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

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

Razão e Fé: estudo do grupo de oração como prática complementar na promoção à saúde

The World Health Organization (WHO) has given special attention to therapeutic procedures other than those practiced in conventional therapy, including homeopathy, phytotherapy, spiritual therapies and prayers, making possible the transition from a mere medicalizating model to a holistic view of the human being. This trend, earmarked in 1978 at the Alma-Ata Conference, questions the ability of technological and specialized medicine to solve the health problems of humankind. In Brazil, the onset of the Brazilian unified health system in 1988, introduced changes in the population s health care model where, within the scope of basic care, emphasis has been given to the Family Health Program since 1994. In this scenery, there is a broad area of complementary practices used in promoting health and preventing and treating diseases to support an understanding of the habits and beliefs underpinning popular practices. The purpose of this study was to analyze the perception users participating in the Peace and Balance group of the Family Health Unit of Nova Cidade, in Natal, Rio Grande do Norte, started in 1999, have of the relationship between the experience of prayer and the changes that may have taken place in their lives after joining the group. It is a case study of descriptive nature and qualitative approach. The data were collected during focus group interviews between January and February 2007, using as tools a questionnaire to describe the research participants and a discussion outline. The theoretical support approached the following: religion and the evolution of thought; complementary health practices; and religion as a complementary health practice. Those interviewed reported, as results of such experience, a reduction in stress and depression, an increase in socialization and self-esteem, improved family interaction, comfort, safety, assurance, improved blood pressure levels and a decrease in the use of antihypertension medication and psychopharmacs. Although most professionals do not consider attention to the religious and spiritual aspects an effective therapeutical complement in health care, its understanding and practice may democratize knowledge and relationships, out of which they can learn how to make health production more effective, strengthening assurance and confidence, and developing and expanding soft technologies aimed at health care promotion and wholeness

Vivência do enfermeiro no cuidado humano na Unidade de Terapia Intensiva adulto

The purpose of the study was to understand the nurse s experience with human care in the Adult Intensive Care Unit (ICU). The objective was to describe the nurse s experience in caring for patients in the ICU and to analyze the nurse s perception of the care provided. The study is a descriptive inquiry of qualitative nature with a phenomenological approach. We interviewed eight nurses, 26 and 43 years of age, that provide care in the ICU of a private hospital in Natal/RN, during the manths of July and August of 2006. We analyzed the data acording to the method of Colaizzi. Four categories emerged from the data: The search for the maintenance of life, The technicalbureaucratic activities, The recognition of the patient s individuality, and the expression of the nurse s feelings.The analysis allowed us to describe the lived experience of the nurse s care the ICU and to comprehend the structural elements of this experience. The results showed that the nurse s experience presents itself as a process of the several actions and feelings that occur while the social relations between the patient and the nurse develop. Finally, we understand that although the study shows an experience based on a biological model of health, these nurses possess an initial idea on how to reach humanized care in its essence, needing, however, of an institutional policy that favors this practice, an educational formation that prepares her to recognize her field of work as a place of continuous learning and an understanding of the health model as an ally in the search of humanized care

Proposta de localização de uma unidade de tratamento de óleo e gordura residual de fritura na cidade do Natal/RN para produção de biodiesel

This work addresses biodiesel by transesterification from the use of waste frying oil as a possible technological alternative for both reducing greenhouse gas emissions and by presenting themselves as an environmental call to designate a rational use of oil when no longer played in the environment to become renewable energy. It has proposed location of a residual oil and fat treatment plant to produce biodiesel, using models of Location and Routing for the improvement of routes. To achieve the goal, questionnaires were administered in establishments that use oil or vegetable fat in their productive activities in order to quantify the residue, to analyze actions and environmental perception of people who work directly with the residue on the destination you are being given to oil and fat used. It has indicated using of two single setup location, the method of Center of Gravity and the model of Ardalan, a geographical point that minimizes the costs of transporting waste to the treatment plant. Actions have been proposed for the improvement of collection routes this residue using the Routing Method of Scanning, as an illustration. The results demonstrated the lack of knowledge of the people who deal directly with large amounts of waste, on the environmental impacts caused by their incorrect disposal. The models used were uniform since point out to neighborhoods in similar regions. The neighborhoods of Lagoa Nova / Morro Branco (Ardalan) and Nova Descoberta (Center of Gravity) as ideal for the installation of treatment plant. However, it is suggested to be tested other models that take into account new variables than those used (supply of waste and the distance between points). The routing through the method of scanning has shown that it is possible, in a simple way to optimize routes in order to reduce distances and therefore the logistics costs in the collection of such waste. Introducing a route as a test to gather the twenty largest oil suppliers used in sample frying, using as a main factor time 8 hour of working shift every day

A pegada de carbono como um dos indicadores de sustentabilidade para medição da responsabilidade socioambiental empresarial: um estudo de caso na unidade sede da Petrobras em Natal-RN

