed that being a farm worker and working over 40 hours/week were risk factors for suboptimal glycemic control. Having greater days of poor mental was associated with suboptimal, borderline, and poor glycemic control. Having greater days of inactivity was associated with poor glycemic control while having greater days of poor physical health was associated with borderline glycemic control. There were no statistically significant relationships between glycemic control, self-reported general health, employment, and missed work. Finally, having an HbA1c value less than 6.5% was protective against mortality. The findings suggest that work-related factors are important in a person’s ability to reach optimal diabetes management levels. Poor glycemic control appears to have significant detrimental effects on HRQOL.

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ABSTRACT This study aimed to evaluate the quality of prenatal Primary Care in Rio G rande do Norte, Brazil in 2012 under the program Improving Access and Quality of Primary Care. The study was cross - sectional, quantitative. Included 156 mothers of children under 2 years who received prenatal care at the health evaluated. We applied a ques tionnaire on profile, minimum queries, regularity of attendance, laboratory tests, vaccination, participation in educational activities, guidance received, clinical and obstetric procedures and prescription Ferrous sulphate and folic acid. The descriptive analysis of the criteria used Humanization Program Prenatal and Birth. The results showed that 92% of mothers had six or more visits; 85% with the same care was professional; 94% subsequent appointments scheduled. As for tests and procedures the percentage s were: Urine 98%; HIV - 96%; VDRL and 88%; 91% glucose; tetanus vaccination 93%; educational groups 56% with 36% participation, knowledge of the delivery location and 59% achievement breast exam 65%, 33% and preventive gynecological 43%; 98% supplemented wi th 96% Ferrous Sulfate and Folic Acid. It was concluded that there were advances in Rio Grande do Norte concerning assistance and there are weaknesses in the educational practices and conducting some minimal clinical examinations.

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This work is a comparative study of three black brotherhoods that existed in Pernambuco in the eighteenth century, it is the Brotherhood of Our Lady of the Rosary of Black Men of Recife, Olinda and Goiás. The goal was to understand the similarities and differences between them, taking as benchmark their operating statutes, called Appointments. From the data analysis of the commitments associated with other documents produced by the Brotherhoods and the administrative and religious authorities, we sought the social profile of the villages in evidence, as well as the participation of black people inside. We sought to understand the historical conditions of that period, from the fact that the slave society, the black was placed in a position of subordination. However, as a carrier element of culture, although this condition, was able to overcome social obstacles, opening possibilities for own cultural manifestations of his group could occur. The coexistence in the Brotherhoods of the Rosary, which in addition to organizations for mutual assistance within the Catholic religion, is also constituted as fields mediators between high culture and popular culture, made those organizations become social spaces and representation allowed the existing order. The Brotherhoods of the Rosary in Recife, Olinda and Goiás, had their own hierarchical logic that engendered the construction of new black identities marked by cultural circularity that became possible due to the Atlantic diaspora process

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The hospital is a place of complex actions, where several activities for serving the population are performed such as: medical appointments, exams, surgeries, emergency care, admission in wards and ICUs. These activities are mixed with anxiety, impatience, despair and distress of patients and their families, issues involving emotional balance both for professionals who provide services for them as for people cared by them. The healthcare crisis in Brazil is getting worse every year and today, constitutes a major problem for private hospitals. The patient that comes to emergencies progressively increase, and in contrast, there is no supply of hospital beds in the same proportion, causing overcrowding, declines in the quality of care delivered to patients, drain of professionals of the health area and difficulty in management the beds. This work presents a study that seeks to create an alternative tool that can contribute to the management of a private hospital beds. It also seeks to identify potential issues or deficiencies and therefore make changes in flow for an increase in service capacity, thus reducing costs without compromising the quality of services provided. The tool used was the Computational Simulation –based in discrete event, which aims to identify the main parameters to be considered for a proper modeling of this system. This study took as reference the admission of a private hospital, based on the current scenario, where your apartments are in saturation level as its occupancy rate. The relocation of project beds aims to meet the growing demand for surgeries and hospital admissions observed by the current administration.

