Prevalência de incontinência urinária e fatores associados em idosos institucionalizados

Urinary incontinence (UI) is a geriatric syndrome that is especially prevalent in institutionalized individuals, and that causes economic and social impacts derived from treatment costs and overload of caregiver. UI also entails physical consequences to the health of the elderly, such as urinary tract infections or pressure ulcers, among other health problems. However, the existing national research on this condition is still scarce and comprises serious methodological biases. Therefore, the objective of this study is to determine the prevalence of urinary incontinence and associated factors in institutionalized elderly. A cross-sectional study is presented herein, conducted between October and December, 2013 and carried out in 10 nursing homes in the city of Natal (Northeast Brazil). UI was verified through the program Minimum Data Set version 3.0, which was also used to assess fecal incontinence, urinary devices and UI control programs. Data collection included sociodemographic information, UI characterization, as well as variables related to the institution itself and to health conditions (comorbidities, medication, pelvic floor surgery, Barthel Index for functional capacity and Pfeiffer test for cognitive status). Bivariate analysis was performed using the Chi-Square Test (or Fisher‟s Exact Test) and the Linear Chi-Square Test, calculating the prevalence ratio with 95% confidence interval. Variables with p value under 0.20 were included in the multivariate analysis, which was performed using the Stepwise Forward logistic regression. The inclusion of variables in the final model depended on the likelihood ratio test, absence of multicollinearity and on the Hosmer-Lemeshow test. A statistical significance level of 0.05 was considered. Six (1.8%) hospitalized elderly, one individual in palliative care (0.3%) and one (0.3%) individual under the age of 60 were excluded from the study. The final sample consisted of 321 elderly, mostly females, with a mean age of 81.5 years. The prevalence of UI was 59.43% and the final model revealed statistically a significant association between UI and white race, physical inactivity, stroke, mobility constraints and cognitive decline. The most frequent UI type was functional UI due to physical or cognitive disability, and incontinence control measures were applied only to a minority of residents (approximately 8%). It is concluded that UI is a health issue that affects more than half of the institutionalized elderly, and is associated with white race, physical inactivity, stroke and other geriatric syndromes such as immobility and cognitive disability. Most of these associated factors are modifiable and therefore the findings of this study highlight the importance of UI prevention and treatment in nursing homes, which include general measures, such as physical and psychosocial activities, and specific measures, such as prompted voiding

Satisfaçã dos Usuários e a qualidade da atenção primária à saúde no Rio Grande do Norte

O presente estudo tem por objetivo avaliar a satisfação dos usuários em relação à qualidade da Atenção Primária à Saúde no Rio Grande do Norte. Trata-se de Pesquisa Avaliativa observacional transversal, com abordagem quantitativa, a qual faz parte da Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ), da Universidade Federal do Rio Grande do Norte. Foram utilizados dados secundários de todas as entrevistas com usuários das equipes que participaram da Avaliação Externa do PMAQ no Estado do RN. A pesquisa foi realizada em 167 municípios do Estado do Rio Grande do Norte, na qual a população foi composta por 1.650 usuários. A amostra se deu por conveniência a partir dos seguintes critérios: usuários que estavam presentes na Unidade Básica de Saúde (UBS) para realizar qualquer tipo de procedimento e que consentisse em participar da avaliação. Foram excluídos os que tinham ido pela primeira vez na unidade e aqueles que não frequentaram há mais de 12 meses. A coleta dos dados foi realizada no período de setembro a novembro de 2013. Para tanto, foi elaborado um protocolo de pesquisa contendo as seguintes dimensões: organizacional, interpessoal e estrutural. Em relação à dimensão organizacional os resultados mostram que a marcação de consultas tem se configurado em empecilho ao acesso do usuário ao serviço de saúde, uma vez que se faz necessário para o atendimento, enfrentar filas, antes da abertura da unidade para pegar fichas. No tocante ao funcionamento da unidade, se destaca o fato dos usuários referirem que o horário de funcionamento da unidade atende à suas necessidades, apesar de funcionar 5 (cinco) dias por semana, a maioria das unidades permanece fechada no horário de almoço. Outro dado importante refere-se à coordenação do cuidado, cujos resultados apresentam diferenças maiores entre os usuários da região metropolitana e do interior do Estado em relação à Capital. Essa diferença se expressa principalmente em relação de marcação de consulta com outros profissionais especialistas. A dimensão interpessoal, no que diz respeito à categorias interação usuário-serviço-equipe e vínculo, demonstraram alguns avanços, contudo os melhores resultados foram observados em relação a satisfação com o cuidado, onde mais de 50% dos usuários se mostraram satisfeitos com o cuidado recebido nas unidades. Em contrapartida, o estudo mostrou que, na opinião de 56% dos usuários da capital, a falta de materiais e equipamentos influencia negativamente no cuidado. Por fim, o estudo contribuiu para reforçar a ideia de que a avaliação da satisfação dos usuários dos serviços de saúde pode ser uma ferramenta importante para subsidiar o processo de decisão compartilhada, de forma a se repensar as práticas profissionais, reorganizar o processo de trabalho desenvolvido, realocar recursos, readequar ações e redefinir objetivos que estejam coerentes com o projeto de saúde estabelecido

