Determinação dos intervalos de referência para lipídios, lipoproteínas e apolipoproteínas no estado do Rio Grande do Norte

The lipid profile is a group of lab tests that include triglycerides, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). However, serum non-HDL-C, Apo A-I and Apo B levels, as well as the lipids ratios (TC/HDL-C, LDL-C/HDL-C and Apo B/Apo A-I), have been described as better predictors of cardiovascular diseases. Reference intervals are tools often used to help the evaluation of the people s health state. These days, Brazilian studies still use the reference intervals of lipids and lipoproteins from other countries, ignoring differences between the populations. Therefore, this study aimed to establish reference intervals for lipids, lipoproteins and apolipoproteins in adults of Rio Grande do Norte/Brazil. Healthy individuals (96 men and 283 women) between 18 and 59years old formed the reference sample group. The samples were collected after fasting 12 to 14 hours. Information on lifestyle and dietary habits of the participants were obtained through questionnaire. The serum glucose level and renal and liver activity were evaluated by laboratory testing. The results of lipid profile were analyzed according to sex, age and mesoregion of Rio Grande do Norte, with significance level of 5% (p < 0,05). The lower and upper reference limits were identified by the 2.5 percentile and 97.5 percentile, respectively, and assurance intervals of 90% was calculated for each of these limits. Among the determinants of lipid profile analyzed, only a few significant differences were observed according to sex, but in terms of age, the groups of smaller and older ages were most likely different. When evaluated by region, the means of West region shown the most significant variations. Not many studies were useful to compare the reference intervals determined in this study. Thus, it becomes necessary to carry out similar studies in other regions of Brazil and of the world given the clinical importance of reference intervals

Implementação da política de assistência social em Mossoró/RN : uma avaliação a partir dos centros de referência da assistência social

The current National Policy for Social Assistance (PNAS) is the instrument that regulates the organization and procedures of social-welfare actions. Developed and approved in 2004 since the Unified Social Assistance System (ITS) was crated in 2003, it reaffirms the democratic principles of the Social Assistance Organic Law (LOAS) focusing on the universalization of social rights and equality of rights when accessing the social-welfare system. In the SUAS point of view, the PNAS highlights the information, monitoring and evaluation fields for being the best way to assure the regulation, organization and control by the Federal Government paying attention to the principles of decentralization and participation. This political-institutional rearrangement occurs through the pact among all the three federal entities. The pact deals with the implementation of the task. It says that it has to be shared between the federal autonomous entities, established by dividing responsibilities. To the cities, considered as the smallest territorial unit of the federation and closer to the population, was given the primary responsibility, which is to feed and maintain the database of SUAS NETWORK and identify families living in situations of social vulnerability. In addition to these responsibilities, the cities that have full autonomy in the management of their actions, have the responsibility to organize the basic social protection and the special social protection, that using the Center of Social Assistance Reference (CRAS) and the Center of Specialized Social Assistance Reference (CREAS), are responsible for the provision of programs, projects and services that strengthen the family and community; that promote people who are able to enjoy the benefits of the Continuing benefit of Provisions (BPC) and transfer of incomes; that hold the infringed rights on its territory; that maximize the protective role of families and strengthen its users organization. In Mossoró/RN, city classified as autonomous in the social assistance management, has five units of CRAS that, for being public utilities, are considered the main units of basic social protection, since they are responsible for the connection between the other institutions that compose the network of local social protection. Also known as Family House, the CRAS, among other programs and services, offers the Integral Attention to Families Program (PAIF), Juvenile ProJovem Program, socio-educational coexistence services programs, as well as sending people to other public policies and social-welfare services network, provides information, among others. In this large field, social workers are highlighted as keys to implement the policy of social assistance within the city, followed by psychologists and educators. They should be effective public employees, as a solution to ensure that the provision of the services are to be continued, provided to the population living around the units. However, what we can find here is inattention to the standard rules of social assistance, which not only undermines the quality of programs and services, but also the consolidation of policy on welfare as public policy of social rights

Atenção ao usuário em um centro de referência HIV/Aids: perspectiva de profissionais e usuários

