977 resultados para Serviços Médicos de Emergência


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Em Goiás, o pequi (Caryocar brasiliense) se destaca, dentre as frutíferas nativas do Cerrado, como promissora para a produção comercial. Um dos obstáculos para a sua produção em grande escala, no entanto, é o fato de que a germinação de sementes seja baixa e irregular. Com o objetivo de avaliar a emergência de sementes de pequizeiro e o desenvolvimento inicial de mudas oriundas de 16 plantas, aos dez meses após a colheita, na presença e ausência de ácido giberélico (GA3), foram conduzidos dois experimentos. O primeiro foi implantado em delineamento de blocos ao acaso, com parcelas subdivididas, tendo as matrizes nas parcelas e, nas subparcelas, um tratamento de imersão por 48 horas, em água pura e em solução de 500 mg L-1 de GA3. Foram realizadas avaliações a cada sete dias, para determinação da percentagem final, tempo médio e índice de velocidade de emergência. Para o segundo experimento, foi utilizado delineamento inteiramente casualizado, com número variado de repetições, de acordo com o número de mudas obtidas no primeiro experimento. Para percentagem, índice de velocidade e tempo médio de emergência, o efeito dos tratamentos foi significativo, sendo que, para os dois primeiros, houve interação significativa entre genótipo e tratamento, para superação da dormência. Observou-se que a utilização de 500 mg L-1 de ácido giberélico pode minimizar a dormência em sementes de Caryocar brasiliense e que o crescimento das matrizes em campo foi linear e contínuo, ao longo do tempo.

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Rapid and uniform germination of seeds followed by prompt emergence are highly desirable characteristics for the production of seedlings. The aim of this study was to identify sowing positions and types of substrate most likely to the seed germination process and growth of seedlings of Schizolobium parahyba (Vell.) S.F. Blake. To germinate the seeds, they were placed in the following positions in relation to the bottom of the furrow in the substrate: hilum uppermost, hilum at the bottom, supported on one side, seed on edge with its sides parallel to the walls of the bag. Three substrates were used: commercial plantmax substrate (control), pine sawdust and sand. The substrates were fully randomized in a 4 x 3 factorial design (four seed positions and three substrates), with four replications of 20 seeds. The parameters evaluated were: the percentage of emergence, the after emergence seedling deaths, the first-count test, the emergence speed index, and the seedling aerial part length. It was concluded that all the seed positions in pine sawdust sowing offer the more favorable conditions for the germination process and seedling growth of Schizolobium parahyba.

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A assistência psiquiátrica e as políticas de atenção à saúde mental passaram por diversas transformações, marcadas ora por avanços, ora por retrocessos centrados no estigma, desinteresse e preconceito que ainda permeiam a sociedade e o senso comum. Este estudo objetivou analisar o processo de reforma psiquiátrica e a política de saúde mental do Município de Natal/RN a partir dos papéis e funções dos profissionais de nível superior dos serviços substitutivos em saúde mental. Trata-se de uma pesquisa analítica, transversal, com dados quantitativos e qualitativos, realizada nos sete serviços substitutivos de saúde mental de Natal, entre os meses de março a agosto de 2013, após aprovação do estudo pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, Parecer nº 217.808, CAAE: 10650612.8.1001.5537, em 01 de março de 2013. A amostra por conveniência compôs-se por 65 profissionais de nível superior das equipes de saúde mental. Utilizou-se um questionário com questões fechadas e semiabertas sobre o perfil socioeconômico, as políticas, as práticas e a formação em saúde mental. Tabularam-se e submeteram-se as respostas das questões fechadas do questionário no programa estatístico SPSS versão 20.0, analisando-os por meio de estatística descritiva, com a formulação de gráficos e tabelas. Para verificar o nível de significância, adotando-se p-valor<0,05, optou-se pela aplicação dos testes qui-quadrado e exato de Fisher. Submeteram-se os dados das questões semiabertas ao software ALCESTE e à luz da análise de conteúdo de Bardin. O perfil dos participantes caracterizou-se por maioria do sexo feminino (79%), faixa etária de 36 a 55 anos (52%), média de 42 anos, carga horária de 40 horas semanais (62%), tempo de conclusão da graduação de 6 a 15 anos (57%), trabalhavam na área de saúde mental há menos de 10 anos (72%) e na instituição pesquisada há 5 anos ou menos (52%). Da amostra estudada, 86% atendiam grupos de usuários, 97% realizavam atendimento individual, 94% observavam o comportamento do paciente, 92% realizavam atendimento familiar, utilizando, principalmente, a abordagem cognitiva (28%). Os dados qualitativos originaram cinco categorias: Formação acadêmica e atuação em saúde mental; Ausência de capacitação e supervisão em saúde mental; Dificuldades da prática profissional nos serviços substitutivos de saúde mental; Trabalho em equipe: entre acertos e conflitos; Política Nacional de Saúde Mental: uma realidade ainda distante. Detectou-se adequabilidade dos papéis e funções dos profissionais quanto ao tempo de trabalho na saúde mental e na instituição pesquisada; no atendimento e atividades individuais; na promoção de ações visando à autonomia do paciente; no atendimento em grupo de pacientes; e, em parte, à família/familiar dos portadores de transtorno mental, havendo inadequação quanto ao atendimento aos grupos de familiares (52.3%), à formação especializada em saúde mental (69.2%; p=0,02) e às dificuldades de trabalho nos serviços (87.7%). Evidenciou-se adequação nos papéis e nas funções d esenvolvidas pelos profissionais nos serviços substitutivos em saúde mental de Natal, embora convivendo em seu cotidiano com inúmeras dificuldades encontradas no desenvolvimento de suas práticas profissiona is frente às condições de trabalho

