As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Controle da neoplasia maligna do colo de útero: a resolutividade na atenção básica

A quantitative, descriptive, cross-sectional and retrospective study, using technical procedures of document consultation from secondary sources and health household survey with application form for face to face inter views, with the assent nº.039/2011 from the Ethics Committee of the Federal University of Rio Grande do Norte. The aim of this study was to analyze the cervix cancer control in the area47 of the Health Family Centre Nova Natal II. The cancer cervix is the second most common cancer among women worldwide. In Brazil screening for early detection and treatment of disease has been poorly done and follow-up to reduce mortality has not been executed. From a total of1170women belonging to area 47, who under went screening by the Pap test in the period from 2005 to 2010,was elected a sample of 38 women with positive cervical changes, over 18 years old. The calculation of frequency analysis of socio demographic and clinical and epidemiological selected variables with the results of cervical changes, using the X2 test and taking as significance level of p<0.05 was not statistically significant. The predominant age range was 25 to 64 years (68.9%), most no white women (60.5%), predominantly with primary education (57.9%), most married (68.4%) and housewives (68.4%) with early age of sexual activity (86.8%), the minority smokers (13.2%), with a sexual partner (36.8%). At the time of interview, 42.1% of the women voiced complaint of discharge, while only 2.6% reported bleeding. In relation to the occurrence of STDs (including HPV), 10.5% of women reported being a carrier. The use of oral contraceptives was 32.3% of women, from 2 to 4 years (44.4%). The result of the last screening test performed, showed prevalence of immature squamous metaplasia (55.3%), followed by intraepithelial low- grade lesion (including the cytopathologic HPV effect and cervical intra epithelial neoplasia grade I) (31.6%); intraepithelial high-grade lesion (including cervical intraepithelial neoplasia grade II and III) (7.9%), atypical squamous non neoplastic cells (5.3%). There was no squamous cell carcinoma and adenocarcinoma. Most women received information about the action that should be done after the last screening test result (55.3%), but how to perform follow, most women did not report having done so (55.3%). The follow-up group of women studied, with varying degrees of cervical abnormalities, should only be completed with the discharge by cure, established inconsecutive negative cytology, a goal that is not being achieved in the area 47 of the Health Family Centre of Nova Natal II

Estratégias de intervenção utilizadas por enfermeiros da ESF do município de Natal/RN no controle do câncer do colo de útero

Cancer of the cervix (cervical cancer) is the second most prevalent cancer among Brazilian women. The high rates of cervical cancer in Brazil justify the implementation of effective strategies to control this, which include actions to promote health, primary prevention, early detection, screening, treatment and palliative care. Despite the existence of the National Programme for Control of the CCU there was no reduction in the incidence and mortality of this disease in Brazil. The Family Health Strategy (FHS) has the potential to facilitate such control and, in this context, one should consider that nurses play a central role. The study aimed to know the general intervention strategies used by nurses FHS of Natal / RN in CCU control, and how specific: analyzing the knowledge of these nurses on the CCU, the actions developed in the ESF for the control of CCU and identify the difficulties faced by them to perform it. This is a descriptive exploratory quantitative developed through a structured interview guide with 106 nurses who have experience in controlling the CCU in FHS teams of Natal / RN. Data analysis was performed using descriptive statistic s. The results pointed to actions taken in the FHS to control the CCU, collection of cervical cancer screening, health education activities, nursing consultation, referral of suspected cases for medical monitoring and active women with abnormal test result . The actions that were not mentioned by the nurses included: forming groups of prevention and health promotion; expand coverage of exams and office hours of consultations, establishment of alternatives to end the pent-up demand in the health units, participation in treatment or rehabilitation process users with the CCU; interventions for pain management, alliances and partnerships with schools, in dustry and the use of protocols. This study can be seen that the practice nurses partially shares to the CCU in Natal / RN. The participants of this study, when asked about the CCU, specifically for signs and symptoms of disease and risk factors in general showed important gaps. Difficulties such as lack of materials for collection of Pap smear; inadequate physical space in the Health Units; pent-up demand in the service, delay in arrival of the test results; obstacles in the actions of referral and counter-referral and cultural factors make the CCU control is compromised. It is believed in this research contributed to a reflection on the importance of the role of nurses in the development of the ESF control actions CCU, pointing out the factors that affect these. It is important to involve all nurses who comprise the ESF as knowledgeable of the risk factors, signs and symptoms, and existing tools for the early detection of cervical cancer in the pursuit of quality improvement actions to promote women`s health, contributing in planning future interventions that may reduce mortality from this disease in Natal / RN.

