996 resultados para Avaliação de Custo-Efetividade


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A reabilitação urbana consiste numa forma de intervenção incorporada sobre a zona urbana existente, em que o património urbanístico é mantido, num todo ou em parte substancial, e modernizado através da realização de obras de remodelação ou beneficiação dos sistemas de infraestruturas urbanas, reconstrução, ampliação, alteração, conservação ou demolição dos edifícios. Em Portugal, ao contrário dos restantes países da união europeia, a reabilitação urbana ainda tem pouca expressão. O objetivo central da presente dissertação é o desenvolvimento de uma avaliação comparativa dos custos de intervenção (execução de obras de reabilitação) para diferentes níveis de estado de conservação de edifícios. Para tal, utiliza-se um caso real de estudo na baixa de Coimbra, mais concretamente dos 27 edifícios da Rua da Moeda, dos quais se efetuou o estudo do estado de conservação. Selecionaram-se cinco edifícios, um por cada um dos diferentes níveis do estado de conservação / tipo de intervenção (Muito ligeira, Ligeira, Média, Grave e Muito Grave) e quantificou-se o custo das obras de reabilitação que seria necessário efetuar para restabelecer em cada um destes edifícios as condições adequadas de habitabilidade, conforto e segurança. Uma vez que as questões relativas à segurança e eficiência energética são cada vez mais um assunto central da agenda pública e política mundial, bem assim, como as relativas à preservação do ambiente, pareceu ainda interessante, procurar estimar a energia incorporada e as emissões de CO2 associadas a cada um dos referidos níveis de intervenção e comparar estes valores com os obtidos para o caso de uma nova construção. Tentou-se, ainda, perceber para quais dos níveis de conservação dos edifícios será economicamente e ambientalmente mais vantajoso reabilitar, do que simplesmente optar por demolir e construir de novo.

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Este estudo avaliou as alterações produzidas nos arcos dentais superiores de pacientes submetidos à Expansão Rápida da Maxila Assistida Cirurgicamente (ERMAC). A amostra utilizada foi composta de 50 modelos de gesso superiores de 18 pacientes, sendo seis do sexo masculino e 12 do sexo feminino, com média de idade de 23,3 anos. Para cada paciente foram preparados três modelos de gesso obtidos em diferentes fases: Inicial, antes do procedimento operatório (T1); três meses pós-expansão (travamento do expansor) e momento da remoção do aparelho expansor tipo Hyrax e colocação da placa removível de acrílico para contenção (T2); seis meses pós-expansão e momento de remoção da placa de acrílico (T3). O dispositivo expansor utilizado foi o disjuntor tipo Hyrax. O procedimento cirúrgico adotado foi a osteotomia lateral da maxila sem o envolvimento da lâmina pterigóide, osteotomia da espinha nasal à linha média dental (incisivos centrais superiores), separação da sutura palatina mediana por meio de cinzel e separação do septo nasal. O início da ativação ocorreu no terceiro dia pós-operatório, sendo ¼ de volta pela manhã e ¼ à noite, sendo que as ativações seguiram critérios clínicos para o controle da expansão. As medidas foram realizadas por meio da máquina de medição tridimensional (SAC), baseando-se nas alterações nos três planos (vertical, sagital e transversal) que ocorreram nos modelos de gesso. Concluiu-se que: 1. Houve um aumento estatisticamente significante nas distâncias transversais em todos os grupos de dentes (de incisivos centrais até segundos molares) de T1 para T2, demonstrando a efetividade do tratamento. De T2 para T3 não houve diferença estatisticamente significante para nenhuma variável, indicando, assim, estabilidade após seis meses do término da ERMAC; 2. Houve um aumento estatisticamente significante nas inclinações dos primeiros e segundos molares dos lados direito e esquerdo e dos segundos pré-molares apenas do lado esquerdo, sugerindo um comportamento assimétrico dos dentes avaliados; 3. Houve um aumento na largura palatina nos intervalos analisados, com diferenças estatisticamente significantes entre T1 x T2 e T1 x T3; 4. Não foram observadas diferenças estatisticamente significantes na profundidade palatina nos intervalos analisados.(AU)

