Análise imunoistoquímica após terapia fotodinâmica com cloro-alumínio ftalocianina em tecidos gengivais de humanos

Although photodynamic therapy have been used as a useful tool over the past 30 years in oncology, few clinical trials have been conducted in dentistry. Photodynamic therapy (PDT) uses non - toxic photosensitizers and selective which are administered in target cells followed by local application of visible light, producing reactive oxygen species capable of causing cell death by apoptosis or necrosis, injured the local vasculature, and exert important effects on the im mune system. New generations of photosensitizing agents, such as nanoparticulate phthalocyanines, has shown excellent results in antitumor and antibacterial activity . In this context, the present work constitutes the first clinical protocol of local appli cation of nanoemulsion chloro - aluminum phthalocyanine (AlClFc) followed by irradiation in human gingiva, and analyzed descriptively and comparatively , by means of immunohistochemistry , the expression of RANK , RANKL , OPG and VEGF in a split - mouth model . Eight healthy volunteers with clinical indication for extraction were included in the study . Seven days before the extraction, was injected in the gingiva of participants, 5 μ M of nanoemulsion AlClFc followed by irra diation with diode laser (660nm , 7 J/cm2 ), the contralateral side was used as control. Tissue specimens were removed seven days after the TFD is performed. Tissues sample were divided into two groups (test and con trol groups) for histological and immunohistochemical analysis. Patients were monitored at days, 0, 7, 14 and 30 to assess adverse effects of the therapy. Vascular alterations were seen in gingival samples that received PDT. Areas of edema and vascular con gestion, and intense vascularization were viewed . Additionally, dystrophic calcification in subepithelial region were observed in the test group. The results showed a similar pattern of immunostaining scores of RANK, RANKL and VEGF between the test and co ntrol groups, with no statistically significant difference (p = 0.317, p = 0.777, p = 0 .814, respectively). RANK and RANKL exhibited weak or absent immunostaining in most specimens analyzed. There was n o immunostaining for OPG. VEGF showed moderate to stro ng immunostaining in specimens from the test group. In addition, the clinical study showed that therapy was well tolerated by all patients. Adverse effects were short - time and completely reversible. Taken together, the results presented in this study showe d that PDT mediated by nanoemulsion containing AlClPc is safe for clinical application in gingival tissue and suggests that a strong immunostaining for VEGF after therapy .

Arquitetura escolar Infantil modulada e flexível

For many y ears, the federal government policy is to use project for in order to speed up the work for decreasing the elementary education deficit vacancy . In Natal municipality the schoolhouses for children, from 0 to 6 years of age are denom inated Muinicipality Centre for Elementary Education. The federal government provides capital for the news edifications by the program of government named PROINFÂNCIA. This program embraces three types of projects. Type “A” must be furnished by the interes ted municipality and approved by Education and Cultura Ministry. The type “B” is standard plan with capability to 120 schoolchildren in full - time or 240 in two turns and ground plot measuring 40 x 70m and the “type C” also a standart projects to 60 schoolc hildren in full - time or 120 in two turns and ground plot measuring 35 x 45m. Sometimes , due to scarcity of bigger ground plot s is the “type C” instead of “type B”, referring to offering vacancies. In this meaning, this study intend s to present the draft - project to elementary schoolhouse, modulated and flexible, emphasizing the children needs . Therefore, it was studied concept, school architecture, construction technology, reference study and visiting to MCEE Fernanda Jales (PROINFÂNC IA “tipo B”). However, the proposal synthesizes the draft - project by module, implanting in its totality or in parts, according to its necessity and lot cha racteristic.