Avaliação da usabilidade de Websites de hotéis segundo as heurísticas de Nielsen: pesquisa exploratória em hotéis da Região Rordeste do Brasil

This Thesis deals with the usability in some sites of hotels placed in a specific region of Brazil. Usability is the property of a site that shows how it allows the user get all information available without a large effort and in a clear and objective way. A questionnaire was used as a tool to value, by the common user perspective, navigation, on line reservation simulation, appreciation of the available content and, by this way, an easiness in the interaction site-users. As a result, it is possible to say that, considering all material analyzed, those sites that present usability criterion are more interactive and dynamic, demonstrating an easy navigation in a users view. By other side, it was possible to note that, about heuristics used in the search, the most of the websites demonstrated a deficiency in questions as firmness, user control and how to avoid mistakes. There was still valued as deficiency by the most of users in websites the general characters and the view of user. It was presented, seeing general characters, that a big part of the websites needs tools that can make user rapidly find what looks for. It was yet possible to see that users don't believe in secret when websites ask them some information. This is a point that needs to be appreciated because it causes some insecurity during navigation

Modelagem de arranjos institucionais para implementação da diretriz de sistema de gestão de segurança e saúde ocupacional da organização internacional do trabalho ILO/OSH 2001 no brasil

The commitment assumed by Brazil to ILO in order to pursue actions toward the ILO/OSH-2001 adoption in the country poses the issue of modeling the institutional arrangement the set roles and relationship between government, standards organizations, health and safety organizations, professionals and other institutions to deploy the ILO/OSH-2001. This Thesis develop institutional arrangement models based on the current model and also in the ISO 9000 scheme and others. It is studied the US case with OSHA and VPP, the OHSAS 18001 and ANSI/AIHA Z-10, in addition to actual context of the regulating norms NR s. The scenarios developed are put to evaluation on feasibility, potential changes and effects on current MTE auditors work scheme. The main results are five scenarios developed and that the MTE auditors tend to be reactive to the change toward the ILO/OSH-2001.

Terceirização em tecnologia da informação sob os aspectos de estratégia, tomada de decisão e análise de investimentos :estudo de múltiplos casos em três organizações franqueadas da Coca-Cola do Brasil

Desde a criação da tecnologia e do seu uso pelas empresas, a relação custo e benefício nem sempre foi bem elucidada tanto para os responsáveis pela área de tecnologia quanto para a alta direção. Mas, apesar disto, cada vez mais as organizações investem maciçamente em tecnologia, esperando que esta seja a solução para diversos problemas. Por isto, esta questão tem se tornado crucial para o processo de tomada de decisões, visto que investimentos nesta área costumam ser dispendiosos e, na atual conjuntura, estas análises precisam ser extremamente criteriosas para que se miniminizem as possibilidades de insucesso dos projetos, principalmente numa economia estabilizada e de concorrência acirrada. Uma das alternativas que as empresas têm buscado para atingir o sucesso e correr menos riscos é a terceirização da área de TI. Partindo desta visão, a presente dissertação tem por objetivo realizar uma investigação sobre a terceirização dos serviços de TI em todos os seus aspectos, isto é, desde a sua motivação, serviços efetivamente terceirizados, vantagens, desvantagens e possíveis obstáculos, a visão do alinhamento estratégico da TI, os processos de gestão de contratos e formas de controle e, por fim, tendências futuras. Trata-se de uma pesquisa de múltiplos casos, envolvendo franquias do Sistema Coca-Cola no Brasil. O estudo apresenta uma pesquisa bibliográfica sobre o processo de tomada de decisão empresarial, a análise de investimentos, a gestão e a terceirização da TI, o que permitem definir as dimensões de análise da pesquisa. Na pesquisa de campo foram entrevistados os gerentes da área de TI, nas cidades de Brasília-DF, Goiânia-GO e Ribeirão Preto-SP. A pesquisa de campo permitiu identificar como as mesmas avaliam seus investimentos em TI, como esta área é gerenciada, o que as levou a optar pela terceirização e como os processos terceirizados afetam a organização. Por se tratar de uma pesquisa qualitativa, optou-se por analisar comparativamente as três organizações. Com a realização deste estudo, obtiveram-se, como principais resultados, que as organizações estão utilizando a terceirização em TI para focar no negócio principal e, mesmo encontrando diversas desvantagens, inclusive com relação a custos, acreditam que os benefícios justificam. Ainda identificaram-se alguns obstáculos internos para a terceirização, principalmente quanto ao receio de se perder a inteligência do negócio. O acompanhamento dessas atividades terceirizadas é realizado pela equipe interna e por critérios estruturados, onde se verificam os níveis de serviço

