RCAAP Repository

The market is becoming progressively more competitive, which makes the continuity of an organization more difficult, because to ensure its market share it must remain competitive, with continuous improvement in the manufacturing process and results. This study developed a study of the production process of a small cheese bread production company in the city of São Paulo. A case study was carried out, initiated with research on the company's production process, with the assumption of a bibliographic survey on the Kaizen process and philosophy, in conjunction with the 3Ms and GUT Matrix tools. Quantitative and qualitative data were considered, which allowed the analysis of the company's points of vulnerability and the need for improvement. Points of improvement were detected in the production process, specifically in the physical rearrangement, with the unnecessary movement of materials and people, as well as maintenance in the furnaces. From the tools used, it was possible to map the production process, find the biggest problems and work in partnership with the employees and the owner to implement optimized solutions for the company with reduced handling and increased production.

Several factors contribute to alterations in the teeth and consequently in the smile, such as tooth discoloration, caries, aging, chemical erosion and diastemas. With the improvement of the ceramic surface treatment and the adhesion to the substrates, the ceramic laminate veneers guaranteed a definitive space in the dental practice, in view of longevity, functionality and aesthetic final result. It is in this scenario that the present study appears, which purpose is to present in detail a method of closing diastemas with the use of ceramic laminate veneers. A female patient attended at Ceuma University (São Luís-MA), with the main complaint of aesthetic dissatisfaction of her smile. Clinical examination revealed the presence of diastemas which persisted even after orthodontic treatment. The treatment started with tooth whitening followed by the gingivoplasty of one dental element, which presented disharmony in the gingival zenith. Then, the steps of the rehabilitation treatment with ceramic laminates were carried out until cementation. Ceramic laminate veneers represent high quality aesthetic and functional solutions for closing diastemas. Success is directly linked with the correct indication and planning, with sufficiently invasive preparation, knowledge of techniques and materials, thus obtaining an aesthetic and harmonious smile, with great guarantee of longevity.

Indirect restorations are commonly manufactured in specialized prosthesis laboratories requiring more steps because these laboratories usually rely on a calibrated technician with experience and skill, in addition to receiving various jobs from different dentists. Like response to the dependence of dental surgeons on denture laboratories, the emergence of Computer-Aided Design (CAD / CAM) technology has been transforming the way indirect restorations are performed. CAD / CAM is an evolution of computer science and engineering to the needs of dentistry and has increased dramatically over the last decade thanks to the rapid development of digital computer technology by means of intraoral scanner and milling machine which can be run several systems such as CEREC. Thus, it is possible to optimize the consultations, presenting excellent aesthetic results and clinical longevity. With the CEREC system for dentists, the whole laboratory stage can be developed by the dentist himself inside the dental office. This article aims to present the CEREC system clarifying its intuitive handling through the clinical case report.

Games and virtual reality are new concepts applied to upper limb rehabilitation after stroke. To perform upper limb physiotherapy rehabilitation and restore motor skills through virtual reality resources it is necessary to use an arm tracker, which would be the input of the video game. However, one of the main issues when starting a post-stroke rehabilitation game project is choosing the most suitable gross upper limb motion tracking device. Thus, this article aims to explore the gross upper limb motion tracking devices most commonly used in the scientific literature. To carry out this research, literature searches in English were conducted up to December 2020 in the ACM, PubMed and IEEE Xplore databases. We have selected a total of ninety-five (95) articles. In these studies, we identified the most used gross upper limb motion devices and we classified them into 5 different categories: RGB-D skeletal tracking, RGB object tracking, IR marker tracking, LeapMotion and RGB markerless body tracking. We found that most studies (52%) used RGB-D skeletal tracking. In addition, we found fifteen (15) different commercial systems or tracking devices and the most used was Kinect® (47% of all studies). However, it was not possible to generalize whether one device is better than the other. Although the amount of research in this area has increased significantly in recent years, additional studies are still needed to quantify the potential of the use of gross upper limb motion tracking devices in rehabilitation with games in post-stroke treatment.