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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

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This study aims to identify the concepts of professional nursing team on assistance in urgency and psychiatric emergencies in SAMU in Mossoró/RN, identifying the difficulties in implementing an emergency assistance to the user in psychiatric distress in this service and point strategies in pursuit of consolidation and expansion of comprehensive health care to the public. It is a descriptive research with qualitative and exploratory approach. The subjects were employees of the nursing staff of SAMU of that mentioned municipality. Semi-structured interviews are applied as tool for data collection. It was counted on the consent of the institution where the study was developed and approval by the Ethics Committee in Research of UFRN with CAAE No 17326513.0.0000.5537, besides signing the Informed Free Consent Term by the participants. Data analysis was done by means of thematic analysis proposed by Bardin. Thus , as a result of the research produced the following categories: mechanistic practice; dehumanization of care; need for qualification, barriers to assistance in urgency and psychiatric emergency and strategies in pursuit of comprehensive care, which proceeded in preparing two articles entitled "Nursing care to the emergency room and psychiatric emergencies in the mobile emergency care service" and "Barriers for emergency service and psychiatric emergencies in the mobile emergency care service". In the studied reality it was identified that nursing care offered to users in situations of urgency and psychiatric emergency is made based primarily on the use of chemical and physical restraints, as well as transportation to the general hospital, constantly using the police force support, which meets the guidelines of the Psychiatric Reform and thereby undermining the provision of an effective and humane care. This scenario is worsened by the lack of an organized network of services in mental health, where after the service the user is taken to a general hospital, considering that there is no ready or appropriate psychiatric emergency service as a Center of Psychosocial Care - CAPs III to reference it, thereby precluding the realization of a resolute and comprehensive care. Thus, it is concluded that nursing care is based on biologicist and medicine-centered model advocated by classical psychiatry, and that despite all the advances in psychiatric reform, still guides the mental health care, so the lack of service network organized in hierarchical and mental health, where the user in urgency and emergency service can be watched in full and the guidelines of the psychiatric reform can be realized in practice

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The increasing competitiveness of the construction industry, set in an economic environment in which the offer is now greater than the demand , causes the prices of many products and services, are strongly influenced by the processes of production and the final consumer. Thus, to become more competitive in the market and construction companies are seeking new alternatives to reduce and control costs, production processes and tools that allow for close monitoring of the construction schedule, with the consequent compliance deadline with the client. Based on this scenario, the creation of control tools, service management and planning work emerges as an investment opportunity and an area that can promote great benefits to construction companies. The goal of this work is to present a system of planning, service management and costs control that through worksheets provide information relating to the production phase of the work, allowing the visualization of possible irregularities in the planning and cost of the enterprise, enabling the company to take steps to achieve the goals of the enterprise in question, and correct them when necessary. The developed system has been used in a piece of real estate in Rio Grande do Norte, and the results showed that its use together allowed the construction company to accompany their results and take corrective and preventive actions during the production process, efficiently and effective

