Depressão em hospital geral: avaliação do desepenho de escalas de rastreamento e desenvolvimento de instrumento para uso na rotina assistencial

O presente estudo desenvolve-se numa perspectiva prática, visando à integração de conhecimentos gerados pela pesquisa a atividades assistenciais no hospital geral universitário, dirigindo-se, especificamente, à questão da detecção da depressão. A depressão é um problema de saúde pública no mundo inteiro, transtorno mental de alta prevalência, com elevado custo para os sistemas de saúde. Entre pacientes clínicos e cirúrgicos, hospitalizados, aumenta a complexidade dos tratamentos, implica maior morbidade e mortalidade, importando também no aumento do tempo e dos custos das internações. Por outro lado, a depressão é subdiagnosticada. Este estudo, originado de um projeto cujo objetivo foi criar um instrumento para a detecção de depressão, utilizável na rotina assistencial, a partir da avaliação do desempenho de escalas de rastreamento já existentes, desdobra-se em três artigos. O primeiro, já aceito para publicação em revista indexada internacionalmente, é a retomada de estudos anteriores, realizados no final da década de 1980. É apresentada a comparação da detecção de depressão, realizada por médicos não-psiquiatras e por enfermeiros, no Hospital de Clínicas de Porto Alegre (HCPA), em 1987 e em 2002. O segundo artigo apresenta o processo de construção da nova escala, a partir da seleção de itens de outras escalas já validadas, utilizando modelos logísticos de Rasch. A nova escala, composta por apenas seis itens, exige menos tempo para sua aplicação. O terceiro artigo é um estudo de avaliação de desempenho da nova escala, denominada Escala de Depressão em Hospital Geral (EDHG), realizado em uma outra amostra de pacientes adultos clínicos e cirúrgicos internados no HCPA. O segundo e terceiro artigos já foram encaminhados para publicação internacional. Esses estudos, realizados em unidades de internação clínicas e cirúrgicas do Hospital de Clínicas de Porto Alegre, permitiram as seguintes conclusões: a) comparando-se os achados de 1987 com os de 2002, a prevalência de depressão e o seu diagnóstico, em pacientes adultos clínicos e cirúrgicos internados, mantêm-se nos mesmos níveis; b) foi possível selecionar um conjunto de seis itens, que constituíram a nova Escala de Depressão em Hospital Geral (EDHG), baseando-se no desempenho individual de cada um dos 48 itens componentes de outras três escalas (BDI, CESD e HADS); c) a EDHG apresentou desempenho semelhante aos das escalas que lhe deram origem, usando o PRIME-MD como padrão-ouro, com a vantagem de ter um pequeno número de itens, podendo constituir-se num dispositivo de alerta para detecção de depressão na rotina de hospital geral.

Diferenças básicas entre líderes e gerentes

Existem algumas diferenças vitais entre os líderes e os administradores. Torna-se crucial diferenciar esses dois tipos de comportamentos. De acordo com alguns autores como Bennis, Gardner, Hickman e Porter por exemplo, é importante ter em mente que: A palavra Administrador costuma indicar que o indivíduo assim rotulado, ocupa um posto de direção numa organização, decidindo sobre os processos através dos quais uma organização funciona, alocando recursos com prudência, utilizando seu pessoal da melhor maneira possível. Líder é usado para indicar alguém que usa o processo de persuasão porque preocupa-se com aquilo que as coisas significam para as pessoas. Os líderes se orientam na direção da inovação desafiando o status quo e inspirando confiança. É capaz de intensificar o comprometimento e o entusiasmo dos empregados. Esse processo significa pessoas rumo a novas direções e inspirá-las a fazerem com que as coisas aconteçam. A maior parte dos administradores exibe algumas habilidades de liderança, e a maior parte dos líderes ocasionalmente se vê administrando. O projeto de pesquisa deverá apontar essas diferenças, embora liderança e administração não sejam a mesma coisa, mas podem se sobrepor. Esta pesquisa tenta demonstrar que líderes e administradores podem harmonizar suas diferentes orientações comportamentais quando trabalham juntos. Isto habilita as organizações a tirar maior proveito dos pontos fortes que eles têm.