We study the health care focused on care in an intercessor and dialogical relationship with the User, which involves the construction of therapeutic projects essential to the quality of the treatment of the user in health services, and it is necessary individual and collective actions. It is intended to acknowledge and analyze the perception of social subjects, users and professionals on the treatment given to a user of a Specialized Outpatient Service (Serviço Ambulatorial Especializado SAE) in STD/HIV/AIDS state reference in Natal, RN. The study is structured in a transdisciplinary vision of science and knowledge, theoretical and methodological principles that give meaning to the expression of the institutional features of care and health care reconnecting them to the social context. As a research strategy we seek the expressions of 56 subjects of social research, which agreed to participate in the sample, from a symbolic map of the attention, coupled with the techniques of observation and semi-structured interview. For the analysis of the results, five categories of analysis were established: the meaning of the service, care perception, process of communication and interaction, treatment perception and organization and evaluation of the service. It is argued that the attention and care are developed in a technical health care assistance to the disease, focusing on attention based on treatment, on diagnostic and drug therapy of antiretroviral drugs, reflecting the traditional biomedical paradigm of attention to the disease. This is also the mode of organization of practical actions in daily SAE: the therapy proves to be fragmented in several specialties, vertical and feeds the same model, generating tension and overload for professionals; showing impersonal care focused on structured and informative technology, unrelated to an interactive dialogic. From the speech of the subjects, the SAE is understood as the place of confrontation with the disease, but also enables greater elaboration of the illness by meeting their peers. Living with HIV and AIDS is living with concern, apprehension and fear, but mainly with the stigma, prejudice and exclusion, which require that the disease is kept in secret. There is a movement of forces and power, expressed in the knowledge-power of those who dominate the technical and administrative capabilities, devices that concentrate the maintenance of the medicalization of care, rapid consultations and with little attention, making it difficult to interact with and listen to, combined with structural failures, organizational and inadequate management of the service. We conclude that there are dimensions that are not considered in the internal dynamics of the care service multiple forms, characterized by care conflicting models, marked by individual interventions related to the disease. The subject is not considered together with his speech as technical discourse is imposed and care production based on material technology is observed

Assistência a mulher com câncer de mama em um cenro de referência no Estado da Paraíba

The assistance to women who have breast cancer is studied in a Reference Center in Paraiba and also the way this assistance is performed in a School Hospital maintained by SUS (Single Health System) is questioned. Breast cancer demands institutional organization, provision of financial, material and human resources, requiring, from the health system, effective assistance with new technologies which make it possible for the population their access to specialized medical services although it not always is able to guarantee those services nor the rights which the legislation granted them, inhibiting a proper relationship between the health professional and the patient. The theme is discussed through a transdisciplinary knowledge view and has as its theoretical referential the contribution of classical and contemporary authors from the human and social sciences and, as an empirical research strategy, the structured interview. The objectives of the research were: identify how the assistance to women with breast cancer is carried on at a Reference Center on Oncology in Campina Grande, Paraiba, identifying their difficulties and their satisfaction with the received assistance; draw up a profile of the women with breast cancer who were assisted in this Reference Center; understand their gynecological and obstetric antecedents, life styles, age group and stage of the disease when the treatment started; check their knowledge about their rights and which benefits they had received. Most women ranged between 40 and 59 years old (63%), which corresponds to the risk range of developing breast cancer. As to their occupations, 38.3% were housewives and 30.1% retired, whose family income was among those who received between less than a minimum salary and one minimum salary (58.2%). This population was mainly constituted of married women (60.2%), whose most frequent schooling was an incomplete elementary school (27.6%) and complete elementary school (24.1%), which added up to 51.6%. It was observed that the majority of the women seemed to be satisfied with the assistance received, noting that a minimum care was enough to define this satisfaction, although it is perceived that the access to the health system does not ensure the ideal attention conditions they need; it was verified that the availability of the services and the assistance itself are seen (in the local culture) as a favor and not as a right. It is also observed that only 30% of the women mentioned that they knew about their rights and the most mentioned ones were the disease assistance (13%), the medicines (13%) and the treatment (12%), which represent the most important triad to face the disease and around which the oncologic assistance most focus on. It is concluded that the condition of the users´ minimum existential of a public health unit and the condition of belonging to a lower social stratum were variables that influenced the respondents´ satisfaction in relation to the assistance received but the importance of the Reference Center for the women with breast cancer´s assistance for the whole region cannot be denied as well as the need to broaden the way the policy of the oncologic assistance in Brazil in the local realm is seen

