Trajetória do hospital dia Dr. Elger nunes: um recorte histórico da psiquiatria e saúde mental no Rio Grande do Norte

In Brazil, the mental health network proposed by the Psychiatric Reform inserts the intermediate and replacement services in the pursuit of alignment or resocialization of patients with mental and behavioral disorder in the community. Was adopted, among other services, the Center for Psychosocial Care, Home Therapy, Sheltered Home, Day Hospital and psychiatric beds in general hospital. In this context, the State of Rio Grande do Norte implanted the Day Hospital Dr. Elger Nunes (HDEN) in Natal / RN in 1996, linked to State Department of Public Health. At HDEN happened a multi and interdisciplinary therapeutic work, besides being the scene of disciplinary practices, and extension projects for graduate courses in Higher Education Institutions in the city. However, with the process of decentralization of local services, the hospital was terminated by an administrative state act in 2006, leaving damage to the activities provided to users, disciplinary practices and extension activities. From this breakdown, the objective was to narrate the trajectory of HDEN through a multidisciplinary team of professionals and teachers who used it as a field of disciplinary practices. It is characterized as a documental and qualitative, backed in the technique of thematic oral history, following the phases: authorization of the interviewee, interview recording, transcription, textualization and transcreation of the material obtained. We used documents, ordinances, general reports of activities, among others, plus interviews to fifteen employees who used this service, being thirteen part of the multidisciplinary team of professionals and two graduation professors of health care area, nursing and medicine. The stories collected were organized according to the technique chosen, respecting its steps. In preparing the body subjected to ALCESTE computer program, priority was given to the vital tone for the formation of categories and classes elected by the program, structured in three thematic areas. In the first axis, called Trajectory of HDEN, were recalled the beginning of its activities, the steps of that time, their activities, and its actors - users, families, professionals, and teaching practices. The second axis has dealt with the process of extinction of HDEN, rescuing the feelings of employees, the main reasons given at the time and immediate postextinction scenario. And the third axis revealed in an articulated form the situation of mental health in Natal / RN, listing to the challenges and prospects for the psychosocial care, starting from the trajectory of HDEN with emphasis on activities. Moreover, the trajectory of HDEN provides recognition of the historical basis outlined in the constitution of the network of substitute services present in the current scenario of psychosocial care in the city of Natal and in RN.

Qualidade da assistência e o conhecimento sobre o direito à saúde das pessoas com úlcera venosa crônica

The study aimed to identify the quality of care and knowledge of health rights of people with chronic venous ulcers (VU) in Brasilian National Health Care System (SUS). It is a cross-sectional study, with quantitative approach, performed at the University Hospital Onofre Lopes (HUOL). The study was approved by the Ethics Committee of HUOL (CAAE nº 0148.0.051.000-10). The sample by accessibility was composed for 30 people with VU treated at the outpatient surgical clinic of HUOL. For data collection we used a structured questionnaire composed of two parts: sociodemographic characteristics and of health, of care and the clinical course of VU; and knowledge of people with VU about the rights of health. The results were processed using SPSS 15.0 and analyzed by descriptive statistics. Given the characterizations sociodemographic and health presented, we identified a clientele of users with VU predominantly female (76,7%), aged from 60 years (66,7%), married/ stable union (60,0%), low education level (83,3%), family income lower than a minimum wage (73,3%), unemployeds and with chronic diseases (53,3%), sleep greater than or equal to 6 hours (76,7%) and were not alcoholics or smokers (93,3%). In relation to clinical conditions, were shown the presence of one or more relapses of VU (73,3%), predominance of granulation tissue/epithelialization in the bed of VU (60,0%), exudate serosanguineous (43,3%), in quantity medium/large (60,0%), with no predominance of presence or absence of odor (50,0%), all patients with tissue loss in grade III / IV, no signs of infection (73,3%) and presence of intense pain (50,0%). In the last 30 days the main venue of achievement of dressing was the HUOL (100,0%), the main compression therapy used was the Unna boot (60,0%) and on inability to perform the dressing on the unit were the own patients who made the exchange at home (40,0%). The majority of respondents listed out more positive factors associated with quality of care (56,7%) were satisfied with the care of SUS (76,7%), claimed to have knowledge about their rights (70,0%), but at the same time did not know the meaning of the acronym SUS (90,0%) and classified their level of information as inappropriate (70,0%). We realize that people with VU identified as good the quality of care and demonstrated inadequate knowledge about their rights to health in the SUS, but showed interest in acquiring more information. The basic rights to entry in the SUS are constitutionally guaranteed and need to be disseminated in order to make them known to the population, so it can be implemented and ensured a greater resolution assistance in treating this type of injury

