Validação de conteúdo de instrumentos sobre conhecimento e habilidade em sondagem nasogástrica

Este estudo teve como objetivo construir e validar conteúdo de instrumentos avaliativos sobre conhecimento e habilidade de enfermagem no procedimento de sondagem nasogástrica. Trata-se de um estudo metodológico realizado na Universidade Federal do Rio Grande do Norte (UFRN) e na Universidade do Estado do Rio Grande do Norte (UERN). A amostra foi composta por 23 juízes, selecionados a partir dos critérios de inclusão: serem enfermeiros, docentes nas disciplinas de Semiologia e/ou Semiotécnica de Enfermagem, ter no mínimo um ano de experiência nestas disciplinas e ser das instituições selecionadas para o estudo. A pesquisa se desenvolveu em três etapas: (A) construção de dois instrumentos com base na revisão da literatura que resultou em um roteiro de observação da habilidade estruturado composto por 28 itens e um questionário sobre o conhecimento com 12 questões; (B) submissão dos instrumentos aos juízes, no período de junho a setembro de 2012, os quais deveriam julgar cada item como adequado , adequado com alterações ou inadequado , além de fazer uma avaliação geral de cada instrumento baseada em 10 critérios adaptados do referencial metodológico de Pasquali; e (C) validação com a verificação do nível de concordância entre os juízes, por meio da aplicação do Índice de Validade de Conteúdo (IVC) e do Índice Kappa. Utilizou-se o nível de consenso maior que 0,75 para o IVC e maior que 0,61 (bom) para o Índice Kappa. Estudo aprovado pelo Comitê de Ética em Pesquisa do Hospital Universitário Onofre Lopes (CEP/HUOL), sob CAAE nº 0002.0.294.000-10. Após serem codificados e tabulados, os dados foram analisados por meio de estatística descritiva. Dos 23 juízes, 87% eram do sexo feminino, com média de idade de 36,5 anos, 73,9% atuavam na UFRN, 78,3% possuíam mestrado acadêmico e 69,6% atuavam exclusivamente na docência. A média de tempo de experiência na docência foi de 7,9 anos e nas disciplinas de Semiologia e/ou Semiotécnica de Enfermagem foi de 5,6 anos. No julgamento do roteiro de observação estruturado e do questionário sobre o conhecimento, nenhum item/questão considerou-se inadequado, uma vez que todos obtiveram nível de concordância dentro dos índices estabelecidos (IVC > a 0,75 e Kappa > 0,61). Em relação ao roteiro estruturado para avaliar habilidade, dos 28 itens presentes, 13 apresentaram índice de concordância perfeito (IVC=1,00; Kappa= 1,00) e outros 15 foram considerados adequados com alterações, principalmente no que diz respeito à sequência instrucional dos tópicos, clareza e vocabulário. No questionário sobre o conhecimento, dentre as 12 questões que o compunham, 03 apresentaram índice de concordância perfeito e as demais adequadas com alterações quanto aos critérios vocabulário, clareza, atualização e precisão. Em relação à avaliação geral dos instrumentos, o roteiro estruturado de habilidade obteve IVC de 0,95 e Kappa de 0,91 e o questionário do conhecimento, IVC de 0,97 e Kappa de 0,94. Os dois instrumentos mostraram-se válidos quanto ao seu conteúdo, e constituem ferramentas para fomentar a qualidade da assistência de enfermagem em relação ao conhecimento e à habilidade em sondagem nasogástrica

Modelagem da decisão por pacotes de viagem: um estudo usando processo de hierarquia analítica AHP