Funções de covariância para produção de leite no dia do controle em bovinos Gir leiteiro

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Controle Adaptativo Robusto para Filtros Ativos de Potência Paralelo

Conventional control strategies used in shunt active power filters (SAPF) employs real-time instantaneous harmonic detection schemes which is usually implements with digital filters. This increase the number of current sensors on the filter structure which results in high costs. Furthermore, these detection schemes introduce time delays which can deteriorate the harmonic compensation performance. Differently from the conventional control schemes, this paper proposes a non-standard control strategy which indirectly regulates the phase currents of the power mains. The reference currents of system are generated by the dc-link voltage controller and is based on the active power balance of SAPF system. The reference currents are aligned to the phase angle of the power mains voltage vector which is obtained by using a dq phase locked loop (PLL) system. The current control strategy is implemented by an adaptive pole placement control strategy integrated to a variable structure control scheme (VS-APPC). In the VS-APPC, the internal model principle (IMP) of reference currents is used for achieving the zero steady state tracking error of the power system currents. This forces the phase current of the system mains to be sinusoidal with low harmonics content. Moreover, the current controllers are implemented on the stationary reference frame to avoid transformations to the mains voltage vector reference coordinates. This proposed current control strategy enhance the performance of SAPF with fast transient response and robustness to parametric uncertainties. Experimental results are showing for determining the effectiveness of SAPF proposed control system

Estratégia de controle robusto para filtro ativo paralelo sem detecção de harmônicos de correntes

Conventional control strategies used in shunt active power filters (SAPF) employs real-time instantaneous harmonic detection schemes which is usually implements with digital filters. This increase the number of current sensors on the filter structure which results in high costs. Furthermore, these detection schemes introduce time delays which can deteriorate the harmonic compensation performance. Differently from the conventional control schemes, this paper proposes a non-standard control strategy which indirectly regulates the phase currents of the power mains. The reference currents of system are generated by the dc-link voltage controller and is based on the active power balance of SAPF system. The reference currents are aligned to the phase angle of the power mains voltage vector which is obtained by using a dq phase locked loop (PLL) system. The current control strategy is implemented by an adaptive pole placement control strategy integrated to a variable structure control scheme (VS¡APPC). In the VS¡APPC, the internal model principle (IMP) of reference currents is used for achieving the zero steady state tracking error of the power system currents. This forces the phase current of the system mains to be sinusoidal with low harmonics content. Moreover, the current controllers are implemented on the stationary reference frame to avoid transformations to the mains voltage vector reference coordinates. This proposed current control strategy enhance the performance of SAPF with fast transient response and robustness to parametric uncertainties. Experimental results are showing for determining the effectiveness of SAPF proposed control system

Controle inteligente de pressão para uma rede sem reservatório de abastecimento urbano de água

