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

Evidências de validação de um protocolo para assistência às pessoas com úlceras venosas em serviços de alta complexidade

Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs . After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa ≥ 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity

Estrutura ANFIS modificada para identificação e controle de plantas com ampla faixa de operação e não linearidade acentuada

In this work a modification on ANFIS (Adaptive Network Based Fuzzy Inference System) structure is proposed to find a systematic method for nonlinear plants, with large operational range, identification and control, using linear local systems: models and controllers. This method is based on multiple model approach. This way, linear local models are obtained and then those models are combined by the proposed neurofuzzy structure. A metric that allows a satisfactory combination of those models is obtained after the structure training. It results on plant s global identification. A controller is projected for each local model. The global control is obtained by mixing local controllers signals. This is done by the modified ANFIS. The modification on ANFIS architecture allows the two neurofuzzy structures knowledge sharing. So the same metric obtained to combine models can be used to combine controllers. Two cases study are used to validate the new ANFIS structure. The knowledge sharing is evaluated in the second case study. It shows that just one modified ANFIS structure is necessary to combine linear models to identify, a nonlinear plant, and combine linear controllers to control this plant. The proposed method allows the usage of any identification and control techniques for local models and local controllers obtaining. It also reduces the complexity of ANFIS usage for identification and control. This work has prioritized simpler techniques for the identification and control systems to simplify the use of the method

Antena de microfita com substrato metamaterial

This paper presents a theoretical and numerical analysis of the parameters of a rectangular microstrip antenna with metamaterial substrate. The metamaterial (MTM) theory was applied along with Transverse Transmission Line (LTT) method to characterize substrate quantities and obtain the general equations of the electromagnetic fields. A study on metamaterial theory was conducted to obtain the constructive parameters, which were characterized through permittivity and permeability tensors to arrive at a set of electromagnetic equations. Electromagnetic principes are used to obtained parameters such as complex resonance frequency, bandwidth and radiation pattern were then obtained. Different metamaterial and antenna configurations were simulated to miniaturize them physically and increase their bandwidth, the results of which are shown through graphics. The theoretical computational analysis of this work proved to be accurate when compared to other studies, and may be used for other metamaterial devices. Conclusions and suggestions for future work are also proposed

Correspondência estéreo usando imagens em multiresolução com profundidade variável

We propose a multi-resolution, coarse-to-fine approach for stereo matching, where the first matching happens at a different depth for each pixel. The proposed technique has the potential of attenuating several problems faced by the constant depth algorithm, making it possible to reduce the number of errors or the number of comparations needed to get equivalent results. Several experiments were performed to demonstrate the method efficiency, including comparison with the traditional plain correlation technique, where the multi-resolution matching with variable depth, proposed here, generated better results with a smaller processing time

SAMVC sistema de autoria de museus virtuais colaborativos

The use of graphical objects three-dimensional (3D) multimedia applications is gaining more space in the media. Networks with high transmission rates, computers with large processing and graphics boost and popularize such three-dimensional applications. The areas of 3D applications ranging from military applications, entertainment applications geared up for education. Within the applications related to education, we highlight the applications that create virtual copies of cultural spaces such as museums. Through this copy, you can virtually visit a museum, see other users, communicate, exchange information on works, etc. Thereby allowing the visit museums physically distant remote users. A major problem of such virtual environments is its update. By dealing with various media (text, images, sounds, and 3D models), its subsequent handling and update on a virtual environment requires staff with specialized knowledge. Speaking of museums, they hardly have people on your team with this profile. Inside the GT-MV (Grupo de Trabalho de Museus Virtuais), funded by RNP (Rede Nacional de Ensino e Pesquisa) propose a portal for registration, amendment and seen collaborative virtual museums of Brazil. The update, be it related to work or physical space, a system with a national scale like this, would be impossible if done only by the project team. Within this scenario, we propose the modeling and implementation of a tool that allows editing of virtual spaces in an easy and intuitive as compared with available tools. Within the context of GT-MV, we apply the SAMVC (Sistema de Autoria de Museus Virtuais Colaborativos) to museums where curators build the museum from a 3D floor plan (2D). The system, from these twodimensional information, recreates the equivalent in three dimensions. With this, through little or no training, team members from each museum may be responsible for updating the system

Estimativa de safra para a cultura do milho através do filme infravermelho colorido