The objective of this dissertation is to propose a Multi Criteria Decision Aid Model to be used by the costumers of the travel agencies and help them to choose the best package travel. The main objective is to contribute for the simplification of the travel package decision choice from the identification of the models of values and preference of the customers and applying them to the existing package. It is used the Analytic Hierarchy Process (AHP) method to structuralize a decision hierarchic model composed by six criteria (package cost, hotel category, security of the city, travel time, direct flight and position in ranking of the 10 most visited destination) and five real alternatives of packages for a holiday of three days created from travel agency data. The decision analysis was realized for the choice of a travel package by a group composed by two couples that regularly travels together, to which was asked to do a pairwise judgment of the criteria and the alternatives. The mains results show that, although been a group that travels together, there are different models of values in the weights of the criteria and a certain convergence in the scales of preferences of the alternatives in the criteria. It was not pointed a dominant alternative for all the members of the group separately, but an analysis of a total utility of the group shows a classification and an order of the travel packages and an alternative clearly in front of the others. The sensitivity analysis revels that there are changes in the ranking, but the two alternatives best classified in the normal analysis are the same ones in the sensitivity analysis, although with the positions changed. The analysis also led to a simplification of the process with the exclusion of alternatives dominated for the others ones. As main conclusion, it is evaluated that the model and method suggested allow a simplification of the decision process in the choice of travel packages

Desenvolvimento de um modelo computacional para a ampliação do atendimento do Programa de Acessibilidade Especial Porta a Porta - PRAE

Worldwide, the demand for transportation services for persons with disabilities, the elderly, and persons with reduced mobility have increased in recent years. The population is aging, governments need to adapt to this reality, and this fact could mean business opportunities for companies. Within this context is inserted the Programa de Acessibilidade Especial porta a porta PRAE, a door to door public transportation service from the city of Natal-RN in Brazil. The research presented in this dissertation seeks to develop a programming model which can assist the process of decision making of managers of the shuttle. To that end, it was created an algorithm based on methods of generating approximate solutions known as heuristics. The purpose of the model is to increase the number of people served by the PRAE, given the available fleet, generating optimized schedules routes. The PRAE is a problem of vehicle routing and scheduling of dial-a-ride - DARP, the most complex type among the routing problems. The validation of the method of resolution was made by comparing the results derived by the model and the currently programming method. It is expected that the model is able to increase the current capacity of the service requests of transport

Algoritmos de otimização para decisões de localização de facilidades e distribuição em sistemas multiníveis de transporte rodoviário de carga

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Dedução de Funções de Alívio para Priorização de Variantes de Chaveamento Adequadas à Eliminação de Sobrecargas

Eventually, violations of voltage limits at buses or admissible loadings of transmission lines and/or power transformers may occur by the power system operation. If violations are detected in the supervision process, corrective measures may be carried out in order to eliminate them or to reduce their intensity. Loading restriction is an extreme solution and should only be adopted as the last control action. Previous researches have shown that it is possible to control constraints in electrical systems by changing the network topology, using the technique named Corrective Switching, which requires no additional costs. In previous works, the proposed calculations for verifying the ability of a switching variant in eliminating an overload in a specific branch were based on network reduction or heuristic analysis. The purpose of this work is to develop analytical derivation of linear equations to estimate current changes in a specific branch (due to switching measures) by means of few calculations. For bus-bar coupling, derivations will be based on short-circuit theory and Relief Function methodology. For bus-bar splitting, a Relief Function will be derived based on a technique of equivalent circuit. Although systems of linear equations are used to substantiate deductions, its formal solution for each variant, in real time does not become necessary. A priority list of promising variants is then assigned for final check by an exact load flow calculation and a transient analysis using ATP Alternative Transient Program. At last, results obtained by simulation in networks with different features will be presented

Metodologia estatística na solução do problema do caixeiro viajante e na avaliação de algoritmos : um estudo aplicado à transgenética computacional