Arquitetura bioclimática para instituição de ensino fundamental em São Gonçalo do Amarante/RN

In the design of a building process must consider climatic variations in the region, the external conditions and the use of available resources in nature, like the sun, vegetation, rain and winds, to provide a built environment with comfort and environment reduced energy expenditure. However, increasing urbanization, often with an occupancy of disordered ground comes disregarding this knowledge and disregarding local characteristics, drastically reducing the green areas. This disordered occupation associated with the reduction of green spaces, is modifying aspects of climate and thus, damaging the thermal comfort of users. Given this situation was born the question: What projetuais strategies can bring better thermal conditions to an educational building located in a region of hot and humid weather? Thus, faced with two important issues , education and environmental comfort , the research is justified by the fact that there is a large national demand for expansions and renovations in its public schools , but not in most areas provides students with quality for good learning development. This paper aims to draw up a project for establishment of Primary Education with the application of the concepts of bioclimatic, highlighting the use of vegetation as a regulatory element of the climate. Initially we carried out a literature search; we analyzed architectural solutions and set up the site. The next phases, called understanding, were raised with the laws, rules and environmental restrictions. Subsequently, the program needs and the development of architectural design was defined. The conclusion of this paper presents the definition of criteria and solutions for the use of vegetation to design of bioclimatic architecture in hot and humid climates and contributes a catalog of plant species for schools in the metropolitan region of Natal, RN.

Nursing Activities Score: avaliação da carga de trabalho de enfermagem em unidade de terapia intensiva adulto

The sizing of nursing human resources is an essential management tool to meet the needs of the patients and the institution. Regarding to the Intensive Care Unit, where the most critical patients are treated and the most advanced life-support equipments are used, requiring a high number of skilled workers, the use of specific indicators to measure the workload of the team becomes necessary. The Nursing Activities Score is a validated instrument for measuring nursing workload in the Intensive Care Unit that has demonstrated effectiveness. It is a cross-sectional study with the primary objective of assessing the workload of nursing staff in an adult Intensive Care Unit through the application of the Nursing Activities Score. The study was conducted in a private hospital specialized in the treatment of patients with cancer, which is located in the city of Natal (Rio Grande do Norte – Brazil). The study was approved by the Research Ethics Committee of the hospital (Protocol number 558.799; CAAE 24966013.7.0000.5293). For data collection, a form of sociodemographic characteristics of the patients was used; the Nursing Activities Score was used to identify the workload of nursing staff; and the instrument of Perroca, which classifies patients and provides data related to the their need for nursing care, was also used. The collected data were analyzed using a statistical package. The categorical variables were described by absolute and relative frequency, while the number by median and interquartile range. Considering the inferential approach, the Spearman test, the Wald chi-square, Kruskal Wallis and Mann-Whitney test were used. The statistically significant variables were those with p values <0.05. The evaluation of the overall averages of NAS, considering the first 15 days of hospitalization, was performed by the analysis of Generalized Estimating Equations (GEE), with adjust for the variable length of hospitalization. The sample consisted of 40 patients, in the period of June to August 2014. The results showed a mean age of 62,1 years (±23,4) with a female predominance (57,5%). The most frequent type of treatment was clinical (60,0%), observing an average stay of 6,9 days (±6,5). Considering the origin, most patients (35%) came from the Surgical Center. There was a mortality rate of 27,5%. 277 measures of NAS score and Perroca were performed, and the averages of 69,8% (±24,1) and 22,7% (±4.2) were obtained, respectively. There was an association between clinical outcome and value of the Nursing Activities Score in 24 hours (p <0.001), and between the degree of dependency of patients and nursing workload (rp 0,653, p<0,001). The achieved workload of the nursing staff, in the analyzed period, was presented high, showing that hospitalized patients required a high demand for care. These findings create subsidies for sizing of staff and allocation of human resources in the sector, in order to achieve greater safety and patient satisfaction as a result of intensive care, as well as an environment conducive to quality of life for the professionals

Ícones urbanos na cidade de Natal: arquitetura e desenvolvimento urbano na cidade do sol e mar