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The National Reading Incentive Program (PROLER) is a national initiative to promote and encourage reading throughout the country, linked to the National Library Foundation (FBN) of the Ministry of Culture (MinC). This research aims to assess the PROLER’s implementation process in the state of Rio Grande do Norte, from the actions of their local committee. The framework is based on contextualize the policies that seek to encourage the book and reading, as well as the processes of implementation and evaluation of public policies. The research is understood as a qualitative descriptive-exploratory study, comprising a single case study. Makes use of semi-structured interview as a tool for data collection, which was attended by 8 members of Potiguar Committee as respondents. The techniques of bibliographical and documentary analysis were used for the analysis and discussion of data obtained from surveys and documents on PROLER; as to the content of the interviews, the technique used was the analysis of conversations. As for the results, the existence of four barriers to program implementation in the state that are worth mentioning is observed: a) the political-administrative discontinuity; b) the limited resources and few partnerships; c) the management of school libraries and absence from the post of librarian in the state and; d) the absence of a process or assessment tool able to evaluate the results or the impacts of actions taken by the Potiguar Committee. It was noticed that these limiting four come PROLER making the implementation of the Rio Grande do Norte a process that, although complying with the national regulations of teacher training and follow school libraries and their needs, not flawed to develop assessments that can measure program impacts, making the feedback process of ineffective policy. Another observation of this study is seen in the fact that the Committee did not get enough to supply their shares resources, as well as not being able to articulate new partnerships, thus contributing negatively to the scope of the program form and, consequently, for the effectiveness of their actions. Has even mentioning the fact that the Committee do nothing regarding the mismanagement of the libraries that are in their care, ie, do not use the power of coercion as guaranteed by the National Policy on Reading and federal laws that treat the school library, and is therefore ineffective in relation to compliance with the program guidelines

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The principal effluent in the oil industry is the produced water, which is commonly associated to the produced oil. It presents a pronounced volume of production and it can be reflected on the environment and society, if its discharge is unappropriated. Therefore, it is indispensable a valuable careful to establish and maintain its management. The traditional treatment of produced water, usualy includes both tecniques, flocculation and flotation. At flocculation processes, there are traditional floculant agents that aren’t well specified by tecnichal information tables and still expensive. As for the flotation process, it’s the step in which is possible to separate the suspended particles in the effluent. The dissolved air flotation (DAF) is a technique that has been consolidating economically and environmentally, presenting great reliability when compared with other processes. The DAF is presented as a process widely used in various fields of water and wastewater treatment around the globe. In this regard, this study was aimed to evaluate the potential of an alternative natural flocculant agent based on Moringa oleifera to reduce the amount of oil and grease (TOG) in produced water from the oil industry by the method of flocculation/DAF. the natural flocculant agent was evaluated by its efficacy, as well as its efficiency when compared with two commercial flocculant agents normally used by the petroleum industry. The experiments were conducted following an experimental design and the overall efficiencies for all flocculants were treated through statistical calculation based on the use of STATISTICA software version 10.0. Therefore, contour surfaces were obtained from the experimental design and were interpreted in terms of the response variable removal efficiency TOG (total oil and greases). The plan still allowed to obtain mathematical models for calculating the response variable in the studied conditions. Commercial flocculants showed similar behavior, with an average overall efficiency of 90% for oil removal, however it is the economical analysis the decisive factor to choose one of these flocculant agents to the process. The natural alternative flocculant agent based on Moringa oleifera showed lower separation efficiency than those of commercials one (average 70%), on the other hand this flocculant causes less environmental impacts and it´s less expensive

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This Doctoral Dissertation deals with the evaluation of impacts, through the Case Study on deviations or redirects present in contracts Pronaf B, at Governador Mangabeira - BA , from 2011 to 2013. From the questioning about the expected impacts not contribute to the effectiveness of the program ? It was possible the measurement of the hypothesis that the effectiveness of unexpected impacts stems from the logic of family farming, unique socio-economic conditions of individuals and family units. The methodology is structured in the theoretical framework regarding the impact assessment and family farming, data collection, questionnaires among redirected contracting credit in PRONAF B and interviews with institutional actors involved . The results confirmed the existence of a logic family farm, able to take own decisions their mode of reproduction of life. As for the impact assessment, we added the importance of the unexpected in the evaluation of public policy impacts , while study of effectiveness with the beneficiaries and the significant contribution of their views.

