Fatores associados à efetividade da doação de órgãos e tecidos para transplantes

The transplantation of organs and tissues presents itself as an important therapeutic option, both from a medical standpoint, the social or economic. Thus, the identification of variables that can interfere in the effectiveness of organs and tissues donation for transplantation needs to be investigated adequately, because it stands before increasing index of chronic and degenerative diseases in the population, what makes the waiting list for transplantation grow disproportionately and patients come to death without the opportunity of realization the treatment due to a lack of donors. In this context, has defined as objective of this study evaluate the factors associated with the effectiveness of organs and tissues donation for transplantation. It is a evaluative research, quantitative, prospective, with longitudinal design, developed at Central of Catchment, Notification and organ donation for transplant, Organ Procurement Organization and in six accredited hospitals to collect and transplantation of organs and tissues, in Natal/RN, between august 2010 and february 2011, after the approval of the Research Ethics Committee, under No. 414/10 and CAAE 007.0.294.000-10. The probabilistic sample without replacement was composed of 65 potential donors. It was used as an instrument of data collection a structured script non-participant observation of checklist type. Data were analyzed using descriptive statistics and presented in tables, charts, graphs and figures. For this, was used Microsoft Excel 2007 and statistical program SPSS version 20.0. To check the level of significance was chosen by applying the chi-square test (χ2) and Mann Whitney and caselas for less than five, it is considered the Fisher exact test. It was adopted as the significance level p-value <0.05. Among the surveyed it was observed that most of the individuals were male (50,8%), in the age group 45 years (53,8%), mean age of 42,3 years, minimum 5 and maximum 73 years (± 17,32 years). Single / widowers / divorced (56,9%), with up to completed elementary school (60,0%) in the exercise of professional activity (86,2%), catholic (83,1%) and residents in metropolitan region of Natal (52,3%). Was obtained donation effectiveness of 27,7%. There was no statistical significance between structure and effectiveness of the donation, but were observed inadequacies in physical resources (36,9%), materials (30,8%), organizational structure (29,2%) and human resources (18,5%). In the process, the maintenance phase (p= 0.004), diagnosis of brain death (p= 0.032), family interview (p≤ 0.001) and documentation (p= 0.001) presented statistical significance with effectiveness. Thus, it is accepts the alternative hypothesis of the study, in which is evidenced that the adequacy of the factors related to structure and process is associated to effectiveness of organs and tissues donation for transplantation. In this way, the effectiveness of organ and tissue donation ends in an essential way the rapidity and accuracy with which the donation process is conducted, requiring appropriate structure, with appropriate physical and material resources and skilled human resources to optimize the reduction of time and the suffering of those waiting for an organ or tissue transplant queued in Brazil

Cuidado de enfermagem ao potencial doador de órgãos em morte encefálica: uma reflexão sobre a prática

Despite of the technological advances that favor the transplant process, there are issues of effectiveness of care necessary for the maintenance of potential organ donors with brain death, which contribute to the no realization of transplants of organs and tissues of these patients. It is presupposed that the problems could be related to perceptions and understandings that the professionals of the units of internment have about the care required by the diagnosis of brain death. The aim of this study was to understand the meaning of the nursing care of the potential organ donor with brain death to the nursing staff. Descriptive study with qualitative approach guided by Action Science Theory and the critic-reflexive research methodology accomplished with five nurses and 19 nursing technicians from Operative Rehabilitation Center in a public hospital at Natal / RN, Brazil, between March and May 2013. Data were collected through semi-structured interviews with individual reflection about the care and through group interview, after approval by the Ethics and Research Committee, CAAE No.: 04255612.7.0000.5537. The analysis was performed in a thematic way according to Bardin. During the group meeting the participants were driven in a discussion about the need for change and how to perform them. The results indicate that the professionals actions are consistent with those required for maintenance of potential organ donors, although the material and human resources are not adequate. That situation leads the professionals to develop a meaning of care as one labor more, demanding more than they can give. They express beliefs and feelings concerning the hope that their care brings a greater good that is to save lives. The reflection for a possible change of action was difficult to accomplish due to professionals not to be able to self evaluate, what lead to direct your changes suggestions for other team members. It is concluded that the care provided to these patients is a difficult care, evidenced by suffering both death situation of the person cared and pain of their families, as the dehumanizing conditions of work, helping themselves to keep distance from patients to not suffer so much. The knowledge impregnated in their act, are scientific, ethical, aesthetic and personal kind with a predominance of the scientific followed by the personal. The study was also relevant to the practice of nursing in maintaining the potential donor, in that it allowed the identification of the knowledge used by nurses in their care practice and the meaning understanding of the professionals on the care provided, as a good action that brings satisfaction when the transplanting is executed. Other experiences are suggested with the critic-reflexive research methodology, both in research as in teaching nursing