Economic landscapes, what are they? an application to the Brazilian economy and to the sugar cane complex

In assessing the economic impact of a sector or group of sectors on a single or multiregional economy, input-output analysis has proven to be a popular method. . However, there has a problem in displaying all the information that can be obtained from this analytical approach. In this paper, we have tried to set new directions in the use of input-output analysis by presenting an improved way of looking at the economic landscapes. While this is not a new concept, a new meaning is explored in this paper; essentially, it will now be possible to visualize, in a simple picture, all the relations in the economy as well as being able to view how one sector is related to the other sectors/regions in the economy. These relations can be measured in terms of structural changes, production, value added, employment, imports, etc. While all the possibilities cannot be explored in this paper, the basic idea is given here and the smart reader can uncover all the various possibilities. To illustrate the power of analysis provided by the economic landscapes, an application is made to the sugar cane complex using an interregional inputoutput system for the Brazilian economy, constructed for 2 regions (Northeast and Rest of Brazil), for the years of 1985, 1992, and 1995.

Percepção de qualidade das escolas do ponto de vista de alunos do ensino médio

This study aims at evaluating the perception towards the quality of services offered by private high schools in Brazil. For this purpose, field research was conducted at four different schools: two in Rio de Janeiro, one in Belo Horizonte and one in the countryside of Minas Gerais. Such research was conducted by using an instrument known a SERVQUAL, a framework developed for assessing service quality. Target audience were 1st and 2nd year high school students and the research was carried out at the schools. 44 items were evaluated, 22 being related to students’ expectations towards the services which should be offered by the school. The other 22 items evaluated students’ perception towards the actual service offered by the school. By analyzing the results it was possible to measure the difference between the service the students expected from the schools and the one actually offered by the schools. Results show great opportunities for improvement in the services and also contribute to a better and wider understanding concerning basic education service quality.

Ecommerce as internationalization strategy: an exploratory study based on premium fashion brazilian brands: case study of farfetch

As stated by Hoffmann and Coste-Manière (2012) “The web is a mass medium that contrast completely with the traditional codes of exclusivity associated with the luxury industry, and has long been simply rejected by the luxury industry for being an illegitimate distribution channel.” Meanwhile this market presents an incomparable pace of growth and is gradually changing the existing retailing business model and companies must be aware of this change and capable to adapt to it. The internet and cross-border sales already changed the competition throughout retailing and it will increase even more, so companies must be ready to face it. Internet has shown its great opportunity for all markets, although luxury/premium market is not yet taking the proper advantage of its potential, but the necessity to be an omnichannel business strategy is growing. This paper presents an exploratory research based on a case study of how premium fashion Brazilian brands are using Farfetch, e-commerce, as an entry market strategy and how this affects them. The research question of this study is: How is Farfetch helping on the internationalization of Brazilian premium fashion brands?, and in order to answer it was conducted an in-depth interview with the Brazilian head of business development of Farfetch, apart an extensive secondary data research. As expected the study found a list of trade-offs of using an e-commerce, luxury specialized, with a marketplace approach to the brands willing to internationalize. As stated by Altagamma and McKinsey (2015) study “[...] luxury brands have no choice but to embrace the digital era and become truly omnichannel. This will require them a radical rethinking of both their customer experience of their consumer engagement strategy.” Looking either from the Farfetch point of view, trying to understand why they offer this opportunity to the brands, or also from the brand side if this is a manageable approach. This study presents a contribution for both sides, trying to give tools to the brands on understanding the internationalization reasons and approach, as well as explaining Farfetch business model, and the advantages it can bring to them, at the same time of a general market trend analysis for Farfecth.

Color measurement using a smartphone applied to Madeira wines

Computer vision is a field that uses techniques to acquire, process, analyze and understand images from the real world in order to produce numeric or symbolic information in the form of decisions [1]. This project aims to use computer vision to prepare an app to analyze a Madeira Wine and characterize it (identify its variety) by its color. Dry or sweet wines, young or old wines have a specific color. It uses techniques to compare histograms in order to analyze the images taken from a test sample inside a special container designed for this purpose. The color analysis from a wine sample using an image captured by a smartphone can be difficult. Many factors affect the captured image such as, light conditions, the background of the sample container due to the many positions the photo can be taken (different to capture facing a white wall or facing the floor for example). Using new technologies such as 3D printing it was possible to create a prototype that aims to control the effect of those external factors on the captured image. The results for this experiment are good indicators for future works. Although it’s necessary to do more tests, the first tests had a success rate of 80% to 90% of correct results. This report documents the development of this project and all the techniques and steps required to execute the tests.

