Comparação da adaptação cervical de estruturas metálicas para metalo-cerâmica obtidas através de técnica de fundição rápida e convencional, utilizando três revestimentos comerciais

Pós-graduação em Odontologia - FOA

Atenção à saúde infantil pela estratégia de saúde da família sob a ótica de usuárias de unidades de Botucatu

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Compreendendo a experiência de crianças e adolescentes submetidos à punção de medula óssea e lombar em centro cirúrgico de um hospital oncológico

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Genetic diversity among volunteer donors of bone marrow in southeastern Brazil, according to the HLA system

CONTEXTO E OBJETIVO:Para a realização de transplantes de medula óssea com material alogênico, é necessária a verificação de histocompatibilidade das moléculas do sistema HLA (human leukocyte antigen), fundamental para o sucesso desses transplantes. O objetivo desta pesquisa foi caracterizar os doadores de medula óssea segundo gênero, idade, etnia e grupos HLA de um centro regional de hemoterapia brasileiro.TIPO DE ESTUDO E LOCAL:Estudo descritivo dos doadores cadastrados em um centro regional de hemoterapia de um hospital público universitário da região Sudeste do Brasil.MÉTODOS:Foram consultadas as fichas dos 66.780 doadores cadastrados entre 2005 e junho de 2011 e tabuladas as variáveis estudadas.RESULTADOS:Encontrou-se distribuição equilibrada entre os gêneros, e 82,8% dos doadores tinham até 45 anos de idade. Quanto à etnia auto-referida, 77,3% se apresentaram como brancos, 15,0% como pardos, 5,7% como negros, os 2% restantes dividindo-se em outras etnias. Quanto à caracterização imunogenética, no grupo alélico HLA-A, o mais frequente foi o HLA-A*02, com 39,20%; no grupo alélico HLA-B, o mais comum foi o HLA-B*35, com 14,18%; no grupo alélico HLA-DRB1, o mais frequente foi o HLA-DRB1*03, com 17,03% do total de doadores. Quando esses resultados são comparados com os dados do cadastro nacional de doadores (REDOME), observam-se diferenças demográficas e imunogenéticas, que se explicam pelo histórico de imigração da região de Ribeirão Preto, no Sudeste brasileiro.CONCLUSÕES:Os resultados encontrados reforçam a importância de conhecer o perfil demográfico e imunogenético das regiões do Brasil, para reduzir o tempo de espera por um doador histocompatível.

Satisfação dos Usuários do Ambulatório Geral do Hospital das Clínicas de Botucatu

The searches for a health service it’s a part of a process, searches for a qualified evaluation can arise the perception, in form of irritating factors taking for an alert state. The personal expectation, it makes influence in its perceptions, too. The objective was to evaluate the satisfaction degree of the users of “Seção Técnica de Ambulatório Geral do Hospital das Clínicas de Botucatu”. The work is about a quantitative and transversal study, with calculated sample of 366 users, chosen randomly and invited to participate through a questionnaire. The population was compounded by a majority of women (64,5%), between 50 to 59 years old and average degree of education (38,3%). 25 specialties were cited. The evaluate about comfort, cleaning, reception, waiting time, medical attention and nursing vary between “very good” and “good”. Obtained significant “regular” assessment, the comfort in the waiting rooms (24%), silence (25%) and cleaning bathroom (63%). Others negative evaluation was the reception about the waiting time (26%), waiting time between arrival and the consultation (34%), waiting time between the request and consultation (27%). 30,6% report to know the place for complaints and 79,4% of these pointed to the ombudsman. 62% consider their problems solved, 84,4% would indicate the hospital, 57,4% would consider the hospital better than imagined. 42,62% used the opened area for thanking, critical for staff, suggestion infrastructure improvements, cleaning and waiting time. The biggest complaint was the staff turnover in the treatment. There was disharmony between the objective and subjective questions, but, all of them must be considered to propose improvements. The satisfaction evaluation makes the service more effective, bringing credibility to the health service and the patients adhere better to the treatment

