Resumo O fenômeno da Reação Álcali-Agregado (RAA) em estruturas de concreto é percebido via expansão e fissuração, inchando o gel como material, causando danos e rupturas nos elementos estruturais. Apesar da extensa padronização, casos de RAA ainda ocorrem persistentemente em todo o mundo. A literatura sobre suscetibilidade de concreto a RAA relatou exemplos de resultados falso negativo e positivo. Portanto, previsão a longo prazo é um problema que ainda representa um grande desafio para os engenheiros. A severidade da RAA sobre a integridade estrutural pode ser principalmente elucidada pela avaliação do histórico das propriedades elásticas. Existe consenso de que RAA causa diminuição da capacidade de carga do concreto, refletida pela redução do módulo de elasticidade devido ao progresso dos danos. Técnicas não destrutivas são frequentemente usadas como primeira abordagem, pois podem fornecer uma avaliação relativamente rápida in situ, bem como em grandes elementos estruturais. A interpretação dos dados carrega certo grau de complexidade devido às características intrínsecas de muitos desses métodos. Este é o caso de Velocidade de Pulso Ultrassônico (VPU), que foi considerado como apresentando várias limitações para esse propósito. Este artigo trata o potencial uso do método de Frequência de Ressonância Longitudinal (FRL) como ferramenta para avaliar o histórico elástico de elementos propensos a RAA. A FRL possui maior energia que VPU. Além disso, usando modulação de frequência no sinal de entrada combinada à geometria de teste, a FRL permite aplicação em amostras maiores, bem como extrair informações complementares ao lado do módulo elástico dinâmico. Dessa forma, a FRL foi aplicada para estudar vigas de concreto testadas sob condições controladas por cerca de 1,5 ano. As variáveis independentes para os testes são: tempo, frequência, tipo de agregado, teor de cimento, teor de álcalis e relação água/cimento. As variáveis dependentes são: amortecimento, fator de perda e módulo de elasticidade. A análise associa dano com amortecimento da vibração, confirmando a redução de elasticidade através do dano com validação experimental e predição de RAA sob modelo reológico.

Abstract The Alkali-Aggregate Reaction (AAR) phenomenon in concrete structures is perceived via expansion and cracking, swelling of gel like material, causing damage and disruption in structural elements. Despite extensive standardization, AAR cases are still persistently occurring worldwide. The literature on susceptibility of concrete to AAR reported examples of false negative and positive results. Hence, long-term prediction is a problem still posing great challenge to engineers. The severity of AAR on the structural integrity can be mostly elucidated by the assessment of the historic of elastic properties. There is consensus that AAR causes decrease in the load capacity concrete, reflected by reduction of elasticity modulus due damage progresses. Non-destructive techniques are often used as first approach, as they can provide relatively fast assessment in situ as well as in large structural elements. Its data interpretation carries certain degree of complexity due intrinsic characteristic of many of these methods. This is the case of Ultrasonic Pulse Velocity (UPV), which have been considered to present several limitations for such purpose. This paper deals the potential use of the Longitudinal Resonance Frequency (LRF) method as tool to evaluate the elastic historic of AAR prone elements. The LRF possesses higher energy than UPV. Also, using modulation of frequency in input signal combined the test geometry, the LRF allow application to larger samples as well as to extract complementary information alongside the dynamic elastic modulus. This way, the LRF was applied to study concrete beams tested under controlled conditions for about 1.5 year. The independent variables to the tests are: time, frequency, aggregate type, cement content, alkali content and water to cement ratio. The dependent variables are: damping, loss factor and elasticity modulus. The analysis associate damage with vibration damping, confirming reduction of elasticity through damage with experimental validation and prediction of AAR under rheological model.

Resumo: O enfrentamento da pandemia de Covid-19 exige que o Estado tome decisões difíceis que perpassam a ação da burocracia que implementa políticas públicas na interação com a população, a burocracia de nível de rua (BNR). Neste artigo, baseado em estudo exploratório de método misto, analisamos como a atuação cotidiana desses burocratas em diferentes políticas públicas - saúde, assistência social, acesso à justiça, segurança pública e educação - foi alterada durante a pandemia, bem como analisamos as suas consequências. Três categorias que ilustram a dinâmica do trabalho da BNR durante a pandemia foram identificadas por análise dos sentimentos dos burocratas, mudanças no seu trabalho e na relação com a população: a BNR que enfrenta a crise na linha de frente; a BNR que sofre os efeitos da pandemia, mas cujo trabalho não demanda enfrentá-la diretamente; e a BNR cujo trabalho migrou para o formato remoto. Concluímos que, durante a pandemia, a BNR, em diferentes graus, deparou-se com um agravamento de problemas estruturais, como o seu alijamento dos processos decisórios, restritos ao alto escalão governamental, e a exacerbação de conflitos e ambiguidades já existentes.