Violência e luta por direitos no capitalismo contemporâneo: crítica à configuração do atendimento às mulheres no Rio Grande do Norte

This research analyzes the Rio Grande do Norte care services to women who face violence in the context of contemporary capitalism. To do so, we situate the patriarchy in the set of current social relations and its relationship with the corporate determinations in everyday life. The new functions of the Patriarchy in the capital sociability permeates the lives of individuals and particularizes the relationships of violence which affects women, requiring, in the immediate level, policy-making to face them. The research found an arsenal of contradictory possibilities and limitations in dealing with violence. In this process, forms of struggle and resistance predominate, which appear as possibilities and limits were identified relate to the socio-historical context of regression of the rights, historical moment in which increase the objective difficulties in everyday life to ensure the legal achievements. It is worth to emphasize the achievements and contradictions that characterize the struggle process for rights, linking services to women to the social policies and to the limits they face in opposition to the aims of the State to meet the mandatory requirements of capital, reducing its role as the main guarantor of policies and rights. In this sense, the trajectory of the achievements that have referred to the proclamation of a specific law to deal with combat violence against women, the Maria da Penha Law - 11.340/06, which provides an integrated set of measures that, if implemented, would allow the women protection from relations of violence they experience. We identified in Rio Grande do Norte precarious services that are essential to achieve the Maria da Penha Law. This situation requires a feminist organization to claim the rights that enable women to see themselves as people with rights in the process of collective struggle. This is the historical need for continuity of struggles that accumulate policies for the existence of a new model of social relations of gender. One of the possibilities that are presented in the current context is the impact on the public budget in order to ensure compliance with the budget for public policies for women - woman budget. In this perspective, feminist segments in national and state level have been organized to understand the functioning and monitoring of social policies. This is a condition and prerequisite for ensuring policies to ensure basic rights and the violence combat , which still requires an integrated set of services. The survey results allow us to consider that the struggle for rights is necessary at this historical moment, however it is not sufficient in human emancipation, which requires new forms of social relations that determine substantive equality between men and women. Thus, the feminist movement faces the challenge to organize and strengthen itself in daily life, in order to execute a project that changes the meaning of women's rights, articulated to a corporate project which wants other command in the set of social relations . This study emphasizes the need for a more and more organic connection between feminism and social struggles, to ensure the inclusion of women in anti-capitalist struggle

