Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária

People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconized in the scientific literature, interfering with wound healing and quality of life of affected. In this sense, the construction of a assistance protocol specific to people with venous ulcers (VU) can help professionals of the Family Health Strategy both in patient assessment as and in establishment of quality assistance. Thus, this study aimed to analyse the validity of a multiprofessional assistance protocol for people with venous ulcers in primary care by health professionals using Delphi technique. This is a quantitative study, the methodological type conducted in two steps: first step related to integrative literature review to subsidize the development of the protocol, then these aspects were organized and proposed to the judges of the study through the Delphi technique. The study was initiated after approval by the Research Ethics Committee. The first step was performed between August and September 2012, in the virtual library of health, in the page of the Coordination of Improvement of Higher Education Personnel, of Municipal Health Secretariat and international guidelines of associations and in the subsequent step carried out between September 2012 to January 2013, was performed search by Lattes platform of the National Council of Technological and Scientific Development, in order to identify health professionals in Brazil who act as judges of the instrument and then, via online, the form was submitted to them.The sample for the second step was 51 judges in the first round and 35 for the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach Kappa and CVI established were: request / realization / test results, demographic data, medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion location/ edema and pain treatment. After removal of items which have not obtained Kappa or CVI index established, it was found achieving optimal levels of these index for the categories. In the next step was the ressubmissão of protocol to judges through the Delphi technique in it was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2 phase and the other three categories remained the same Kappa and IVC of the previous phase. As for the average of evaluation requirements of the protocol was found that the scores assigned by the judges were higher in the second phase in nine of the 10 items, remaining the same in only one of the items indicating validity of the instrument before the consensus of the judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The formulation of this assistance protocol valid and reproducible will enable a reorganization and redesign of assistance, with standardization of actions and continuity of care for persons with venous ulcers in primary health care

Teste de condutividade elétrica em sementes de maracujazeiro-amarelo

O teste de condutividade elétrica pode proporcionar informações importantes e complementares sobre o potencial fisiológico de sementes em período de tempo relativamente curto, visto que o teste de germinação se completa aos 28 dias para sementes de maracujá. Dessa forma, o objetivo deste trabalho foi avaliar a eficiência do teste de condutividade elétrica na avaliação do potencial fisiológico e padronizar a metodologia para sementes de maracujá-amarelo. Quatro lotes de sementes foram submetidos aos testes de germinação e vigor (primeira contagem, envelhecimento acelerado, índice de velocidade de germinação e emergência de plântulas em casa de vegetação), incluindo o teste de condutividade elétrica, conduzido com 25 e 50 sementes imersas em 50 e 75 mL de água desionizada,e as leituras realizadas após três, seis, nove, 12 e 24 h de embebição. Somente o lote 2 apresentou comportamento de baixo vigor apontado pelos testes de primeira contagem, emergência de plântulas e condutividade elétrica. A determinação do vigor de sementes de maracujá-amarelo por meio do teste de condutividade elétrica pode ser realizada utilizando 50 sementes e 75 mL após 24 h de embebição.

Atendimento Pré-hospitalar Móvel. Mapeando Riscos e Prevenindo Erros

The attention with safety of the patients is important in the quality of the nursing and health care. In the pre-hospital care, such care is essential on site with the purpose of avoiding possible consequences to the individual, ensuring a fast and appropriate care, with improvement of the morbidity and reduction of the mortality. This medical attention is equally associated with the significant risks of adverse events and serious mistakes, which can be reduced with the awareness of the professionals, organization and quality management. It is a descriptive, transversal research, of quantitative approach, with the objective of identifying the risks for the safety of the patient during the mobile pre-hospital care under the view of the nurses, in a city of the Brazilian Northeast. The sample was formed by 23 nurses. The inclusion criteria: to have at least two years of experience and accept to participate on the research. The data collection was done in two steps, first photo collection, through the adapted method of photographic analysis, and the second with the application of questionnaire, divide in two parts: socio-professional data and digital photo punctuation instrument of the patient s safety. The majority of the nurses had an average working time in the mobile pre-hospital care of six years and six months, in the age group of 38 to 53 years old (69,56%) and with Lato sensu specialization (73,91%), being (29,41%) emergency and (29,41%) in intensive care. The (74%) have the Advance Cardiac Life Support (ACLS) and (100%) have the Pre-Hospital Trauma Life Support (PHTLS); (91, 30%) know the thematic safety of the patient. On the pictures it was observed a bigger variability of the categories (risks) where 44% of variance emerged on the first picture of the research. The pictures 4 and 9 with the average below 5 were classified as very insecure, while pictures 7 and 3 with an average above 7, very secure. On the results of risks observed for the patient s safety in the mobile pre-hospital care five categories emerged: organization and packaging of the equipment and materials, routines and specificities in the mobile pre-hospital care, risks on the management of medications, for traumas and infections. Starting from the analysis of these risks, it was proposed ten steps for the safety in the mobile pre-hospital care: 1- Identify the patient; 2- Safety related to prevention of infection; 3- Safety in the management of medications; 4- Safety and standardization of the packaging of equipment and materials; 5- Attention to the specificities of the mobile pre-hospital care; 6- Incentive and value the participation of the patient and family; 7- Promote the communication with the central of regulation; 8- Prevention of traumas and falls; 9- Protect the skin from additional injuries; 10- Understand the benefit of all the equipment in the ambulance. The multiple risks and their emerged combinations on the research indicate a variety of actions to be developed and stimulated, like the use of steps for the patient s safety in the mobile pre-hospital care which contributes with the aid and management of risks, reduction of mistakes, disabilities and death

