1000 resultados para Avaliação econômica de tecnologias em saúde


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Descriptive research aimed at evaluating the assistance offered to patients with venous ulcers, on lower limbs, attended by the Family Health Program (FHP) team, from the municipality of Natal/RN. The target population was composed of 74 patients with venous ulcers (VU), attended by the FHP teams in the 31 FHUs. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (protocol n.55/05). The data collection was performed in patients homes and in the FHUs, through structured interviews and physical examinations of patients with VU and non-participant observation during the changing of wound dressings in these Units and in users homes. The data was organized into an Excel electronic table and transported into the SPSS 14.0 program, for descriptive analysis on 2x2 contingency tables and inferential (Qui-Square χ2, Spearman Correlation, Binomial Proportion Test and p-value <0.05). The prevalence of VU (0.36/1000) in the target population (over 20 years of age) was greater than in the population registered in FHP (0.25/1000). We detected a greater prevalence in the age area of over 60 years (2.22/1000), with 2.98/1000 for females and 1.3/1000 for males (p-value=0.008). The sociodemographical and health characteristics of patients with VU revealed predominance of females (74.5%), elders over 60 years of age (67.6%), with fundamental education (74.3%), family earnings of up to 2 minimum wages (68.9%), retired (90.5%), ortostatic position (23.0%), inadequate sleep (59,9%), presence of CVI (100.0%), hypertension (44.6%) and diabetes (25.7%). As for the time of existence of the VU, 64.9% had over 1 year, and 35.1% less than 1 year), with predominance of one wound (67.6%). The changing of wound dressings is performed mostly at home, in and inadequate way, especially with incorrect cleaning techniques, likewise incorrect use of products and substances, and reduced participation of the FHP team on the evaluation and application of the dressing and choosing of products and substances. The compressive therapy is not part of therapeutic conducts for treatment in the FHUs. As for the evaluation of assistance to patients with VU, 90.5% were inadequate and only 9.5% adequate. The main inadequacy factors were the absence of: diagnosis (47.3%), consultation with and angiologist (63.5%), compressive treatment (100.0%), adequate optical therapy (98.62%), adequate dressing kit (70.3%), training for the changing of dressings (67.6%), following by the FHP team (51.4%) and performed exams (55.4%). We ve concluded that patients with VU mostly present now socioeconomical level and associated chronic diseases. Considering that assistance offered by FHP is non-systematic, fragmented, with no diagnosis planning, continual evaluation and evolution, we qualify the assistance as inadequate and with low level of solution, directly interfering on the maintenance of the VUs chronic state

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A avaliação de alimentos é um dos principais pontos a serem observados no setor de nutrição animal, a qual diz respeito à utilização de métodos para descrever alimentos ao seu público e à sua capacidade de sustentar diferentes tipos e níveis de desempenho animal. Atualmente, as pesquisas têm buscado relacionar o conteúdo de nutrientes dos alimentos com seu aproveitamento digestivo e metabólico. A nutrição animal é uma ciência bastante dinâmica, sempre lança mão de novas tecnologias e estratégias para melhorar o aproveitamento dos alimentos e busca novas metodologias para respondem às demandas emergenciais.. Dessa forma, o estabelecimento de estratégias apropriadas para obtenção de respostas é essencial para que o sucesso na pesquisa seja atingido. Assim, esta revisão irá abordar e discutir as principais técnicas utilizadas na avaliação de alimentos aplicadas à nutrição de ruminantes.

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Cento e oitenta poedeiras comerciais Isa Brown, com 60 semanas de idade, foram distribuídas em delineamento inteiramente ao acaso, em esquema fatorial 2 õ 2, com dois níveis de fitase (0 e 500 ftu/kg de ração) e dois de farelo de girassol (4 e 8%), totalizando cinco dietas, avaliadas com seis repetições de seis aves. As dietas foram formuladas a partir de uma ração controle, à base de milho e farelo de soja, isenta de fitase e farelo de girassol, valorizando na formulação das dietas a matriz nutricional da fitase. O período experimental foi dividido em quatro ciclos de 28 dias cada. A matriz nutricional preconizada para fitase permitiu o atendimento pleno das exigências das aves, mesmo quando as dietas foram formuladas com níveis nutricionais reduzidos, isso quando desconsiderados os nutrientes presentes na matriz nutricional da enzima, de acordo com recomendação da empresa produtora. A adição de fitase na dieta reduz a excreção de fósforo pelas aves e melhora os parâmetros econômicos. A inclusão de farelo de girassol no nível de 8% prejudica a produção de ovos, mas não afeta os demais parâmetros de desempenho e qualidade dos ovos.