Natal has come through major changes in the last 150 years, since the actions of city beautification, in the 19th century, until the present day, when such transformations start to have the objective of including the city in the competition for the attraction of the capital flows and consumption, domestically and in a foreign sense. It is thought that the first initiatives aimed at increasing tourism in Natal occurred in the 1960s, however, it became apparent that only from the 1980s was there a significant increase in tourist activities in Natal and the Metropolitan Region, especially on the east coast of the state of Rio Grande do Norte, leading to an expansion of the labour market, the significant increase of foreign investment, territorial changes of great impact and the production of buildings primarily intended for the hotel industry and second residence for European tourists. Since then, the incentives for tourist activity in the state have been maintained and even increased, based on tourism aimed at natural beauties, local cuisine and events, which transformed the tourist activity in one of the main sources of foreign exchange for the city of Natal. In the early 21st century, the construction of high-rise condominiums, monuments (including the designer ones), such as the Parque da Cidade, designed by Oscar Niemeyer, were already established. Also, shopping centers and, in order to host the World Cup, the new football stadium, the Arena das Dunas, among others, which were aimed at local and foreign consumers, especially European, stood out in the city. It is understood that these new buildings, monuments and also renovations and restorations that were deployed in the city of Natal aimed at constructing a new identity for the city, within the process of capitalist development and urban spectacle. It is considered that the monuments and the iconic buildings are attributes of the cities aimed at selling locations as goods, establishing a new urban environment, a new role as cities, which aimed at seeking greater autonomy from the nation-state. In this research, it was sought to analyze the architectural object, that is, buildings and monuments built or restored in Natal and its relevance to the city marketing promoted by the city itself. It was found that, indeed, such buildings and monuments are inserted in contemporary architectural production as a basis for increasing the competitive nature of Natal. In addition, they reveal a capitalist mode of production, supported by public resources, operating in the production of urban space with a view to repeating the hegemonic model of a competitive city

Avaliação da usabilidade e da arquitetura da informação do site do Instituto do Cérebro da UFRN: um estudo de caso com base nas opiniões dos usuários da instituição

The objective of the current piece of research presents was draw up a list of recommendations for the site of the Instituto do Cérebro da Universidade Federal do Rio Grande do Norte, with an emphasis on fault identification in usability and information architecture, through the application of design techniques with users of the institution. From the use of the following techniques: Cardsorting, applied to a group of six people as target public, such as professor, administrative technicians and graduate student of the institution; Interviews, carried out with the director of the Instituto do Cérebro, secretaries of the undergraduate and graduate courses; Cooperative Evaluation applied in two ways: in group and individually. The evaluation in group was fulfilled in four sessions that occurred with a group composed of six people who are part of the technical staff of the Instituto do Cérebro. In the Individual Cooperative Evaluation, eight users (graduate students and administrative technicians of the Instituto do Cérebro da UFRN) performed tasks which are frequently fulfilled by users from the public target in the site of the Instituto do Cérebro. After each session of the Individual Cooperative Evaluation, a questionnaire of the user´s satisfaction was used about his or her perception in regard to the site usability and utility of the mentioned institute site. Therefore, it was concluded that, by means of the analysis of the results and the triangulation of the obtained data in each one of the techniques applied with the users, in the present piece of research, problems were verified, among others; all related to the unsuitable use of the interface elements, navigation, labeling of some menu terms, and still, the lack of search space and integration with the social networks – besides the lack, positioning and inappropriate formatting of information that would be of high relevance to the users. Finally, a list of recommendations is presented and this can be used in a future interface redesign with the goal to improve the information architecture and the usability of the site of the Instituto do Cérebro da Universidade Federal do Rio Grande do Norte.

Uma linguagem de descrição arquitetural baseada em uma arquitetura de referência para sistemas ubíquos

A computação ubíqua é um paradigma no qual dispositivos com capacidade de processamento e comunicação são embutidos nos elementos comuns de nossas vidas (casas, carros, máquinas fotográficas, telefones, escolas, museus, etc), provendo serviços com um alto grau de mobilidade e transparência. O desenvolvimento de sistemas ubíquos é uma tarefa complexa, uma vez que envolve várias áreas da computação, como Engenharia de Software, Inteligência Artificial e Sistemas Distribuídos. Essa tarefa torna-se ainda mais complexa pela ausência de uma arquitetura de referência para guiar o desenvolvimento de tais sistemas. Arquiteturas de referência têm sido usadas para fornecer uma base comum e dar diretrizes para a construção de arquiteturas de softwares para diferentes classes de sistemas. Por outro lado, as linguagens de descrição arquitetural (ADLs) fornecem uma sintaxe para representação estrutural dos elementos arquiteturais, suas restrições e interações, permitindo-se expressar modelo arquitetural de sistemas. Atualmente não há, na literatura, ADLs baseadas em arquiteturas de referência para o domínio de computação ubíqua. De forma a permitir a modelagem arquitetural de aplicações ubíquas, esse trabalho tem como objetivo principal especificar UbiACME, uma linguagem de descrição arquitetural para aplicações ubíquas, bem como disponibilizar a ferramenta UbiACME Studio, que permitirá arquitetos de software realizar modelagens usando UbiACME. Para esse fim, inicialmente realizamos uma revisão sistemática, de forma a investigar na literatura relacionada com sistemas ubíquos, os elementos comuns a esses sistemas que devem ser considerados no projeto de UbiACME. Além disso, com base na revisão sistemática, definimos uma arquitetura de referência para sistemas ubíquos, RA-Ubi, que é a base para a definição dos elementos necessários para a modelagem arquitetural e, portanto, fornece subsídios para a definição dos elementos de UbiACME. Por fim, de forma a validar a linguagem e a ferramenta, apresentamos um experimento controlado onde arquitetos modelam uma aplicação ubíqua usando UbiACME Studio e comparam com a modelagem da mesma aplicação em SySML.