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The sizing of nursing human resources is an essential management tool to meet the needs of the patients and the institution. Regarding to the Intensive Care Unit, where the most critical patients are treated and the most advanced life-support equipments are used, requiring a high number of skilled workers, the use of specific indicators to measure the workload of the team becomes necessary. The Nursing Activities Score is a validated instrument for measuring nursing workload in the Intensive Care Unit that has demonstrated effectiveness. It is a cross-sectional study with the primary objective of assessing the workload of nursing staff in an adult Intensive Care Unit through the application of the Nursing Activities Score. The study was conducted in a private hospital specialized in the treatment of patients with cancer, which is located in the city of Natal (Rio Grande do Norte – Brazil). The study was approved by the Research Ethics Committee of the hospital (Protocol number 558.799; CAAE 24966013.7.0000.5293). For data collection, a form of sociodemographic characteristics of the patients was used; the Nursing Activities Score was used to identify the workload of nursing staff; and the instrument of Perroca, which classifies patients and provides data related to the their need for nursing care, was also used. The collected data were analyzed using a statistical package. The categorical variables were described by absolute and relative frequency, while the number by median and interquartile range. Considering the inferential approach, the Spearman test, the Wald chi-square, Kruskal Wallis and Mann-Whitney test were used. The statistically significant variables were those with p values <0.05. The evaluation of the overall averages of NAS, considering the first 15 days of hospitalization, was performed by the analysis of Generalized Estimating Equations (GEE), with adjust for the variable length of hospitalization. The sample consisted of 40 patients, in the period of June to August 2014. The results showed a mean age of 62,1 years (±23,4) with a female predominance (57,5%). The most frequent type of treatment was clinical (60,0%), observing an average stay of 6,9 days (±6,5). Considering the origin, most patients (35%) came from the Surgical Center. There was a mortality rate of 27,5%. 277 measures of NAS score and Perroca were performed, and the averages of 69,8% (±24,1) and 22,7% (±4.2) were obtained, respectively. There was an association between clinical outcome and value of the Nursing Activities Score in 24 hours (p <0.001), and between the degree of dependency of patients and nursing workload (rp 0,653, p<0,001). The achieved workload of the nursing staff, in the analyzed period, was presented high, showing that hospitalized patients required a high demand for care. These findings create subsidies for sizing of staff and allocation of human resources in the sector, in order to achieve greater safety and patient satisfaction as a result of intensive care, as well as an environment conducive to quality of life for the professionals

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The soursop (A. muricata) is a fruit rich in minerals especially the potassium content. The commercialization of soursop in natura and processed has increased greatly in recent years. Drying fruit pulp in order to obtain the powdered pulp has been studied, seeking alternatives to ensure the quality of dehydrated products at a low cost of production. The high concentration of sugars reducing present in fruits causes problems of agglomeration and retention during fruit pulp drying in spouted bed dryers. On the other hand in relation to drying of milk and fruit pulp with added milk in spouted bed, promising results are reported in the literature. Based on these results was studied in this work drying of the pulp soursop with added milk in spouted bed with inert particles. The tests were based on a 24 factorial design were evaluated for the effects of milk concentration (30 to 50% m/m), drying air temperature (70 to 90 °C), intermittency time (10 to 14 min), and ratio of air velocity in relation to the minimum spout (1.2 to 1.5) on the rate of production, of powder moisture, yield, rate of drying and thermal efficiency of the process. There were physical and chemical analysis of mixtures, of powders and of mixtures reconstituted by rehydration powders. Were adjusted statistical models of first order to data the rate of production, yield and thermal efficiency, that were statistically significant and predictive. An efficiency greater than 40% under the conditions of 50% milk mixture, at 70 ° C the drying air temperature and 1.5 for the ratio between the air velocity and the minimum spout has been reached. The intermittency time showed no significant effect on the analyzed variables. The final product had moisture in the range of 4.18% to 9.99% and water activity between 0.274 to 0.375. The mixtures reconstituted by rehydration powders maintained the same characteristics of natural blends.

