Abstract: Currently, the diversity of sources generating data in a massive online manner cause data streams to become part of many real work applications. Learning from a data stream is a very challenging task due to the non-stationary nature of this type of data. Characteristics such as infinite length, concept drift, concept evolution and recurrent concepts are the most common problems that need to be addressed by data stream learning algorithms. In this work an algorithm for data stream classification based on an associative classifier is presented. This proposal combines a clustering algorithm and the Naïve Associative Classifier for Online Data (NACOD) to address this problem. A set of micro-clusters (MCs), a data structure that summarizes the information of the current data, is used instead of storing the whole data. The MCs are continually updated with the arriving data, either to create new MCs or to update existing ones. The added MCs helps to deal with concept drift. To assess the performance of the proposed model, experiments were carried out on 3 data sets commonly used to evaluate data stream classification algorithms: KDD Cup 1999, Forest Cover Type and Statlog (Shuttle). Our model achieved higher accuracies than those achieved with algorithms such as data stream version of Naïve Bayes and Hoeffding Tree, the average accuracies achieved were for KDD Cup 1999: 100 %, Statlog (Shuttle): 99.01 % and Forest Cover Type 70.44 %.

Resumo O desenvolvimento de projetos de desenvolvimento agrícola é de grande importância atualmente, pois atende às prioridades nacionais. Isso exige a diversificação e a eficiência dos produtos financeiros para cobrir as necessidades de investimento e de capital de giro desses projetos. Entretanto, mesmo quando existem fundos para a promoção da atividade agrícola, há limitações em sua gestão, o que limita a implementação de ideias de projetos de desenvolvimento nos setores estatais e não estatais. Em vista desse problema, o principal objetivo deste artigo é elaborar um procedimento para a gestão da Banca de Fomento Agrícola que contribua para a implementação de projetos associados à produção agrícola. O principal método de pesquisa utilizado foi o de indução-dedução, que é aplicado ao projeto do procedimento proposto e à formulação de ações para facilitar sua implementação. O procedimento proposto representa uma ferramenta de apoio na gestão do Fundo de Desenvolvimento Agrícola das instituições financeiras em nível municipal e tem um conjunto de sugestões que facilitarão sua aplicação, que são variáveis de acordo com os critérios dos atores que o implementam.

Abstract The development of projects to promote agricultural activity is of great importance today, as it responds to national priorities. To this end, it is necessary to diversify and make financial products more efficient in order to cover the investment and working capital needs of such projects. However, even when there are funds for the promotion of agricultural activity, there are limitations in their management, which limits the implementation of development project ideas in the state and non-state sectors. In view of this problem, the main objective of this article is to design a procedure for the management of the Agricultural Development Bank that will contribute to the implementation of projects associated with agricultural production. The main research method used was the induction-deduction, which is applied for the design of the proposed procedure and the formulation of actions to facilitate its implementation. The proposed procedure represents a support tool in the management of the Agricultural Development Fund from the financial institutions at the municipal level and has a set of suggestions that will facilitate its application, which are variable according to the criteria of the actors who implement it.

Resumen El desarrollo de proyectos de fomento de la actividad agrícola reviste gran importancia en la actualidad, ya que responde a prioridades nacionales. Para ello, se hacen necesarias la diversificación y eficiencia de los productos financieros en función de cubrir las necesidades de inversión y capital de trabajo de dichos proyectos. Sin embargo, aun cuando existen fondos para el fomento de la actividad agrícola, se evidencian limitaciones en su gestión, lo que limita la ejecución de las ideas de proyectos de desarrollo en los sectores estatal y no estatal. En función de esta problemática, el artículo tiene como objetivo fundamental diseñar un procedimiento para la gestión de la Banca de Fomento Agrícola que contribuya a la implementación de proyectos asociados a las producciones agrícolas. El principal método de investigación utilizado fue el de inducción-deducción, el que se aplica para el diseño del procedimiento propuesto y la formulación de las acciones para facilitar su implementación. La propuesta de procedimiento representa una herramienta de apoyo en la gestión del Fondo de Fomento Agrícola desde las instituciones financieras a escala municipal y cuenta con un conjunto de sugerencias que facilitarán su aplicación, los cuales son variables de acuerdo con el criterio de los actores que lo implementan.