O sistema tradicional para estimativas de safra utiliza-se de relatórios técnicos de fontes diversas. A coleta de informações, se inicia antes da época do plantio e as estimativas são vendo ajustadas de acordo com o desenvolvimento das culturas. O trabalho em questão, pretende mostrar as possibilidades do filme infravermelho colorido na estimativa de safra para a cultura do milho. As informações quantitativas foram obtidas através da densitometria de transmissão. Os trabalhos foram conduzidos na Fazenda Experimental São Manuel da Faculdade de Ciências Agronômicas - Campus de Botucatu - UNESP. Os seis tratamentos consistiram em doses diferenciais de adubo, prevendo prováveis quedas em produção. A cultura foi fotografada com filme colorido (Kodak Ektachrome 64 ASA) e infravermelho colorido (Kodak Ektachrome Infrared Film) e a densidade ótica medida em um microdensitômetro de transmissão marca Weston, modelo 877 e abertura de 0,8 mm. Para avaliar a interação entre Produção e Densidade Ótica, utilizou-se das análises de correlação e regressão linear. A análise dos resultados permitiram as seguintes conclusões principais: a) Desde que se faça as necessárias calibrações, o filme infravermelho pode ser utilizado na estimativa de safra para a cultura do milho; b) A utilização do densitômetro de transmissão, para a interpretação quantitativa dos resultados, revelou-se importante sugerindo a aplicação do método em outros tipos de culturas.

Superando os riscos da segurança baseada em perímetro - Uma abordagem com identificação federada através de certificados digitais A3/ICP-Brasil e SAML

The traditional perimeter-based approach for computer network security (the castle and the moat model) hinders the progress of enterprise systems and promotes, both in administrators and users, the delusion that systems are protected. To deal with the new range of threats, a new data-safety oriented paradigm, called de-perimeterisation , began to be studied in the last decade. One of the requirements for the implementation of the de-perimeterised model of security is the definition of a safe and effective mechanism for federated identity. This work seeks to fill this gap by presenting the specification, modelling and implementation of a mechanism for federated identity, based on the combination of SAML and X.509 digital certificates stored in smart-cards, following the A3 standard of ICP-Brasil (Brazilian official certificate authority and PKI)

Desenvolvimento e avaliação de padrão de torque para calibração de torquímetros em três faixas de medição

The continuous development of instruments and equipment used as tools or torque measurement in the industry is demanding more accurate techniques in the use of this kind instrumentation, including development of metrological characteristics in torque measurement. The same happens with the needs in calibration services. There is a diversity of methods of hand torque tools in the market with different measuring range but without complaining with technical standards in terms of requirements of quality and reliability. However, actually there is no choice of a torque measuring standard that fulfils, with low cost, the needs for the calibration of hand torque tools in a large number of ranges. The objective of this thesis is to show the development and evaluation of a torque measuring standard device with a conception to allow the calibration of hand torque tools with three levels of torque with an single instrument, promoting reduction of costs and time in the calibration, also offering reliability for the evaluation of torque measuring instrument. To attend the demand in the calibration of hand torque tools it is necessary that the calibration laboratories have a big collection of torque measuring standards, to fulfills the needs of the costumer, what is very costly. The development of this type of torque measuring standard revealed a viable technique and economically making possible the calibration of hand torque tools in different nominal ranges through a single measurement system versatile, efficient and of easy operation

Influência da intensidade de aeração na formação do floco de lodo ativado e na eficiência de remoção de matéria orgânica

In wastewater treatment, activated sludge systems have been a technology widely applied as secondary treatment. During this step, which has a strong biological aspect, it is necessary to introduce oxygen supply for the maintenance of metabolic activity of the bacteria through the aerators. Aeration devices are responsible for most of the energy consumption in this stage. In this background, the influence of three aeration intensities (atmospheric air flow 3.5, 7.0 and 10.5 L.min-1) and the concentration of dissolved oxygen (DO) on the dimension of activated sludge flocs as well as on the efficiency of organic matter removal were assessed using a traditional activated sludge system which was fed with synthetic domestic wastewater. Samples were taken weekly from the three units that make up the system feed, aeration and storage tank in order to verify the Chemical Oxygen Demand (COD). It was established the process efficiency through a comparison between the initial and final COD. Besides the parameters already mentioned, this monitoring work on activated sludge batch system was also observed by Mixed Liquor Suspend Solids (MLSS), Volatile Suspend Solids (VSS), pH and temperature measures. The results have showed a maximum removal efficiency around 75% in the first aeration sequence and approximately 85% for the second and third one. For the first aeration, the DO concentration remained higher than 3.0 mg.L-1 and a diameter range from 10 to 60 μm was observed. In the second e third sequence, the DO concentration remained higher than 4.0 mg.L-1 with a diameter range of 10 until 200 μm. Although the sequence 1 and 2 have presented similar performances for organic matter removal, the sequence 2 promoted a regular floc size distribution and with lower values of Sludge Volumetric Index (SVI) meaning a better flocculating ability. In addition, the results reaffirmed what the literature has reported: higher DO concentrations produce flocs with greater dimensions