The sanitation companies from Brazil has a great challenge for the XXI century: seek to mitigate the rate of physical waste (water, chemicals and electricity) and financial waste caused by inefficient operating systems drinking water supply, considering that currently we already face, in some cases, the scarcity of water resources. The supply systems are increasingly complex as they seek to minimize waste and at the same time better serve the growing number of users. However, this technological change is to reduce the complexity of the challenges posed by the need to include users with higher quality and efficiency in services. A major challenge for companies of water supplies is to provide a good quality service contemplating reducing expenditure on electricity. In this situation we developed a research by a method that seeks to control the pressure of the distribution systems that do not have the tank in your setup and the water comes out of the well directly to the distribution system. The method of pressure control (intelligent control) uses fuzzy logic to eliminate the waste of electricity and the leaks from the production of pumps that inject directly into the distribution system, which causes waste of energy when the consumption of households is reduced causing the saturation of the distribution system. This study was conducted at Green Club II condominium, located in the city of Parnamirim, state of Rio Grande do Norte, in order to study the pressure behavior of the output of the pump that injects water directly into the distribution system. The study was only possible because of the need we had to find a solution to some leaks in the existing distribution system and the extensions of the respective condominium residences, which sparked interest in developing a job in order to carry out the experiments contained in this research

Controlador adaptativo por posicionamento de pólos e estrutura variável aplicado ao controle de geradores eólicos baseados em máquina de indução duplamente alimentada

In the last decade, the renewable energy sources have present a major propulsion in the world due to several factors: political, environmental, financial and others. Within this context, we have in particular the energy obtained through wind, wind energy - that has highlighted with rapid growth in recent years, including in Brazil, mostly in the Northeast, due to it s benefit-cost between the clean energies. In this context, we propose to compare the variable structure adaptive pole placement control (VS-APPC) with a traditional control technique proportional integral controller (PI), applied to set the control of machine side in a conversion system using a wind generator based on Double-Fed Induction Generator (DFIG). Robustness and performance tests were carried out to the uncertainties of the internal parameters of the machine and variations of speed reference.

Estratégia de controle robusto para interconexão de sistemas PV trifásicos à rede elétrica

Atualmente há uma grande preocupação em relação a substituição das fontes não renováveis pelas fontes renováveis na geração de energia elétrica. Isto ocorre devido a limitação do modelo tradicional e da crescente demanda. Com o desenvolvimento dos conversores de potência e a eficácia dos esquemas de controle, as fontes renováveis têm sido interligadas na rede elétrica, em um modelo de geração distribuída. Neste sentido, este trabalho apresenta uma estratégia de controle não convencional, com a utilização de um controlador robusto, para a interconexão de sistemas fotovoltaicos com à rede elétrica trifásica. A compensação da qualidade de energia no ponto de acoplamento comum (PAC) é realizada pela estratégia proposta. As técnicas tradicionais utilizam detecção de harmônicos, já neste trabalho o controle das correntes é feita de uma forma indireta sem a necessidade desta detecção. Na estratégia indireta é de grande importância que o controle da tensão do barramento CC seja efetuado de uma forma que não haja grandes flutuações, e que a banda passante do controlador em regime permanente seja baixa para que as correntes da rede não tenham um alto THD. Por este motivo é utilizado um controlador em modo dual DSM-PI, que durante o transitório se comporta como um controlador em modo deslizante SM-PI, e em regime se comporta como um PI convencional. A corrente é alinhada ao ângulo de fase do vetor tensão da rede elétrica, obtido a partir do uso de um PLL. Esta aproximação permite regular o fluxo de potência ativa, juntamente com a compensação dos harmônicos e também promover a correção do fator de potência no ponto de acoplamento comum. Para o controle das correntes é usado um controlador dupla sequencia, que utiliza o princípio do modelo interno. Resultados de simulação são apresentados para demonstrar a eficácia do sistema de controle proposto

Controle automático para injeção otimizada de gás em poços de petróleo equipados para funcionamento com gás lift contínuo

The continuous gas lift method is the main artificial lifting method used in the oil industry for submarine wells, due to its robustness and the large range of flow rate that the well might operate. Nowadays, there is a huge amount of wells producing under this mechanism. This method of elevation has a slow dynamics due to the transients and a correlation between the injected gas rate and the of produced oil rate. Electronics controllers have been used to adjust many parameters of the oil wells and also to improve the efficiency of the gas lift injection system. This paper presents a intelligent control system applied to continuous gas injection in wells, based in production s rules, that has the target of keeping the wells producing during the maximum period of time, in its best operational condition, and doing automatically all necessary adjustments when occurs some disturbance in the system. The author also describes the application of the intelligent control system as a tool to control the flow pressure in the botton of the well (Pwf). In this case, the control system actuates in the surface control valve