As a contemporary tendency, it is been evidenced that the environmental changes theme, already admitted as a concernment to international economical and political reality, is also gaining repercussion on industrial and business sector. Firms are implementing actions on trial to minimize their own greenhouse gases (GHG) emissions impacts. However, the great majority of those actions of Corporative Social-Environmental Responsibility (CSR) are referred only to direct emissions of the main production systems. Direct emissions are those derived of an isolate process, without considering the upstream and downstream processes emissions, which respond for the majority of emissions originated because of respective firm‟s production system existence. Because the greenhouse effect occurs globally and the GHG emissions contribute to the environmental changes independently of their origin, it must be taken into account the whole productive life cycle of products and systems, since the energy invested on resources extraction and necessary materials to the final disposal. To do so, it must be investigated all relevant steps of a product/production system life cycle, tracking all activities which emit greenhouse gases, directly or indirectly. This amount of emissions consists in the firm‟s Carbon Footprint. This research purpose is to defend the Carbon Footprint relevance and its adoption viability to be used as an Environmental Indicator on measurement/assessment of CSR. It has been realized a study case on Petrobras‟s seat unity at Natal-Brazil, assessing part of its Carbon Footprint. It has been used the software GEMIS 4.6 to do the emissions quantifying. The items measured were the direct emissions of the own unity vehicles and indirect emissions of offset paper (A4), energy and disposable plastic cups consumed. To 2009, these emissions were 3.811,94 tCO2eq. We may conclude that Carbon Footprint quantification is indispensable to the knowledge of real emissions caused by a productive process existence, must serving as basis to CSR decisions about the environmental changes reversion challenge

Balanced scorecard como ferramenta de gestão aplicada a unidade hospitalar privada

In this study the objective is to implant Balanced Scorecard administration for the development of a Strategic Map, for the support of the electric outlet of decisions in the administration of operations of an unit of attendance doctor-hospitalar. The present work presents a case study developed at a private hospital in the State of Rio Grande do Norte. The collection of data was developed after the analysis of the revision of the literature, and he/she had as critical judgement of evaluation used by the following Unit. The work is concluded in the proposition of a strategic map that elevates the return on investment (financial perspective), in the item profitability and growth. In the search of the customer's satisfaction (customer's perspective), that is nothing else than it already exists inside of the Unit in study, just needing to be organized and aligned with the executive picture and the other collaborators. The requirements competitiveness, information, innovation and technology (perspective of the internal processes), they were indispensable to eliminate the re-work, waste and to improve the automation. It is finally, the investment and development of innovation mechanisms, they enlarge important competitive advantage in the processes for creation of value, through the ability, attitude and knowledge (perspective of the learning and growth). As one of the results of this study a strategic map was developed, looked for in Balanced Scorecard, for support in the electric outlet of decisions of the administration of operations of an Unit Doctor- Healthcare

Análise de desempenho de sistemas de comunicação sem-fio para monitoramento de unidade de produção de poços petrolíferos terrestres

The greater part of monitoring onshore Oil and Gas environment currently are based on wireless solutions. However, these solutions have a technological configuration that are out-of-date, mainly because analog radios and inefficient communication topologies are used. On the other hand, solutions based in digital radios can provide more efficient solutions related to energy consumption, security and fault tolerance. Thus, this paper evaluated if the Wireless Sensor Network, communication technology based on digital radios, are adequate to monitoring Oil and Gas onshore wells. Percent of packets transmitted with successful, energy consumption, communication delay and routing techniques applied to a mesh topology will be used as metrics to validate the proposal in the different routing techniques through network simulation tool NS-2

Influência da densidade básica da madeira de clones de Eucalyptus grandis x Eucalyptus urophylla na qualidade da polpa branqueada.

The study analyzed the wood basic density effect in two Eucalyptus grandis x Eucalyptus urophylla hybrid clones (440 kg/m(3) e 508 kg/m(3)) on bleached pulp quality (fiber dimensions and physical-mechanical properties). The woods performance on pulping, bleaching and beating results were analyzed. The Kraft pulping was carried out in forced circulation digester in order to obtain 17 +/- 1 kappa number targets. The pulps were bleached to 90 +/- 1 using delignification oxygen and D0EOPD1 bleaching sequence. Bleached pulp of low basic density clone showed, significantly, lowest revolutions number in the PFI mill to reach tensile index of 70 N.m/g, low Schopper Riegler degree and generated sheets with higher values to bulk and opacity. These characteristics and properties allow concluding that bleached pulp of low basic density clone was the most indicated to produce printing and writing sheets. The bleached pulp of high basic density clone showed higher values of bulk and capillarity Klemm and lower water retention value when analyzed without beating. The bleached pulp of high basic density clone showed more favorable characteristics to the production of tissue papers.