Úlceras de pressão: um estudo com pacientes de unidade de terapia intensiva

To characterize patients according to gender, age category, internment time, diagnostical hypothesis and location of the pressure ulcer; to identify the susceptibility conditions, intrinsical and extrinsical factors present on ICU patients and to verify on the existence of association between the susceptibility conditions and the intrinsecal and extrinsecal factors on the occurrence of PU. Methods: It is a descriptive study, of longitudinal design of the panel type, with quantitative approach, performed on two ICU s of a private hospital located in Natal/RN, with 40 patients interned at these units. The data collection was performed on all three shifts through a structured observation and physical exam of the patients' skin form seeking to identify the presence of PU. Results: The greatest occurence of PU was on individuals of the male gender (70%) when compared to the female gender (30%), that difference being statistically significant (p=0,0267), with the male gender presenting 4,3 times greater chance of developing PU than the female; the predominant age category was from 60 years of age on (85%), 60,0% presented 1 to 2 PU s after 7 (seven) days of permanence in the ICU s, the predominant diagnostical hypothesis on the patients with PU were the respiratory diseases (42,3%) and the most frequent locations of PU were the sacral region (40,0%) and heels (36,0%). 25 PU s of stage I were diagnosed on 50,0% of the followed patients, with general incidence of 50,0% on both ICUs. from the 88 variables researched, 75 were identified on the patients from the study, being the predominant conditions (anemia, hypotension, leukocytosis, other diseases hypertension blood pressure, cardiac insuffience, pneumonia - and ansiolythic), the intrinsecal factors (diminished muscular strenght and/or mass, discrete edema, totally compromised mobile coordination and total inability for movement on the bed) and the extrinsecal factors (inadequate mattress type, permanence on a single position for >2 hours, shearing/friction force, bed clothes with folds that leave marks on the body, pressure force) predominated on patients with PU. The male gender variables (p=0,0267,OR=4,3), sedation (p=0,0006,OR=4,1), psychomotive agitation (p=0,0375,OR=5,8) and leukocytosis (p=0,0285,OR=5,0) presented a significant statistical diference when analyzed independently. We verified an association of 17,3%, statistically significant (p=0,0384), between the susceptibility conditions (anemia, leukocytosis and hypotension), the intrinsecal factors (age equal or above 60 years, diminished/absent pain sensibility and smooth, fine or delicate skin) and the extrinsecal factors (inadequate mattress, pressure forces, shearing/friction force, permanence on a single position for more than 2 hours, elevation between 30 to 45 degrees and inadequate bed clothes' conditions), with a chance ratio of 4,6 times the risk of occurrence of PU on the patients that presented the referred association. Conclusion: The incidence of PU detected on the ICU-interned patients was high and we made evident the existence of association between the susceptibility conditions, the intrinsecal and extrinsecal factors on the occurrence of PU s on the ICUinterned patients, and thus we accept the alternative hypothesis proposed on the study

Efeito da adição de agentes tróficos na dieta de leitões desmamados sobre a estrutura e ultraestrutura do intestino delgado e sobre o desempenho

Foram estudados os efeitos da glutamina, dos ácidos graxos poli-insaturados e da parede celular de levedura (PCL) sobre a estrutura e ultraestrutura do intestino delgado e o desempenho de leitões. Foram utilizados 45 leitões, desmamados aos 21 dias de idade, para testar os seguintes tratamentos: T1 - dieta basal; T2 - dieta basal + 1% de glutamina; T3 - dieta basal + 0,2% de PCL; T4 - dieta basal + 5% de óleo de peixe. Nos dias sete e 14 pós-desmame, foram abatidos cinco leitões de cada tratamento. Os aditivos testados não alteraram a altura e a densidade dos vilos nem a profundidade das criptas do intestino delgado. Foi observado efeito de idade, mostrando redução na altura e na densidade dos vilos e na profundidade das criptas após o desmame. No duodeno e jejuno, foram observados maiores valores de relação vilo:cripta, que aumentaram com a idade pós-desmame. Ocorreram redução da altura dos microvilos do duodeno aos sete dias e aumento da largura dos microvilos do jejuno aos 14 dias pós-desmame. A área de superfície apical dos enterócitos não foi alterada pelos fatores estudados. Os aditivos estudados não foram eficientes em prevenir a atrofia da mucosa intestinal do jejuno, ao não interferir na sua ultraestrutura. Os aditivos incluídos na dieta não influenciaram o desempenho dos leitões no pós-desmame.