Assistência de enfermagem às urgências e emergências psiquiátricas no serviço de atendimento móvel de urgência em Mossoró-RN

This study aims to identify the concepts of professional nursing team on assistance in urgency and psychiatric emergencies in SAMU in Mossoró/RN, identifying the difficulties in implementing an emergency assistance to the user in psychiatric distress in this service and point strategies in pursuit of consolidation and expansion of comprehensive health care to the public. It is a descriptive research with qualitative and exploratory approach. The subjects were employees of the nursing staff of SAMU of that mentioned municipality. Semi-structured interviews are applied as tool for data collection. It was counted on the consent of the institution where the study was developed and approval by the Ethics Committee in Research of UFRN with CAAE No 17326513.0.0000.5537, besides signing the Informed Free Consent Term by the participants. Data analysis was done by means of thematic analysis proposed by Bardin. Thus , as a result of the research produced the following categories: mechanistic practice; dehumanization of care; need for qualification, barriers to assistance in urgency and psychiatric emergency and strategies in pursuit of comprehensive care, which proceeded in preparing two articles entitled "Nursing care to the emergency room and psychiatric emergencies in the mobile emergency care service" and "Barriers for emergency service and psychiatric emergencies in the mobile emergency care service". In the studied reality it was identified that nursing care offered to users in situations of urgency and psychiatric emergency is made based primarily on the use of chemical and physical restraints, as well as transportation to the general hospital, constantly using the police force support, which meets the guidelines of the Psychiatric Reform and thereby undermining the provision of an effective and humane care. This scenario is worsened by the lack of an organized network of services in mental health, where after the service the user is taken to a general hospital, considering that there is no ready or appropriate psychiatric emergency service as a Center of Psychosocial Care - CAPs III to reference it, thereby precluding the realization of a resolute and comprehensive care. Thus, it is concluded that nursing care is based on biologicist and medicine-centered model advocated by classical psychiatry, and that despite all the advances in psychiatric reform, still guides the mental health care, so the lack of service network organized in hierarchical and mental health, where the user in urgency and emergency service can be watched in full and the guidelines of the psychiatric reform can be realized in practice

Identificação das condições gerais de conservação dos reservatórios integrantes do sistema de abastecimento de água de Natal