Desenvolvimento de um software de comunicação sem fio aplicado à instrumentação de unidade de elevação de petróleo tipo Plunger Lift

This dissertation aims to develop a software applied to a communication system for a wireless sensor network (WSN) for tracking analog and digital variables and control valve of the gas flow in artificial oil s elevation units, Plunger Lift type. The reason for this implementation is due to the fact that, in the studied plant configuration, the sensors communicate with the PLC (Programmable and Logic Controller) by the cables and pipelines, making any changes in that system, such as changing the layout of it, as well as inconveniences that arise from the nature of the site, such as the vicinity s animals presence that tend to destroy the cables for interconnection of sensors to the PLC. For software development, was used communication polling method via SMAC protocol (Simple Medium Access ControlIEEE 802.15.4 standard) in the CodeWarrior environment to which generated a firmware, loaded into the WSN s transceivers, present in the kit MC13193-EVK, (all items described above are owners of Freescale Semiconductors Inc.). The network monitoring and parameterization used in its application, was developed in LabVIEW software from National Instruments. The results were obtained through the observation of the network s behavior of sensors proposal, focusing on aspects such as: indoor and outdoor quantity of packages received and lost, general aspects of reliability in data transmission, coexistence with other types of wireless networks and power consumption under different operating conditions. The results were considered satisfactory, which showed the software efficiency in this communication system

UMEB - Unidade Móvel para Ensaio da Barra de Tração

Um equipamento denominado Unidade Móvel de Ensaio da Barra de Tração - UMEB, foi desenvolvido na FCA/UNESP de Botucatu para realizar ensaios de tratores em solo agrícola. Construída a partir de um reboque (trailer), a UMEB foi adaptada para servir como carro dinamométrico instrumentado, utilizado na avaliação do desempenho de tratores submetidos a ensaios na barra de tração. Sua massa total é de 10.500 kg sustentados por um conjunto de seis rodados pneumáticos. Ensaios de campo mostraram que a UMEB proporcionou força de tração acima de 35 kN, mantendo-a constante, em diferentes condições de superfície do solo, mesmo quando a velocidade de deslocamento foi modificada.

Um modelo de unidade de medida inercial utilizando três acelerômetros triaxiais

No espaço tridimensional, um corpo rígido qualquer pode efetuar translações e ou rotações em relação a cada um de seus eixos. Identificar com precisão o deslocamento realizado por um corpo é fundamental para alguns tipos de sistemas em engenharia. Em sistemas de navegação inercial tradicionais, utilizam-se acelerômetros para reconhecer a aceleração linear e giroscópios para reconhecer a velocidade angular registrada durante o deslocamento. O giroscópio, entretanto, é um dispositivo de custo mais elevado e com alto consumo de energia quando comparado a um acelerômetro. Essa desvantagem deu origem a pesquisas a respeito de sistemas e unidades de medidas inerciais que não utilizam giroscópios. A ideia de utilizar apenas acelerômetros para calcular o movimento linear e angular surgiu no início da década de 60 e vem se desenvolvendo através de modelos que variam no número de sensores, na maneira como estes são organizados e no modelo matemático que é utilizado para derivar o movimento do corpo. Esse trabalho propõe um esquema de configuração para construção de uma unidade de medida inercial que utiliza três acelerômetros triaxiais. Para identificar o deslocamento de um corpo rígido a partir deste esquema, foi utilizado um modelo matemático que utiliza apenas os nove sinais de aceleração extraídos dos três sensores. A proposta sugere que os sensores sejam montados e distribuídos em formato de L . Essa disposição permite a utilização de um único plano do sistema de coordenadas, facilitando assim a instalação e configuração destes dispositivos e possibilitando a implantação dos sensores em uma única placa de circuito integrado. Os resultados encontrados a partir das simulações iniciais demonstram a viabilidade da utilização do esquema de configuração proposto

Protótipo de uma unidade com tri-geração de energia para utilizações remotas: aplicação de módulo secondutivo gerador termoelétrico

The generation for termoeletricity is characterized as a solid process of conversion of thermal energy (heat) in electric without the necessity of mobile parts. Although the conversion process is of low efficiency the system presents high degree of trustworthiness and low requisite of maintenance and durability. Its principle is based on the studies of termogeneration carried through by Thomas Seebeck in 1800. The frank development of the technologies of solid state for termoeletricity generation, the necessity of the best exploitation of the energy, also with incentive the cogeneration processes, the reduction of the ambient impact allies to the development of modules semiconductors of high efficiency, converge to the use of the thermoeletric generation through components of solid state in remote applications. The work presents the development, construction and performance evaluation of an prototype, in pilot scale, for energy tri-generation aiming at application in remote areas. The unit is composed of a gas lamp as primary source of energy, a module commercial semiconductor for thermoelectric generation and a shirt for production of the luminosity. The project of the device made compatible a headstock for adaptation in the gas lamp, a hot source for adaptation of the module, an exchanger of to be used heat as cold source and to compose first stage of cogeneration, an exchanger of tubular heat to compose second stage of cogeneration, the elaboration of a converter dc-dc type push pull, adequacy of a system of acquisition of temperature. It was become fullfilled assembly of the prototype in group of benches for tests and assay in the full load condition in order to evaluate its efficiency, had been carried through energy balance of the unit. The prototype presented an electric efficiency of 0,73%, thermal of 56,55%, illumination of 1,35% and global of 58,62%. The developed prototype, as the adopted methodology of assay had also taken care of to the considered objectives, making possible the attainment of conclusive results concerning to the experiment. Optimization in the system of setting of the semicondutor module, improvement in the thermal insulation and design of the prototype and system of protection to the user are suggestions to become it a commercial product