Ronei Marcos de Moraes

Avaliação do acesso às ações de controle da tuberculose no contexto das equipes de saúde da família de Bayeux - PB

A descentralizacao das acoes de controle da Tuberculose para o âmbito da Atencao Primaria a Saude (APS), vem impondo reorientacao da pratica das Equipes de Saude da Familia (ESF) e requerendo metodologias que avaliem em que medida os componentes da APS estao sendo alcancados. Este estudo toma como recorte um componente da APS-acesso, com o objetivo de avaliar as acoes de controle da Tuberculose no contexto das ESF em Bayeux-PB. Pesquisa avaliativa, de abordagem quantitativa, que envolveu 82 profissionais de saude. O instrumento utilizado continha sete perguntas fechadas, segundo possibilidades produzidas por escala intervalar tipo Likert. Os dados foram tabulados utilizando-se o programa - Statistical Package for the Social Sciences e analisados segundo frequencia e mediana. Os resultados revelaram fragilidades e potencialidades de acesso as acoes de controle da Tuberculose (TB). Quanto as potencialidades, constatou-se que a descentralizacao do tratamento dos casos de TB vem se estabelecendo na pratica das ESF: 92,7% dos entrevistados mencionaram que os doentes de TB sempre conseguem consulta nas unidades, sendo possivel para 82,9% obte-la no prazo de 24 horas; os medicamentos especificos apresentaram-se acessiveis para 64,6% das ESF. Como fragilidades, verificou-se que 61% dos entrevistados nao realizaram coleta de escarro; 54,9% das unidades nao oferecem atendimento no horario de almoco; 89,8% dos entrevistados nao contam com auxilio transporte; apenas 40,2% das unidades adotam regularmente a visitacao domiciliar. Recomenda-se a adocao de mecanismos de gestao que viabilizem a uniformizacao e utilizacao dos recursos existentes, ampliando a capacidade resolutiva das ESF, promovendo eficiencia na prestacao de servicos e assegurando o acesso da populacao.

Modelagem da incidência do dengue na Paraíba, Brasil, por modelos de defasagem distribuída

The literature provides several statistical models to explain dengue incidence. However, there is disagreement as to the real contribution of models based on climate factors or models based on relative variables to combat the vector, because their variability fails to provide a satisfactory statistical explanation for the behavior of dengue incidence. Distributed lag models (DLM) posit that a variable response Y will be explained by the presence of a variable X at the same moment in time t and in the previous moments (t-1, ...). The current study presents the use of DLM in dengue modeling. Among the several models tested, two displayed apparently interesting results. A DLM using rainfall was not validated statistically. Another model using the number of counties (municipalities) with dengue presented valid and satisfactory results. This DLM was also feasible from the perspective of State Health Departments, allowing the development of a model with interesting statistical results and good accuracy, using a single data source.

Using fuzzy hidden Markov models for online training evaluation and classification in virtual reality simulators

The goal of the training evaluation in a simulation is to provide feedback about the user performance in the training environment. Approaches to online or offline evaluation of training in simulators based on virtual reality have been proposed. An online evaluator must have low complexity algorithm to not compromise the performance of the simulator. A new approach to quality of training online evaluation in virtual reality worlds is proposed in this work. This approach uses fuzzy hidden Markov models (FHMM) for modeling and classification of trainee in pre-defined classes of training.The goal of the training evaluation in a simulation is to provide feedback about the user performance in the training environment. Approaches to online or offline evaluation of training in simulators based on virtual reality have been proposed. An online evaluator must have low complexity algorithm to not compromise the performance of the simulator. A new approach to quality of training online evaluation in virtual reality worlds is proposed in this work. This approach uses fuzzy hidden Markov models (FHMM) for modeling and classification of trainee in pre-defined classes of training.

Análise espacial da violência doméstica contra a mulher entre os anos de 2002 e 2005 em João Pessoa, Paraíba, Brasil

This was a quantitative, ecological, exploratory study using spatial analysis and a geographic information system. The population consisted of all the women that had filed complaints against domestic violence in the city of Joao Pessoa, Paraiba State, Brazil, from 2002 to 2005, at the Specialized Police Precinct for Women. The aim was to investigate the spatial distribution of domestic violence in order to assist policymakers in the decision-making process. Analysis of the results allowed identifying areas of low and high incidence of domestic violence, besides comparing the risk in each neighborhood to the overall rate for the city of Joao Pessoa. Based on the Getis and Ord index, the study produced a decision on priority areas for intervening in domestic violence. The authors highlight the need for changes in care for female victims of violence and the link among institutions with permanent education in the services, including discussions on gender and violence against women.