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Este trabalho objetivou avaliar os efeitos da aplicação de óleo de fúsel, comparativamente a vinhaça e flegmaça, sobre o desenvolvimento e a composição química de plantas de guanxuma (Sida rhombifolia), capim-braquiária (Brachiaria decumbens) e cana-de-açúcar (variedade RB72454), cultivadas simultaneamente em casa de vegetação. As concentrações de 12,5; 25,0; 50,0; e 100,0% (v/v) de cada subproduto e a testemunha (água) foram aplicadas (numa taxa equivalente a 150 m³ ha-1) no solo dos vasos (22 L), contendo uma planta de cana-de-açúcar (13 cm de altura) e 100 sementes de cada planta daninha. O delineamento foi o inteiramente casualizado, com 13 tratamentos e 4 repetições, em esquema fatorial 3 x 4 (três tipos de resíduos e quatro concentrações), e uma testemunha adicional com água. O óleo de fúsel inibiu a emergência de Sida rhombifolia e Brachiaria decumbens e matou a cana-de-açúcar. A vinhaça e a flegmaça prejudicaram a emergência e o desenvolvimento de B. decumbens, bem como o de S. rhombifolia, mas não o da cana-de-açúcar.

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O presente trabalho tee como objetivo estudar a emergência e o desenvolvimento de plantas de marmeleiro, com potencial para serem utilizadas como porta-enxertos. O trabalho foi desenvolvido no Centro APTA Frutas/IAC, de maio/05 a janeiro/06. Sementes dos marmeleiros 'Mendoza INTA-37', 'Provence', 'Portugal' e 'Japonês' foram extraídas de frutos maduros, lavadas em água corrente, secas à sombra por 48 h e estratificadas a frio por 20 dias. em seguida, foram semeadas em bandejas de poliestireno (72 células, capacidade de 120 cm³/célula) contendo a vermiculita como substrato. Foi feito contagem da porcentagem de emergência após 30 dias da semeadura, a cada 10 dias, em um total de quatro coletas. em seguida, foi retirada uma amostra de 10 plântulas por repetição e avaliados a altura média da parte aérea, nº de folhas, massa seca média da parte aérea e das raízes. Foram ainda separados 10 plântulas uniformes e representativos de cada repetição e transplantados para sacos plásticos (capacidade de 3 L) contendo como substrato solo + esterco de curral curtido + areia (1:1:1 v/v). As plântulas permaneceram em viveiro telado (sombrite 50%), sendo irrigadas periodicamente. A cada 30 dias, foram mensurados a altura e o diâmetro das plântulas até o final da sexta avaliação (após 180 dias do transplantio). Concluiu-se que o marmeleiro 'Japonês' apresenta maior porcentagem de emergência (70%), altura das plântulas (111,83 cm) e diâmetro (0,7 cm), possuindo maior performance e uma excelente alternativa como porta-enxerto para marmeleiros.

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The objective of this work consists of considering a script so that operating companies in the telecommunications sector, mainly small and medium-sized enterprises, can reach excellency in its operations and get, thus, conditions to compete with companies consolidated in its niche of market. The proposal intends to lead the enterprises to a level of qualification of processes that to become them apt to adopt the Six Sigma method as part of its culture. From the analysis of the essential processes of the sector, methods and tools will be suggested for guarantee the continuous improvement of these processes, without forgetting the internal peculiarities of each company

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This Master s Thesis proposes the application of Data Envelopment Analysis DEA to evaluate economies of scale and economies of scope in the performance of service teams involved with installation of data communication circuits, based on the study of a major telecommunication company in Brazil. Data was collected from the company s Operational Performance Division. Initial analysis of a data set, including nineteen installation teams, was performed considering input oriented methods. Subsequently, the need for restrictions on weights is analyzed using the Assurance Region method, checking for the existence of zero-valued weights. The resulting returns to scale are then verified. Further analyses using the Assurance Region Constant (AR-I-C) and Variable (AR-I-V) models verify the existence of variable, rather than constant, returns to scale. Therefore, all of the final comparisons use scores obtained through the AR-I-V model. In sequence, we verify if the system has economies of scope by analyzing the behavior of the scores in terms of individual or multiple outputs. Finally, conventional results, used by the company in study to evaluate team performance, are compared to those generated using the DEA methodology. The results presented here show that DEA is a useful methodology for assessing team performance and that it may contribute to improvements on the quality of the goal setting procedure.