An improved and fast UHPLC-PDA methodology for determination of L-ascorbic and dehydroascorbic acids in fruits and vegetables: evaluation of degradation rate during storage

This study provides a versatile validated method to determine the total vitamin C content, as the sum of the contents of L-ascorbic acid (L-AA) and dehydroascorbic acid (DHAA), in several fruits and vegetables and its degradability with storage time. Seven horticultural crops from two different origins were analyzed using an ultrahigh-performance liquid chromatographic–photodiode array (UHPLC-PDA) system, equipped with a new trifunctional high strength silica (100% silica particle) analytical column (100 mm×2.1 mm, 1.7 μm particle size) using 0.1% (v/v) formic acid as mobile phase, in isocratic mode. This new stationary phase, specially designed for polar compounds, overcomes the problems normally encountered in HPLC and is suitable for the analysis of large batches of samples without L-AA degradation. In addition, it proves to be an excellent alternative to conventional C18 columns for the determination of L-AA in fruits and vegetables. The method was fully validated in terms of linearity, detection (LOD) and quantification (LOQ) limits, accuracy, and inter/intraday precision. Validation experiments revealed very good recovery rate of 96.6±4.4% for L-AA and 103.1±4.8 % for total vitamin C, good linearity with r2-values >0.999 within the established concentration range, excellent repeatability (0.5%), and reproducibility (1.6%) values. The LOD of the method was 22 ng/mL whereas the LOQ was 67 ng/mL. It was possible to demonstrate that L-AA and DHAA concentrations in the different horticulture products varied oppositely with time of storage not always affecting the total amount of vitamin C during shelf-life. Locally produced fruits have higher concentrations of vitamin C, compared with imported ones, but vegetables showed the opposite trend. Moreover, this UHPLC-PDA methodology proves to be an improved, simple, and fast approach for determining the total content of vitamin C in various food commodities, with high sensitivity, selectivity, and resolving power within 3 min of run analysis.

An investigation of Leishmania spp. in Didelphis spp. from urban and peri-urban areas in Bauru (São Paulo, Brazil)

Blood and bone marrow samples were taken from 112 Didelphis spp., collected between March 2005 and February 2006, from urban and peri-urban areas of Bauru, São Paulo State, Brazil, to evaluate the hypothesis that these animals might constitute a reservoir of Leishmania spp. Anti-Leishman ia ssp. antibodies were screened in the serum samples using an enzyme-linked immuno-sorbent assay (ELISA) and the polymerase chain reaction (PCR). PCR was performed on fragments of DNA samples from Leishmania spp. using primers 13A and 13B, and showed a positive outcome in 91.6% of the 112 samples tested. of the 107 samples analyzed by ELISA, 71 % were positive. Evidence of epidemiological risk factors such as a circulating parasite and freely moving vectors suggests that Didelphis spp. may participate in the transmission cycle of Leishmania spp. in Bauru. (c) 2007 Elsevier B.V. All rights reserved.

Space dependency of chemical attributes in an area with sugarcane plantation in Pereira Barreto, SP

The behavior of the chemical attributes is directly influenced by superficial flow and water movement inside the soil. This work aimed to study the space dependency of chemical attributes in an area with sugarcane plantation in Pereira Barreto, SP. An area of 530.67 hectares was mapped using an equipment of Global Positioning System and obtaining a Digital Elevation Model. A set of 134 soil samples were collected every seven hectares in the depths of 0-0.25 m and 0.80-1.00 m. The pH, organic matter (OM), Ca, Mg, K, BS, CEC and base saturation (BS) were analyzed. All the chemical attributes presented similar behavior in the superficial and subsuperficial layer of the soil, which provided better visualization and definition of the homogeneous tillage zones.