Narrativa autobiográfica como prática de formação e de atualização de si : os grupos referência e o grupo reflexivo na mediação da constituição identitária docente

The thesis: "autobiographical narrative as practical continuous training and updating of itself: the groups-reference and the reflexive group in the mediation of identity construction of teaching" begins in the founder matter: "What are the implications of groups-reference in the process of identity formation and the teaching role of teachers which is participating of the research? This object of study deals with the continuing education of teachers of Basic Education and the role of the reflective group as space-time of (re) construction of educational knowledge, for the recognition of yourself. The thesis defends that the autobiographical narrative, as a pedagogical tool and research, for the initial and continuous training, is presented as theoretical and methodological foundation necessary for identity formation of the teacher. The research is limited to the qualitative approach with a focus on the autobiographical narrative. The participants are six teachers, three teachers and three students-teachers. The corpus comprises six autobiographical narratives, six reports of successful experiences, two studies on the biographical work, and six individual testimonials about the impact in personal and professional life. The data analysis was to reference Dausien and Alheit (2006), Bruner (1997), Contreras (2002), Delory-Momberger (2007), Freire (2005), Giddens (2002), Josso (2004), new (1988, 2002), Passeggi (2001, 2002), Pineau (2004), Ricoeur (2004), Souza (2006), Tardif (2002) and Vygotsky (2005). The research revealed that the formation of identity as a teachers of the educators occurred in the reference group, involving the formal, non-formal and informal of the processes of knowledge , in a movement of alternation training that includes yourself, the other and the ambient. Also revealed that the pedagogical choices of the teachers studied aimed at minimizing educational gaps that were lived in both field personal and social; that the personal identity is configured as an identity narrative and the methodology of the biographical work, through the mimesis of continuing education, provided the passage from the group reflective to the group of reference

Construindo um modelo de referência ao despertar do interesse dos sujeitos em projetos educativos em ambiente on-line

This dissertation was written for the making of a model to be used as reference to the construction and diagnoses of educational projects in on-line environments. The model approaches a series of characteristics, technical and humans, which if considered can increase the potential of awake the interests to the active use of these projects for the students and build conditions to the development of an active posture by the students, fundamental factor to the educational advances. Focused in the students, not in the technology in use, we propose this model as a guide, reference to be used in a critical way in relation with every educational context. This research was made from the qualitative category, trough the method of study of case, using as reference to the analysis the use of the website guanabara.info - website outside of the school context - by it users, heard through the internet, by the use of semi-opened interview, in a data taken of the primary type. We follow as theoretical references Paulo Freire´s work, considering his vision of education and the building of knowledge as a process which occurs between man, and Celestín Freinet, in his pedagogy of humanized and critical insertion of the technologies in the school. At the end, we show the practical utilization of the model constructed using it for the diagnostics of an educational project in the on-line educational environmental moodle

Análise de qualidade da atenção à criança na estratégia saúde da família: o óbito infantil evitável como referência