Cronopoiese e cronotrofia na história em quadrinhos

This article proposes a reflection on the “continuities of the process” in narratives, defined by the closure of the space and by the waiting in time (chronopoiesis), as well as on the “halts of the process” in narratives, defined by the opening of the space and by the repose in time (chronotrophy). In Claude Zilberberg?s proposal about the missive making (le faire missif ), it means, the profound making that governs the becoming of the narratives, temporality and spatiality are related to the categories of closure and opening. The terms chronopoiesis and chronotrophy, established by Zilberberg from the Greek stems, have etymologically in common the stem “krónos”, the time. The first term is added to “poiesis”, “creation”; the second comes together with “trophê”, the “feeding”, the “development”. The remissive making, that carries the “continuities of the process”, is chronopoietic (the expectant temporality, which creates the waiting time), and spatially closed. On the other hand, the emissive making, which carries the “halts of the process”, is chronotrophic (the “originating” temporality, because it is “fed”, creating the passing time) and spatially open. Our reflection on chronopoiesis and chronotrophy aims at verifying if these temporal operations of the missivity necessarily correspond to spatial closures and openings, respectively, as the Zilberberg’s model proposes, in verbo-visual narratives, specifically in comics.

Avaliação da qualidade de vida dos pacientes submetidos a artroplastia total primária do quadril antes e após a cirurgia

Pós-graduação em Saúde Coletiva - FMB

DiffServer: Application Level Differentiated Services for Web Servers

Web content hosting, in which a Web server stores and provides Web access to documents for different customers, is becoming increasingly common. For example, a web server can host webpages for several different companies and individuals. Traditionally, Web Service Providers (WSPs) provide all customers with the same level of performance (best-effort service). Most service differentiation has been in the pricing structure (individual vs. business rates) or the connectivity type (dial-up access vs. leased line, etc.). This report presents DiffServer, a program that implements two simple, server-side, application-level mechanisms (server-centric and client-centric) to provide different levels of web service. The results of the experiments show that there is not much overhead due to the addition of this additional layer of abstraction between the client and the Apache web server under light load conditions. Also, the average waiting time for high priority requests decreases significantly after they are assigned priorities as compared to a FIFO approach.

Avaliação da qualidade de vida dos pacientes submetidos a artroplastia total primária do quadril antes e após a cirurgia

Pós-graduação em Saúde Coletiva - FMB

Subcritical fatigue in fuse networks

We obtain the Paris law of fatigue crack propagation in a fuse network model where the accumulated damage in each resistor increases with time as a power law of the local current amplitude. When a resistor reaches its fatigue threshold, it burns irreversibly. Over time, this drives cracks to grow until the system is fractured into two parts. We study the relation between the macroscopic exponent of the crack-growth rate -entering the phenomenological Paris law-and the microscopic damage accumulation exponent, gamma, under the influence of disorder. The way the jumps of the growing crack, Delta a, and the waiting time between successive breaks, Delta t, depend on the type of material, via gamma, are also investigated. We find that the averages of these quantities, <Delta a > and <Delta t >/< t(r)>, scale as power laws of the crack length a, <Delta a > proportional to a(alpha) and <Delta t >/< t(r)> proportional to a(-beta), where < t(r)> is the average rupture time. Strikingly, our results show, for small values of gamma, a decrease in the exponent of the Paris law in comparison with the homogeneous case, leading to an increase in the lifetime of breaking materials. For the particular case of gamma = 0, when fatigue is exclusively ruled by disorder, an analytical treatment confirms the results obtained by simulation. Copyright (C) EPLA, 2012

A study of pent-up demand in ophthalmology: Divinolandia Hospital/Unicamp

Objective: To assess the waiting time for eye care identifying the number of patients with each complaint; to investigate how the waiting time may worsen the patient's condition; to check the screening of urgent cases for effectiveness; and to devise means of increasing the medical-surgical care capacity. Methods: A retrospective descriptive survey was conducted using data obtained on 12 occasions during collaborative team visits to provide eyecare services. These initiatives were designed to decrease the waiting time and to treat urgent cases that occurred on each occasion; eyecare services were provided every Saturday, in the period from June to August 2006, in 16 cities of the region covered by Conderg (Consortium for the Development of the Sao Joao da Boa Vista Administrative Region). Results: Referrals used 1,743 (87.1%) of the 2,000 places available. The most frequent diagnoses were refractive errors, with 683 cases, corresponding to 39.1% of the total, followed by cataracts, with 296 cases, corresponding to 20.9%. Of the 238 surgeries indicated, 54.6% were phakectomies. Thirty-five (2.0%) cases were considered urgent. Conclusion: The most common diagnoses made during the team visits to manage the excess demand for eyecare were refractive errors and cataracts, which, together, accounted for the majority of the cases. The Divinolandia Hospital has the necessary human and material resources to meet the demand left unattended by the local SUS network. Immediate referral of urgent cases by the primary units' screeners proved effective.