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This thesis deals with the factors affecting customer satisfaction, loyalty and recommendation in the health care sector. It is adapted a model proposed by Johnson et al. (2001) of quality and loyalty antecedent factors and it is conducted a survey with a sample of 109 customers of a hospital on the ambulatory in Natal city, a capital of a Northeastern State of Brazil. It is carried descriptive and multiple regression statistical analysis. The main findings related to satisfaction are that quality factors of doctor professionalism, clerical staff efficiency, consultancy room comfort, time to provide the medical consultancy but also hospital localization are the most significant factors affecting satisfaction. Regarding personal full loyalty, satisfaction with the hospital and affective commitment are the main factors yet for partial loyalty image and calculate commitment play the main role. For recommendation satisfaction, image and brand are the main factors. The overall model used fairly explains the satisfaction, loyalty and recommendation outcomes with varying factors regarding each final purpose, e.g. loyalty or recommendation

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This thesis shows concepts and models related to customer satisfaction measurement, focusing in detail on patients satisfaction evaluations in a policlinic sector of a hospital located in Natal RN. To reach this aim, two hundred and fifty one patients of this hospital were interviewed. The methodology approach includes a theoretical basis through a review and study of previous research on the topic, governmental initiatives and management systems which deal with excellence and need more reports concerning customers perceptions about satisfaction. Furthermore, it was included some models of nationals index about customer satisfaction. The Norwegian model was used in this thesis. The use of this approache, together with a multiple regression analysis, led to results that shows the factors which affect patients satisfaction in a policlinic sector. They are four as following: The evaluation of physician attendance; its results; simplicity of accessibility when health services are needed; and both support and tranquility given by the hospital. The study results can support researches of a conceptual model to determinate the aspects which affect the patient s satisfaction and could be a contribution to a development of a national costumer satisfaction index

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With the increasing offer of education services in Brazil, it is necessary to evaluate the quality of service in education, especially in those institutions for vocational education which have a greater interaction with the labor market, in order to form qualified professionals and meet the growing demand that the country has today[A1] . In Brazil, the evaluation of the quality of library services has influenced the assessment of educational institutions and in this context, there needs to be a process to monitor the quality of services provided by libraries. However, the service is not done in a single moment and thus to a more detailed assessment it needs to be measured and evaluated each different time the customer uses it. Therefore, the aim of this work consists in measuring the quality in every moment of truth of a cycle of library services to assess which are the most relevant moments in the client's perspective at the library of the Federal Institute of Education, Science and Technology of Rio Grande do Norte (IFRN) Campus João Câmara in building the overall quality of service. In the literature review, internal secondary sources were used, from the database of the institution studied, and also external sources, through literature in books, articles, dissertations, theses and journals on compost quality, service quality, cycle services, measuring quality, satisfaction, teaching activities, and on library services specifically. We applied a questionnaire to students in the library based on models of quality measurement SERVPERF and SERVQUAL and its variations such as SERVQUAL pondered and SERVPERF pondered . Through analysis based on concepts of reliability and validity of measuring instruments, it was found that the SERVPERF model is the instrument that most closely matches the dimensions of quality assessed in the library with customer satisfaction measured by the questionnaire. From there, the search results as measured by statistical techniques of analysis, indicated that the initial and final moments of truth of the cycle of service quality had the greatest influence on overall customer satisfaction with the library service

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This work presents a study in quality of health care, with focus on consulting appointment. The main purpose is to define a statistical model and propose a quality grade of the consulting appointment time. The time considered is that from the day the patient get the appointment done to the day the consulting is realized. It is used reliability techniques and functions that has as main characteristic the analysis of data regarding the time of occurrence certain event. It is gathered a random sample of 1743 patients in the appointment system of a University Hospital - the Hospital Universitário Onofre Lopes - of the Federal University of Rio Grande do Norte, Brazil. The sample is randomly stratified in terms on clinical specialty. The data were analyzed against the parametric methods of the reliability statistics and the adjustment of the regression model resulted in the Weibull distribution being best fit to data. The quality grade proposed is based in the PAHO criteria for a consulting appointment and result that no clinic got the PAHO quality grade. The quality grade proposed could be used to define priority for improvement and as criteria to quality control