Construction of an alkaline phosphatase-liposome system: a tool for biomineralization study

Alkaline phosphatase is required for the mineralization of bone and cartilage. This enzyme is localized in the matrix vesicle, which plays a role key in calcifying cartilage. In this paper. we standardize a method for construction an alkaline phosphatase liposome system to mimic matrix vesicles and examine a some kinetic behavior of the incorporated enzyme. Polidocanol-solubilized alkaline phosphatase, free of detergent, was incorporated into liposomes constituted from dimyristoylphosphatidylcholine (DMPC), dilaurilphosphatidylcholine (DLPC) or dipalmitoylphosphatidylcholine (DPPC). This process was time-dependent and >95% of the enzyme was incorporated into the liposome after 4 h of incubation at 25 degreesC. Although, incorporation was more rapid when vesicles constituted from DPPC were used, the incorporation was more efficient using vesicles constituted from DMPC. The 395 nm diameter of the alkaline phosphatase-liposome system was relatively homogeneous and more stable when stored at 4 degreesC.Alkaline phosphatase was completely released from liposome system only using purified phosphatidylinositol-specific phospholipase C (PIPLC). These experiments confirm that the interaction between alkaline phosphatase and lipid bilayer of liposome is via GPI anchor of the enzyme, alone. An important point shown is that an enzyme bound to liposome does not lose the ability to hydrolyze ATP, pyrophosphate and p-nitrophenyl phosphate (PNPP), but a liposome environment affects its kinetic properties, specifically for pyrophosphate.The standardization of such system allows the study of the effect of phospholipids and the enzyme in in vitro and in vivo mineralization, since it reproduces many essential features of the matrix vesicle. (C) 2002 Elsevier B.V. Ltd. All rights reserved.

Qualidade do serviço de informação digital :um estudo exploratório em web sites de Programas de Pós-Graduação

This dissertation of Mestrado investigated the performance and quality of web sites. The target of the research is the proposal of an integrated model of evaluation of services of digital information in web educational sites. The universe of the research was constituted by eighteen Brazilian Universities that offer after-graduation courses, in the levels of mestrado and doutorado in the area of Engineering of Production. The adopted methodology was a descriptive and exploratory research, using the technique of systematic comment and focus group, for the collection of the data, using itself changeable independent dependents and, through the application of two instruments of research. The analysis protocol was the instrument adopted for evaluation and attainment of qualitative results. E the analysis grating was applied for evaluation and attainment of the quantitative results. The qualitative results had identified to the lack of standardization of web sites, under the attributes of content, hierarchy of information, design of the colors and letters. It of accessibility for carriers of auditory and visual special necessities was observed inexistence, as well as the lack of convergence of medias and assistivas technologies. The language of the sites also was evaluated and all present Portuguese only language. The general result demonstrated in grafico and tables with classification of the Universities, predominating the Good note As for the quantitative results, analysis method ed was estatistico, in order to get the descriptive and inferencial result between the dependent and independent variaveis. How much a category of analysis of the services of the evaluated sites, was found it props up and the index generality weighed. These results had served of base for ranking of existence or inexistence the Universities, how much of the information of services in its web sites. In analysis inferencial the result of the test of correlation or association of the independent variaveis (level, concept of the CAPES and period of existence of the program) with the caracteristicas, called was gotten categories of services. For this analysis the estatisticos methods had been used: coefficient of Spearman and the Test of Fisher. But the category you discipline of the Program of Mestrado presented significance with variavel independent and concept of the CAPES. Main conclusion of this study it was ausencia of satandardization o how much to the subjective aspects, design, hierarchy of information navigability and content precision and the accessibility inexistence and convergence. How much to the quantitative aspects, the information services offered by web sites of the evaluated Universities, still they do not present a satisfactory and including quality. Absence of strategies, adoption of tools web, techniques of institucional marketing and services that become them more interactive, navigable is perceived and with aggregate value