Velocidade do fluxo de ar em barra de pulverização no controle químico de Anticarsia gemmatalis, Hübner e percevejos na cultura da soja

A lagarta Anticarsia gemmatalis (Hübner) e os percevejos fitófagos são pragas importantes na cultura da soja no Brasil. Este trabalho objetivou avaliar o controle desses insetos após o tratamento com inseticidas, sob diferentes velocidades do fluxo de ar junto à barra de pulverização nessa cultura. O experimento foi desenvolvido em Botucatu, na cultura da soja [Glycine max (L.) Merrill], var. Conquista (safra 2007/08), no delineamento experimental de blocos ao acaso (quatro velocidades do fluxo de ar: 0, 9, 11 e 29 km h-1), mais testemunha, totalizando cinco tratamentos e quatro repetições. No estádio de desenvolvimento vegetativo (V10) realizou uma aplicação do inseticida deltametrina na dosagem de 6,5 g do i.a. ha-1 para o controle de lagartas e no estádio de desenvolvimento reprodutivo (R6) aplicou o inseticida tiametoxam associado com lambda-cialotrina na dosagem de 25,38 + 19,08 g do i.a. ha-1 para o controle de percevejos. A aplicação foi feita com um pulverizador Advanced Vortex 2000, com pontas de pulverização jato cônico JA2, conferindo um volume de calda de 200 L ha-1. As avaliações antes e após a aplicação foram realizadas pelo método de batidas no pano. Avaliaram-se os danos causados por percevejos, considerando-se a porcentagem de danos às sementes, ao poder germinativo e à produtividade. No geral, o número médio de lagartas e percevejos foram significativamente menores nas parcelas tratadas em relação ao obtido na testemunha. Não houve diferença de produtividade entre os tratamentos. A porcentagem de emergência e sementes picadas por percevejos foram significativamente menores nos tratamentos que receberam o controle em comparação à testemunha.

Controle químico de plantas daninhas aquáticas em condições controladas - caixa d'água

Durante o ano de 1998 foram conduzidos quatro experimentos em Botucatu, Estado de São Paulo, Brasil, em condições de caixas d'água, com o objetivo de estudar o efeito de alguns herbicidas sobre Eicchornia crassipes, Pistia stratiotes, Thypha subulata e Salvinia molesta. Os herbicidas e doses utilizadas foram: imazapyr a 125, 250, 500, 1.000, 1.500 e 2.000 g e.a./ha; 2,4 D a 1.200 g e.a./ha; glyphosate a 3.360 g e.a./ha. Houve, ainda, uma testemunha sem aplicação de herbicidas. Os experimentos foram instalados no delineamento experimental em blocos ao acaso, com quatro repetições. As parcelas experimentais foram constituídas pelas caixas d'água com dimensões de 60x60x60 cm e colocadas a pleno sol no campo. Utilizou-se 3, 12, 25 e 60 plantas/caixa de T. subulata, P. stratiotes, E. crassipes e S. molesta, respectivamente. Os herbicidas foram aplicados com pulverizador costal a pressão constante de CO2 de 1,75 Bar, munido de barra com bicos Teejet 110.02 VS e com um consumo de calda de 200 l/ha. Foram efetuadas avaliações visuais de controle de sete em sete dias por 35 a 49 dias, dependendo da espécie. Todos os herbicidas testados foram eficientes no controle de E. crassipes e o imazapyr foi o único herbicida a promover morte total das plantas, independente da dose utilizada. Os herbicidas 2,4 D e glyphosate não foram eficientes no controle de P. stratiotes. O herbicida imazapyr foi eficiente no controle de P. stratiotes, exceto na dose de 125 g e.a./ha. Todos os herbicidas foram eficientes no controle de T. subulata, exceção ao imazapyr na dose de125 g e.a./ha. Houve rebrota de T. subulata nas parcelas aplicadas com 2,4 D. Nenhum tratamento químico foi eficiente no controle de S. molesta.