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The Solidarity Economy is considered in this work as a development option. Talk about it is to think in the workforce as a producer of material wealth and, above all , subjective , therefore it is necessary to take into account that these relations coexist different types of practices that encompass emotions , lifestyles , etc. This research has as an object of study evaluating the effectiveness of public policy for Solidarity Economy, microrregion Angicos / RN, demonstrating how the Solidarity Economy has encouraged the development not only as a driving force for economic growth, but as the expansion capabilities and freedoms. The Solidarity Economy has several definitions, and despite having its origin in the cooperative movement, is a concept under construction. Focused on the discussion of public policy, is now understood as a proposal for employability, either as a generator of employment and income, reflecting its polymorphism. Theories and concepts developed by Amartya Sen is an important analytical tool for understanding the Solidarity Economy as a development strategy. When speaking of instrumental freedoms, Senniana theory contributes to reflection on how participants socioeconomic actions are becoming active agents of change i n their own freedoms. The analysis was based on the discussion of development beyond economic bias, using the lines of the vari ous local stakeholders with PCPR II, p hase 2, for microrregion Angicos / RN, comprising: public managers, technical advisors and beneficiaries of the program rural poverty alleviation. Besides the discussion of the economic organization of the RN and its spatial distribution, the survey brings the result that the Solidarity Economy in microrregion Angicos / RN contributed to the dev elopment as freedom, proving the effectiveness of public policy by allowing an improvement in the quality of life, enabling efetivations, even without major proportions.

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Stabilization ponds are biological treatment systems in that stabilization of organic matter is performed by the bacterial oxidation and / or reduction of photosynthetic algae. This study aimed to monitor and evaluate the efficiency of stabilization ponds in the Rio Grande do Norte State. Collections were made of the treated effluent, made directly in the output boxes of facultative lagoons and maturation (M1 and M2) and raw sewage (EB) that arrived at the stations. The variables analyzed were: pH, temperature, dissolved oxygen, total suspended solids, chlorophyll "a", apparent color, total phosphorus, organic nitrogen, ammonia nitrogen, Kjeldahl nitrogen, turbidity, cyanobacteria density and concentrations of microcystin. Variance analysis (ANOVA one way) observing the premises using the Tukey test, so as to check differences between treatments. The evaluate the stations found to COD removals in the bands of 48,8% (Pipa) to 75,8% (Caiçara Rio do Vento) and 57,5% (Pipa) to 83,0% (Santo Antônio), respectively. The mean concentrations of cyanobacteria varied from LFs density of 62,545 cels.mL-1 (Pedro Velho Roça) cels.mL-1 to 2,669,048 (Ponta Negra), while the final effluent showed range between 9,072 Cels.mL- 1 (Pedro Velho Roça) to 1,899,981 cels.mL-1 (Macau – Ilha de Santana) and the average concentrations of microcystin the final effluent ranged from 0.02 μg.L-1 (Ponta Negra) to 0.15 μg.L-1 (Macau – Ilha de Santana) at the studied the stations.

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Textile industry has been a cause of environmental pollution, mainly due to the generation of large volumes of waste containing high organic loading and intense color. In this context, this study evaluated the electrochemical degradation of synthetic effluents from textile industry containing Methylene Blue (AM) dye, using Ti/IrO2-Ta2O5 and Ti/Pt anodes, by direct and indirect (active chlorine) electrooxidation. We evaluated the influence of applied current density (20, 40 and 60 mA/cm2 ), and the presence of different concentrations of electrolyte (NaCl and Na2SO4), as well as the neutral and alkaline pH media. The electrochemical treatment was conducted in a continuous flow reactor, in which the electrolysis time of the AM 100 ppm was 6 hours. The performance of electrochemical process was evaluated by UV-vis spectrophotometry, chemical oxygen demand (COD) and total organic carbon (TOC). The results showed that with increasing current density, it was possible to obtain 100 % of color removal at Ti/IrO2-Ta2O5 and Ti/Pt electrodes. Regarding the color removal efficiency, increasing the concentration of electrolyte promotes a higher percentage of removal using 0,02 M Na2SO4 and 0,017 M NaCl. Concerning to the aqueous medium, the best color removal results were obtained in alkaline medium using Ti/Pt. In terms of organic matter, 86 % was achieved in neutral pH medium for Ti/Pt; while a 30 % in an alkaline medium. To understand the electrochemical behavior due to the oxygen evolution reaction, polarization curves were registered, determining that the presence of NaCl in the solution favored the production of active chlorine species. The best results in energy consumption and cost were obtained by applying lower current density (20 mA/cm2 ) in 6 hours of electrolysis.