This study aims to reveal the patients’ experiences with a comprehensive medication management (CMM) service delivered in a specialty pharmacy in Brazil. This is a qualitative study performed from September 2015 to February 2016. In-depth semi-structured interviews were conducted with 10 patients followed-up in a CMM service in a specialty pharmacy located in Minas Gerais state. The interviews were recorded, transcribed and analyzed with the assistance of the NVivo11® software. According to the participants, they did not know what to expect from CMM at first. They showed difficulties on establishing a solid concept for CMM, however, they pointed some key aspects of pharmaceutical care philosophy based on their experience with the service. The interviewees identified the CMM pharmacist, seen as a care professional, as a different professional compared to the traditional pharmacist, mainly identified by them as a salesman. The ability to listen and the time that the CMM professional dedicated in the consultations were highlighted as primordial in the process of building a therapeutic relationship with the patient. The difficulties the patients have for establishing a solid concept for CMM might be due to the lack of pharmacists exerting this function, considering CMM is still a new service in Brazil. The results of this work can guide efforts to build a better interaction between patients and pharmacists, in a constant search for offering the best care possible.

This article presents the main challenges of the Bovine Parasitic Tristeza (TPB) complex, based on a literary review on the subject. TPB is a complex of diseases caused by the protozoa Babesia bovis and Babesia bigemina combined with the bacterium Anaplasma marginale, which are transmitted by the vector Rhipicephalus (Boophilus) microplus (tick) to its bovine host, negatively impacting the bovine host. animal health and causing millions in losses to the rural economy, either in the fight and control of the parasite, or in expenses with medicines, according to data from the Ministry of Agriculture, Livestock and Supply (MAPA), and the IBGE. The main methods of control and treatment of diseases caused by B. bovis, B. bigemina and A. marginale, at present, are summarized in the fight against the vector with the application of chemical products, such as acaricides, to contaminated animals. However, the challenges of this method lie in the practice of sequentially and frequently applying these chemicals to the bovine population, which generally causes the configuration of multi-drug resistant ticks to the chemical agents. Several studies have shown small results with homeopathic treatments and pasture rotation, alternative treatments to combat the Rhipicephalus microplus parasite. In 2020, MAPA launched a guide with the Selective Bovine Treatment (TBS) methodology, whose objective is to monitor the contaminated bovine population case by case to carry out the animal selection process, so that sick animals are treated. To ensure success, the Selective Control Program for Bovine Ticks (PCSCB) is offered, created by the Federal University of Paraná.

This study aimed to describe the process of building and validating an instrument through Multivariate Analysis, in which the Factor Analysis technique combined with Cluster Analysis was used, in order to analyze the conceptions of high school students about the importance of the Science discipline in the ninth year of Elementary School, with an emphasis on Physics concepts (Optics). To this end, a pilot questionnaire was applied, made available virtually to 21 high school students from a federal public college, located in the city of Campo Grande in the state of Mato Grosso do Sul. This research is of a quantitative nature, in which it seeks to answer the object of study, being characterized as conclusive. The research requires defined, formal and structured information, so a sample is presented and the data analysis is statistical and conclusive. When applying all tests and analyzes (Cronbach's Alpha, Bartlett's Test, KMO, Principal Component Analysis, Factor Analysis and Cluster Analysis), it is concluded that the instrument has reliability, commonality, suitability and interdependence between the variables, being validated by Multivariate Analysis techniques.

We aimed to systematically review the literature on early intervention programs and the impacts on the development of children with Congenital Zika Virus Syndrome (SCZ). Following PRISMA recommendations, articles were collected in October 2020 in the databases: PubMed, SciELO, LILACS, SCOPUS, Web of Science, EMBASE, PsycINFO, CINHAL, using the MeSH terms "zika virus infection", "early educational intervention", "rehabilitation", "child development", "infant" and "child", as well as the corresponding synonyms/keywords combined using the "OR" operator. The "AND" operator linked the strategies. Four studies were included, and the early intervention programs were identified: intensive physical therapy training with therapeutic dressing, a program based on the GAME protocol, and conventional multidisciplinary therapy. These studies showed impaired motor and cognitive development, stabilization or little improvement in motor skills and functional performance of children with SCZ, even after these interventions. The program based on the GAME protocol showed positive impacts on family participation in the care provided to infants with SCZ. There is a lack of studies on early intervention programs for children with SCZ, making it impossible to infer about appropriate or more efficient programs, although positive impacts on motor skills and family participation in the care provided are noted. We foresee the need to develop new early intervention programs that provide positive impacts for the development of this population.