Inhibition of peroxidase activity and scavenging of reactive oxygen species by astilbin isolated from Dimorphandra mollis (Fabaceae, Caesalpinioideae)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Synthesis and in vitro anti Mycobacterium tuberculosis activity of a series of phthalimide derivatives

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

Um estudo na teoria do movimento brownianno com viscosidade variável

In this work we investigate the stochastic behavior of a large class of systems with variable damping which are described by a time-dependent Lagrangian. Our stochastic approach is based on the Langevin treatment describing the motion of a classical Brownian particle of mass m. Two situations of physical interest are considered. In the first one, we discuss in detail an application of the standard Langevin treatment (white noise) for the variable damping system. In the second one, a more general viewpoint is adopted by assuming a given expression to the so-called collored noise. For both cases, the basic diffententiaql equations are analytically solved and al the quantities physically relevant are explicitly determined. The results depend on an arbitrary q parameter measuring how the behavior of the system departs from the standard brownian particle with constant viscosity. Several types of sthocastic behavior (superdiffusive and subdiffusive) are obteinded when the free pamameter varies continuosly. However, all the results of the conventional Langevin approach with constant damping are recovered in the limit q = 1

HOW FAR do WE GET USING MACHINE LEARNING BLACK-BOXES?

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

Administração repetida de baixas doses de reserpina: um possível modelo para o estudo de déficits cognitivos e motores associados à Doença de Parkinson

Parkinson's disease (PD) is one of the most common neurodegenerative brain disorders and is characterized primarily by a progressive degeneration of dopaminergic neurons nigroestriatais. The main symptoms of this disease are motor alterations (bradykinesia, rigidity, tremor at rest), which can be highly disabling in advanced stages of the condition. However, there are symptomatic manifestations other than motor impairment, such as changes in cognition, mood and sensory systems. Animal models that attempt to mimic clinical features of PD have been used to understand the behavioral and neural mechanisms underlying neurophysiological disturbance of this disease. However, most models promote an intense and immediate motor impairment, consistent with advanced stages of the disease, invalidating these studies for the evaluation of its progressive nature. The administration of reserpine (a monoamine depletor) in rodents has been considered an animal model for studying PD. Recently we found that reserpine (in doses lower than those usually employed to produce the motor symptoms) promotes a memory deficit in an aversive discrimination task, without changing the motor activity. It was suggested that the administration of this drug in low doses can be useful for the study of memory deficits found in PD. Corroborating this data, in another study, acute subcutaneous administration of reserpine, while preserving motor function, led to changes in emotional context-related (but not neutral) memory tasks. The goal of this research was to study the cognitive and motor deficits in rats repeatedly treated with low doses of reserpine, as a possible model that simulates the progressive nature of the PD. For this purpose, 5-month-old male Wistar rats were submitted to a repeated treatment with vehicle or different doses of reserpine on alternate days. Cognitive and motor parameters and possible changes in neuronal function were evaluated during treatment. The main findings were: repeated administration of 0.1 mg / kg of reserpine in rats is able to induce the gradual appearance of motor signs compatible with progressive features found in patients with PD; an increase in striatal levels of oxidative stress and changes in the concentrations of glutamate in the striatum were observed five days after the end of treatment; in animals repeatedly-treated with 0. 1 mg/kg, cognitive deficits were observed only after the onset of motor symptoms, but not prior to the onset of these symptoms; 0.2 mg / kg reserpine repeated treatment has jeopardized the cognitive assessment due to the presence of severe motor deficits. Thus, we suggest that the protocol of treatment with reserpine used in this work is a viable alternative for studies of the progressive appearance of parkinsonian signs in rats, especially concerning motor symptoms. As for the cognitive symptoms, we suggest that more studies are needed, possibly using other behavioral models, and / or changing the treatment regimen