Alma-Ata declaration bring the Primary Attention to the Health (PAH) as first level of health attention for individuals, family and community, which considers infant group as priority. Several initiatives that gave bases to integral attention to the children health formalized in the principles of Unique Health System. Family Health Strategy (FHS) comes to strengthen this attention, instituting new ways of work organization and professional practices that gave impact in their quality indicators. One of them is children mortality, showing decline in their values. Though, studies indicates persistence of avoidable infant deaths. In Natal RN, this reality is also perceptible leading to inquietudes, mainly at the space of services production, it means, which motivated the accomplishment of the present study intending to analyse the way that the organizational and structural processes as long as the professional practices in FHS interfered in the quality of children s health attention who died by avoidable death in the year of 2007 in municipal district of Natal-RN. It treats, therefore, to an exploratory and descriptive survey of cases study type, thar had as primary sources the oficial documents of MH, the family prontuary, pregnant card, child card and testimony obt ined from instrument of research elaborated based in investigation form of infant death by MH, applied to 10 mothers of children who had avoidable death. In analysis it was appealed silmultaneous triangulation of methods and sources, allowing a bigger aproximation from obtained informations. To elucidate the cases, the aspects studied were analyzed to the light of explicative model of Social Determinants of Health. Among individual and family aspects were highlighted the related to age, schooling, family habits and customs and mother s economic condition, besides of pregnancy age, newborn weight and associated diseases, which don t differ from literature about the theme. Reffering to the factors organizational and structural processes and professionals practice, highlihgted, the treatment given by the professionals, the territorialization and adscription of areas, the difficulty of having access to the services or sleepers and the reference and counterreference. But also, the ausence or few greet, the lack of communication, few assiduity and ponctuality by professionals in service, among others. In a general way mothers considers the attendance received in the hospital good and very good , opnions that in the Basic Attention weren t so favorable, in spite of many of predictible actions in this level have been performed in the studied cases. It is observed, therefore, that the social determinants of health has a strong influence in ocurrence of infant deaths, what implicates in a large actuation by Infant Mortality Committee from municipal district. This way, it becomes fundamental the reflection and evaluation about the effectiveness and execution by the processes of vigilance to health in FHUs; the rethink about the social determinants of health in a wide and articulate way to the services quality, to permanent education, to management in service, to the given attention and to the way how it is installed the popular participation and social control. To the professionals it is presented the great challenge to review their daily practice, their values, behaviors and commitment, which ones must be guided by logical of sharing, work in team, humanescence and alterity, not only by the accomplishment of a professional duty

Avaliação da dor oncológica: estudo comparativo com pacientes internados em um hospital de referência em Natal/RN

Quasi-experimental study, with prospective data, comparative with quantitative approach, performed in a reference hospital, aiming to identify the effectiveness of the Numerical Rating Scale (NRS) and McGill Pain Questionnaire, used simultaneously, to evaluate a group of patients with oncologic pain (Experimental Group); to identify the effectiveness of the Numerical Rating Scale (NRS) to evaluate a group of patients with oncologic pain (Control Group); to identify the resolution of pain according to prescribed medication, considering the result of the rating scales, and to compare it between the two groups of patients in the study. The population consisted of 100 patients, with both the experimental and control groups being composed of 50 people, with data collected from February to April 2010. The results show that in the experimental group, 32% of the patients were aged 60 to 69, 80% were female; 30% had a primary tumor in the breast, 58% had metastasis, and on 70% the disease was localized. In the first pain evaluation, 26% identified it as light; 46%, moderate; and 28%, severe; with an average of 5.50. In the second pain evaluation, 2% reported no pain; 70%, light; 26%, moderate. and 2%, severe, with an average of 3.30. On those with moderate pain, 60% used non-opioid medicine, 25% under severe pain were medicated with non-opioids and 41.67% with weak opioids. Regarding the Pain Management Index (PMI), 44.0% were rated as "-1". In the control group, 28% were aged 40 to 49, and 54% were male; 20% had primary tumor in the breast and genital-urinary system, consecutively; 56% presented metastasis; on 64% the disease was localized. In the first pain evaluation, 14% considered it light; 42%, moderate; and 44%, severe; with an average of 6.26. In the second pain evaluation, 18% did not signal pain; on 38% pain was light; 40%, moderate; and 4%, severe; with an average of 3.0. Regarding medicine therapy, 71.43% with moderate pain used non-opioids, 22.73% with severe pain used non-opioids and 27.27% weak opioids. Considering PMI, 42% were rated "-1"; and 42%, rated "0". We conclude that, despite the importance of pain as the 5th vital sign, it is still under-identified and under-treated by professionals. Nevertheless, studied oncologic patients had a tendency to report pain more easily when evaluated with the NRS instrument than with the combined use of NRS and MPQ. We believe, however, that the combination of these two instruments represents a more effective evaluation of pain, as it allows comprehension of its quantitative and qualitative aspects. We recommend, however, the replication of this study on a larger population, for a longer span of time, and consequently generating more evaluations, so this can confirm or deny the hypothesis that NRS and MPQ can, together, better evaluate pain on the oncologic patient