Resumo O envelhecimento populacional decorrente da nova realidade demográfica e epidemiológica brasileira, fenômeno relativamente recente, exige respostas inovadoras e eficientes. Neste artigo, apresentamos um modelo assistencial para a população idosa com o que há de mais contemporâneo no cuidado integral e com excelente relação custo-benefício. A proposta é voltada para a promoção da saúde, a prevenção e a coordenação do cuidado, com ênfase nas instâncias leves. Os modelos integrados buscam resolver o problema dos cuidados fragmentados e mal coordenados nos sistemas de saúde atuais. Por isso propomos uma unidade de cuidados leves, uma avaliação epidemiológica, um centro de convivência e uma equipe formada por uma dupla de profissionais de medicina e enfermagem, com apoio de gerontólogos. E ainda: um prontuário que cubra aspectos clínicos e sociais, além de um sistema de informação de qualidade - tudo com muita tecnologia, disponível na nuvem para médicos e clientes, que podem acessar a qualquer momento pelo celular. Quanto mais o profissional de saúde conhecer o histórico do seu paciente, melhores serão os resultados. São descritos os conceitos e a estrutura que fundamentam este modelo, que visa reduzir os desperdícios, oferecendo mais qualidade a custos reduzidos. É nossa contribuição para beneficiar - seja no setor público ou no setor suplementar - a assistência médica voltada para o grupo etário que mais cresce no país.

Abstract The population aging that has arisen from Brazil’s new demographic and epidemiological reality, a relatively recent phenomenon, requires innovative and efficient responses. This article presents a care model for the older population with the most contemporary comprehensive care and an excellent cost-benefit ratio. The proposal is aimed at health promotion, disease prevention and the coordination of care, with an emphasis on low complexity instances of care. The integrated models seek to solve the problem of fragmented and poorly coordinated care in current health systems. For this reason, we propose a low complexity care unit, an epidemiological assessment, a social center and a team formed by a pair of medical and nursing professionals, with the support of gerontologists. There will also be medical records that cover clinical and social aspects, as well as a quality information system - all involving advanced technology, accessible by doctors and clients at any time via cloud technology and a cell phone app. The more the healthcare professional knows their patient’s history, the better the results. The concepts and structure that underlie this model, which aims to reduce waste, offering greater quality at reduced cost, are set out. It is our contribution to benefit - be it in the public or supplementary sector - health care aimed at the fastest growing age group in Brazil.

Intellectual development disorders (IDDs) are a set of development disorders characterized by significantly limited cognitive functioning, learning disorders, and disorders related to adaptive skills and behavior. Previously grouped under the term "intellectual disability," this problem has not been widely studied or quantified in Latin America. Those affected are absent from public policy and do not benefit from government social development and poverty reduction strategies. This article offers a critical look at IDDs and describes a new taxonomy; it also proposes recognizing IDDs as a public health issue and promoting the professionalization of care, and suggests an agenda for research and regional action. In Latin America there is no consensus on the diagnostic criteria for IDDs. A small number of rehabilitation programs cover a significant proportion of the people who suffer from IDDs, evidence-based services are not offered, and health care guidelines have not been evaluated. Manuals on psychiatric diagnosis focus heavily on identifying serious IDDs and contribute to underreporting and erroneous classification. The study of these disorders has not been a legal, social science, or public health priority, resulting in a dearth of scientific evidence on them. Specific competencies and professionalization of care for these persons are needed, and interventions must be carried out with a view to prevention, rehabilitation, community integration, and inclusion in the work force.

Los trastornos del desarrollo intelectual (TDI) son un grupo de alteraciones del desarrollo caracterizadas por una notable limitación de las funciones cognitivas, trastornos del aprendizaje y de las habilidades y conductas adaptativas. Anteriormente agrupados bajo el término discapacidad intelectual, constituyen un problema poco estudiado y cuantificado en América Latina. Los afectados están ausentes en las políticas públicas y no se benefician de las estrategias gubernamentales de desarrollo social y reducción de la pobreza. En este artículo se aporta una visión crítica de los TDI y se describe una nueva taxonomía. Además, se propone reconocerlos como problema de salud pública, promover la profesionalización de la atención, y sugerir una agenda de investigación y acción regional. En América Latina no hay consenso sobre los criterios diagnósticos de los TDI. Pocos programas de rehabilitación cubren una proporción importante de las personas que los padecen, no se ofrecen servicios basados en la evidencia científica y las directrices de atención no se han evaluado. Los manuales de diagnóstico psiquiátrico conceden más importancia a la identificación de los TDI graves, favorecen su subregistro y clasificaciones erróneas. Su estudio no se ha priorizado desde las perspectivas jurídica, de las ciencias sociales y de la salud pública. Por ello escasean las pruebas científicas sobre estos trastornos. Faltan competencias específicas y profesionalización para el cuidado de estas personas y es indispensable realizar intervenciones de prevención, rehabilitación, integración comunitaria e inclusión laboral.