The problems of combinatory optimization have involved a large number of researchers in search of approximative solutions for them, since it is generally accepted that they are unsolvable in polynomial time. Initially, these solutions were focused on heuristics. Currently, metaheuristics are used more for this task, especially those based on evolutionary algorithms. The two main contributions of this work are: the creation of what is called an -Operon- heuristic, for the construction of the information chains necessary for the implementation of transgenetic (evolutionary) algorithms, mainly using statistical methodology - the Cluster Analysis and the Principal Component Analysis; and the utilization of statistical analyses that are adequate for the evaluation of the performance of the algorithms that are developed to solve these problems. The aim of the Operon is to construct good quality dynamic information chains to promote an -intelligent- search in the space of solutions. The Traveling Salesman Problem (TSP) is intended for applications based on a transgenetic algorithmic known as ProtoG. A strategy is also proposed for the renovation of part of the chromosome population indicated by adopting a minimum limit in the coefficient of variation of the adequation function of the individuals, with calculations based on the population. Statistical methodology is used for the evaluation of the performance of four algorithms, as follows: the proposed ProtoG, two memetic algorithms and a Simulated Annealing algorithm. Three performance analyses of these algorithms are proposed. The first is accomplished through the Logistic Regression, based on the probability of finding an optimal solution for a TSP instance by the algorithm being tested. The second is accomplished through Survival Analysis, based on a probability of the time observed for its execution until an optimal solution is achieved. The third is accomplished by means of a non-parametric Analysis of Variance, considering the Percent Error of the Solution (PES) obtained by the percentage in which the solution found exceeds the best solution available in the literature. Six experiments have been conducted applied to sixty-one instances of Euclidean TSP with sizes of up to 1,655 cities. The first two experiments deal with the adjustments of four parameters used in the ProtoG algorithm in an attempt to improve its performance. The last four have been undertaken to evaluate the performance of the ProtoG in comparison to the three algorithms adopted. For these sixty-one instances, it has been concluded on the grounds of statistical tests that there is evidence that the ProtoG performs better than these three algorithms in fifty instances. In addition, for the thirty-six instances considered in the last three trials in which the performance of the algorithms was evaluated through PES, it was observed that the PES average obtained with the ProtoG was less than 1% in almost half of these instances, having reached the greatest average for one instance of 1,173 cities, with an PES average equal to 3.52%. Therefore, the ProtoG can be considered a competitive algorithm for solving the TSP, since it is not rare in the literature find PESs averages greater than 10% to be reported for instances of this size.

Contribuições aos Processos de Clustering com Base em Métricas não-Euclidianas

In this work we present a new clustering method that groups up points of a data set in classes. The method is based in a algorithm to link auxiliary clusters that are obtained using traditional vector quantization techniques. It is described some approaches during the development of the work that are based in measures of distances or dissimilarities (divergence) between the auxiliary clusters. This new method uses only two a priori information, the number of auxiliary clusters Na and a threshold distance dt that will be used to decide about the linkage or not of the auxiliary clusters. The number os classes could be automatically found by the method, that do it based in the chosen threshold distance dt, or it is given as additional information to help in the choice of the correct threshold. Some analysis are made and the results are compared with traditional clustering methods. In this work different dissimilarities metrics are analyzed and a new one is proposed based on the concept of negentropy. Besides grouping points of a set in classes, it is proposed a method to statistical modeling the classes aiming to obtain a expression to the probability of a point to belong to one of the classes. Experiments with several values of Na e dt are made in tests sets and the results are analyzed aiming to study the robustness of the method and to consider heuristics to the choice of the correct threshold. During this work it is explored the aspects of information theory applied to the calculation of the divergences. It will be explored specifically the different measures of information and divergence using the Rényi entropy. The results using the different metrics are compared and commented. The work also has appendix where are exposed real applications using the proposed method

Algoritmo SOM com estrutura hierárquica e dinâmica aplicado a compressão de imagens

ln this work the implementation of the SOM (Self Organizing Maps) algorithm or Kohonen neural network is presented in the form of hierarchical structures, applied to the compression of images. The main objective of this approach is to develop an Hierarchical SOM algorithm with static structure and another one with dynamic structure to generate codebooks (books of codes) in the process of the image Vector Quantization (VQ), reducing the time of processing and obtaining a good rate of compression of images with a minimum degradation of the quality in relation to the original image. Both self-organizing neural networks developed here, were denominated HSOM, for static case, and DHSOM, for the dynamic case. ln the first form, the hierarchical structure is previously defined and in the later this structure grows in an automatic way in agreement with heuristic rules that explore the data of the training group without use of external parameters. For the network, the heuristic mIes determine the dynamics of growth, the pruning of ramifications criteria, the flexibility and the size of children maps. The LBO (Linde-Buzo-Oray) algorithm or K-means, one ofthe more used algorithms to develop codebook for Vector Quantization, was used together with the algorithm of Kohonen in its basic form, that is, not hierarchical, as a reference to compare the performance of the algorithms here proposed. A performance analysis between the two hierarchical structures is also accomplished in this work. The efficiency of the proposed processing is verified by the reduction in the complexity computational compared to the traditional algorithms, as well as, through the quantitative analysis of the images reconstructed in function of the parameters: (PSNR) peak signal-to-noise ratio and (MSE) medium squared error