Infrastructure works are included in strategic areas for the social development. For that matter that all of the investments are very important for the social development. When the population has enough water and an acceptable quality, and it includes a wastewater gathering and its treatment, the whole society became less susceptible to the water diseases. Even the Water Supply and the Sewage depend for its perfect operation of reservoirs, or of the accumulation of water to provide the popular necessity, either due to retention or for the treatment wastewarer. These structures present very specific environmental conditions, because the microclimate created around them, like high environmental humidity and for the existence of many harmful substances for the concrete, such as chloride ions presents in water. The reservoir that compose the System of Water Supply of Natal were built between 1970s and 1980s, a period whom the technical and scientific community did not have in-depth studies about the reinforced concrete mechanism of deterioration. Therefore, these reservoirs have been suffered accelerated deterioration progress, and they have been shown many pathological manifestations strikingly visible. In front of all these problems this academic work aims to identify the generally conditions of conservation of all the reservoirs components of the Water Supply System of Natal. This academic work objectives to develop a recuperation plan for use in these reservoirs, in this academic work it was achieved all the survey of pathological manifestation existing in each reservoir. It was made with local visits, photographic recorders of all manifestations viii and realization of in loco tests. The other step consisted in a application of GDE/UnB metodolgy reformulated by Fonseca (2007). In the step of local visits in each reservoir it was evaluated carbonation depth, by spreading a phenolphthalein solution with 1% of concentration; evaluation of contamination of chlorides, by spreading silver nitrate solution with 1% of concentration, and evaluation of width cracks. After the conclusion of all the testings, it was established that all reservoir, studied in this academic work, have showed an advanced deteriorating condition. It´s presents prevalent pathological manifestations as unacceptable cracks, spots, efflorescence and reinforcement corrosion, and in some cases, chlorides contamination. After the conclusion of the testings and its concatenation it was able to implementing, using GDE/UnB methodology, the order of the restoration its service life and initial safety conditions

Turismo de eventos como estratégia no combate à sazonalidade: uma análise na hotelaria de Natal - RN

The aim of this work is to analyse the tourism events and the performance of this segment from market as strategy in the combat of Natal's hotel seasonality, in the executives/managers's vision from this sector. Two searches were realized to turn available this study: Inicialy a bibliographic search involving the concepts associated with the tematic in question so that it arranges the embasament theoric-scientific and a survey from facts through the country search, where it was applicable in the establishments of work's population with the auxiliary from a formulary answered by a personal interview. The analyses techniques through facts were: estatistic descritive and Kolmogorov-smirnov test.Among the results found, it was verified that the main reasons alleged by the hotels to ingress in the segment from the events were the alinement from the competitive company, the diversification in the options in the sense of occupy the establishments during the period of low season and answer to the demand of market. Investigated the profile from the events occured in the Natal hotels referring to the port, public origin , kinds of events and frequency from their realizations, as well as , the capacity from these establishments to attend this segment.It was noticed that in spite of the hotels agree that the events are important estrategies to combat the seasonality, the establishments still suffer with the flutuation, what can be justified from the moment that it's considered that the events also behave from seasonal manner, having more concentration in certain periods from the year. It was evaluated that the main advantage noticed by the realization from the hotels's events is the utilization from alimentation and drinking services, surpassing the advantage from elevation of taxes occupation from the apartments

Estratégia pública de gestão ambiental :uma contribuição para a realização de eventos públicos

The present study is included in the environmental international theme, approaching the search for the environmental conformity in public events. It describes the main environmental impacts, objects of the study Sound Disturbances, implications concerning the increase in the Volume of Traffic and in the volume of Solid Residues generated in the surroundings of the event. The methodology used consists of the report of the case study of the festivity called Carnatal, held in Natal/RN, in December of 2001. As a work method, it was used a quantitative evaluation of the sound intensity level, according to the effective legislation, an electronic count of volume of traffic and an evaluation of the productive performance of the means of production of public urban sanitation company used in the event. The results pinpoint the recognition of the impacts generated by the event and the proposition of a Program of Environmental Management, aiming at, in addition to the establishment of the instruments and goals for the mitigation of the impacts, defining the role of the social actors in the search for the environmental conformity of festivities

Análise comparativa de modelos de maturidade em gerenciamento de projetos: uma contribuição ao estudo da maturidade organizacional em setores de engenharia