Colorectal cancer is a serious health problem in which screening is capable of reducing both the mortality and the incidence of the disorder. Colonoscopy, the mainstay of this type of screening, allows to establish an early diagnosis and also to eliminate malignant precursor lesions. The screening test which is performed in Spanish programs is the determination of fecal occult blood using the immunochemical method which gives around 70% of positive values for colonoscopy for any type of neoplasia. As a result, in 2009 the National Health System set as an objective that these programs cover 50% of the population by 2015. It is well known that colon screening is highly cost effective with a ratio of around 2500€ per QALY, much lower than ratios of other programs. Only the direct costs of colon and rectal cancer in Spain can be estimated at more than one thousand million euros per year. Early diagnosis and the cancers avoided thanks to screening can reduce these costs by 40%. The impact that the introduction of this screening has on health services can be lessened if the indications for colonoscopy are followed adequately. In conclusion, there is no justification for not acting to prevent CRC and this is especially so in times of crisis as there is no better social cost invested than that which saves suffering, deaths and even money.

El cáncer colorrectal es un grave problema de salud en el que el cribado es capaz de reducir su mortalidad e incidencia. La colonoscopia, acto central de este tipo de cribado, permite tanto el diagnóstico precoz como la eliminación de los precursores malignos que son los adenomas. La prueba de cribado que se realiza en los programas españoles es la determinación de sangre oculta en heces por método inmunoquímico con lo que se consiguen valores predictivos positivos para la colonoscopia para cualquier tipo de neoplasia cercanos al 70%. Por todo ello, en 2009, el Sistema Nacional de Salud estableció el objetivo de un 50% de cobertura poblacional para 2015 para estos programas. Se sabe que el cribado de colon es altamente coste-efectivo con una ratio alrededor de los 2.500 euros por AVAC ganado, muy inferior al de otros programas. Solo los costes directos del cáncer de colon y recto en España pueden estimarse en más de mil millones de euros anuales. El diagnóstico precoz y los cánceres evitados gracias al cribado pueden disminuir estos costes en un 40%. El impacto que sobre los servicios sanitarios tiene implantar este cribado puede atenuarse si se trabaja en la adecuación de las indicaciones de la colonoscopia. En conclusión, no hay justificación para no actuar en prevención del CCR y especialmente no la hay en época de crisis ya que no hay coste social mejor invertido que el que ahorra sufrimiento, muertes e incluso dinero.

We consider a pickup and delivery vehicle routing problem (PDP) commonly found in the real-world logistics operations. The problem includes a set of practical complications that have received little attention in the vehicle routing literature. There are multiple vehicle types available to cover a set of transportation orders with different pickup and delivery time windows. Transportation orders and vehicle types must satisfy a set of compatibility constraints. In addition, we include some dock service capacity constraints as required in real-world operations when there are a large number of vehicles to schedule. This problem requires to be attended on large scale instances: transportation orders ≥ 500, single-haul vehicles ≥ 100. Exact algorithms are not suitable for large scale instances. We propose a model to solve the problem in three stages. The first stage constructs initial solutions at the aggregated level relaxing time windows and dock service constraints of the original problem. The other two stages impose time windows and dock service constraints within a cut generation scheme. Our results are favorable in finding good quality solutions in relatively short computational time.

Se considera un problema de vehículos dedicados a la carga y descarga de producto (PDP) el cual es comúnmente encontrado en las operaciones logísticas. El problema incluye un conjunto de complejidades prácticas encontradas en el mundo real y que han recibido relativamente poca atención en la literatura científica dedicada a los problemas de ruteo de vehículos. Existen múltiples tipos de vehículos disponibles para cubrir un conjunto de órdenes de transporte con diferentes ventanas de atención tanto en la carga como también en la descarga. Las órdenes de transporte así como los vehículos deben satisfacer ciertas restricciones de compatibilidad. Además, se incluyen algunas restricciones de capacidad de andenes de servicio en los nodos de carga y descarga. Este problema requiere ser resuelto para instancias de gran tamaño: ordenes de transporte ≥ 500, vehículos ≥ 100. Los algoritmos de solución exacta no son adecuados para este tipo de instancias. Por tanto se propone un modelo de tres etapas. La primera etapa construye las soluciones iniciales de manera agregada mediante la relajación temporal de las restricciones de ventanas de horario y andenes disponibles. Las otras dos etapas van añadiendo dichas restricciones al problema dentro de un esquema iterativo de generación de cortes. Los resultados obtenidos son favorables tanto lo que respecta a la calidad de las soluciones como en los tiempos computacionales requeridos.