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The gestation process, in general, is a very important event on a woman’s life and it brings phisical, phisiological and emotional changes, which by itself is an experience full of intense feelings. By late-aged pregnancy we mean those which occurs at the age of 35 or further. The occurance of this type of pregnancy is rising in Brasil and throughout the world, factors such as, better access to birth control resources and the search for financial stability explains the pregnancy delay. Important processes like resilience and social support can help late-aged pregnant women, in a benefical way, to adapt to the gestation process. Resilience is the capacity that a certain individual or group of individuals have to go through an adverse situation, be able to overcome it and become streghtened, transforming it in motivation for its biopsichosocial development. Social support is a complex and dinamic process that involves transactions between individuals and their social networks, meeting the social needs, promoting and complementing the personal resources that they have to face new demands. This research has the intention of raising information about the issues of late-aged pregnant women in the County of Natal- RN, the main objective was to evaluate the resilience indicators and the social support on late-aged pregnant women in the Natal-RN County. A transversal cut, correlational and descriptive research that was done with 150 lateaged pregnant women. The tools that were used were: A form with sociodemographic and gestation info, the scale of resilience and social support. An eletronic spreadsheet sofware (Excel e SPSS 21.0) was used to analize data which helped on the statistics according to its variables and the objective of this work. For the nominal variables, relative frequencies were used and for continuous the Pearson correlation and determination coefficient were used, regarding that; the sample had a normal distribution. The project fulfilled the ethnic aspects prescribed by Resolution 466/12 of the National Health Council, with a favorable decision (356.436/ 2013) of the UFRN Ethics on Research Committee. Most of the pregnant women had a low money income and education level, born in the state of Rio Grande do Norte they had an average age of 37,49 (±2,577), catholic, married, house wives, they had more than one child and were on their third trimester of pregnancy; they also had a low past abortion rate, not having planned their pregnancy, with an average of 4,22 (±2,506) pre-natal appointments, residing with an average of 3,673 (±1,397) people, having used any sort of birth control device and having high indicators of resilience and social support. The correlations kept between resilience, social support and some of the social demographics and gestation variables were considered low. Such data points out the fact that most of these women were in a stable relationship; they hadn’t had a past of abortion, they were involved with some kind of religion, they were not first pregnancy mothers, had an age on which they are not considered inexperienced mothers and even had scored high on the social support scale, these may all possibly be the most contributing factors on development and resilience building on these 35 years or more mothers. We expect that the data and information from this research may add up knowledge, actions and improvements regarding late-aged pregnant women and the pregnancy phenomena in general.

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The attention to health issues in aging has increased and it becomes a challenge for public policies directed to the elderly. This study aimed at learning the social representations built by seniors about the service in the Family Health Unit. It is an exploratory study, funded by the Theory of Social Representations of Moscovici. It was held at the Health Unit of the Family Felipe Shrimp, located in the neighborhood Felipe Shrimp in the city of Natal / RN-Brazil. The participants were one hundred and two elderly / as, served by the Family Health Strategy. The data collection period was extended from July to September 2014. Data were collected through the Word Free Association Test and Interview semi-structured, and analyzed with the help of EVOC software. Interviews were conducted with 20 elderly and subjected to content analysis. The research was approved by the Ethics Committee of the University Hospital Research Onofre Lopes, in the opinion 704,323. It was possible to apprehend negative connotations regarding attendance, listing it as bad and disrespectful, and the limited hours of service, difficult to schedule appointments and tests and inadequate infrastructure, the most marked aspects. Seniors express satisfaction with the medical care, however, they understand that it is necessary that all services are properly integrated to a qualified service. The statements reveal that the service in the drive needs to implement new strategies host for users to participate more in educational and health promotion. It is noted, the need of integrated care, the host of qualified hearing in the health services that they address the elderly seeking care at the clinic of the family, so sticking to the principles of the Unified Health System.

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O objetivo deste estudo foi relacionar dor de dente com condição socioeconômica, acesso aos serviços de saúde bucal e estilo de vida em adolescentes do município de Sobral, Ceará, desenvolvido com delineamento transversal analítico, com amostra composta por 688 indivíduos. A prevalência de dor de dente no grupo pesquisado foi de 31,8%. Para avaliar a relação entre as variáveis independentes e a dor de dente, realizou-se teste de associação pelo qui-quadrado, estimando-se a razão de prevalências por meio da regressão de Poisson. Os fatores que mais demonstraram relação com a dor de dente foram severidade da cárie, motivo do atendimento odontológico relacionado com urgência, frequência ao dentista e recebimento de escova na escola. Observou-se que a alta prevalência de dor de dente em adolescentes está diretamente relacionada às condições de acesso, assim como às características das ações desenvolvidas pelos serviços de saúde. Assim como há necessidade da implantação de serviços vinculados à promoção de saúde, pautados pela equidade e integralidade, é necessária a implantação de serviços de urgência que não simplesmente intervenham na dor de forma mutiladora, mas a encarem como mecanismo de estímulo ao desenvolvimento de procedimentos de prevenção das doenças bucais.