The study aims to review the scientific literature taking into account the interest in independent studies on public policy, outpatient care, demands and classification, in order to contribute to the quality of care provided to users of urgent and emergency health services classified as non-urgent. The methodological procedures adopted considered the six phases of integrative review proposed by Ganong, (1987) and consulted PubMed and the Virtual Health Library from the Scielo, Medline and Lilacs databases. As a result, 27 (twenty-seven) articles from the years 2015 to 2020 were obtained, 20 (twenty) of which were included in the study and among them 10 from 2018 to 2020. 7 (seven) articles were excluded because they deal with review and quantitative studies and the remaining 20 (twenty) were divided into 3 levels of evidence which are: 14 (fourteen) with level 4 or evidence from descriptive studies (non-experimental) or with a qualitative approach, 2 (two) at level 5 or evidence from reports of case or experiences and 4 (four) at level 6 that are evidence based on expert opinions. The studies have shown the need for greater investment in urgent and emergency issues in all points of health care, mainly in primary care as the coordinator of the care process; that the family members and users of the services emphasize the need for welcoming, risk classification and resolution in the care of health professionals and services; that the care regulation process needs to advance in the role of integrating health care levels and finally that the SUS is an unfinished health policy that needs evaluation, and investment because despite its advanced legislation to achieve its principles doctrinal and operational aspects have allowed space to consider health as a consumer good.

The human immunodeficiency virus (HIV) is a sexually transmitted infection (STI) that mainly affects the immune system, affecting several people in the world, thus constituting a public health problem. In primary care, there is the first contact between nurse and patient, promoting, then, a service with clear guidelines on the HIV / AIDS virus. Objective: to analyze through a literature review the main difficulties in nursing care for PLHIV in primary care. Methodology: this is an integrative literature review of an explanatory type, of a qualitative character, carried out between August 2020 and May 2021, presenting in the databases of the Virtual Health Library (VHL) platform indexed in the databases. data, Scientific Eletronic Library Online (SCIELO), Latin American and Caribbean Literature in Health Sciences (LILACS) Medical Literature Analysis and Retrieval System Online (MEDLINE). Qualitative and quantitative studies were published, published in the last 10 years in Brazil, with complete texts and available in full and excluded without relevance to the theme and repeated in the search bases. After detailed reading, 15 articles were selected for the preparation of the study. Results: the study obtained data that describe the difficulties in nursing care for PLHIV, carried out in different regions of Brazil (North, Northeast, South and Southeast). Conclusion: Therefore, the articles show the failures of the public system in relation to the primary care in which they are linked to the logistics of inputs and materials, limiting assistance and impairing access to a quality service.

Objective: To provide specific recommendations for infection control, prevention, and clinical management before COVID-19 for primary care health professionals. Methodology: This is a literature review searches were performed in the PubMed and Virtual Health Library (VHL) databases, using the combined descriptors based on the terms available in Health Sciences / Medical Subject Headings (DeCS / MeSH), search terms were: "Coronavirus infections"; "SARS-CoV-2"; "Infection control"; "Prevention and control"; " Unified Health System"; " Health Personnel "and" Family Health Strategy ". Searching for papers published between Jun/2020 and May/2021. The inclusion criterion was studied involving English and Portuguese languages, published in the period from 2020 to 2021, official documents from the Ministry of Health of Brazil and World Health Organization. Publications that did not present the objective similar to our study and duplicates were excluded.  Results: the main recommendations to be addressed to Primary Health Care professionals after reading and analyzing the selected material were: “Clinical management of flu syndrome in the (APS / ESF)”; "Identification of suspected case of influenza and covid-19 syndrome by professional category" and "The importance of Health Surveillance in the context of the pandemic". Conclusion: All members that make up the PHC health team have specific professional responsibilities and must be informed and attentive to safety recommendations to offer better assistance to users in SUS, as these guidelines are being updated amid the continuous spread of the pandemic in Brazil.

The study aims to recognize the importance of nurses in the postoperative period to assist women in the rehabilitation of mastectomy with dissection of axillary lymph nodes. This is an integrative review, which took place through a survey in the database of the Virtual Health Library, where data from LILACS, SciELO, Bdenf, among others, are available. In view of the analysis of the data collected, applying the inclusion and exclusion criteria, the following categories emerged: Nursing in the recommendations to women with knowledge deficits submitted to mastectomy and Reception to women with body image disorder. It was observed that the care provided by the nursing team to women in the post-mastectomy rehabilitation period, provides great benefits when used together with educational actions, guidance and active listening. In addition, the support network - friends, family and health professionals - is of fundamental importance in accepting self-image and adhering to postoperative recovery.