Dois critérios de seleção na pré- desmama em bovinos da raça Gir. 2. Efeito na classificação dos animais

A utilização de dois critérios de seleção na pré-desmama, ganho médio diário do nascimento à desmama (GMD) e dias para ganhar 160 kg do nascimento à desmama (D160), foi estudada, analisando-se informações de 16.592 animais, provenientes do controle de desenvolvimento ponderal da Associação Brasileira dos Criadores de Zebu, nascidos no período de 1978 a 1994. Foram incluídos no modelo o efeito fixo de grupo de contemporâneos e os efeitos aleatórios genético aditivo de animal e materno, de ambiente permanente materno e o erro. A covariância entre os efeitos direto e materno foi considerada igual a zero. As estimativas dos componentes de variância e herdabilidade foram obtidas pelo método da máxima verossimilhança restrita e os valores genéticos preditos (VGs), por modelos animais uni-característica. As estimativas de herdabilidade foram: 0,12; 0,05; 0,10 e 0,05 para GMD (efeito direto), GMD (efeito materno), D160 (efeito direto) e D160 (efeito materno), respectivamente. Foram estimadas a correlação genética entre GMD e D160 (efeito direto e materno) e a correlação de classificação (Spearman) entre os valores genéticos para as categorias de touros, vacas e bezerros. As estimativas de correlação genética entre GMD e D160 foram 0,86 e 0,88, para o efeito direto e materno, respectivamente. As estimativas de correlação de ;rank;, também foram altas, entretanto, nenhuma foi igual a um, resultando em alterações na classificação dos animais. A relação entre as médias aritmética (A) e harmônica (H) e o desvio-padrão (S) do GMD ajustado para efeitos ambientais e maternos (GMDc) foi verificada utilizando-se um modelo restrito, sem intercepto, mediante as regressões linear e quadrática do S do GMDc sobre a diferença entre a média aritmética e média harmônica (A-H). Os resultados evidenciaram que, semelhantemente a H, o critério D160 apresentou a propriedade de discriminar touros com progênie mais uniforme.

Development and validation of an analytical method by RP-HPLC for quantification of sibutramine hydrochloride in pharmaceutical capsules

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A Proposal for System Performance Evaluation for an ERP Knowledge Extraction Model

Much has been researched and discussed in the importance played by knowledge in organizations. We are witnessing the establishment of the knowledge economy, but this "new economy" brings in itself a whole complex system of metrics and evaluations, and cannot be dissociated from it. Due to its importance, the initiatives of knowledge management must be continually assessed on their progress in order to verify whether they are moving towards achieving the goals of success. Thus, good measurement practices should include not only how the organization quantifies its knowledge capital, but also how resources are allocated to supply their growth. Thinking about the aspects listed above, this paper presents an approach to a model for Knowledge extraction using an ERP system, suggesting the establishment of a set of indicators for assessing organizational performance. The objective is to evaluate the implementation of projects of knowledge management and thus observe the general development of the organization.

Time-domain analysis of piezoelectric impedance-based structural health monitoring using multilevel wavelet decomposition

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Power performance evaluation of an electric home fan with triac-based automatic speed control system

In order to provide a low cost system of thermal comfort, a common model of home fan, 40 cm diameter size, had its manual four-button control system replaced by an automatic speed control. The new control system has a temperature sensor feeding a microcontroller that, by using an optic coupling, DIAC or TRIAC-based circuit, varies the RMS value of the fan motor input voltage and its speed, according to the room temperature. Over a wide range of velocity, the fan net power and the motor fan input power were measured working under both control system. The temperature of the motor stator and the voltage waveforms were observed too. Measured values analysis showed that the TRIAC-based control system makes the fan motor work at a very low power factor and efficiency values. The worst case is at low velocity range where the higher fan motor stator temperatures were registered. The poor power factor and efficiency and the harmonics signals inserted in the motor input voltage wave by the TRIAC commutation procedure are correlated.

Material processing by plasma shock wave generated in an inverse Z-pinch plasma expander

The applicability of plasma shock wave for material processing was investigated using modified inverse Z-pinch device. Shock wave expanding speed and plasma spectral analysis were studied using an internal magnetic,probe and spatially collimated light spectroscopy. The material processing capability of the device was shown by many different surface analysis techniques such as AES, IRS, EPM and SEM. The interactions between a plasma shock wave of similar to4x10(6) cm/s speed with a Si substrate surface shows some ion implantation capability using a nitrogen plasma and thin film formation using a methane plasma.