Controle democrático no capitalismo contemporâneo: limites e contradições

This study examines the determinations of the structural crisis of capital in the democratic control effected on the councils of rights and policies. Therefore the research aimed to apprehend and analyze the conjunctural and structural determinations and cyclical changes that incide on democratic control established by the Federal Constitution of 1988. The specific objectives turned to: (1) identify and analyze the theoretical and political fundamentals of democratic control in the production of social service in ENPESS 2010, in the productions of CFESS and the journal social services and society, (2) apprehend and analyze the possibilities, limits, contradictions and social direction of democratic control in contemporaneity and (3) identify and analyze the major political forces that constitute support and opposition to the exercise of democratic control. To approximate to the intended objectives the way theoretical and methodological covered was based in a perspective of totality that allows the apprehension of the object of study in their contradictory dimensions of universality, particularity and singularity. The results enabled to develop critical analysis of theoretical production of the Brazilian social service on the subject, having as snip studies of the journals social service and society; works of ENPESS 2010 and CFESS positioning. It was found, so in analysis undertaken, the spaces of democratic control suffer inflections of capital that shape their practices and social direction. In theoretical productions chosen, identified the prevalence of democratic control studied under an endogenous perspective to participatory canals, with incipient connections to the structural/conjunctural determinations of a historical period of crisis and seeks to restore the hegemony of capital. The positioning of the CFESS tends to recognition of democratic control in its contradictory dynamics recognizing the limits imposed by the sociability of the capital at the present time

As Faces e os Disfaces da Informalidade no Capitalismo Conteporâneo: Um Estudo do Comércio de Rua em Pau dos Ferros/RN

This paper discusses the expression of informality in contemporary capitalism. Thematic of relevance to the analysis of the reality of work today and the logic that moves the capital, its real presence in the lives of individuals. The street trading of Pau dos Ferros town, popularly known as "street market" was chosen as the search space. The main objective is to seize and examine the articulations and logic, present in the configuration of the street trading of this city, located in the state of Rio Grande do Norte, explaining the functionality of informality for capitalist accumulation, but also for the reproduction of segments of the working class. Our analysis is based in the perspective of totality, trying to grasp the historical determinations of the phenomenon in focus. It includes the analysis of the mechanisms used by the capital to reproduce itself in the current historical context, which has been implicated in the composition of the labor markets of different countries and in various forms of exploitation to which workers in general are subject. It also means discussing the development of capitalism in Brazil, the logic that permeates its dependence, and especially the use of over-exploitation of labor, as a lever for internal accumulation. The course of investigation consisted of theoretical research to form the basis of theoretical and methodological analysis and to outline the context in which our research object is inserted, and field research conducted in two phases: systematic observation, which allowed to map traders features and the infrastructure of commerce, and the conduction of interviews with key informants. The material collected was scrutinized according to analytical scheme inspired by the content analysis. Among the main considerations developed from the research process we include: the street trading of Pau dos Ferros remains shrouded in the majority sale of agricultural products, this demonstrates the structural characteristics of the region. However, the supply of this product is no longer restricted to the excess of small local producers. The presence of the dealer changed the distribution of the product, streamlining it. In parallel, business practices are developed, practices in which traded goods (industrial) reflect the moment of capitalist restoration, a larger business network. The reflections also made it possible to show that street trading follows developing on the basis of informal work, which gains functionality to the system, as it is configured as a space commonly used to drain part of the production, of industries (clothing/shoes), especially if the distribution is considered as an essential element of the complex process that aims at capital appreciation. This activity has been functioning as a place of employment and income generation for the subjects who are away from formal employment, masking, this way, unemployment, moreover, they allow them to continue as consumers. Such expressions reflect the ability and the logic of capital to expand and aggregate into so many realities. It is underway today, the logic that has led many workers to join the project of domination of capital, by the illusory chance to become capitalists. The aim has been to turn the subject into a consumer and the worker an enterprising

A articulação da instrumentalidade no exercício profissional do assistente social em Natal/RN