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OBJECTIVE: To dev elop and evaluate the use of a body adjustable device for training of peripheral venous catheterization for healthcare undergraduate students . METHODS: This study involved two phases: I) development of the innovative simulator and II) a controlled trial co mparing the performance of the body adjustable device in relation to the commercial simulator for the training of venipuncture skills. A total of 79 first - year medical students participated in the intervention phase, which consisted of pretest assessment, lecture on peripheral venous access, randomization into two groups according to the simulator used for training (Commercial Simulator and Experimental Simulator), real venipuncture procedure, post - test assessment and evaluation of satisfaction. RESULTS: Gr oups were homogeneous in age, sex, pre - test and post - test scores, attitudinal assessment and performance in performing the real venipuncture. Students from the Experimental Simulator group performed better on the filling of simulated records. At the end of the study, cognitive gain significantly increased in both groups. The degree of realism perceived by students was equivalent for two groups. A total of 85.7% of students rated the Experimental Simulator as good or excellent. CONCLUSIONS: Experimental simu lator proved to be a low cost alternative for the training of venipuncture skills in upper limb. The cognitive procedural and attitudinal performances of students who used the experimental simulator were similar to those observed in the group trained with commercial simulator.

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Introduction: Polycystic Ovary Syndrome (PCOS), present in 6-12% of women of reproductive age, the criterion of Rotterdam, is characterized by hyperandrogenism, insulin resistance (IR) and its inflammatory state, exacerbated by obesity and factors associated with the increase in damage DNA. Weight loss, combined with healthy eating, acts restoring the reproductive and metabolic functions in the SOP, though its influence in reducing DNA damage in PCOS are unknown. Aim: To investigate whether there are differences between DNA damage markers and factors of cardiometabolic risk in women with PCOS and control, and evaluate the effectiveness of nutritional intervention in DNA damage markers and cardiometabolic risk markers in overweight and obese women with PCOS. Methods: the study was conducted in two studies and the participants were aged between 18 and 35 years. In the first study, a prospective case-control, were included 27 women diagnosed with PCOS and 20 controls. In the second study, clinical trial of nutritional intervention with 12-week calorie-restricted diet 500Kcal / day. The genotoxicity, DNA damage (intensity tail, tail moment and tail length) was evaluated by the comet assay. Anthropometric data, dietary intake, hormonal, biochemical and inflammatory were evaluated in different studies. Results: there was no significant difference between the DNA damage marker tail intensity (p = 0.18), tail moment (p = 0.76) and tail length (p = 0.109) in PCOS when compared to the control group. Data after nutritional intervention in PCOS women with overweight and obesity showed a decrease in DNA damage markers: tail intensity (24.35 ± 5.86 - pre-diet vs. 17.15 ± 5.04 -Post-diet) and tail moment (20.47 ± 7.85 - pre-diet vs. 14.13 ± 6.29 -post-diet) (p <0.001). Reduction of weight (3.5%) and decreased cardiometabolic markers IR and hyperandrogenism. Conclusion: women with PCOS have a worse cardiometabolic risk profile compared to control however similar genotoxicity identified by DNA damage. Nutritional intervention reduced the genotoxicity of overweight and obese women with PCOS, and reduce the factors of cardiometabolic risk.