The purpose of this dissertation is to formulate guidelines for the improvement of maturity models, or the development of new ones, aiming at its application to project departments. The maturity of project management has become critical for organizations that develop projects and want to stand out in the market they serve. For this purpose, maturity models provide paths in order to guarantee that the institutionalization of project management is achieved in the best possible way. Generally, these models assess the organization, define its current situation in managing projects and propose steps to be performed in the search of more advanced levels of maturity. With the objective of contributing to the improvement of maturity models for specific cases, a bibliographical research was conducted for the preparation of a comparative analysis matrix and performed a case study for application of two maturity models (MMGP and PMMM levels 2 and 3), selected based on criteria found in the literature, in an engineering department of an oil company. The case study supported the realization of a comparative analysis of models, from which guidelines were formulated for improvement. The results showed that thedepartment is evaluated in a medium stage of maturity, recording significant progress in some dimensions assessed. They also found that the results of applying the two models are presented as complementary, although the model is highlighted by the greater depth of MMGP diagnostic, considering many variables in their levels of maturity than model PMMM (levels 2 and 3).Finally, directions have been formulated that contribute to the improvement of maturity models, taking in account the organizational environment in which this work was developed

Desenvolvimento de uma cadeira de rodas robótica para transporte de portador de necessidades especiais

The objective of the dissertation was the realization of kinematic modeling of a robotic wheelchair using virtual chains, allowing the wheelchair modeling as a set of robotic manipulator arms forming a cooperative parallel kinematic chain. This document presents the development of a robotic wheelchair to transport people with special needs who overcomes obstacles like a street curb and barriers to accessibility in streets and avenues, including the study of assistive technology, parallel architecture, kinematics modeling, construction and assembly of the prototype robot with the completion of a checklist of problems and barriers to accessibility in several pathways, based on rules, ordinances and existing laws. As a result, simulations were performed on the chair in various states of operation to accomplish the task of going up and down stair with different measures, making the proportional control based on kinematics. To verify the simulated results we developed a prototype robotic wheelchair. This project was developed to provide a better quality of life for people with disabilities

Avaliação do desenvolvimento sustentável na bacia hidrográfica do Rio Seridó em face das políticas públicas e da gestão dos recursos hídricos

The reality of water resources management in semiarid regions, such as the Seridó region, has been shaped by a complex chain involving social-cultural, political, economic and environmental aspects, covering different spheres of activity - from local to federal. Because water is a scarce element, the most rational way pointed out by our recent history has been to move towards an increasing emphasis on the need for a truly rational, integrated, sustainable and participatory water resources management, supported by legislation and by a network of institutions that could materialize it. In this sense, despite all the advances in the formulation of public policies in water resources, which ones have indeed lead to significant changes that have occurred or are underway in semiarid regions such as Seridó? What factors may be preventing the realization of the desires rationality embedded in the framers of water policies intents? How to properly manage water resources if the current actors who promote their management and the political, human, cultural and institutional processes that intervene in this management, show strong traces of unsustainability? The research methodology adopted in this paper led to a breakdown of the traditional approach to water resource management, to integrate it into other areas of knowledge, especially to political science and public administration, catalyzed by the concept of "sustainable development". From a broad, interdisciplinary literature review, an exhaustive characterization of the river basin Seridó, a set of interviews with key people in the public administration acting in the region, a series of diagnoses and a set of propositions were made in order to correct the direction of current public policies for the region. From the point of view of public policies, it is in the deployment phase, not in its formulation, which lies a major problem of the lack of significant progress in water management. The lack of coordination between government programs are well characterized, as well as the lack of efficiency and effectiveness of their actions. The causes of this secular model are also discussed, including political factors and social relations of production, which led to a stalemate difficult, but of possible solution. It can be perceived there is a scenario of progressive deterioration of natural resources of the fragile ecosystem and a network of environmental and social consequences difficult to reverse, the result of a persistent and inertial sociopolitical culture, whose main factors reinforce itself. The work leads towards a characterization of the water resources management also from the perspective of environmental, institutional, political and human sustainability , the latter being identified, particularly as investment in the development of people as autonomous beings - not based in ideological directives of any kind - in the emancipation of the traditional figure of the poor man of the hinterland" to the "catalyst for change" responsible for their own decisions or omissions, based upon an education for free-thinking that brings each one as co-responsible epicenter of (self-) sustainable changes in their midst