PERFORMANCE EVALUATION OF RESOURCE-AWARE BUSINESS PROCESSES USING STOCHASTIC AUTOMATA NETWORKS

In this work, we study the performance evaluation of resource-aware business process models. We define a new framework that allows the generation of analytical models for performance evaluation from business process models annotated with resource management information. This framework is composed of a new notation that allows the specification of resource management constraints and a method to convert a business process specification and its resource constraints into Stochastic Automata Networks (SANs). We show that the analysis of the generated SAN model provides several performance indices, such as average throughput of the system, average waiting time, average queues size, and utilization rate of resources. Using the BP2SAN tool - our implementation of the proposed framework - and a SAN solver (such as the PEPS tool) we show through a simple use-case how a business specialist with no skills in stochastic modeling can easily obtain performance indices that, in turn, can help to identify bottlenecks on the model, to perform workload characterization, to define the provisioning of resources, and to study other performance related aspects of the business process.

A study of pent-up demand in ophthalmology: Divinolândia Hospital/Unicamp

OBJECTIVE: To assess the waiting time for eye care identifying the number of patients with each complaint; to investigate how the waiting time may worsen the patient's condition; to check the screening of urgent cases for effectiveness; and to devise means of increasing the medical-surgical care capacity. METHODS: A retrospective descriptive survey was conducted using data obtained on 12 occasions during collaborative team visits to provide eyecare services. These initiatives were designed to decrease the waiting time and to treat urgent cases that occurred on each occasion; eyecare services were provided every Saturday, in the period from June to August 2006, in 16 cities of the region covered by Conderg (Consortium for the Development of the São João da Boa Vista Administrative Region). RESULTS: Referrals used 1,743 (87.1%) of the 2,000 places available. The most frequent diagnoses were refractive errors, with 683 cases, corresponding to 39.1% of the total, followed by cataracts, with 296 cases, corresponding to 20.9%. Of the 238 surgeries indicated, 54.6% were phakectomies. Thirty-five (2.0%) cases were considered urgent. CONCLUSION: The most common diagnoses made during the team visits to manage the excess demand for eyecare were refractive errors and cataracts, which, together, accounted for the majority of the cases. The Divinolândia Hospital has the necessary human and material resources to meet the demand left unattended by the local SUS network. Immediate referral of urgent cases by the primary units' screeners proved effective.

La qualità erogata da un'azienda di trasporto collettivo in ambito urbano: calcolo del livello di servizio delle principali linee di ATC (BO)

Oggetto di questa tesi è lo studio della qualità del servizio di trasporto erogato che condiziona la qualità percepita dall’utente, poiché spesso proprio a causa di un errato processo di pianificazione e gestione della rete, molte aziende non sono in grado di consolidare un alto livello di efficienza che permetta loro di attrarre e servire la crescente domanda. Per questo motivo, si è deciso di indagare sugli aspetti che determinano la qualità erogata e sui fattori che la influenzano, anche attraverso la definizione di alcuni indicatori rappresentativi del servizio erogato. L’area di studio considerata è stata quella urbana di Bologna, e sono state prese in esame due linee di ATC, la 19 e la 27, caratterizzate entrambe da una domanda di trasporto molto elevata. L’interesse è ricaduto in modo particolare sugli aspetti legati alla regolarità del servizio, ovvero al rispetto della cadenza programmata delle corse e alla puntualità, ossia il rispetto dell’orario programmato delle stesse. Proprio da questi due aspetti, infatti, dipende in larga misura la percezione della qualità che gli utenti hanno del servizio di trasporto collettivo. Lo studio è stato condotto sulla base di dati raccolti attraverso due campagne di rilevamento, una effettuata nel mese di maggio dell’anno 2008 e l’altra nel mese di settembre dello stesso anno. La scelta del periodo, della zona e delle modalità di rilevamento è strettamente connessa all’obiettivo prefissato. Il servizio è influenzato dalle caratteristiche del sistema di trasporto: sia da quelle legate alla domanda che da quelle legate all’offerta. Nel caso della domanda di trasporto si considera l’influenza sul servizio del numero di passeggeri saliti e del tempo di sosta alle fermate. Nel caso dell’offerta di trasporto si osservano soprattutto gli aspetti legati alla rete di trasporto su cui si muovono gli autobus, analizzando quindi i tempi di movimento e le velocità dei mezzi, per vedere come le caratteristiche dell’infrastruttura possano condizionare il servizio. A tale proposito è opportuno dire che, mentre i dati della prima analisi ci sono utili per lo studio dell’influenza del tempo di sosta sull’intertempo, nella seconda analisi si vuole cercare di effettuare ulteriori osservazioni sull’influenza del tempo di movimento sulla cadenza, prendendo in esame altri elementi, come ad esempio tratti di linea differenti rispetto al caso precedente. Un’attenzione particolare, inoltre, verrà riservata alla verifica del rispetto della cadenza, dalla quale scaturisce la definizione del livello di servizio per ciò che riguarda la regolarità. Per quest’ultima verrà, inoltre, determinato anche il LOS relativo alla puntualità. Collegato al problema del rispetto della cadenza è il fenomeno dell’accodamento: questo si verifica quando i mezzi di una stessa linea arrivano contemporaneamente ad una fermata uno dietro l’altro. L’accodamento ha, infatti, origine dal mancato rispetto della cadenza programmata tra i mezzi ed è un’evidente manifestazione del mal funzionamento di un servizio di trasporto. Verrà infine condotta un’analisi dei fattori che possono influenzare le prestazioni del servizio di trasporto pubblico, così da collocare i dati ottenuti dalle operazioni di rilevamento in un quadro più preciso, capace di sottolineare alcuni elementi di criticità e possibili rapporti di causalità.