Estratégia de escalonamento de controladores PID baseado em regras Fuzzy para redes industriais foundation fieldbus usando blocos padrões

The main objective of work is to show procedures to implement intelligent control strategies. This strategies are based on fuzzy scheduling of PID controllers, by using only standard function blocks of this technology. Then, the standardization of Foundation Fieldbus is kept. It was developed an environment to do the necessary tests, it validates the propose. This environment is hybrid, it has a real module (the fieldbus) and a simulated module (the process), although the control signals and measurement are real. Then, it is possible to develop controllers projects. In this work, a fuzzy supervisor was developed to schedule a network of PID controller for a non-linear plant. Analyzing its performance results to the control and regulation problem

ISE-SPL: Uma abordagem baseada em linha de produtos de software aplicada à geração automática de sistemas para educação médica na plataforma E-learning

E-learning, which refers to the use of Internet-related technologies to improve knowledge and learning, has emerged as a complementary form of education, bringing advantages such as increased accessibility to information, personalized learning, democratization of education and ease of update, distribution and standardization of the content. In this sense, this paper aims to develop a tool, named ISE-SPL, whose purpose is the automatic generation of E-learning systems for medical education, making use of concepts of Software Product Lines. It consists of an innovative methodology for medical education that aims to assist professors of healthcare in their teaching through the use of educational technologies, all based on computing applied to healthcare (Informatics in Health). The tests performed to validate the ISE-SPL were divided into two stages: the first was made by using a software analysis tool similar to ISE-SPL, called SPLOT and the second was performed through usability questionnaires to healthcare professors who used ISESPL. Both tests showed positive results, proving it to be an efficient tool for generation of E-learning software and useful for professors in healthcare

Desenvolvimento de compósito de pu de mamona com carga de resíduo de couro para isolação térmica

The standardization of the bovine skin thickness in the leather industry generates a residue known as wet-blue . At the end of twentieth century, the brazilian industry discarded about 131 thousand tons of this residue in nature, provoking a great environmental liability. In this paper is presented the analyses of the termophysical properties, thermal and volumetric expansion performance of a composite of vegetable resin of castor oil plant (Ricinus communis) with load of industrial residue of leather "wet-blue", for application as thermal isolation material of warm surfaces. There were considered four percentile levels of residue load in the proportions in mass of 0%, 5%, 10% and 15%, added to the expansible resin of castor oil plant in two configurations: sawed leather and crushed leather in a smaller particle (powder) by grinding in a mill of balls. Twenty-one proof bodies were produced for termophysical properties analysis (three for each configuration) and four proof bodies for rehearsals of thermal acting. Analyses of thermal acting were done in test cameras. The results of the rehearsals were compared to those obtained considering the castor oil plant foam without residue addition. A small reduction of the thermal conductivity of the composite was observed in the proportion of 10% of leather residue in both configurations. Regarding thermal conductivity, calorific capacity and diffusivity, it was verified that the proposed composite showed very close values to the commercial insulating materials (glass wool, rock wool, EPS). It was still demonstrated the technical viability of the use of composite as insulating thermal for systems of low potency. The composite presented larger volumetric expansion with 15% of sawed residue of leather.