Abstract: Dealing with the Covid-19 pandemic requires that the State make hard decisions that involve the action of bureaucrats who interact with the population through the implementation of public policy, the street-level bureaucracy (SLB). In this paper, based on a mixed- method exploratory study, we analyze how the daily performance of street-level bureaucrats in different policy areas- health and social care, access to the justice system, public security and education - has changed during the pandemic. We also explore the repercussions of those changes. Based on the analysis of the perceptions of bureaucrats, changes in their work and in their relationship with the public, we identify three categories that illustrate the dynamics of SLB work during the pandemic: the SLB who faces the crisis on the front lines; the SLB who suffers the effects of the pandemic, but whose work does not require her to face it directly; and the SLB who began to work remotely. We conclude that, during the pandemic, SLB suffered in varying degrees an aggravation of structural problems, such as their removal from decision-making processes - now restricted to the highest government level - and the exacerbation of already existing conflicts and ambiguities.

Resumen: Hacer frente a la pandemia de Covid-19 requiere que el Estado tome decisiones difíciles que van más allá de la acción de la burocracia que implementa las políticas públicas en la interacción con la población, la burocracia de primera línea (BPL). En este artículo, a partir de un estudio exploratorio de método mixto, analizamos cómo el desempeño diario de estos burócratas en diferentes políticas públicas - salud, asistencia social, acceso a la justicia, seguridad pública y educación - se modificó durante la pandemia y sus consecuencias. Se identificaron tres categorías que ilustran la dinámica del trabajo de BNR durante la pandemia, analizando los sentimientos de los burócratas, los cambios en su trabajo y en la relación con la población: la BPL que enfrenta la crisis en primera línea; la BPL que sufre los efectos de la pandemia, pero cuyo trabajo no exige enfrentarla directamente; y la BPL cuyo trabajo migró al formato remoto. Concluimos que, durante la pandemia, la BPL, en diferentes grados, enfrentó un agravamiento de problemas estructurales, como su remoción de los procesos de toma de decisiones, restringida al más alto nivel de gobierno, y la exacerbación de conflictos y ambigüedades ya existentes.

Abstract Introduction: malnutrition is a frequent event in cancer, and unless identified early, it can lead to progressive functional impairment of the organism. Objective: to associate the early application of the Global Subjective Evaluation Produced by the Patient (GSEPP) to the time of hospitalization and death in cancer patients. Methods: a cross-sectional, analytical study carried out between July and September 2014 in patient records (> 20 years) with cancer, with hospitalization for more than three days in a reference cancer hospital. Age, sex, origin, disease location, antineoplastic treatment, length of stay and application of GSEPP, type of discharge, weight loss in one and six months, body mass index (BMI) and GSEPP score were collected. Results: three hundred and sixty-six patients were evaluated: 51.6% women, 54.9% adults, 27.6% tumors of the digestive tract, 11.5% with metastasis, 21.9% of deaths and 40.4% with hospitalization time greater than or equal to ten days. The length of hospital stay was statistically lower in the early application of GSEPP (11.4 ± 1.5 vs 23.3 ± 1.3 days). The delay in the application of GSEPP was positively correlated with the increase in length of hospital stay, the GSEPP score, as well as malnutrition by BMI and weight loss in one and six months. Conclusion: early application of GSEPP was associated with improvements in the parameters of malnutrition, shorter hospitalization time, but not mortality. Measures that abbreviate its application should be taken to awaken the importance and the impact of this instrument in the health of the evaluated patient.