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Natural gas, although basically composed by light hydrocarbons, also presents in its composition gaseous contaminants such as CO2 (carbon dioxide) and H2S (hydrogen sulfide). Hydrogen sulfide, which commonly occurs in oil and gas exploration and production activities, besides being among the gases that are responsible by the acid rain and greenhouse effect, can also cause serious harm to health, leading even to death, and damages to oil and natural gas pipelines. Therefore, the removal of hydrogen sulfide will significantly reduce operational costs and will result in oil with best quality to be sent to refinery, thereby resulting in economical, environmental, and social benefits. These factors highlight the need for the development and improvement of hydrogen sulfide sequestrating agents to be used in the oil industry. Nowadays there are several procedures for hydrogen sulfide removal from natural gas used by the petroleum industry. However, they produce derivatives of amines that are harmful to the distillation towers, form insoluble precipitates that cause pipe clogging and produce wastes of high environmental impact. Therefore, the obtaining of a stable system, in inorganic or organic reaction media, that is able to remove hydrogen sulfide without forming by-products that affect the quality and costs of natural gas processing, transport and distribution is of great importance. In this context, the evaluation of the kinetics of H2S removal is a valuable procedure for the treatment of natural gas and disposal of the byproducts generated by the process. This evaluation was made in an absorption column packed with Raschig ring, where natural gas with H2S passes through a stagnant solution, being the contaminant absorbed by it. The content of H2S in natural gas in column output was monitored by an H2S analyzer. The comparison between the obtained curves and the study of the involved reactions have not only allowed to determine the efficiency and mass transfer controlling step of the involved processes but also make possible to effect a more detailed kinetic study and evaluate the commercial potential of each reagent

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This work studies the fabrication of spaghetti through the process at high temperatures through the use of flour added to flour and flaxseed meal, with the aim of evaluating the final product quality and estimate the cost of production. The values of moisture, ash, protein, wet gluten, gluten index, falling number and grain of flour and mixtures to test to be the possible use in mass manufacturing and technological criteria for compliance with current legislation. Spaghetti noodles type were manufactured by adding 10% and 20% flour and 10% and 20% flaxseed meal with performance of physical-chemical, sensory and rheological properties of the products. Further analysis was performed on the product acceptance and estimation of production cost in order to create subsidies to enable the introduction of products with greater acceptance and economic viability in the market by the food industry. On the rheology of the product test was cooking the pasta, specifying the volume increase, cooking time and percentage of solid waste. In the sensory evaluation was carried out the triangular test of product differentiation with 50 trained judges and acceptance testing by a hedonic scale with evaluation of the aspects color, taste, smell and texture. In defining the sensory profile of the product was performed with ADQ 9 judges recruited and trained at the factory, using unstructured scale of 9 cm, assessing the attributes of flavor of wheat, flax flavor, consistency, texture of raw pasta, raw pasta color and color of cooked pasta. The greater acceptance of product quality was good and the pasta with 20% flour, 10% followed by the full product, 10% and 20% flaxseed characterized the average quality of the criterion of loss analysis of solids, together with mass full commercial testing. In assessing the estimated cost of production, the two products more technologically feasible and acceptable (20% whole and 10% flaxseed) were evaluated in high temperature processes. With total cost of R $ 4,872.5 / 1,000 kg and R $ 5,354.9 / 1,000 kg respectively, the difference was related to the addition of lower inputs and higher added value in the market, flour and flaxseed meal. The comparative analysis of cases was confirmed the reduction in production time (10h), more uniform product to the drying process at high temperature compared to conventional

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The acquisition of machinery used in timber harvesting depends on high financial investment, which implies the need for assessments that allow defining more precisely, what is the machine or the whole more recommended for streamlining the operation. This study aimed to technically and economically evaluating the performance of a harvester in Eucalyptus forest harvest first cut. The technique analysis included a time and movements, productivity, efficiency operational and mechanical availability. The economic analysis included the parameters operational cost, harvesting cost and energy consumption. The results obtained from the technological-economic parameters evidenced that of Diameter at Breast Height directly influenced the productivity of harvester. Consequently the lower costs of forest harvest were obtained for the compartments with wider diameter trees.