Evaluation einer kognitiv-verhaltensbezogenen Gruppen- und Einzeltherapie zur Behandlung von Patienten mit Hypochondrie

Das Störungsbild der Hypochondrie stellt für die Betroffenen eine erhebliche Belastung und Beeinträchtigung dar und ist zudem von hoher gesundheitspolitischer Relevanz. Hieraus ergibt sich die Notwendigkeit für die Entwicklung und Evaluation wirkungsvoller Behandlungsansätze. Mit der vorliegenden Untersuchung wird die bisher umfangreichste Studie zur Wirksamkeit von gruppentherapeutischen Interventionen bei Patienten mit Hypochondrie beschrieben. Insgesamt nahmen 35 Patienten, die die DSM-IV-Kriterien der Hypochondrie erfüllten, an der Studie teil. Die durchgeführte Behandlung bestand aus insgesamt acht Gruppen- und sechs Einzelsitzungen. Zur Beurteilung des Therapieerfolgs wurden standardisierte Fragebogen und Einschätzungen der behandelnden Therapeuten eingeholt. Zudem wurde vor und nach der Behandlung die implizite Ängstlichkeit der Patienten mit Hilfe des Ängstlichkeits-IATs (Egloff & Schmukle, 2002) erfasst. Die Datenerhebung der Fragebögen erfolgte zu vier Messzeitpunkten. Eine Teilgruppe der Patienten (n = 10) konnte zudem über eine zweimonatige Wartezeit befragt werden. Ingesamt wurde die Therapie von den Patienten gut akzeptiert. Im Laufe der Behandlung zeigten sich auf den Selbstbeurteilungsverfahren umfangreiche Veränderungen im Erleben und Verhalten der Patienten. Es zeigte sich eine Reduktion von krankheitsbezogenen Kognitionen und Ängsten, eine Abnahme des Krankheitsverhaltens und eine Zunahme von Störungs- und Bewältigungswissen. Die Reduktion der hypochondrischen Symptomatik stellte sich als klinisch relevant heraus. Zudem zeigte sich eine Reduktion der allgemeinen Belastung und Ängstlichkeit sowie depressiver und körperlicher Symptome. Die Einschätzungen der behandelnden Therapeuten bestätigten die mittels Fragebogen ermittelten Befunde. Mit Hilfe des Ängstlichkeits-IATs konnte eine Veränderung des angstbezogenen Selbstkonzepts nachgewiesen werden. In einer Wartekontrollzeit zeigten sich nur geringfügige Reduktionen der hypochondrischen Symptomatik und keine bedeutsamen Reduktionen der allgemeinen Psychopathologie. Die Ergebnisse der durchgeführten Kombinationstherapie sind mit den Befunden bisheriger Evaluationen zur Effektivität von Einzeltherapien bei Hypochondrie vergleichbar. Die Befunde unterstreichen die Gleichwertigkeit von ökonomischeren gruppentherapeutischen Interventionen bei der Behandlung der Hypochondrie.