Formação continuada de professores que ensinam matemática: o papel do ábaco na ressignificação da prática pedagógica

The present dissertation performs a study about abacus part on the continuous education of Elementary School s Mathematic teachers on what concerns the basic operations of addition and subtraction with (re)unification by using the manipulative and/or informatical abacus. Therefore, the research intends to answer the following question: How does a teacher reframe the pedagogical practice while teaching the Decimal Numeral System and the conventional operations of addition and subtraction with (re)unification through manipulative and informatical abacus? In order to do so, we rely ourselves on the Guy Brousseau s Theory of Didactic Situations (TDS) from 1996 that affirms the necessity to trace a way in accordance with the teaching situations that lead the student s learning; and on the work of Pierre Lévy (1993), in which the poles of communication oral, written and virtual create three ways of communication through which the learning process happens. The methodology of this paper was based on the Strategic Research-Action of Franco (2005). The didactic sequence was elaborated in accordance with TDS and used the manipulative and informatical abacus as didactic resource. With the application of the didactic sequence, it was verified that the continued formation of Elementary School s teachers concerning the operations of addition and subtraction on the initial years/levels is pertinent once it has been observed some difficulties of the teachers concerning this mathematical subject. Besides, the analysis of the didactic sequence has allowed one to realize that teachers had some difficulties concerning the numeric representation with order zero, the resolution of operations of addition and subtraction using the manipulative and informatical abacus and the realization of (re)unification on the subtraction with meaning. These observations has been discussed with the teachers and, after that, it has been done some didactic-methodological routings of the operations of addition and subtraction with re(unification) that contributes with the teaching and learning process.

Propostas e discussões para o ensino de astronomia nos 1º e 2º ciclos do nível fundamental e na educação de jovens e adultos

This work aims to propose and to discuss methodologies and practical activities for Astronomy teaching in the 1st and 2nd cycles of the primary education and in the adult education. The proposals presented here were applied to students from the metropolitan region of Natal (RN), including students of the called normal education (formerly magisterial education) and of the undergraduate formation in pedagogy at the Instituto de Formação Superior Presidente Kennedy , and also, in particular, to teachers and students of public municipal school Escola Municipal Djalma Maranhão at the district of Felipe Maranhão II, also analyzing some didactic books used by these institutions. Several elements which we confronted with during this didactic-pedagogical experience were systematized, indicating principles, contents, reflections and procedures related to Astronomy teaching to students of those levels of education. Doing this we aim to make such an experience accessible to those interested in developing a similar approach involving the themes treated here as well as other ones related to Astronomy for those levels of education. The resources and practices implemented here aim to contribute to the effective realization of an interdisciplinary and contextualized education according to orientations proposed by the Parâmetros Curriculares Nacionais (Brazilian National Curricular Guidelines). In order to guarantee a broad accessibility to what we propose in this work, we intend to make available in printed form and also in an Internet page the procedures, instruction materials and texts we developed

As construções adverbiais em mente: análise funcionalista e implicações para o ensino de língua materna

This research aims at investigating the constructions with adverbials in ly, based on the view of contemporaneous linguistic functionalism, such as proposed by Givón, Hopper, Thompson, Traugott, Furtado da Cunha, as well as the cognitivist notion of language, through construction grammar support upon the patterns of Goldberg and the prototypes theory. The cognitive functional approach adopted here considers the change as a proper and inherent phenomenon of language and understands the linguistic phenomenon as resulting from effective use of language. Another aspect to be considered to the realization of this study is the fact that the formation adjective + ly is a word construction mechanism really productive, which generates interests on linguistic description. In a particular way, our leading objective is to exam the constructions with adverbials in ly in the context of language in use, in its oral and written forms, looking for to apprehend the meaning multiple manifestations forged in the use. Bearing this in mind, we worked with data from the Corpus Discurso & Gramática (Natal). There are, in the data, adverbs ended in ly that take the signification of mode, as foreseen in traditional models, but there are also other significations, for instance, the modalizador in its different manifestations. The results show that this adverb is a linguistic mark that carries in its constitution the multissêmico and multifunctional character, which interferes extremely in the ordination of this category, assuming a position sometimes pre-verbal, sometimes post-verbal. Other aspect observed refers to the relationship between the adverb and the verb, with emphasis on the compatibility or restriction between them, option which is related to the semantic aspect. The data in analysis legitimate the use in different constructions with adverb ended in ly in various genres, as follows: personal experience narrative, retold narrative, local description, proceeding account, opinion account, both in oral as in written language