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In heavy oil fields there is a great difficulty of the oil to flow from the reservoir to the well, making its production more difficult and with high cost. Most of the original volumes of oil found in the world are considered unrecoverable by the use of the current methods. The injection of micellar solutions has a direct action in the oil interfacial properties, resulting in an enhanced oil recovery. The objective of this research was the study and selection of micellar solutions with ability to decrease the interfacial interactions between fluids and reservoir formation, increasing oil production. The selected micellar solutions were obtained using commercial surfactants and surfactants synthesized in laboratory, based on the intrinsic properties of these molecules, to use in the enhanced oil recovery. Petroleum Reservoirs were simulated using sandstone plugs from Botucatu formation. Experiments with conventional and enhanced oil recovery techniques were accomplished. The obtained results showed that all micellar solutions were able to enhance oil recovery, and the micellar solution prepared with a SB anionic surfactant, at 2% KCl solution, showed the best recovery factor. It was also accomplished an economic analysis with the SB surfactant solution. With the injection of 20% porous volume of micellar solution, followed by brine injection, the increment in petroleum recovery can reach 81% recovery factor in the 3rd porous volume injected. The increment in the total cost by the addition of surfactant to the injection water represents R$ 7.50/ton of injected fluid

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The petroleum industry deals with problems which are difficult to solve because of their relation to environmental issues. This is because amounts of residue are generated which vary in type and danger level. The soil contamination by non aqueous liquid phase mixtures, specifically hydrocarbon petroleum has been a reason for great concern, mainly the aromatic and polycyclic aromatic, which present risk to human health due to its carcinogenic and mutagenic character. The Advanced Oxidative Processes (AOP) are efficient technologies for destruction of organic compounds of difficult degradation and, often, they are present in low concentrations. They can be considered clean technologies, because there is no formation of solid by-products or the transfer of pollutor phases. This work focuses on the study of the degradation of petroleum industrial waste, by Advanced Oxidation Processes. Treatments tackling petroleum residues, contaminated soil, and water occurring in the production of petroleum reached the following Polycyclic Aromatic Hydrocarbons (PAH) degradation levels: solid residues 100% in 96 treatment hours; water residue - 100% in 6 treatment hours; soil contamination (COT degradation) - 50.3% in 12 treatment hours. AOP were effective in dealing with petroleum residues thus revealing themselves to be a promising treatment alternative

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This study aimed to technically and economically evaluate the Feller-buncher in different conditions of harvest in eucalypt forests of second cut. The technical analysis included a study of time and movements by the method of continuous time, and operational performance was determined by volume in cubic meters of harvested wood. The economic analysis included the parameters of operational cost, harvest cost and energy consumption. The analysis of the data showed that the composition of main line harvesting and the arrangement of bundles of trees influenced operational performance. The average operational cost was US$ 86.26 per hour of actual work, which resulted in an average cost of forest harvesting of US$ 1.09 m(-3).