Análise dos custos assistenciais de uma operadora de plano de saúde no Brasil

The relevance of rising healthcare costs is a main topic in complementary health companies in Brazil. In 2011, these expenses consumed more than 80% of the monthly health insurance in Brazil. Considering the administrative costs, it is observed that the companies operating in this market work, on average, at the threshold between profit and loss. This paper presents results after an investigation of the welfare costs of a health plan company in Brazil. It was based on the KDD process and explorative Data Mining. A diversity of results is presented, such as data summarization, providing compact descriptions of the data, revealing common features and intrinsic observations. Among the key findings was observed that a small portion of the population is responsible for the most demanding of resources devoted to health care

Classificação de distúrbios na rede elétrica usando redes neurais e wavelets

Post dispatch analysis of signals obtained from digital disturbances registers provide important information to identify and classify disturbances in systems, looking for a more efficient management of the supply. In order to enhance the task of identifying and classifying the disturbances - providing an automatic assessment - techniques of digital signal processing can be helpful. The Wavelet Transform has become a very efficient tool for the analysis of voltage or current signals, obtained immediately after disturbance s occurrences in the network. This work presents a methodology based on the Discrete Wavelet Transform to implement this process. It uses a comparison between distribution curves of signals energy, with and without disturbance. This is done for different resolution levels of its decomposition in order to obtain descriptors that permit its classification, using artificial neural networks

Fontes e níveis de proteína em rações iniciais para leitões desmamados aos 21 dias de idade

Foi conduzido um experimento com o objetivo de avaliar fontes e níveis de proteína em rações iniciais para leitões desmamados aos 21 dias de idade. Utilizou-se um delineamento inteiramente casualizado em esquema fatorial 2 x 2 x 2, onde foram estudados os fatores: tipos de dieta (soro de leite em pó e farinha de peixe + lactose), níveis de proteína bruta (20,0% e 24,0%) e pesos dos leitões ao desmame (< 6,0 e > 6,0 kg), totalizando oito tratamentos com quatro repetições cada. O desempenho de leitões desmamados aos 21 dias de idade alimentados com rações contendo farinha de peixe + lactose foi superior ao dos leitões que consumiram apenas o soro de leite em pó. O nível de 24% de proteína bruta nas rações foi mais eficiente, sobretudo com a combinação farinha de peixe + lactose. Concluiu-se que os tipos de dietas estudados não exerceram efeito sobre os parâmetros histológicos e que a altura das vilosidades é uma função direta do peso do leitão.

Fontes de lactose, níveis de lisina dietéticos e peso dos leitões ao desmame

Desenvolveu-se um experimento com o objetivo de avaliar o uso de fontes de lactose (soro de leite em pó e lactose) e níveis de lisina em rações (1,20 e 1,50%), além do peso ao desmame (<6,0 e >6,0 kg), sobre o desempenho e a morfologia intestinal de 384 leitões desmamados com diferentes pesos e idade de 21 dias. Os leitões foram distribuídos em delineamento inteiramente casualizado em esquema fatorial 2 x 2 x 2, totalizando oito tratamentos em quatro repetições cada. Três leitões de cada tratamento foram abatidos aos 42 dias de idade, quando foram coletadas amostras do duodeno para estudo da morfologia intestinal. Foram avaliadas as características de desempenho ganho de peso, consumo de ração e conversão alimentar. Altura das vilosidades, profundidade de criptas duodenais e a relação altura de vilosidades/profundidade de criptas, bem como a relação peso do pâncreas/peso da carcaça, foram as características morfológicas avaliadas. O uso de lactose em rações à base de milho e farelo de soja proporcionou melhor desempenho dos leitões quando combinado a um nível de 1,5% de lisina. Concluiu-se ainda que os tipos de dietas estudados não exerceram efeito sobre a morfologia do duodeno e a relação peso do pâncreas/peso corporal e que a altura das vilosidades é uma função direta do peso do leitão.

Revisitando o problema de visibilidade para visualização tridimensional

We revisit the problem of visibility, which is to determine a set of primitives potentially visible in a set of geometry data represented by a data structure, such as a mesh of polygons or triangles, we propose a solution for speeding up the three-dimensional visualization processing in applications. We introduce a lean structure , in the sense of data abstraction and reduction, which can be used for online and interactive applications. The visibility problem is especially important in 3D visualization of scenes represented by large volumes of data, when it is not worthwhile keeping all polygons of the scene in memory. This implies a greater time spent in the rendering, or is even impossible to keep them all in huge volumes of data. In these cases, given a position and a direction of view, the main objective is to determine and load a minimum ammount of primitives (polygons) in the scene, to accelerate the rendering step. For this purpose, our algorithm performs cutting primitives (culling) using a hybrid paradigm based on three known techniques. The scene is divided into a cell grid, for each cell we associate the primitives that belong to them, and finally determined the set of primitives potentially visible. The novelty is the use of triangulation Ja 1 to create the subdivision grid. We chose this structure because of its relevant characteristics of adaptivity and algebrism (ease of calculations). The results show a substantial improvement over traditional methods when applied separately. The method introduced in this work can be used in devices with low or no dedicated processing power CPU, and also can be used to view data via the Internet, such as virtual museums applications

Localização de faltas em linhas de transmissão de múltiplos terminais a partir de registros oscilográficos sincronizados via transformada wavelet