Estudo do domínio segurança/proteção da NANDA internacional em pacientes de unidade de terapia intensiva

The study aimed to analyze the field of nursing diagnoses safety / protection of NANDA International present in patients in the Intensive Care Unit. This is a crosssectional study in intensive care complex of a university hospital in northeastern Brazil. The research took place in two stages. The first step was to collect data through an interview form and physical examination, with 86 patients admitted to the unit, during the months of December 2013 to May 2014. Spreadsheets were built in Microsoft Office Excel 2010 Software in which were marked by the researcher of this study, the presence or absence of defining characteristics, related factors and risk factors of the 31 studied diagnoses. In the second stage, held between July and August 2014, the sheets were sent to three diagnosticians, previously trained to perform the diagnostic inference. Data were analyzed using descriptive and inferential statistics for the diagnoses that showed higher frequencies than 50%, using IBM SPSS version 20.0 for Statistic Windows.O project was approved by the 440/414 and Presentation Certificate for Ethics Assessment number 22955113 .2.0000.5292. The results indicated the presence of 29 field of nursing diagnoses safety / protection in hospital clientele in the Intensive Care Unit, of which five were present in 100% of patients, namely: Risk of contamination, injury risk, falls risk,risk of allergic response and risk of trauma. Diagnoses that presented more frequently than 50% were: Risk of infection, dry eye risk, poisoning risk, vascular trauma risk, impaired skin integrity, impaired dentition, bleeding risk, risk imbalance in body temperature, Risk perioperative positioning injury, impaired tissue integrity, peripheral neurovascular dysfunction Risk, Risk adverse response to contrast media with iodine, shock Hazard and Risk of aspiration. For these analyzes, we identified 35 risk factors, 11 defining characteristics and three related factors showed statistically significant association with the studied diagnoses. For diagnostics: Risk of contamination, injury risk, falls risk, allergic response risk, trauma Risk, Risk of infection, dry eye risk and risk poisoning there was no association with any of their risk factors. We conclude that most of the area of nursing diagnoses safety / protection feature is prevalent in critically ill patients, with special attention to the risk diagnoses. There was a significant association between these diagnoses and its components. It is noteworthy, therefore, that the lifting of this profile contributes relevant clues to the inference of the priority nursing diagnoses domain safety / protection in the study population, supporting the practice of nursing and stimulating knowledge on the subject.

Mecanismo de tolerância a falhas através de escalonamento para uma arquitetura reconfigurável de grão grosso

The continuous evolution of integrated circuit technology has allowed integrating thousands of transistors on a single chip. This is due to the miniaturization process, which reduces the diameter of wires and transistors. One drawback of this process is that the circuit becomes more fragile and susceptible to break, making the circuit more susceptible to permanent faults during the manufacturing process as well as during their lifetime. Coarse Grained Reconfigurable Architectures (CGRAs) have been used as an alternative to traditional architectures in an attempt to tolerate such faults due to its intrinsic hardware redundancy and high performance. This work proposes a fault tolerance mechanism in a CGRA in order to increase the architecture fault tolerance even considering a high fault rate. The proposed mechanism was added to the scheduler, which is the mechanism responsible for mapping instructions onto the architecture. The instruction mapping occurs at runtime, translating binary code without the need for recompilation. Furthermore, to allow faster implementation, instruction mapping is performed using a greedy module scheduling algorithm, which consists of a software pipeline technique for loop acceleration. The results show that, even with the proposed mechanism, the time for mapping instructions is still in order of microseconds. This result allows that instruction mapping process remains at runtime. In addition, a study was also carried out mapping scheduler rate. The results demonstrate that even at fault rates over 50% in functional units and interconnection components, the scheduler was able to map instructions onto the architecture in most of the tested applications.