Presents the discussion of practical and social dimensions that comprise the instrumentality (formative; theoretical and intellectual; investigative; technical-instrumental; and ethical-political) Social Work from research in social and occupational areas in which they operate social workers in Natal in Rio Grande do Norte. Chapters expose positions, experiences and reality of the respondents and the theoretical constructs and analytical, to understand: the evaluation of the training process, relating the teaching practice, the role of knowledge and the importance of research in professional practice of social workers, the seizure of technical-instrumental dimension, articulating demands, duties, powers and instruments, as elements that comprise it, and finally the ethical-political dimension, discussing the challenges of ethics and materialization of the ethical-political in daily work. In this sense, the dissertation sought add to production and academic debate about the work of the social worker, as well as contribute to their own professional practice, revealing how professionals articulate the practical and social dimensions that comprise the instrumentality in their daily work

Serviço social na educação: análise das tendencias dos perfis pedagógicos do assistente social

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

MARISA-MDD: uma abordagem para transformações entre modelos orientados a aspectos: dos requisitos ao projeto detalhado

Aspect Oriented approaches associated to different activities of the software development process are, in general, independent and their models and artifacts are not aligned and inserted in a coherent process. In the model driven development, the various models and the correspondence between them are rigorously specified. With the integration of aspect oriented software development (DSOA) and model driven development (MDD) it is possible to automatically propagate models from one activity to another, avoiding the loss of information and important decisions established in each activity. This work presents MARISA-MDD, a strategy based on models that integrate aspect-oriented requirements, architecture and detailed design, using the languages AOV-graph, AspectualACME and aSideML, respectively. MARISA-MDD defines, for each activity, representative models (and corresponding metamodels) and a number of transformations between the models of each language. These transformations have been specified and implemented in ATL (Atlas Definition Language), in the Eclipse environment. MARISA-MDD allows the automatic propagation between AOV-graph, AspectualACME, and aSideML models. To validate the proposed approach two case studies, the Health Watcher and the Mobile Media have been used in the MARISA-MDD environment for the automatic generation of AspectualACME and aSideML models, from the AOV-graph model

Projeto e implementação de uma plataforma MP-SoC usando SystemC

This work presents the concept, design and implementation of a MP-SoC platform, named STORM (MP-SoC DirecTory-Based PlatfORM). Currently the platform is composed of the following modules: SPARC V8 processor, GPOP processor, Cache module, Memory module, Directory module and two different modles of Network-on-Chip, NoCX4 and Obese Tree. All modules were implemented using SystemC, simulated and validated, individually or in group. The modules description is presented in details. For programming the platform in C it was implemented a SPARC assembler, fully compatible with gcc s generated assembly code. For the parallel programming it was implemented a library for mutex managing, using the due assembler s support. A total of 10 simulations of increasing complexity are presented for the validation of the presented concepts. The simulations include real parallel applications, such as matrix multiplication, Mergesort, KMP, Motion Estimation and DCT 2D

Squid impact analyser: uma ferramenta para análise de impacto de mudança em linhas de produto de software

Software Products Lines (SPL) is a software engineering approach to developing software system families that share common features and differ in other features according to the requested software systems. The adoption of the SPL approach can promote several benefits such as cost reduction, product quality, productivity, and time to market. On the other hand, the SPL approach brings new challenges to the software evolution that must be considered. Recent research work has explored and proposed automated approaches based on code analysis and traceability techniques for change impact analysis in the context of SPL development. There are existing limitations concerning these approaches such as the customization of the analysis functionalities to address different strategies for change impact analysis, and the change impact analysis of fine-grained variability. This dissertation proposes a change impact analysis tool for SPL development, called Squid Impact Analyzer. The tool allows the implementation of change impact analysis based on information from variability modeling, mapping of variability to code assets, and existing dependency relationships between code assets. An assessment of the tool is conducted through an experiment that compare the change impact analysis results provided by the tool with real changes applied to several evolution releases from a SPL for media management in mobile devices

Avaliação da execução de aplicações orientadas à dados na arquitetura de redes em chip IPNoSys