Resumen Introducción: la desnutrición es un acontecimiento frecuente en el cáncer. Si no se identifica precozmente puede provocar el compromiso funcional progresivo del organismo. Objetivo: asociar la aplicación precoz de la Evaluación Subjetiva Global Producida por el Paciente (ASGPPP) al tiempo de internación y muerte en pacientes con cáncer. Métodos: estudio transversal, analítico, realizado entre julio y septiembre de 2014 en historiales de pacientes (> 20 años) con cáncer, con ingreso superior a tres días en un hospital de referencia en cáncer. Se recogieron los siguientes datos: edad, sexo, procedencia, localización de la enfermedad, tratamiento antineoplásico, tiempo de internación y de aplicación de la ASGPPP, tipo de alta, pérdida de peso al mes y seis meses, índice de masa corporal (IMC) y puntaje de la ASGPPP. Resultados: se evaluaron trescientos sesenta y seis pacientes: el 51,6% mujeres, el 54,9% adultos, el 27,6% con tumores del tracto digestivo, el 11,5% con metástasis, con un 21,9% de óbitos y un 40,4% de casos con tiempo de internación mayor o igual a diez días. El tiempo de ingreso fue estadísticamente menor en la aplicación precoz de la ASGPPP (11,4 ± 1.5 vs. 23,3 ± 1,3 días). La demora en la aplicación de la ASGPPP se correlacionó positivamente con el aumento del tiempo de internación, la puntuación de la ASGPPP, así como, la desnutrición medida mediante IMC la pérdida de peso al mes y los seis meses. Conclusión: la aplicación precoz de la ASGPPP se asoció con mejoras de los parámetros de desnutrición y menor tiempo de internación, pero no con la mortalidad. Se deben tomar medidas que abrevien su aplicación para reforzar la importancia y el impacto de este instrumento en el pronóstico del paciente evaluado.

RESUMO Objetivo Associar a Avaliação Subjetiva Global produzida pelo paciente à mortalidade e ao tempo de internação em pacientes com câncer. Métodos Pesquisa transversal analítica com coleta secundária de dados, conduzida entre julho e setembro de 2014 em 366 prontuários de pacientes internados entre janeiro de 2010 a janeiro de 2014 de um hospital de referência em câncer. Participaram do estudo pacientes com tempo de internação maior ou igual a três dias e idade mínima de 20 anos. Foi coletado o escore da avaliação subjetiva global produzida pelo paciente e associado às características clínicas, antropométricas e do desfecho dos pacientes (óbito e elevado tempo de internação). Resultados Dos 366 avaliados, 36.0% eram desnutridos. A presença de desnutrição pela avaliação subjetiva global produzida pelo paciente se associou estatisticamente com a presença de metástase (52.4%), desnutrição (e morte (55.0%) pelo índice de massa corporal em adultos (55.8%) e em idosos (54.2%) e morte (55.0%). O modelo de regressão logística ajustada demonstrou que foram associadas ao tempo de internação prolongada: triagem nutricional precoce, presença de desnutrição grave e os tratamentos radio e quimioterápicos associados e o cirúrgico. Já em relação à mortalidade: a localização tumoral no sistema reprodutor masculino, a presença de metástase, o tratamento clínico, a internação prolongada e a presença de algum grau de desnutrição estiveram associadas. Conclusão O escore da avaliação subjetiva global produzida pelo paciente é um marcador de risco importante para internação prolongada e morte. Sendo um instrumento valioso, capaz de contornar vieses significativos na avaliação nutricional do paciente com câncer.

ABSTRACT Objective To determine the association of a scored patient-generated Subjective Global Assessment with mortality and length of hospital stay in cancer patients. Methods Cross-sectional study carried out between July and September 2014 using secondary data collection using data from 366 medical records of patients admitted to a hospital recognized as a cancer center of excellence. The present study included patients with hospital stay over than or equal three days and minimum age of 20 years. The patient-generated Subjective Global Assessment scores were calculated and compared with the patients’ clinical and anthropometric characteristics and outcomes (death and long length of stay in hospital). Results Of the 366 patients evaluated, 36.0% were malnourished. The presence of malnutrition, according to the scored patient-generated Subjective Global Assessment, was statistically associated with the presence of metastasis (52.4%). On the other hand, malnutrition, according to the body mass index in adults (55.8%) and in older elderly patients (54.2%), was associated with death (55.0%). The adjusted logistic regression model showed that the following factors were associated with prolonged hospitalization: early nutritional screening, presence of severe malnutrition, radiotherapy and chemotherapy, and surgical procedures. As for mortality, the associated factors were: male reproductive system tumor, presence of metastasis, clinical treatment, prolonged hospitalization, and the presence of some degree of malnutrition. Conclusion The patient-generated Subjective Global Assessment score is an important risk marker of prolonged hospitalization and mortality rates. It is a useful tool capable of circumventing significant biases in the nutritional evaluation of cancer patients.