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OBJETIVO: Avaliar a qualidade de vida relacionada à saúde de cortadores de cana-de-açúcar. MÉTODOS: Estudo longitudinal em uma usina sucroalcooleira no Oeste do estado de São Paulo de abril (final da entressafra) a outubro (final da safra) de 2010. Foram avaliados 44 cortadores de cana-de-açúcar tabagistas e não tabagistas em três períodos: ao final da entressafra, no fim do terceiro mês de safra e no final da safra. A qualidade de vida relacionada à saúde foi avaliada pelo questionário Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Foram realizados análise de variância para medidas repetidas e teste de Friedman para comparar a qualidade de vida entre os períodos. Utilizou-se o teste de Goodman para identificar a frequência dos trabalhadores cujo escore aumentou nos períodos de safra em comparação com a entressafra (respondedores positivos), considerando-se as variáveis qualitativas dos domínios do SF-36. RESULTADOS: Ao final da entressafra, 23% dos trabalhadores desistiram do trabalho; 27% eram tabagistas. Houve decréscimo significativo no domínio vitalidade no final da safra em comparação com a entressafra. Os desistentes apresentaram maior escore no domínio aspecto social em relação ao grupo que permaneceu no trabalho. Não houve diferença na qualidade de vida relacionada à saúde entre tabagistas e não tabagistas. No entanto, observou-se maior percentual de respondedores positivos entre não tabagistas nos domínios aspecto físico, social e emocional nos três meses de safra e nos domínios estado geral de saúde e aspecto social nos seis meses de safra, quando comparados aos tabagistas. CONCLUSÕES: A qualidade de vida relacionada à saúde em cortadores de cana-de-açúcar mostrou-se diminuída após o período de safra no domínio vitalidade. Os trabalhadores que permaneceram na safra são os que apresentaram piores aspectos sociais, o que mostra a necessidade de promoção de políticas assistencialistas de saúde a essa população específica, principalmente durante a safra canavieira.

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In Brazil, 0-5 years old children just have an oral health care system since 1990 s. Innumerable experiences of implantation of the attendance to the babies in the cities had appeared throughout the years, but it hasn´t been evaluated the comparative effect between children displayed and not displayed to the program. In this regard, the main of this research was describe the Early Childhood Oral Health Care in public health service in Natal, Rio Grande do Norte, Brazil and evaluate the impact of this specific oral health care for babies by comparison of indicators between exposed and non-exposed children. It was created an experimental group, formed by children covered by program which was paired, based on sex, age and socioeconomic status, with a control group, formed by uncovered children. After filling ethical application, the parents of children were questioned about some risk factors to dental caries and, in sequence, it was accomplish an oral examination in the child. It was verified the Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), dmf-s and verification of caries activity. The sample was 40 children in each group. The results showed, for VPI, a difference of 7 percentile points for the experimental group, however this difference had no statistical significance, obtained by Student s t test (p=0.314). In relation to GBI, the control group showed a low mean (0.8%) comparing with experimental group (2.77%) and this difference was statistically significant (p=0.003). The results for dmf-s and evaluation of caries activity showed no statistical difference between groups. Among the probable reasons for absence of impact of intervention, could be included: (a) the practice model was the same in two groups, or the difference was very weak and (b) the oral health care has intrinsic limitations for to impact on oral health in low income populations

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Due to the fact of oral health sector reestructuration within Brazilian public health politics, this work had the object of evaluating, under users point of view, the accessibility to oral health services in Santa Cruz (RN), focusing on the organizational aspect. To achieve this, questionnaires were given to users in their homes, considering the censitary sector. Nine sectors of the urban zone were evaluated, selected by chance, and one from the rural zone, selected by convenience. The sample was composed by 194 users, calculated considering the estimated prevalence of event represented by the indicator I ve never been to the dentist + I ve been to the dentist more than three years ago from the Projeto SB Brasil Report . To complement the results, interviews were made with others actors involved in the process of oral health care: professionals (dentists) and manager (Health Municipal Secretary). From the data obtained it was possible to identify that 12,9% of the population had never visited the dentist, and that the search for the service was not influenced by the users individual and socioeconomics characteristics, excepting the gender. It was verified that 36,1% of the users went to the dentist in less than one year, with the youngests (p<0,05) being among those who went to the dentist more frequently. 63,3% of the interviewed related that they found some kind of difficulty when they search for dentistry services, with the difficulties for schedule, the queues and the long wait among the most cited. It was identified that 43,2% of the users wait three weeks or more for the appointment. It is still pointed out that 71,4% of the interviewed find difficulties to get urgency appointment, the long wait to be attended by the dentist was the most found. 92,9% and 94,1% of the interviewed had never been headed to especialized appointments and complementary exams, respectively. Due to the data founded, it was possible to verify that the accessibility to oral health services in Santa Cruz (RN) is damaged by factors related to the organization of public polices developed, mainly in relation to the working process