The objective of this study was to analyze the antimicrobial effect of nisin against MRSA (Methicillin-Resistant Staphylococcus aureus) and MSSA (Methicillin-Sensitive Staphylococcus aureus), and at the same time examine the possibility of the bacteria to develope nisin resistance. The antimicrobial susceptibility of the strains was tested using the agar diffusion and/or microdilution methods. To select nisin-resistant strains, bacteria were grown consecutively at sublethal concentrations of the bacteriocin. Nisin showed bactericidal activity against most of the tested strains. MRSA required higher doses of bacteriocin compared to MSSA both for inhibition and cell death. However, transfers in the presence of nisin could completely eliminate nisin activity with an increase in minimal inhibitory concentration value of up to 250 times. Nisin-resistance could be maintained in MRSA and MSSA even in the absence of the bacteriocin. Nisin resistance affected antibiotic susceptibility of both MRSA and MSSA to mainly Cefoxitin, Oxacillin, and Erythromycin. These results indicate that nisin-resistance is a complex trait among MSSA and MRSA and must be elucidated before the therapeutic recommendation of nisin to treat infections caused by these bacterial species.

Objective: To prospectively evaluate the analgesic effect of self-selected music for patients with diabetic retinopathy who underwent laser retinal photocoagulation (LRP). Methodology: This is a controlled, randomized, blinded, two-period crossover clinical trial. Twenty patients (40 eyes) with proliferative diabetic retinopathy who underwent LRP was enrolled. Listening to the patient's favorite music before and during the LRP was the non-pharmacological intervention. The control group (CG) was composed of patients who received only standard pharmacological treatment and the experimental group (EG) of those who received the intervention associated with standard pharmacological treatment. Pain was measured using the Numerical Verbal Scale. Differences in pain scores were tested using Aligned Rank Transformed ANOVA, Mann-Whitney U and Wilcoxon tests. The effect size of the differences was assessed using Rank Bisserial and Partial Square Effect Sizes. Results: Participants were predominantly male (60%), adults (57.4±9.1 years), with comorbidities (65%), with visual impairment ≥ 1 year (65%). Participants who heard music had lower pain scores (EG: 4.80±2.46) compared to those who did not (CG: 6.75±1.59; p=0.013). The application of self-selected music showed a large size of the analgesic effect (η²=0.189). Conclusion: Listening to the patient's favorite music, associated with standard analgesia, is effective in relieving acute LRP-related pain and should be incorporated into clinical practice for the multimodal treatment of pain in this procedure.

To analyze the pathophysiological aspects of lupus mastitis (LM), clinical presentation, epidemiology, radiological and histological findings, and treatment, to disseminate it to the academic community and draw attention to this pathology as one of the differential diagnoses in the management of breast lesions in males, especially in the case of breast cancer in men. A literature review was done by searching scientific studies in the PubMed / Medline, Scopus, Scielo, Embase, Web of Science, and Google Scholar databases. Relevant scientifically validated studies related to lupus mastitis in men were selected. The analysis, review and selection of articles carried out in pairs, blindly and separately, based on the reading of the title and abstract, with a third reviewer in case of disagreement.  The LM should be suspect in patients known to have lupus erythematosus who present painful breast nodules associated with skin changes. However, LM can be the initial manifestation of lupus and mimic, both clinically and imaging, malignant neoplasms. The histopathological diagnostic criteria are well-established, finding mainly hyaline fat necrosis and lymphoplasmacytic infiltrate. Treatment must be drug-based as invasive procedures can exacerbate the injury. Due to physiological and anatomical aspects, this condition can appear and evolve differently in men. The knowledge of this pathology is necessary to carry out the correct approach since the non-identification of the disease and its erroneous management can lead to complications and irreversible sequelae to the patient.