Desenvolvimento de esquema de controle com realimentação visual para um robô manipulador

This work proposes a kinematic control scheme, using visual feedback for a robot arm with five degrees of freedom. Using computational vision techniques, a method was developed to determine the cartesian 3d position and orientation of the robot arm (pose) using a robot image obtained through a camera. A colored triangular label is disposed on the robot manipulator tool and efficient heuristic rules are used to obtain the vertexes of that label in the image. The tool pose is obtained from those vertexes through numerical methods. A color calibration scheme based in the K-means algorithm was implemented to guarantee the robustness of the vision system in the presence of light variations. The extrinsic camera parameters are computed from the image of four coplanar points whose cartesian 3d coordinates, related to a fixed frame, are known. Two distinct poses of the tool, initial and final, obtained from image, are interpolated to generate a desired trajectory in cartesian space. The error signal in the proposed control scheme consists in the difference between the desired tool pose and the actual tool pose. Gains are applied at the error signal and the signal resulting is mapped in joint incrementals using the pseudoinverse of the manipulator jacobian matrix. These incrementals are applied to the manipulator joints moving the tool to the desired pose

Localização de um robô móvel usando odometria e marcos naturais

Several methods of mobile robot navigation request the mensuration of robot position and orientation in its workspace. In the wheeled mobile robot case, techniques based on odometry allow to determine the robot localization by the integration of incremental displacements of its wheels. However, this technique is subject to errors that accumulate with the distance traveled by the robot, making unfeasible its exclusive use. Other methods are based on the detection of natural or artificial landmarks present in the environment and whose location is known. This technique doesnt generate cumulative errors, but it can request a larger processing time than the methods based on odometry. Thus, many methods make use of both techniques, in such a way that the odometry errors are periodically corrected through mensurations obtained from landmarks. Accordding to this approach, this work proposes a hybrid localization system for wheeled mobile robots in indoor environments based on odometry and natural landmarks. The landmarks are straight lines de.ned by the junctions in environments floor, forming a bi-dimensional grid. The landmark detection from digital images is perfomed through the Hough transform. Heuristics are associated with that transform to allow its application in real time. To reduce the search time of landmarks, we propose to map odometry errors in an area of the captured image that possesses high probability of containing the sought mark

Escalabilidade Paralela de um Algoritmo de Migração Reversa no Tempo (RTM) Pré-empilhamento

The seismic method is of extreme importance in geophysics. Mainly associated with oil exploration, this line of research focuses most of all investment in this area. The acquisition, processing and interpretation of seismic data are the parts that instantiate a seismic study. Seismic processing in particular is focused on the imaging that represents the geological structures in subsurface. Seismic processing has evolved significantly in recent decades due to the demands of the oil industry, and also due to the technological advances of hardware that achieved higher storage and digital information processing capabilities, which enabled the development of more sophisticated processing algorithms such as the ones that use of parallel architectures. One of the most important steps in seismic processing is imaging. Migration of seismic data is one of the techniques used for imaging, with the goal of obtaining a seismic section image that represents the geological structures the most accurately and faithfully as possible. The result of migration is a 2D or 3D image which it is possible to identify faults and salt domes among other structures of interest, such as potential hydrocarbon reservoirs. However, a migration fulfilled with quality and accuracy may be a long time consuming process, due to the mathematical algorithm heuristics and the extensive amount of data inputs and outputs involved in this process, which may take days, weeks and even months of uninterrupted execution on the supercomputers, representing large computational and financial costs, that could derail the implementation of these methods. Aiming at performance improvement, this work conducted the core parallelization of a Reverse Time Migration (RTM) algorithm, using the parallel programming model Open Multi-Processing (OpenMP), due to the large computational effort required by this migration technique. Furthermore, analyzes such as speedup, efficiency were performed, and ultimately, the identification of the algorithmic scalability degree with respect to the technological advancement expected by future processors