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The childhood cancer is characterized by a predominance of hematogenic and lymphatic system neoplasm, although a fTequency of the central nervous system tumors and sarcomas are widely common. Particularities of many childhood cancers and the adverses effect of the antineoplastic agents can change radically the oral environrnent and predisposes to the risk of oral complications. This study assessment clinically the oral health of 40 children on treatment for different types of malignant neoplasm with age range of O to 1S years old (Group I) and compared to 38 nonnal children in the same age range (Group lI). The results shown that nonnal patients had a gingival bleeding index (GBI) and caries experience minar than patients of Group lI, the visivel plaque index (VPI) was lightly higher in patients of Group 1. There was not difference statistically significant in the variables. Sixteen patients of Group I developed together 61 oral complications with predominance of mucositis, followed by spontaneous oral bleeding, candidiasis and xerostomy, that complication were most commons in patients with systemic neoplasm. Its was concluded that patients submitted to antineoplastic therapy with poor oral health had a higher risk to develop oral complications

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This research aimed to evaluate the Family Health Strategy (FHS) in Natal, Rio Grande do Norte, through its managers, professionals and users, having as its support the Theory of Belief and the Cognitive-Behavioral Theory. This is a multimethod research and is divided into three sub-studies. In the first study, nine managers answered to a semi-structured interview, to verify the knowledge and beliefs on SUS; the quantitative data were analyzed with descriptive statistics with the aid of SPSS software and the qualitative data were submitted to lexical analysis with support of ALCESTE software. In the second study, we have a descriptive correlational research in which the antecedent variables are related to working conditions in the family health units (FHUs) and to the professionals‟ profile; the corresponding variables refer to the evaluations of the FHS; a stratified probabilistic sample with 475 professionals, who answered to two scales, both consisting of three factors: Physical infrastructure, Material resources, and Treatment effectiveness, and data were analyzed using descriptive, bivariate and multivariate statistics, with the aid of SPSS. The third study is a descriptive correlational research in which the antecedent variables refer to the treatment in the FHUs and to the users‟ profile, and the corresponding variables refer to the evaluations of the FHS, with a stratified non-probabilistic sample with 390 users, who contributed to the construction of a new scale with a factor, effectiveness in treatment, analyzed through descriptive, bivariate and multivariate statistics, with the aid of SPSS. The results showed problems which start from management, under the shape of admission due to political indication and lack of knowledge on SUS and the FHS; they pass through the low tenure of professionals and insufficient professional; and they end up spreading all over the analyzed items: infrastructure of FHUs, material resources, professionals‟ training, accessibility and referral system. One concludes that, despite following an ideal model, the FHS is in need of changes with regard to the barriers to its operational reality

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This research evaluated the contribution of the Support Center for Family Health (SCFH) in relation to its effect on the Family Health Units through perception of the Family Health Strategy (FHS) and SCFH professionals, in addition to the satisfaction of users in relation to that role. Data were collected in the public health services of the city of Macaíba-RN in 2012, through semi-structured questionnaire and non participant systematic observation and it counted as investigated subjects 272 individuals (60 FHS professionals, 12 SCFH professionals and 200 users representatives of 20 units). For analysis of the responses of the opened questions was used categorization process and, in relation to the observational method, that was based on checking the space organization, the characteristics of the participating subjects and the specific set of activities performed by SCFH teams through an observation guide. The results point to a good acceptance of the SCFH teams role by most FHS professionals who reported active participation in the health units routine, its integration activities to the FHS teams with resolving based health promotion actions. Regarding the SCFH professionals, they also reported positive contribution by participating actively in the units routine with integrated activities to the ESF teams and developing resolute actions. For users, the SCFH brought assurance services with better access to specialized, resolving and welcoming care. Systematic observation ratified data obtained by questionnaire. It was perceived the need to implement actions related to man`s health, to invest in expanding the number of the SCFH teams, the greater supply of medications, improving the regulatory process and planning together as a key strategy to promote a more effective integration between teams SCFH / FHS