A terapia comunitária e a vivência de estudantes de medicina: uma estratégia de ensino aprendizagem do cuidado humanizado na ESF?

Before the scenario full of criticism about a medical model that gives privilege to the diseases and not to the diseased, there are many arguments that defend the need of redeem the humanized relationship between doctor and patient. It became indispensable to mold during the medical graduation a professional capable of perform a special care, less instrumental and more humanized; however, even though the advances of the pedagogical program of the medical graduation, we still face numerous challenges in the process of molding. This study has as general goal to understand if the students medicine experience with the Integrative Community Therapy (TCI) at the Primary Attention – APS/Family Healthy Strategy-ESF, presents potential to configure itself while strategy of teaching-learning to the integral and humanized care. It was held a qualitative research with the students of the medical graduation from the tenth to the twelfth semester that had experience with the TCI, as part of the Boarding of Family and Community Medicine – MFC. We used interviews with script and we resorted to analyze the narratives to Gadamerian Hermeneutics. It was possible to find that before join the boarding of MFC, the students were unaware the TCI and their preconceptions lined up with depreciated character. The experience with the TCI enabled the reframing of the prejudices and the build of new concepts. Internship in ESF and participate of TCI revealed potential to learning of the humanized care by the practical exercise with experiences that privilege the built of ties; the autonomy of the patient; the fulfillment of the longitudinality at the care of the patient; the acknowledgment of the power of resilience of the patients, at the strength of the collective, at the pain sharing, at the strength of a good communication, at the gains of qualified listening exercise. The absence of models of what to do was replaced by experiences of pains and joys at the learning of becoming a doctor. The pains spoke of the structural difficulties (inputs), at the get along with the socials vulnerabilities of the users and the difficult of perform a good communication with the patients. The joys were experienced at the finding of the humanized care exercise. Questions as structural difficulties, low number of people with TCI degree, a shortly experience of with TCI, show up as limitations to its utilization as pedagogical tool. In turn, the reflective potential is capable of cause resignifications about the know-how before the pain of the other being very much present at the narratives, signaling the potential of the learning of TCI. Therefore, this study advocate that the participation of the students at the TCI, beyond the power of offering the students a teaching-learning strategy to the humanized care, represents the possibility of enlarge the horizons of those future doctors at a glance much more conscious of the difficulties and potential of a professional at the ESF, contributing to the graduation of more sensitized professionals and prepared to perform an integral and humanized approach of the person and his/her community, contributing to an APS/ESF more resolute and rewarding to everyone.

Autonomic hardware manager: uma arquitetura de hardware autonômico usando a solução de repositório ativo de componentes

This Thesis main objective is to implement a supporting architecture to Autonomic Hardware systems, capable of manage the hardware running in reconfigurable devices. The proposed architecture implements manipulation, generation and communication functionalities, using the Context Oriented Active Repository approach. The solution consists in a Hardware-Software based architecture called "Autonomic Hardware Manager (AHM)" that contains an Active Repository of Hardware Components. Using the repository the architecture will be able to manage the connected systems at run time allowing the implementation of autonomic features such as self-management, self-optimization, self-description and self-configuration. The proposed architecture also contains a meta-model that allows the representation of the Operating Context for hardware systems. This meta-model will be used as basis to the context sensing modules, that are needed in the Active Repository architecture. In order to demonstrate the proposed architecture functionalities, experiments were proposed and implemented in order to proof the Thesis hypothesis and achieved objectives. Three experiments were planned and implemented: the Hardware Reconfigurable Filter, that consists of an application that implements Digital Filters using reconfigurable hardware; the Autonomic Image Segmentation Filter, that shows the project and implementation of an image processing autonomic application; finally, the Autonomic Autopilot application that consist of an auto pilot to unmanned aerial vehicles. In this work, the applications architectures were organized in modules, according their functionalities. Some modules were implemented using HDL and synthesized in hardware. Other modules were implemented kept in software. After that, applications were integrated to the AHM to allow their adaptation to different Operating Context, making them autonomic.