Paradigmas, valores e educação

O texto levanta os perfis epistemológico e socianalítico da questão paradigmática. Mauss evidenciara o moule affectif das noções científicas de força e causa. Posteriormente Baudouin falaria na indução arquetípica das noções e a antropologia do imaginário de Durand concluiria pela indução arquetipal do conceito pela imagem. Chegava-se, assim, ao desvendamento do substrato inconsciente das ideações, de um substrato regido pela catexis vetorializada, traduzindo-se nos valores como cerne das ideações. É o famoso a priori emotivo. Portanto, no texto, questionam-se dois mitos, esteios da ciência clássica: o mito da objetividade científica e o da neutralidade axiológica. Destaca, assim, a falácia da existência de uma ruptura epistemológica entre ciência e ideologia. A partir daí, as ideações tornam-se ideologias, sobretudo nas ciências do homem e nas ciências da educação que, ademais, tornam-se suporte de uma disfarçada luta ideológica, na qual, num colonialismo cognitivo, as estratégias de conhecimento dissimulam as de preconceito. Entretanto, assumir a realidade desse suporte fantasmanalítico e ideológico propicia uma tarefa educativa salutar: os paradigmas tornam-se fantasias e, nessa relativização crítica, podem ser usados como um campo de objetos transicionais coletivos num ludismo cultural e educativo. No policulturalismo da sociedade contemporânea, o politeísmo de valores de Weber transforma-se num politeísmo epistemológico, regido pelo relativismo ontológico de Feyerabend e por uma ética do pragmatismo. Articulando cultura, organização e educação, a antropologia das organizações educativas e a culturanálise de grupos de Paula Carvalho traduzem as heurísticas dessa dialética transicional.

Representações discentes sobre a afetividade nas aulas de inglês de uma escola técnica

This work has risen from the researcher s pedagogical practice at a technical school in Natal, and it aims to observ how affectiveness is noticed by the students in their English classes, since we can have an idea of technicist teaching, which foccus on the acquisition of technical abilities. As cognition and affectiveness are considered indivisible elements in this research, we tried to identify the linguistic signs that express the students representations about affectiveness in their English classes. We used the Systemic Functional Linguistics approach to study the Ideational metafunction of Halliday (1994), by means of the transitivity system, to show how the clauses are used to illustrate these representations, and the interpersonal metafunction, that deals with the relationship between the teacher and the students. We tried to identify the most common processes (HALLIDAY, 1994) mentioned by the 68 students who participated in this work. We used learning narratives (BARCELOS, 2006) submitted to Wordsmith Tools computing program (SCOTT, 2009), whose results indicate the most frequent lexical items found in their narratives. The lexical choices seem to indicate that affectiveness is noticed as a composing element of the English classes in that school. There are representations of interacting classes, where the students needs are considered. These representations are built in the relationship of the students and the teacher, and they are grammatically realized by means of the polarity adjunct no , the intensity adjunct very , and the nominal group the teacher . The relational and mental processes (be) and (like) are the most used in their narratives, and we also observe that affectiveness and disponibility to help the students are considered the most important attitudes in their representations. The Appraisal system is used to analise the choices related to the attitudes and judgement of the students, that show appreciation for interacting classes, but there is still authorithary berhavior from the teacher in the English classes

Entre a fé, a obra social e a publicidade: uma análise crítica do discurso da responsabilidade social da Igreja Universal do Reino de Deus