The increasing complexity of integrated circuits has boosted the development of communications architectures like Networks-on-Chip (NoCs), as an architecture; alternative for interconnection of Systems-on-Chip (SoC). Networks-on-Chip complain for component reuse, parallelism and scalability, enhancing reusability in projects of dedicated applications. In the literature, lots of proposals have been made, suggesting different configurations for networks-on-chip architectures. Among all networks-on-chip considered, the architecture of IPNoSys is a non conventional one, since it allows the execution of operations, while the communication process is performed. This study aims to evaluate the execution of data-flow based applications on IPNoSys, focusing on their adaptation against the design constraints. Data-flow based applications are characterized by the flowing of continuous stream of data, on which operations are executed. We expect that these type of applications can be improved when running on IPNoSys, because they have a programming model similar to the execution model of this network. By observing the behavior of these applications when running on IPNoSys, were performed changes in the execution model of the network IPNoSys, allowing the implementation of an instruction level parallelism. For these purposes, analysis of the implementations of dataflow applications were performed and compared

RR3D: Uma solução para renderização remota de imagens médicas tridimensionais

The visualization of three-dimensional(3D)images is increasigly being sed in the area of medicine, helping physicians diagnose desease. the advances achived in scaners esed for acquisition of these 3d exames, such as computerized tumography(CT) and Magnetic Resonance imaging (MRI), enable the generation of images with higher resolutions, thus, generating files with much larger sizes. Currently, the images of computationally expensive one, and demanding the use of a righ and computer for such task. The direct remote acess of these images thruogh the internet is not efficient also, since all images have to be trasferred to the user´s equipment before the 3D visualization process ca start. with these problems in mind, this work proposes and analyses a solution for the remote redering of 3D medical images, called Remote Rendering (RR3D). In RR3D, the whole hedering process is pefomed a server or a cluster of servers, with high computational power, and only the resulting image is tranferred to the client, still allowing the client to peform operations such as rotations, zoom, etc. the solution was developed using web services written in java and an architecture that uses the scientific visualization packcage paraview, the framework paraviewWeb and the PACS server DCM4CHEE.The solution was tested with two scenarios where the rendering process was performed by a sever with graphics hadwere (GPU) and by a server without GPUs. In the scenarios without GPUs, the soluction was executed in parallel with several number of cores (processing units)dedicated to it. In order to compare our solution to order medical visualization application, a third scenario was esed in the rendering process, was done locally. In all tree scenarios, the solution was tested for different network speeds. The solution solved satisfactorily the problem with the delay in the transfer of the DICOM files, while alowing the use of low and computers as client for visualizing the exams even, tablets and smart phones

Projeto e implementação em FPGA de um processador com conjunto de instrução reconfigurável utilizando VHDL

The Reconfigurable Computing is an intermediate solution at the resolution of complex problems, making possible to combine the speed of the hardware with the flexibility of the software. An reconfigurable architecture possess some goals, among these the increase of performance. The use of reconfigurable architectures to increase the performance of systems is a well known technology, specially because of the possibility of implementing certain slow algorithms in the current processors directly in hardware. Amongst the various segments that use reconfigurable architectures the reconfigurable processors deserve a special mention. These processors combine the functions of a microprocessor with a reconfigurable logic and can be adapted after the development process. Reconfigurable Instruction Set Processors (RISP) are a subgroup of the reconfigurable processors, that have as goal the reconfiguration of the instruction set of the processor, involving issues such formats, operands and operations of the instructions. This work possess as main objective the development of a RISP processor, combining the techniques of configuration of the set of executed instructions of the processor during the development, and reconfiguration of itself in execution time. The project and implementation in VHDL of this RISP processor has as intention to prove the applicability and the efficiency of two concepts: to use more than one set of fixed instructions, with only one set active in a given time, and the possibility to create and combine new instructions, in a way that the processor pass to recognize and use them in real time as if these existed in the fixed set of instruction. The creation and combination of instructions is made through a reconfiguration unit, incorporated to the processor. This unit allows the user to send custom instructions to the processor, so that later he can use them as if they were fixed instructions of the processor. In this work can also be found simulations of applications involving fixed and custom instructions and results of the comparisons between these applications in relation to the consumption of power and the time of execution, which confirm the attainment of the goals for which the processor was developed