Avaliação do processo industrial da cerâmica vermelha na região do Seridó - RN

Particularly in Braziland in Rio Grande do Norte, companies manufacturing red ceramic, play an important role as agents of development to study the region Seridó- RN, specific place for carrying out the research. It is observed in this region a concentration of red ceramic industries of small size, which, despite its importance in the ceramic, they are unable to enjoy or use the new forms of administrative management and technological advances designed and offered by universities, centers of research and projects of governments, remained almost entirely outside the progress and modernization, technological and administrative. These companies still have outdated technology, and management processes, providing quality problems and standardization of end products. Upon these conditions are the companies going through crisis and struggling to survive alone and without assistance. The region of Seridó-RN, lets make a detailed case study of red ceramic companies in the region proposed from the existing theoretical and actual lifting of the condition of the product manufacturing red ceramic, allowing through this overview of the implementation of collect samples of raw materials, allowing the study of each ceramic industry that contributed to the participation of the research, which was determined parameters such as: analysis of the physical, chemical and technological properties of raw materials, characterization of the processes used, raising the technological resources considering equipment, machinery, supplies, raw materials and facilities available and its organization by type of products from companies involved in this study. The methodology consists of the following steps: collection of raw material, crushing and screening, characterization of raw materials (liquid limit, chemical analysis, mineralogical analysis, differential thermal analysis, sieve analysis), mixing, forming, cutting, drying and burning of ceramic bodies and bodies of evidence. The results showed that it was clay with distinct characteristics with respect to plasticity. With respect to the different compositions of mixtures of ceramic masses, we conclude that the ceramic properties showed a direct proportionality with increasing fraction of the clay not plastic. However, the compositions of the masses studied proved to be the most appropriate for the types of simulated clay for use in ceramics. Adopted in the ceramic processing made it possible to obtain products the resulted in consistent properties, and in some cases even exceeding the requirements of technical studies and standard-Brazilian clays to obtain ceramic products such as tiles, bricks and tiles to floor. Based on the discussions from the results obtained in the various processing steps of this work, one can draw conclusions according to the physico-chemical and mineralogical properties of raw materials, the properties of ceramic products burned and analysis. This work may be used by other researchers, private companies and governmental organizations, undergraduate students and graduate, can develop studies and future research to: develop projects to modify the furnaces; mapping projects develop and rationalize the exploitation of raw materials ;promoting reforestation and forest management; develop reduction projects and recovery of waste; develop training projects in manpower sector, and develop security projects, improving the conditions of work in the area pottery

Validação de uma metodologia de ensaio de resistência ao cisalhamento para avaliação da aderência de interfaces revestimento metálico-bainha de cimento aplicada a poços de petróleo

Improving the adherence between oilwell metallic casing and cement sheath potentially decrease the number of corrective actions present/y necessary for Northeastern wells submitted to steam injection. In addition to the direct costs involved in the corrective operations, the economic impact of the failure of the primary cementing aIso includes the loss in the production of the well. The adherence between casing and cement is current/y evaluated by a simple shear tests non standardized by the American Petroleum Institute (API). Therefore, the objective of the present is to propose and evaluate a standardized method to assess the adherence of oilwell metallic casing to cement sheath. To that end, a section of a cemented oilwell was simulated and used to test the effect of different parameters on the shear stress of the system. Surface roughness and different cement compositions submitted or not to thermal cycling were evaluated. The results revealed that the test geometry and parameters proposed yielded different values for the shear stress of the system, corresponding to different adherent conditions between metallic casing and cement sheath

Diagnóstico regional do processo de queijo coalho comercializado em Natal/RN

Coalho cheese is a typical product of the Northeastern Brazil, which is consumed both raw and cooked. The present work aimed to study the characteristics of artisanal and industrial processes in the production of coalho cheese sold in Natal / RN in order to evaluate its quality and consumer s profile. Four artisanal cheeses plants were monitored and a questionnaire was sent to different cheese industries. Besides this, eight cheese samples (four artisanal and four industrial) were evaluated in regard to the microbiological quality, physical-chemical and sensory attributes. The sensory acceptance was evaluated by using 108 non-trained panelists by using the hedonic scale. The consumer s profile survey was applied to 400 consumers of coalho cheese. The lack of hygiene control was detected at the artisanal cheese production, which uses raw milk as its raw material. Research has shown that the industrialized cheeses are made from pasteurized milk provided by their own production or by a third party, as observed in cheese making dairies. In general, the results indicate variation in the manufacturing process of coalho cheese, which results in the lack of product standardization. Regarding the physical-chemical analysis, most artisanal and industrial samples presented moisture content between 36 and 40 %, classified as medium moisture cheese, which is the only parameter that showed no significant difference (p>0.05). However, the water activity (Aw), pH and acidity results differed significantly. All artisanal samples showed coliform contamination at 35 °C, which confirms the poor hygienic conditions. In regard to coliforms at 45 °C, 75 % of artisanal coalho cheese samples had value higher than 103 MPN / g, a value above the lawful limits determined by RDC nº 12. Fifty percent of industrial coalho cheese samples showed coagulase-positive Staphylococcus values above the limit allowed by the RDC nº 12, indicating poor handling. The sensory evaluation revealed that the taste was the only parameter that showed significant difference, and this difference was only between two industrial brands. The consumer s survey showed that the coalho cheese flavor is the most important reason for buying this kind of cheese. Although coalho cheese is mainly bought in supermarkets, open street markets and country shops are still important selling points. It is concluded that there is no coalho cheese standardization in the RN state, which leads to variations in physical-chemical and sensory attributes. Moreover, it is necessary greater hygiene control in the production and handling procedures of coalho cheese.