Integração de projetos no ensino através de BIM: uma abordagem dos cursos de arquitetura e urbanismo da UFRN e da UFPB

The integration between architectural design and structur al systems consi sts, in academic education, one of the main challenges to the architectural design education . Recent studies point to the relevance of the use of computational tools in academic settings as an important strategy for such integration. Although in recent yea rs teaching experience using BIM (BuildingInformationModeling) may be incorporated by the a rchitecture schools , notes the need for further didactic and pedagogical practices that promote the architectural design and structur al integration teaching. This pa per analyzes experiences developed within the UFRN and UFPB, seeking to identify tools, processes and products used, pointing limitations and potentials in subjects taught in these institutions. The research begins with a literature review on teaching BIM and related aspects to the integration of architectural design and stru c tur e . It has been used as data collection techniques in studio the direct observation, the use of questionnaires and interviews with students and teachers, and mixed method, qualitativ e and quantitative analysis . In UFRN, the scope of the Integrated Workshop as a compulsory subject in the curriculum, favors the integration of disciplines studied here as it allows teachers from different disciplines at the same project studio . Regarding the use of BIM form initial users, BIM modelers, able to extract quantitative and automatically speed up production, gaining in quality in the products, however learn the tool and design in parallel cause some difficulties. UFPB, lack of required courses o n BIM, generates lack of knowledge and confidence in using the tool and processes, by most students. Thus we see the need for greater efforts by school to adopt BIM skills and training. There is a greater need for both BIM concept, in order to promote BIM process and consequent better use of tools, and obsolete avoiding impairment of technology, merely a tool. It is considered the inclusion of specific subjects with more advanced BIM skills, through partnerships with engineering degrees and the promotion of trans disciplinary integration favoring the exchange of different cultures from the academic environment.

Fatores determinantes da near miss materna em uma unidade de terapia intensiva obstétrica: avaliação das competências profissionais da área médica

Objective: Evaluate the determinants of morbidity and mortality in an obstetric intensive care unit and professional medical skills of students/residents at a university hospital. Methods: observational cross - sectional with 492 pregnant/pue rperal women and 261 students/residents. Patients were admitted to the obstetric intensive care unit during a year, being informed about the proposals of the study and a questionnaire was applied. The analysis was performed using Microsoft Excel 2013 and G raphPad6. Chi - square tests were used to evaluate risk factors and student t test evaluates resident/students' skills concerning the cognitive test and the Mini - Cex. Results: the main risk factors to near miss were: non - white race (OR = 2.527; RR = 2.342) ; marital status(married women) (OR = 7.968; RR = 7.113) , schooling (primary) (OR = 3.177 ; RR = 2.829) , from country town (OR = 4.643 ; RR = 4.087), low income (OR = 7014 ; RR = 5.554) , gestational hypertensive disorders (OR = 16.35 ; RR = 13.27) , re alization of pre - natal (OR = 5.023 ; RR = 4.254) and C - section before labor(OR = 39.21 ; RR = 31.25). In cognitive/Mini - cex analysis were noted significant difference in the performance of students on the subject (3.75 ± 0.93, 4.03 ± 0.94 and 4.88 ± 0.35). We still observed the best performance of residents, when compared to graduation students (p < 0.01). Conclusions: the prevalence of near miss was associated with socioeconomic/clinics factors and care issues, revealing the importance of interventions to improve these indicators. In addition, we suggest a better curriculum insertion of this subject in the medical Course disciplines due the importance to avoid the near miss through of adequacy of medical education.