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The software product line engineering brings advantages when compared with the traditional software development regarding the mass customization of the system components. However, there are scenarios that to maintain separated clones of a software system seems to be an easier and more flexible approach to manage their variabilities of a software product line. This dissertation evaluates qualitatively an approach that aims to support the reconciliation of functionalities between cloned systems. The analyzed approach is based on mining data about the issues and source code of evolved cloned web systems. The next step is to process the merge conflicts collected by the approach and not indicated by traditional control version systems to identify potential integration problems from the cloned software systems. The results of the study show the feasibility of the approach to perform a systematic characterization and analysis of merge conflicts for large-scale web-based systems.

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Diesel fuel is one of leading petroleum products marketed in Brazil, and has its quality monitored by specialized laboratories linked to the National Agency of Petroleum, Natural Gas and Biofuels - ANP. The main trial evaluating physicochemical properties of diesel are listed in the resolutions ANP Nº 65 of December 9th, 2011 and Nº 45 of December 20th, 2012 that determine the specification limits for each parameter and methodologies of analysis that should be adopted. However the methods used although quite consolidated, require dedicated equipment with high cost of acquisition and maintenance, as well as technical expertise for completion of these trials. Studies for development of more rapid alternative methods and lower cost have been the focus of many researchers. In this same perspective, this work conducted an assessment of the applicability of existing specialized literature on mathematical equations and artificial neural networks (ANN) for the determination of parameters of specification diesel fuel. 162 samples of diesel with a maximum sulfur content of 50, 500 and 1800 ppm, which were analyzed in a specialized laboratory using ASTM methods recommended by the ANP, with a total of 810 trials were used for this study. Experimental results atmospheric distillation (ASTM D86), and density (ASTM D4052) of diesel samples were used as basic input variables to the equations evaluated. The RNAs were applied to predict the flash point, cetane number and sulfur content (S50, S500, S1800), in which were tested network architectures feed-forward backpropagation and generalized regression varying the parameters of the matrix input in order to determine the set of variables and the best type of network for the prediction of variables of interest. The results obtained by the equations and RNAs were compared with experimental results using the nonparametric Wilcoxon test and Student's t test, at a significance level of 5%, as well as the coefficient of determination and percentage error, an error which was obtained 27, 61% for the flash point using a specific equation. The cetane number was obtained by three equations, and both showed good correlation coefficients, especially equation based on aniline point, with the lowest error of 0,816%. ANNs for predicting the flash point and the index cetane showed quite superior results to those observed with the mathematical equations, respectively, with errors of 2,55% and 0,23%. Among the samples with different sulfur contents, the RNAs were better able to predict the S1800 with error of 1,557%. Generally, networks of the type feedforward proved superior to generalized regression.

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An amperometric FIA method for nitrite quantification based on nitrite electroreduction and employing a carbon paste electrode (CPE) chemically modified with iron hexacyanoferrate (HCF) as an amperometric detector was developed. The influence of experimental conditions on the preparation of the electrode materials was evaluated and the materials obtained in each study were used for the development of modified electrodes. The electrochemical sensors were prepared by a fast, simple, and inexpensive procedure, and the long-term performance of the electrodes were quite satisfactory as the stability was maintained over one year. HCF was an effective redox mediator for nitrite electroreduction in acidic media, allowing nitrite detection at +0.2 V vs. Ag/AgClsat, which is a potential free of possible interfering species that are normally present in food and water samples. The electrochemical cell used in the FIA system was similar to a batch injection analysis cell, enabling recirculation of the carrier solution. This is an attractive feature because it allows the use of a high flow rate (6 mL min-1) leading to high sensitivity and analysis speed, while keeping reagent consumption low. The proposed method had a detection limit of 9 μmol L-1 and was successfully employed for nitrite quantification in spiked water and sausage samples. The obtained results were in good agreement with those provided by the spectrophotometric official method. At a 95 % confidence level it was not observed statistical differences neither in nitrite content nor in the precision provided by both methods. The experimental conditions for the synthesis of HCF were optimized and the best electrode material was prepared by mixing FeCl3, K4[Fe(CN)6] and carbon powder subjected to an acid and thermal treatment (400 ºC), followed by ultrasonic agitation at 4 °C. This material was used to construct an electrode with improved analytical performance to reduce nitrite, which presented greater stability compared to HCF film electrodeposited on the EPC, showing that the preparation procedure of the electrode material is an effective strategy for the development of HCF modified electrodes.