HOPF BIFURCATION FROM LINES of EQUILIBRIA WITHOUT PARAMETERS IN MEMRISTOR OSCILLATORS

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

O corpo no pensamento de Epicuro: limites e possibilidades

The theme that fits the perspective of this thesis comes from the interest of treating, in the Epicurean corpus, about the importance of the body and its manners of realization for understanding the thought of Epicurus of Samos. Based on the inferences contained in the texts that remained from Epicurus, we did an analysis of the aspects that characterize Epicurism as a thought that makes repeated references to the body as an instance of sensitivity. It was necessary, therefore, to discuss how the body is linked to the possibility of thought, and how the latter can be admitted as a body element. It is further understood that the atomistic physics converges to the idea that asserts natural phenomena as likely to be contained and explained by the observations that come from the senses which are manifested through the body. For this reason, it was also pertinent to reflect on the admission of the body as a key element for the interpretation of Epicurean thought, even under the constitution of language. The Epicurean construction about body image was also used for the interpretation and questioning of the dynamics that define the relationships between individuals, characterizing the koinonía of the garden through the notion of corporeal unity. It was defined, therefore, that the characterization of the action field of individuals who lived in the Epicurean garden revolves around the use of logos, with the dialogues coming from the exercise of philosophy for therapeutic purposes, which were able to introduce a specific mode of political action marked by the absence of strange interests of the notion of philía

Efeitos do treino em esteira na marcha com dupla tarefa de indivíduos com doença de Parkinson: ensaio clínico controlado randomizado

Background: The gait automaticity loss difficults realization of concurrent activities - Dual Task (DT). In these situations, individuals with Parkinson`s disease (PD) show a significant reduction in gait velocity and stride length, as strides variability and asymmetry increased, factors predisposing to falls. However, recent studies have shown that training involving DT may cause subsequent improvements in gait variables with DT in individuals with PD. The treadmill use was adopted by this study, by promoting greater regularity in step and enhance training. Objective:To investigate immediate effects of gait training associated with cognitive tasks on gait in individuals with PD. Methods: Twenty-two volunteers were randomly divided into two groups: control group (n = 11), who performed gait training on a treadmill for 20 minutes, and the experimental group (n = 11), who performed treadmill gait training for 20 minutes associated with cognitive tasks of verbal fluency, memory, and spatial planning. Participants were evaluated in phase on of antiparkinsonian medication as the demographic, clinical and anthropometric (identification form), cognitive status (Montreal Cognitive Assessment - MoCA), executive function (Frontal Assessment Battery), level of physical disability (Hoehn and Yahr Modified), motor and functional status (Unified Rating Scale for Parkinson`s Disease - UPDRS), and kinematics (Qualisys Motion Capture System). Results: There were not differences between groups, but both showed improvement after the intervention. The control group had an increase in velocity (p = 0.008), stride length (p = 0.04), step length (p = 0.02) and decreased double support time(p = 0.03). The experimental group showed an increase in speed (p = 0.002), stride length (p = 0.008), step length (p = 0.02) and cadence (p = 0.01), as well as a decrease in the width stride (p = 0.001) and total support time (p = 0.02). As the angular variables, the experimental group had a significant increase in the initial contact angle of ankle (p = 0.01). Conclusion: The gait training combined with cognitive activities didn`t provide significant improvements in gait variables with DT, but this study was the first to demonstrate that gait training on treadmill as simple task minimized the negative interference of DT in PD