Multiple assessment for multiple users in virtual reality training environments

With recent computational advances, several interaction devices can be used by different users who share the same virtual world, allowing the simulation of realistic environments, such as surgical rooms. In order to deal with this feature, assessment systems must be generalized to evaluate, individually, all users of the simulation and to make the aspects of their interactions known. In this paper we propose a new assessment system for training based on virtual reality which can evaluate more than one user at a time. The methodology proposed uses data collected from user interaction and group interactions during training to create user profile and group profile. The main advantages of that approach are: both of reports can be used to increase group performance and the interactions among users, during training, can be monitored to correct and improve group tasks in procedure such as sequential, simultaneous or collaborative tasks.

Gaussian Mixture Models for Supervised Classification of Remote Sensing Multispectral Images

This paper proposes the use of Gaussian Mixture Models as a supervised classifier for remote sensing multispectral images. The main advantage of this approach is provide more adequated adjust to several statistical distributions, including non-symmetrical statistical distributions. We present some results of this method application over a real image of an area of Tapajos River in Brazil and the results are analysed according to a reference image. We perform also a comparison with Maximum Likelihood classifier. The Gaussian Mixture classifier obtained best adjust about image data and best classification performance too.

Relation between glucose levels, high-sensitivity C-reactive protein (hs-CRP), body mass index (BMI) and serum and dietary retinol in elderly in population-based study

The aim of this study was to evaluate the relationships between fasting glucose levels, hs-CRP, BMI and serum retinol and diet in elderly people. For this study, a cross-sectional, epidemiological, population-based format was adopted. One hundred and sixty-three individuals between 60 and 90 years of age participated; the participants were from different socioeconomic and health backgrounds, except for the individuals diagnosed with diabetes. Most subjects had serum concentrations in the reference ranges for all variables. There was not a significant relationship between fasting glucose and serum retinol or diet. There was a significant correlation between hs-CRP and BMI (r=0.22, p=0.0082) and hs-CRP and total calorie intake (p=0.0091), which reinforces the notion that an increased intake of calories results in being overweight and/or obese. Considering the importance of vitamin A in various physiological processes, more studies on these relationships are necessary to establish a recommendation of vitamin A for the treatment and prevention of changes in fasting glucose and obesity in the elderly population.

VR-based simulation for the learning of gynaecological examination

Training is an effective way to acquire learning. Recently, virtual reality systems have been proposed and developed to provide training in medical procedures. This work presents the SITEG, a virtual reality simulator for education in the practice of gynaecological examinations. The SITEG offers a virtual environment where the user can practice the two steps present in a real exam and learn different stages of diseases like Herpes and Human papillomavirus. For that, the system integrates stereoscopic view and a haptic device to allow the identification of malignancies commonly found in this kind of examination. Attached to the simulator there is an assessment tool to classify the user training.

A 3D Intelligent Campus to Support Distance Learning

The Intelligent Campus is an extension of control and monitor systems for interactive models. More than a simple 3D model, the Intelligent Campus is an interactive 3D model of a real campus that allows remote access of learning tools developed and available locally for present learning. It increases the set of learning tools and services provided by the institution and do not require re-development of tools. For access control, the Intelligent Campus implements an account mechanism that requires password for specific services and control access for distance learning classes that can occur in the campus. To manage the accesses were included levels of complexity in the virtual model that control the interactive details of an object presented to the user.

Psychomotor skills assessment in medical training based on virtual reality using a Weighted Possibilistic approach

Virtual reality has been used to provide training systems in several areas, particularly in medicine. In that area, users interactions in a virtual environment are modeled and compared with predefined classes of performance to know how much users are prepared to perform that procedure on human beings. In this paper is proposed a new approach for online Single Users Assessment System (SUAS) using Weighted Possibility and Necessity measures. Those fuzzy measures provide an interval-based estimator to check the compatibility between interactions of an user and previous stored classes of performance. This approach integrates the kernel of a decision support system and it contributes to improve the users assessment taking into account the individual relevance of variables in a procedure. It was verified in performance tests, when this new SUAS approach achieved better results, according to Kappa Coefficient, when compared with other previous approaches.