Situated on Applied Linguistics (PENNYCOOK, 1998; MOITA LOPES, 2003, 2006, 2008, 2009), this thesis, which is inscribed in a qualitative-interpretative approach of a critical analysis perspective , lies on the speech of social responsibility and the way like that is employed in seeking for legitimacy and prestige within the neopentecostal brazilian religious field, more specifically of the Universal Church of the Kingdom of God. The general goal of this research is t reflect upon the speech on social responsibility and the rethoric of selfpromotion of the Universal Church through the role of social actors in the making of his her identities, materialized in the newspaper Folha Universal. In order to achieve that, we have conjugated, in this research, social and discursive analysis. On the linguistic-discursive approach, the research is based on the Critical Analysis of Discourse (ACD), specially in Fairclough (2001, 2003, 2006), a proposal that provides theoretical-methodological tools to investigate the language beyond the linguistic structures , that is, the discourse, social practices in which it occurs and more ample structures. Theoretical assumptions were also used of Sistemico-Functional Linguistics(LSF), matching with categories of the Transitivity System of Halliday (1994, 2004), of the forms of representation of social actors in the socioeconomic perspective by Van Leeuwen (1997, 2008) and of the Appraisal system by Martin and White (2005). As we develop the argumentation on thesobre social role of religion in this thesis, we make use of the authors such as Freston (1994), Oro (1997, 2003), Campos (1996, 1999), Mariano (1999), Meneses (2008), among several ones. We have also used a series of concepts and categories coming from the field of communication and marketing on the business social responsability and social marketing . In this area, we take as references the contributions of Bueno (2003), Fossá and Sartoretto (2003) and Zenone (2006). The corpus of the work is framed by news taken at the newspaper Folha Universal, in which are given the social responsibility actions of the church . The timeframe used was on the editions of 2010 thru 2012. Results found at he analysis of the News lead to semantic features of Assessment of Affection, Judgment and Appreciation, many times followed by Gradation, and the Attribution, one of the subsystems of the Attachment, are evidence of positive assessments for the Universal Church and its agents and make up rethorical elements which provide structure for the discourse of the Universal Church at the newspaper Folha Universal consisted of its image (style) of social responsibility . Results show that the most frequente social actors of the discourse are, on one hand, the Universal Church itself and its volunteers, famous (actors, actresses, presenters), politicians and authorities, on the other hand, the population which was helped by the Church social projects . The first group seems to be Always activated, however the second one, most of the time rather passive. These are also represented by assimilation in most of the occurrences, however the other ones by individualization and nomination entitled by honorification, except for the volunteers that are represented either as an individual, or as a group

A intervenção do poder judiciário no acesso a medicamentos no Rio Grande do Norte: uma análise sob a ótica das políticas nacionais de medicamento e de assistência farmacêutica

The present study aimed to evaluate the inclusion of the principles of the National Medicines Policy - PNM and the Pharmaceutical assistance - PNAF in the prosecution of lawsuits involving medicines. To fulfill this necessity , data collection was performed on the website by the Tribunal Rio Grande do Norte - TJ RN ( Rio Grande do Norte Court) , in 2012 . It was obtained 115 judgments, which were analyzed in order to generate Monitoring Indicators from lawsuits and conduct content analysis proposed by Bardin (2006). The results showed that : a) 100 % of the decisions were favorable to the author , b) 76 % of decisions were requests by the trade name of the drug , c) only one drug (eculizumabe) had not granted by ANVISA , d) 36 % of drugs were present in the list of standard medicines in SUS , 16 % of primary care block and 20 % of specialized component , e) 76 % of the decisions presented the request of at least 01 non-standard medicine. With regard to decentralization of PNM and PNAF we observed a commitment to this principle at judicial decisions, to see that municipalities and states are often forced to buy medicines of responsibility from another federal entity or other tertiary units as CACONs and UNACONS. The content analysis revealed that the argument from the judges used when you utter their decisions was that the right to health is recognized by Brazilian law as a fundamental right and should be guaranteed by the State for all its citizens. So, health is more than budgetary constraints of federal entities, which are severally liable for lawsuits , regardless the medication requested belongs or not to a particular block of a pharmaceutical assistance funding. Given these data, it is observed that there are gaps in the judgment when it comes to the insertion of the words and principles of PNM and PNAF, creating then the need for greater dialogue between the executive and judicial, so that they may consider relevant the effectiveness and application of such principles to minimize the negative consequences of the phenomenon of health judicialisation. Keywords: Judicialisation, Medicines, Public Policy, Pharmaceutical Care