Gasto com a internação de idosos em unidades de terapia intensiva

Introduction: Population aging in Brazil underscores the need to discuss the proper management of the budget allocated in health field, especially in the sectors of high complexity, where coexist costly procedures, limited resources and the need for cost containment. In the other hand, demand is growing in a way directly proportional to the increase in the number of elderly in country. Objective: In this way, this research had as main objective to analyze the costs resulting from the admission of elderly in intensive care units (ICU) and its associated factors. Methods: This is a cross-sectional study with a quantitative approach and featured as a descriptive and exploratory research. Data were collected from medical records of elderly hospitalized in ICU from a brazilian city called Natal-RN, between november first, 2013 and january, 31 of 2014. The variables collected relate to the socio demographic profile, morbidity framework and characterization of hospitalization. The dependent variable was categorized by quartile 75 in high and low expense of hospitalization and submitted to chi-square test with the independent variables of the survey. Associations with p value <0.20 in the bivariate analysis were submitted to the technique of multiple logistic regression. We opted for the construction of three regression models from the above algorithm: general regression model, composed by all 493 hospitalizations in the study, other made with 181 individuals admitted in health public system (SUS) and a third one related to 312 cases from private service in health area. Results: In the general regression model, the variables respiratory diseases, hospitalizations in the private system, disoriented patient and previous stroke were associated with greater probability of high spending in the ICU. In the other hand, in SUS kind of hospitalizations, this probability was associated with disoriented patient, 80 years old or more, sepsis and admission for clinical reason. In the cases from the private network health, the high expenditure was associated with respiratory disease, mechanical ventilation, hospitalization for clinical reason and disoriented patients. Conclusion: The increased expenditure on hospitalization of elderly in intensive care depends on the clinical conditions of individuals. This highlights the importance of avoiding hospitalizations due to diseases sensitive to primary care by health preventive actions and providing comprehensive care to the elderly. In addition, obtaining different explanatory models, according to kind hospital funding, demonstrates the importance of the organization in health services related to composition of costs of hospitalization among the elderly. Another question founded was the need that to improve the funding, we must use rationally the available resources by avoiding unnecessary hospitalizations of elderly people in the extremes of severity. On this kind of precarious funding, ICU hospitalization of elderly non-critical or in a terminal state can compromise the quality of services provided to those who really need intensive care.

Gravidade do olho seco em pacientes internados em unidade de terapia intensiva: análise de conceito e construção de definições

Dry eye syndrome is a multifactorial disease of the tear film, resulting from the instability of the lacrimal functional unit that produces volume change, up or tear distribution. In patients in intensive care the cause is enhanced due to various risk factors, such as mechanical ventilation, sedation, lagophthalmos, low temperatures, among others. The study's purpose is to build an assessment tool of Dry Eye Severity in patients in intensive care units based on the systematization of nursing care and their classification systems. The aim of this study is to build an assessment tool of Dry Eye Severity in hospitalized patients in Care Unit Intensiva.Trata is a methodological study conducted in three stages, namely: context analysis, concept analysis, construction of operational definitions and magnitudes of nursing outcome. For the first step we used the methodological framework for Hinds, Chaves and Cypress (1992). For the second step we used the model of Walker and Avant and an integrative review Whitemore seconds, Knalf (2005). This step enabled the identification of the concept of attributes, background and consequent ground and the construction of the settings for the result of nursing severity of dry eye. For the construction of settings and operational magnitudes, it was used Psicometria proposed by Pasquali (1999). As a result of context analysis, visualized from the reflection that the matter should be discussed and that nursing needs to pay attention to the problem of eye injury, so minimizing strategies are created this event with a high prevalence. With the integrative review were located from the crosses 19 853 titles, selected 215, and from the abstracts 96 articles were read in full. From reading 10 were excluded culminating in the sample of 86 articles that were used to analyze the concept and construction of settings. Selected articles were found in greater numbers in the Scopus database (55.82%), performed in the United States (39.53%), and published mainly in the last five years (48.82). Regarding the concept of analysis were identified as antecedents: age, lagophthalmos, environmental factors, medication use, systemic diseases, mechanical ventilation and ophthalmic surgery. As attributes: TBUT <10s, Schimer I test <5 mm in Schimer II test <10mm, reduced osmolarity. As consequential: the ocular surface damage, ocular discomfort, visual instability. The settings were built and added indicators such as: decreased blink mechanism and eyestrain.