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OBJECTIVE: To describe the distribution of malocclusion and its associated factors in Brazilian adolescents. METHODS: Data from 7,328 subjects aged 12 years and 5,445 adolescents aged 15-19 years were analyzed. The adolescents took part in the Brazilian Oral Health Survey (SBBrasil 2010). The outcome was severe malocclusion according to the dental aesthetic index. The independent variables were sex, skin color, monthly household income, possessions, number of individuals in the household, untreated dental caries, missing teeth and dental appointments or lack thereof, frequency, and reason. Logistical regression analysis was carried out, considering the complex sampling cluster design, based on a hierarchical model. RESULTS: The prevalence of severe malocclusion was 6.5% and 9.1% in the 12-year-olds and the 15-19-year-olds, respectively. After adjustment, those with lighter- skinned black or black skin were 1.59 (95%CI 1.08;2.34) times more likely to present the outcome compared with those with white skin. The loss of one or more first molars increased 2.66 (95%CI 1.26;5.63) the chance to present severe malocclusion by the age of 12. Adolescents aged 15-19 whose household income was below R$ 1,500.00 (OR 2.69 [95%CI 1.62; 4.47]) and those who had seen a dentist for treatment (OR 2.59 [95%CI 2.55;4.34]) had the greatest chance of having severe malocclusion compared with those with higher incomes and those who visited the dentist for prevention.

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Objective: This study aimed to evaluate the accessibility to oral health services in Santa Cruz (RN), focusing on the organizational aspect which is characterized by variables like delay in getting consultation, waiting lines, difficulty scheduling appointments, lack of material, among others. Material and Methods: For such purpose, questionnaires were addressed to 194 users’ houses based on census tract. Results: It has been found that 12.9% of the population has never gone to the dentist’s office, and that the service demand has not been affected by users’ individual and socioeconomic characteristics, except for gender. Data have revealed that 36.1% of users went to the dentist’s in less than a year. In addition, the youngest users are among those who seek the dentist’s office more frequently (p<0.05). 63.3% of the interviewees have reported they find some kind of difficulty when seek for dental care, and 43.2% of users have waited three weeks or more for assistance. It is also noteworthy that 7.4% of the interviewees have been finding difficulties in getting access to urgency care, and that long wait for the consultation is the most frequently cited matter. Conclusion: It could be verified that accessibility to oral health services in the municipality of Santa Cruz (RN) has been hampered by factors related to public policies organization, especially with regards to the work process.

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Objective: This study aimed to evaluate the accessibility to oral health services in Santa Cruz (RN), focusing on the organizational aspect which is characterized by variables like delay in getting consultation, waiting lines, difficulty scheduling appointments, lack of material, among others. Material and Methods: For such purpose, questionnaires were addressed to 194 users’ houses based on census tract. Results: It has been found that 12.9% of the population has never gone to the dentist’s office, and that the service demand has not been affected by users’ individual and socioeconomic characteristics, except for gender. Data have revealed that 36.1% of users went to the dentist’s in less than a year. In addition, the youngest users are among those who seek the dentist’s office more frequently (p<0.05). 63.3% of the interviewees have reported they find some kind of difficulty when seek for dental care, and 43.2% of users have waited three weeks or more for assistance. It is also noteworthy that 7.4% of the interviewees have been finding difficulties in getting access to urgency care, and that long wait for the consultation is the most frequently cited matter. Conclusion: It could be verified that accessibility to oral health services in the municipality of Santa Cruz (RN) has been hampered by factors related to public policies organization, especially with regards to the work process.

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In the early 1990s, a major milestone in the treatment of Acquired Immune Deficiency Syndrome was the development of highly active combination antiretroviral therapy. The great benefit generated by the use of this therapy was prolonging the survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Despite improvements generated by this therapy, there are still many difficulties to be overcome. One is the patient adherence to their treatment, bringing challenges to services and health professionals. Hence the need for early identification of nursing diagnosis Lack of Accession so that solutions are sought by the nurse with the patient and his family. With this problem, adds to the difficulty of hospital nurses in inferring that diagnosis, especially in identifying their defining characteristics. In this context, the objective was to evaluate the accuracy of clinical indicators of nursing diagnosis Lack of Adherence to antiretroviral treatment for people living with the Acquired Immunodeficiency Syndrome. The research took place in two stages. The first consists of the evaluation of the diagnostic indicators in the study; and second, the diagnostic inference performed by specialist nurses. The first step took place in a referral hospital in the treatment of infectious diseases in the Northeast of Brazil, and data were collected through an instrument for carrying out history and physical examination and analyzed for the presence or absence of the diagnostic indicators. In the second stage, the data were sent to experts, who judged the presence or absence of the diagnosis in the studied clientele. The project was submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the General Certificate for Ethics Assessment (CAAE) No 46206215.3.0000.5537. Data were analyzed using descriptive and inferential statistics. Test were used Fisher's exact, chi-square test of Pearson and logistic regression. Since the accuracy of clinical indicators was measured by sensitivity, specificity, predictive values, likelihood ratios. As a result, we identified the presence of diagnosis Lack of Accession on 69% (n = 78) of the study patients. The defining characteristics that showed statistically significant association with the diagnosis studied were: lack of adherence behavior, complications related to development, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. The characteristic with greater sensitivity was missing scheduled appointments and the highest specificity behavior of noncompliance. The logistic regression showed as predictors for the diagnosis Lack of Accession: lack of adherence behavior, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. It was concluded that the identification of clinical indicators accurately enabled a good prediction of the nursing diagnosis Lack of Accession on people living with the Acquired Immune Deficiency Syndrome, helping nurses develop early on strategies for promoting adherence to the use of antiretrovirals.