Objectives: Identify how palliative care (PC) is offered for residents of brazilian favelas. Methods: This is a bibliographic review of the integrative type, from which were analyzed articles published between the year of 2014 and 2019, in the Scielo, Lilacs, Bdenf and Medline databases (via PubMed). On this study were included original articles that were available in full text and that respected the established time limit. Results and discussion: 25 articles were selected. 19 of them were about the situation of PC in Brazil and 6 of them were about PC in vulnerable communities, and they were divided in two categories: “the understanding of health access for favela’s residents” and “difficulties in accessing palliative care in poverty areas”. These articles show that the needs of people eligible for PC in favelas are unknown by public health services. Conclusion: Cultural barriers around death and dying associated with lack of financial and educational investments contribute for an incipient development of palliative care in Brazil. In addition, is important to highlight the need of further studies about the availability of this service on poor communities in Brazil to raise information to support the provision of appropriate actions to guarantee the right to health and well-being of life of this population.

The amount of construction waste deposited in landfill in Lorena city - SP is approximately 50 tons/day. This landfill is already at its limit capacity and represents an unusable area responsible for several environmental, economic and social impacts. The aim of this work is the development and characterization of a sustainable product from solid waste from civil construction. The morphology of the collected waste was analyzed by SEM/EDS. The residues were macerated, mixed in different proportions with cement and water, and made into rectangular boxes. The mechanical test was carried out by flexing three points on specimens, absorbing water and analyzing fracture by SEM. Morphology of samples showed a heterogeneous and porous mass, with particles of different sizes, few agglomerates, and the presence of organic material. Resistance to the average rupture of the samples was obtained in MPa, characteristic of concrete for structural application. This being so, a mockup was developed proposing a hollow element type product, Cobogó style, indicating the potential of using civil construction waste as a sustainable product.

Objective: To characterize the possible pathologies associated to the early weaning with the contribution of a poor dietary introduction in the last 10 years. Methodology: This is a bibliographic review, the search for the material was carried out online in large databases, such as Lilacs, Pubmed and Capes. For sample selection, the inclusion criteria were used: online articles, available in full, full article, master's / doctoral thesis, free articles, published in Portuguese and Spanish, in the period between 2010 and 2020 and that included the chosen subject to be studied. Result: The selected publications corroborate the innumerable benefits of breastfeeding in preventing diseases, in the different stages of infant life, report on the factors that contribute to early weaning and poor dietary introduction. Final considerations: Among the studies, most employ that the early introduction of food is associated with the risk of children being overweight and obese. Throughout the study, there were several limitations in the search for articles on the subject, so it is necessary to have more studies and research related to this discussion.

Objective: To evaluate the mesial-distal positioning of the maxillary first permanent molar in children who present with ectopic eruption of the maxillary first permanent molar (PFMEE).  Methods: panoramic radiographs and lateral cephalometric radiographs 12 children of both genders were evaluated. The study group was composed of 12 children with PFMEE and the control group was composed of 12 children with normal occlusion with the first upper permanent molar in occlusion. After selecting the exams from both groups and performing the anatomical tracings, linear and angular measurements were performed. In the lateral cephalometric radiographs the following angles were evaluated: SNGo.GN, SN.GN, SNA, SNB, ANB, 6mx.Palatal Plane and the 6mx.PTV distance. In the panoramic radiograph the angles 6mx.Infraorbital Plane and 6mx.Occlusal Plane were evaluated. Results: PFMEE can occur in individuals regardless of their skeletal pattern. The control group showed much greater angular measurements 6mx.Palatal Plane and 6mx.Infraorbital Plane. Conclusion: There is no relationship between PFMEE and craniofacial growth pattern, there is no direct relationship with the anteroposterior relationship of the apical bases and in cases of PFMEE the mesial angulation is reduced, representing lack of space for eruption of the first permanent molars.

The retail of Brazil undergoes changes every day with the intention of meeting the demands of consumers. Supermarkets reinvent themselves every day so that the visual needs of the organization of the shelves are efficient for customers and thereby increase their profitability. The study was carried out in a supermarket in the city of Muritiba - Bahia, between September and November 2019. The evaluation was carried out in a qualitative way, through the observation of the daily life of a supermarket. For the discussion of the observations, a search for data was carried out to carry out a comparative discussion regarding the organization and existing routines in the sector. Thus, enabling a better understanding of the nature of the variables in order to develop arguments and propose solutions to the problem. The observation was to verify that supermarkets need improvements so that customers can be served in an appropriate and efficient manner. Assign a single employee responsible for the purchasing sector, in addition to employees who check the batches, the validity and if the products have any damage, are essential to ensure the quality of the products offered, as well as to ensure less rework in the organization of the supermarket shelves.