ABSTRACT INTRODUCTION: The elderly population is growing rapidly. Political and socio-economic changes led to the demographic transition in this population with the highest number of surgeries and as well as many comorbidities. OBJECTIVE: To evaluate the impact of cardiovascular intervention on quality of life of elderly patients after three and six months. METHODS: Analytical prospective cohort study with elderly between 60 and 80 years of age, of both sexes, with a diagnosis of coronary artery disease and underwent cardiovascular intervention during the period June 2010 to June 2011. Data were collected by individual interviews in the pre and postoperative periods (after three and six months) by telephone. We used the SF-36 to analyse quality of life in order to assess the physical and mental health of the study population. RESULTS: Of the 44 individuals evaluated, 59.1% were men, 75% in the range of 65 to 74 years, 38.6% were white and 38.6% were black, 31.8% were uneducated, 43.2% were married and 68.2% had less than a minimum wage. Prevailed patients: non-diabetics (68.2%), non-obese (81.8%), hypertensive (84.1%), non-alcoholic and non-smokers (68.2% and 61.4%, respectively). A significant increase in the average of the SF-36 scores between pre and post-surgical periods (three and six months) for the domains: functional capacity, pain, general health, vitality and emotional aspect. CONCLUSION: The elderly population undergoing intervention may have cardiovascular benefits and improvements of quality of life. Physical fitness improvement measures can be taken to resume that capability.

The electrochemical oxidation (EO) of hydroquinone (H2Q) has been performed, in acidic media, at PbO2 electrode by galvanostatic electrolysis applying 10 and 30 mAcm−2. The concentration of H2Q during its EO was also monitored by differential pulse voltammetry (DPV) by using PbO2 electrode. The experimental results of galvanostatic electrolyses showed that the performances of the process remarkably depend on the applied current density and in particular, the removal efficiencies obtained at PbO2 anode were 100% and 80%, at 30 and 10 mAcm−2, respectively. Additionally, the electroanalytical technique was efficiently used as a detection method during H2Q electrooxidation and when DPV analyses were compared with HPLC method, it achieved a good fit, confidence intervals and limits.

La oxidación electroquímica (OE) de hidroquinona (H2Q) se llevó a cabo en medio acuoso ácido, en el electrodo PbO2 por electrólisis galvanostática, aplicando 10 y 30 de mAcm−2. La concentración de H2Q durante su EO fue también monitoreada por voltametría diferencial de pulso (VDP) mediante el uso del electrodo PbO2. Los resultados experimentales de las electrólisis galvanostáticas mostraron que la eficiencia del proceso dependen de manera notable de la densidad de corriente aplicada y, en particular, las eficiencias de eliminación obtenidas usando el ánodo de PbO2 fueron 100% y 80% a las densidades de corriente de 30 y 10 mAcm−2, respectivamente. Adicionalmente, la técnica electroanalítica fue eficientemente usada como un método de detección durante la oxidación electroquímica de H2Q y cuando los análisis efectuados por VDP fueron comparados con el método CLAR, lograron un buen ajuste, intervalos de confianza y límites.

INTRODUCTION: Hepatitis B virus (HBV) infection is an important worldwide public health problem. In Brazil, the Ministry of Health estimates that 15% of the population has had contact with HBV, and that the mean rate of chronic carriers in Northeastern Brazil is around 0.5%. OBJECTIVE: The aim of this study was to assess the prevalence of HBV markers in pregnant women receiving prenatal care at the public maternity hospitals of São Luís. Methods: Demographical and epidemiological data were collected from 541 pregnant women according to the research protocol. Blood samples were collected, and the anti-HBc test was performed first. If positive, the sample was subsequently tested for HBsAg and anti-HBs. All HBsAg and/or anti-HBc positive samples were additionally tested for HBV-DNA. RESULTS: 40 (7.4%) pregnant women turned out positive for anti-HBc. Of those, five (0.9%) were HBsAg positive, four (0.7%) were anti-HBc positive with negative HBsAg and anti-HBs, and 31 (5.7%) were positive for anti-HBc and anti-HBs. Anti-HBc positivity was associated with family history of hepatitis and education level below 11 years of schooling. HBV-DNA was positive in only one HBsAg-positive sample. There was no HBV-DNA positivity among HBsAg negative samples. CONCLUSIONS: The prevalence of HBsAg in pregnant women in this study confirmed that São Luís is a low endemicity area. Occult hepatitis B was not detected in these samples.