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In the early 1990s, a major milestone in the treatment of Acquired Immune Deficiency Syndrome was the development of highly active combination antiretroviral therapy. The great benefit generated by the use of this therapy was prolonging the survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Despite improvements generated by this therapy, there are still many difficulties to be overcome. One is the patient adherence to their treatment, bringing challenges to services and health professionals. Hence the need for early identification of nursing diagnosis Lack of Accession so that solutions are sought by the nurse with the patient and his family. With this problem, adds to the difficulty of hospital nurses in inferring that diagnosis, especially in identifying their defining characteristics. In this context, the objective was to evaluate the accuracy of clinical indicators of nursing diagnosis Lack of Adherence to antiretroviral treatment for people living with the Acquired Immunodeficiency Syndrome. The research took place in two stages. The first consists of the evaluation of the diagnostic indicators in the study; and second, the diagnostic inference performed by specialist nurses. The first step took place in a referral hospital in the treatment of infectious diseases in the Northeast of Brazil, and data were collected through an instrument for carrying out history and physical examination and analyzed for the presence or absence of the diagnostic indicators. In the second stage, the data were sent to experts, who judged the presence or absence of the diagnosis in the studied clientele. The project was submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the General Certificate for Ethics Assessment (CAAE) No 46206215.3.0000.5537. Data were analyzed using descriptive and inferential statistics. Test were used Fisher's exact, chi-square test of Pearson and logistic regression. Since the accuracy of clinical indicators was measured by sensitivity, specificity, predictive values, likelihood ratios. As a result, we identified the presence of diagnosis Lack of Accession on 69% (n = 78) of the study patients. The defining characteristics that showed statistically significant association with the diagnosis studied were: lack of adherence behavior, complications related to development, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. The characteristic with greater sensitivity was missing scheduled appointments and the highest specificity behavior of noncompliance. The logistic regression showed as predictors for the diagnosis Lack of Accession: lack of adherence behavior, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. It was concluded that the identification of clinical indicators accurately enabled a good prediction of the nursing diagnosis Lack of Accession on people living with the Acquired Immune Deficiency Syndrome, helping nurses develop early on strategies for promoting adherence to the use of antiretrovirals.

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Infrared selection is a potentially powerful way to identify heavily obscured AGNs missed in even the deepest X-ray surveys. Using a 24 μm-selected sample in GOODS-S, we test the reliability and completeness of three infrared AGN selection methods: (1) IRAC color-color selection, (2) IRAC power-law selection, and (3) IR-excess selection; we also evaluate a number of IR-excess approaches. We find that the vast majority of non-power-law IRAC color-selected AGN candidates in GOODS-S have colors consistent with those of star-forming galaxies. Contamination by star-forming galaxies is most prevalent at low 24 μm flux densities (~100 μJy) and high redshifts (z ~ 2), but the fraction of potential contaminants is still high (~50%) at 500 μJy, the highest flux density probed reliably by our survey. AGN candidates selected via a simple, physically motivated power-law criterion ("power-law galaxies," or PLGs), however, appear to be reliable. We confirm that the IR-excess methods successfully identify a number of AGNs, but we also find that such samples may be significantly contaminated by star-forming galaxies. Adding only the secure Spitzer-selected PLG, color-selected, IR-excess, and radio/IR-selected AGN candidates to the deepest X-ray-selected AGN samples directly increases the number of known X-ray AGNs (84) by 54%-77%, and implies an increase to the number of 24 μm-detected AGNs of 71%-94%. Finally, we show that the fraction of MIR sources dominated by an AGN decreases with decreasing MIR flux density, but only down to f_24 μ m = 300 μJy. Below this limit, the AGN fraction levels out, indicating that a nonnegligible fraction (~10%) of faint 24 μm sources (the majority of which are missed in the X-ray) are powered not by star formation, but by the central engine. The fraction of all AGNs (regardless of their MIR properties) exceeds 15% at all 24 μm flux densities.