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Concepção dos gestores municipais de saúde em relação ao acolhimento com avaliação de risco: limites e possibilidades
(Universidade Federal de São Carlos, 2013-04-09) Sudré, Graciano Almeida; Souza, Mariza Borges Brito de; https://lattes.cnpq.br/0610841005775750; https://lattes.cnpq.br/6780495629799281
This is a qualitative study aimed to evaluate the limits and possibilities for implementation of user embracement and risk assessment. In particular, from the perspective of local health managers of San Carlos, a town in the state of São Paulo. To collect the data, some semi-structured interviews were conducted with managers of the municipal health system: 61.53% graduated in nursing, 15.38% in medicine, 7.69% in dentistry; 7.69% in management and production engineering. The data were analyzed through thematic analysis. For this research, after collecting and analyzing data, six categories emerged from the analysis: (1) user embracement by organizing the service, (2) undesirable reality or constructed intentionally, (3) something intended but not accomplished, (4) A dream under construction, (5) learning to learn in daily service, (6) speaking the same language. From this definition, the study pointed out that there are different conceptions of user embracement , due to the approach assumed by each manager as suitable. There are also disparities in taking user embracement and under risk assessment as a procedure, possibly as a result of intricate political actions on health. To implement user embracement and risk assessment, it was possible to perceive the existence of limits and possibilities, with regards to organization of the service, local reality, care approaches, quality of assistance, permanent and continuing education as well as networking.
Atenção à saúde de pessoas vivendo com o diabetes mellitus tipo 2 em uma Unidade de Saúde da Família
(Universidade Federal de São Carlos, 2013-04-09) Neiva, Caroline Fernandes Diniz; Feliciano, Adriana Barbieri; https://lattes.cnpq.br/9398810638733882; https://lattes.cnpq.br/8300813529343885
This is an epidemiological study, the type or cross sectional. Objectives: To describe the profile of individuals with type 2 DM according to sociodemographic variables, disease history, lifestyle habits, morbidity, access to health services, to identify the types of drug treatment in place to care for the disease; describe adherence to medication in people with type 2 diabetes; describe the profile of care offered at the clinic for patients with type 2 DM. The study population comprised the universe of 102 patients with type 2 DM, enrolled in a USF in São Carlos, SP. Three instruments were used for data collection, one being the instrument to measure treatment adherence - MAT. The first stage of information gathering were the records of patients with type 2 DM and the second included interviews with users suffering from type 2 diabetes. The results showed that the study population was predominantly female (63%), and the age group 71-91 years (28.9%), most (47.8%) had education between 1 to 5 years of study and (54.4%) are retired. The majority (52.3%) found the DM within 5 years, (84.4%) diagnosed in the clinic. Regarding the habit of living 72% do not exercise and exhibit more significant comorbidities as hypertension and dyslipidemia. With regard to health status, 70% of women considered it fair / bad. Most participants (86.7%) use medications to control type 2 diabetes. Regarding the use of medications, most (64.5%) ingests up to four medications daily, and the therapeutic class of antidiabetic Biguanides most used (36.7%) and 21.1% use insulin. Regarding medications for comorbidities 35.5% use only antihypertensives. Regarding the description of adherence to treatment 64.1% had adherence to medication. Found higher frequency of diabetes in medical consultations (85%) compared to the consultation with the nurse (50%), 17.4% of subjects were in multidisciplinary care, and 31.4% were referred to a specialist. There are records of dental care in 16.3% of records. As to laboratory median total cholesterol (mg / dl) in women are higher (near 200), as the value of HDL-C in males there is a higher percentage of individuals (50%) with a median below 45 mg / dl, the average value of LDL-C (mg / dl) is closest to 100 mg / dL in male patients, the median TG (mg / dL) in both sexes showed values above 150 mg / dl, fasting glucose in female median value closer to 100 mg / dl, values Hb1Ac showed poor glycemic control. There are records of diabetic foot evaluation in 24.4% of records. We conclude that there is need for ongoing training of health professionals that are part of the Family Health Teams in order to achieve greater implementation of education programs in diabetes and clinical protocols intensify strategies to improve adherence to drug treatment, and control metabolic health monitoring.
Soldagem por fricção e mistura (FSW) no aço inoxidável austenítico AISI 304
(Universidade Federal de São Carlos, 2013-04-09) Plaine, Athos Henrique; Alcântara, Nelson Guedes de; https://lattes.cnpq.br/3123107570992184; https://lattes.cnpq.br/8992899102845408
Stainless steels are an important class of engineering materials with attractive properties such as high mechanical and corrosion resistance and thereby widely used in a variety of industries and environments due to its outstanding properties such as mechanical and corrosion resistance. These materials, which are usually considered difficult to weld by conventional fusion welding processes, have demonstrated outstanding performance when joined by Friction Stir Welding (FSW), a solid-state joining process. FSW input energy regulates the magnitude of the thermal cycle and the intensity of deformation during the process, and it can be controlled by the welding parameters, which affects the grain features and consequently the mechanical properties of the joints. The aim of this work is to evaluate the feasibility of producing friction stir welds of a 304 austenitic stainless steel and correlate this process to the microstructures and mechanical properties in these joints. The samples were produced using a polycrystalline cubic boron nitrides (PCBN) tool and four different rotational speeds. Microstructural investigation showed that all joints presented, besides the base material (BM), the three typical FSW zones: stir zone (SZ), termomecanically affected zone (TMAZ) and heat affected zone (HAZ). The ZTA exhibited a microstructure similar to MB, while ZTMA and ZM were characterized by dynamic recovery and recrystallization, respectively. In the advancing side of ZM was observed the formation of sigma phase, a brittle and undesirable phase. The welding parameters variation affected mainly the deformation experienced by the material, the average grain size and length of the weld zones. The mechanical tests were consistency with the observed microstructures, being the mechanical properties of joints higher than BM, which is very attractive from the technological point of view.