Efeito do ácido lático sobre as características microbiológicas, físico-químicas e sensoriais na carne do sol

The dried beef is a food traditionally eaten by Northeastern and has an extensive trade in the city of Natal-RN. It is usually produced in an empirical manner, without any standardization in production. Characterized as partially dehydrated meat product, so that the activity of water present is not sufficient to prevent microbial growth, degradation or the production of microbial toxins. The guarantee that the market dried beef is to provide a quality product hygienic, microbiological, physicochemical and sensory stable and adequate for the safety and consumer satisfaction, which has been increasingly attracted to food with natural preservatives. Thus, the meat industries are replacing the current seasonings and natural preservatives for similar, with it without affecting the shelf life of products. Lactic acid has been used to meet these requirements. In this sense, this study aimed to evaluate the effect of lactic acid on the physico-chemical, microbiological and sensory, besides knowing the consumer profile of dried meat of the City of Natal / RN. The results demonstrated that the use of lactic acid in concentrations of 1% and 2% during the processing of dried meat, had statistically significant effect (p < 0.05) on the physico-chemical (pH and water activity) and consequently reduced the microbial count does not alter the taste of the new product developed. Regarding the results on the consumer profile, it was found that the majority of respondents (71.75%) did not observe the presence of the stamp of the Federal Inspection Service (SIF) to buy this meat food that 81.55% of consumers check the hygiene conditions of the site and handlers, however, a large proportion of respondents not concerned with the guarantee of origin of typical regional products featuring a hazard to food safety for consumers of the city of Natal-RN

A new method to quantify macroalgae and a practical sampler for experimentation in lotic habitats

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Para uma crítica da razão socioeducativa em entidades assistenciais

Buscou-se cartografar as instituições de assistência social que atendem à infância e à adolescência consideradas em situação de risco pessoal e social, em um município do interior do estado de São Paulo, utilizando o instrumental da análise institucional. O papel de membro do Conselho Municipal dos Direitos da Criança e do Adolescente e do Conselho Municipal de Assistência Social facultou a realização de uma análise documental nos arquivos desses Conselhos, relativa às entidades assistenciais cadastradas, tais como organizações governamentais, organizações não-governamentais e outros estabelecimentos filantrópicos. Os resultados indicam que, no universo da Assistência Social, a constelação criança/adolescente orbita em torno do astro-rei socioeducativo. Todas as atividades desenvolvidas nas entidades parecem recobertas por esse significantemestre, que conota dimensões pedagógicas e terapêuticas, educativas e corretivas, de vigilância e de prevenção, promovendo controle e normalização.

Desenvolvimento de um sistema hierárquico de classificação com aplicação baseada em abordagem Fuzzy

Land cover mappings represent important tools for the regional planning. However, the current mappings are related to very specific purposes and, consequently, they are limited in their capacity to define the wide variety of existing types of land cover. In that context, this paper aims at developing a wide and including hierarchical classification system for land cover mapping in regional scale, which should contribute for a future standardization of classes. Besides, it is intended to test that system for a study case that contemplates the use of a classification method based on fuzzy approach, which has shown to be more appropriate than conventional approaches. Therefore, it was proposed a hierarchical classification system with three detailing levels and a study case was defined with the specification of the test area and of the classification project. Then, the georreferencing of a TM/Landsat-5 image that comprises the test area was carried out. Later, it was applied a fuzzy classification approach in the TM/Landsat-5 image, starting from images of probability for the mapped classes and an uncertainty image were generated. Finally, it was produced a conventional output that represents the thematic mapping of the test area.