Utilização do tanque Classe A para a estimativa da evapotranspiração de referência dentro de casa de vegetação

O trabalho teve como objetivos estimar a evapotranspiração de referência (ETo) dentro e fora de casa de vegetação, pelo método do tanque Classe A, utilizando-se de dois valores de Kp e estabelecer correlações entre a ETo, dentro e fora da casa de vegetação, buscando evitar a instalação do tanque Classe A dentro da mesma. O experimento foi conduzido na Faculdade de Ciências Agrárias e Veterinárias, Câmpus de Jaboticabal - SP. Instalaram-se dois tanques Classe A, um dentro e outro fora da casa de vegetação. Para o tanque instalado dentro da casa de vegetação, utilizaram-se dois coeficientes de tanque: Kp = 0,7 e Kp = 1,0. Para o tanque instalado fora da casa de vegetação utilizou-se Kp = 0,85. Constatou-se que a ETo dentro da casa de vegetação foi menor que a estimada fora da mesma. Recomenda-se a instalação do tanque Classe A dentro da casa de vegetação para a estimativa da ETo, utilizando-se de Kp = 1,0.

Estabilidade e robustez de um controlador adaptativo indireto por um modelo de referência e estrutura variável

In this thesis, it is developed the robustness and stability analysis of a variable structure model reference adaptive controller considering the presence of disturbances and unmodeled dynamics. The controller is applied to uncertain, monovariable, linear time-invariant plants with relative degree one, and its development is based on the indirect adaptive control. In the direct approach, well known in the literature, the switching laws are designed for the controller parameters. In the indirect one, they are designed for the plant parameters and, thus, the selection of the relays upper bounds becomes more intuitive, whereas they are related to physical parameters, which present uncertainties that can be known easier, such as resistances, capacitances, inertia moments and friction coefficients. Two versions for the controller algorithm with the stability analysis are presented. The global asymptotic stability with respect to a compact set is guaranteed for both cases. Simulation results under adverse operation conditions in order to verify the theoretical results and to show the performance and robustness of the proposed controller are showed. Moreover, for practical purposes, some simplifications on the original algorithm are developed

Desacoplamento de um gerador síncrono através de um controle adaptativo por modelo de referência baseado em funções de Base radial

An alternative nonlinear technique for decoupling and control is presented. This technique is based on a RBF (Radial Basis Functions) neural network and it is applied to the synchronous generator model. The synchronous generator is a coupled system, in other words, a change at one input variable of the system, changes more than one output. The RBF network will perform the decoupling, separating the control of the following outputs variables: the load angle and flux linkage in the field winding. This technique does not require knowledge of the system parameters and, due the nature of radial basis functions, it shows itself stable to parametric uncertainties, disturbances and simpler when it is applied in control. The RBF decoupler is designed in this work for decouple a nonlinear MIMO system with two inputs and two outputs. The weights between hidden and output layer are modified online, using an adaptive law in real time. The adaptive law is developed by Lyapunov s Method. A decoupling adaptive controller uses the errors between system outputs and model outputs, and filtered outputs of the system to produce control signals. The RBF network forces each outputs of generator to behave like reference model. When the RBF approaches adequately control signals, the system decoupling is achieved. A mathematical proof and analysis are showed. Simulations are presented to show the performance and robustness of the RBF network

Referência ao discurso do outro: uma análise de problemas de relações de sentido entre discurso citado direto e indireto citante no gênero monográfico