The electric energy is essential to the development of modern society and its increasing demand in recent years, effect from population and economic growth, becomes the companies more interested in the quality and continuity of supply, factors regulated by ANEEL (Agência Nacional de Energia Elétrica). These factors must be attended when a permanent fault occurs in the system, where the defect location that caused the power interruption should be identified quickly, which is not a simple assignment because the current systems complexity. An example of this occurs in multiple terminals transmission lines, which interconnect existing circuits to feed the demand. These transmission lines have been adopted as a feasible solution to suply loads of magnitudes that do not justify economically the construction of new substations. This paper presents a fault location algorithm for multiple terminals transmission lines - two and three terminals. The location method is based on the use of voltage and current fundamental phasors, as well as the representation of the line through its series impedance. The wavelet transform is an effective mathematical tool in signals analysis with discontinuities and, therefore, is used to synchronize voltage and current data. The Fourier transform is another tool used in this work for extract voltage and current fundamental phasors. Tests to validate the location algorithm applicability used data from faulty signals simulated in ATP (Alternative Transients Program) as well as real data obtained from oscillographic recorders installed on CHESF s lines.

Avaliação do desempenho de um sistema de secagem projetado para os pequenos produtores rurais

O presente trabalho foi realizado na Fazenda Experimental Lageado, da Universidade Estadual Paulista em Botucatu, SP, e objetivou-se analisar o desempenho de um silo secador alambrado com ar à temperatura ambiente, de projeto simples, com possibilidades de atender às necessidades de pequenos cafeicultores. Para a avaliação do desempenho da secagem, foram realizadas medições do teor de água do café, temperaturas da massa de grãos, do ar de exaustão, do ar de secagem e do ar ambiente, umidade relativa ambiente, velocidade do ar de secagem e o tempo total de secagem. Para avaliar a qualidade do produto seco, foi feito o teste de bebida. Paralelamente, realizou-se a secagem em terreiro para se formar a testemunha. Os resultados observados permitiram concluir que o silo secador alambrado apresentou uma boa eficiência energética, proporcionando um produto seco com o mesmo padrão de qualidade do café seco em terreiro.

Enxertia em figueira 'Roxo de Valinhos' por borbulhia e garfagem

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Obtenção e caracterização de farinha de frutas e vegetais através do uso de um sistema de secagem solar de baixo custo

In this work a solar drying system for food dehydration was developed. It is a direct exposition drying apparatus that uses solar energy to heat the circulating air. First, the construction and assembly of this apparatus was described, in which was used scrap wraps of used tires for thermal insulation, allowing the reuse of solid waste, being an ecologically correct recycling option. After, the results obtained in experiments for cashew drying showed the thermal and economical feasibility of the proposed solar drying system, focusing on the process of flour production and in its chemical characterization. It was also demonstrated the social importance of this production for socially excluded people, since the value added to this fruit, in relation to its in nature form, may represent an option for job and income generation. The main features of the proposed dryer are its low cost and its easy fabrication and assembly process. After cashew drying, the obtained product was processed into flour by using a knife mill and it was added crushed rapadura to reduce the rancid taste caused by tannin

Estudo da viabilidade de uso de secadores solares fabricados com sucatas de luminárias

It presents a direct exposure to solar dryer for drying of food, built from a scrap of luminaire. The dryer works under direct exposure to natural circulation. Will be presented their methods of construction and assembly of that dryer that allows the reuse of materials, constituting a environmentally correct recycling dryer main features proposed are its low cost and simple manufacturing processes and assembly. Test results will be presented for the drying of foods that prove the feasibility and cost of thermal solar drying alternative system proposed. It is worth emphasizing the social importance that such application is for the most excluded since the value-added fruits, vegetables, legumes and other foods in relation to fresh may represent an option of income generation. It will also study the transformation of some of dry food meal and demonstrated that the drying times for the foods tested are competitive and sometimes pointed in the solar literature

Viabilidade de utilização de um compósito de matriz cerâmica com cargas recicláveis na fabricação de equipamentos solares

Composite materials can be defined as materials formed from two or more constituents with different compositions, structures and properties, which are separated by an interface. The main objective in producing composites is to combine different materials to produce a single device with superior properties to the component unit. The present study used a composite consisting of plaster, cement, EPS, tire, PET and water to build prototype solar attempt to reduce the manufacturing cost of such equipment. It was built two box type solar cookers, a cooler to be cooled by solar energy, a solar dryer and a solar cooker concentration. For these prototypes were discussed the processes of construction and assembly, determination of thermal and mechanical properties, and raising the performance of such solar systems. Were also determined the proportions of the constituents of the composite materials according to specific performance of each prototype designed. This compound proved to be feasible for the manufacture of such equipment, low cost and easy manufacturing and assembly processes