In this study we investigate the reference to other s discourse done it through the resource of direct cited discourse at background section in monographic texts produced by university students at the last phase of final work in their graduate Letras course. This work is guided in cited/related discourse studies in Bakhtin (2004), Authier-Revuz (1990, 1998, 2004), Maingueneau (1996, 2002), Charaudeau and Maingueneau (2004); in genre approaches developed by Bakhtin (2000); Maingueneau (1996, 2002); socio-discursive interaction (BRONCKART, 1999, 2003; SCHNEUWLY, 2004; DOLZ e SCHNEUWLY, 2004) and Bazerman (2005); and also in presuppositions of Textual Linguistics presented by Charrolles (1988), Van Dijk (1997), Beaugrande and Dressier (1981), Koch and Travaglia (1993, 1995), Koch (2002, 2004) and Val (2000, 2004). We have established as aims to analyze and interpret meaning relations problems in how to articulate direct cited discourse with citing discourse and at the same time explain semantic implications that comes from that articulation that compromise text meaning, at background section in that monographic genre. The analysis, by qualitative and quantitative basis in eleven monographic works that form our corpus, gave us the opportunity to achieve and see that meaning relationships in the articulation of direct cited discourse with citing discourse show problems that may be categorized into three different groups: problems related to meaning relationships with citing discourse that comes before it, problems of meaning relationships with citing discourse that comes after it, and problems with of meaning relationships with citing discourse that come before it and at the same time with citing discourse that comes after it (i.e. in relation to both). These analysis also allow us assert that, these problems, just because they occur frequently, they affect the micro level text coherence, and they also compromise the text global meaning. The results show that students at Letras Course, even in the ending process of their course do not show the real domain in relation to some ways of direct cited discourse organization and working, and also how the ideas articulation work in the construction of relations between direct cited discourse and the citing discourse that can turn those students able to produce a text that enhance acceptable patterns

Análise do modelo troposférico empregado na geração de uma estação de referência virtual utilizando o posicionamento por ponto preciso

In the past few years the interest is accomplishing a high accuracy positioning increasing. One of the methods that has been applied by the scientific community is the network based on positioning. By using multiple reference station data, it is possible to obtain centimetric positioning in a larger coverage area, in addition to gain in reliability, availability and integrity of the service. Besides, using this concept, it is possible to model the atmospheric effects (troposphere refraction and ionosphere effect). Another important question concerning this topic is related to the transmission of the network corrections to the users. There are some possibilities for this fact and an efficient one is the Virtual Reference Station (VRS) concept. In the VRS concept, a reference station is generated near to the rover receiver (user). This provides a short baseline and the user has the possibility of using a single frequency receiver to accomplish the relative positioning. In order to test this kind of positioning method, a software has been developed at São Paulo State University. In this paper, the methodology applied to generate the VRS data is described and the VRS quality is analyzed by using the Precise Point Positioning (PPP) method.

Processos cognitivos que operam na construção da referência: uma análise das produções textuais elaboradas na EaD - UFRN

Beneath the theoretical assumptions of Cognitive Linguistics contemporary, we analyze the cognitive processes underlying the construction of the reference in the text. To do so, we choose as corpus the written textual productions of undergraduates at the Department of Distance Education/UFRN provided in sections of responses of presential evaluation activities and activities in the Moodle virtual ambience. These activities and texts were produced in the discipline of Reading, Interpretation and Textual Production taught in the courses of Chemistry, Physics, Mathematics, Biology and Geography we monitor during the period of 2008.1 to 2010.1. Through the analysis of discursive productions, it was evident that the construction of the reference is made by means of the activation and manipulation of information acquired through our perceptual and social experiences. Thus, we confirm the cognitive assumption that the linguistic clues available in the texts of the activities serve as guides towards cognitive domains that activate the process of building reference

Valores de referência para pressão inspiratória nasal SNIFF na população brasileira

The strength of respiratory muscle are frequently assessed by maximal inspiratory and expiratory pressure, however, the maneuvers to assess PImax and PEmax are difficult for many patients. The sniff nasal inspiratory pressure (SNIP) is a simple and noninvasive technique use to assess inspiratory muscles strength. Reference values have been previous established for SNIP in adults but no previous studies have provided reference values for SNIP in adult Brazilian population. The main objective of this study were propose reference values of SNIP for Brazilian population through establishment of relationship between anthropometric measurements, physical activity profile and SNIP and at the same time compare the values obtained with reference values previously published. We studied 117 subjects (59 male and 58 female) distributed in different age grouped 20-80 years old. The results showed on significant positive relationship between SNIP and height and negative correlation with age (p<0.05). In the multiple linear regression analysis only age continued to have an independent predictive role for the two dependent variables that correlated with SNIP. The values of SNIP found in Brazilian population were higher when compared with predict values of previous studies. The results of this study provide reference equations of SNIP for health Brazilian population from 20 to 80 years old