In Chiapas, Mexico, soil erosion is the main problem affecting the sustainability of hillside lands. As a result, yields and incomes are low, and soil quality continues to decrease. With the aim of finding sustainable technological alternatives, an evaluation was performed on the following systems: maize in conservation tillage (MLC); maize in plant barriers (MBMV) and maize alternated with fruit trees (MIAF), in terms of surface runoff, production of sediments and loss of nitrogen and phosphorous from June to November, 2009. The systems were set up in adjacent microbasins, belonging to the basin of river Catarina, Jiquipilas, Chiapas. The soil is a Typic haplustepts, with a slope that varies between 3 0 and 40%. Out of the total rainfalls, 54% caused soil erosion, 15 % of these with rains of over 40 mm 62% of the total erosion. The runoff coefficient and the specific soil degradation were similar and lower in the micro basins; MIAF (12, 5.8 t ha-¹) and MBMV (13, 6.3 t ha-¹ ) than in the microbasin with MLC (19, 16.8 t ha-¹), respectively. In MIAF, the runoff filter and total cover provided by maize and bean plants during most of the growth season played an important part in obtaining these results, despite this microbasin presenting a greater slope steepness and length. In regards to the nutrients, there was a greater loss of nitrates in the microbasin with the system MBMV, possibly due to the nitrogen contribution by the leftovers of the pruning ofGliricidia sepium. In regard to phosphorous, the system MIAF displayed a greater loss, caused by the yearly phosphoric fertilization performed on the guava trees for three years.

En Chiapas, México, la erosión del suelo es el principal problema que afecta la sustentabilidad de las tierras de ladera. Como resultado, los rendimientos y los ingresos son bajos y la calidad del suelo continúa disminuyendo. Con el objetivo de encontrar alternativas tecnológicas sostenibles, se evaluaron los sistemas: maíz en labranza de conservación (MLC); maíz en barreras de muro vivo (MBMV) y milpa intercalada con árboles frutales (MIAF), en términos del escurrimiento superficial, producción de sedimentos y pérdida de nitrógeno y fósforo en el periodo de junio a noviembre de 2009. Los sistemas se establecieron en microcuencas adyacentes pertenecientes a la cuenca del río Catarina, Jiquipilas, Chiapas. El suelo es un Typic haplustepts, con una pendiente que varía de 30 a 40%. Del total de las precipitaciones, 54% causaron erosión del suelo, y 15% de estos con una precipitación superior a 40 mm 62% de la erosión total. El coeficiente de escurrimiento y la degradación específica de suelo fueron similares y más bajos en las micro cuencas; MIAF (12, 5.8 t ha-¹) y MBMV (13, 6.3 t ha-¹) que en la microcuenca con MLC (19, 16.8 t ha-¹), respectivamente. En el MIAF, el filtro de escurrimiento y la cobertura total proporcionada por el maíz y el frijol durante la mayor parte de la temporada de crecimiento tuvo un papel importante para obtener esos resultados, no obstante que esa microcuenca presentó mayor grado y longitud de pendiente. En cuanto a los nutrientes se determinó una mayor pérdida de nitratos en la microcuenca con el sistema MBMV, posiblemente debido al aporte de nitrógeno por los residuos de la poda de Gliricidia sepium. Respecto a fósforo, el sistema MIAF presentó una pérdida mayor, atribuyéndose a la fertilización fosfórica anual que se realizó a los árboles de guayaba durante tres años.

Hospital institutions, with their private work organization, are made of very peculiar environments characterized by tension, pain and suffering. This way the hospital sets rules, specific routines and determines the actions of the health team about the care service provided for the patients. In this context, it is possible to identify aspects in the professional actions that can set in stress symptoms, mainly due to the contact with emotionally intense situations, such as life, illness and death. Stress has been related to sensations of tension, anxiety, fear and discomfort, and there has been an increase in the number of people who define themselves as stressed. Therefore, stress is made up of psycho-physiological alterations that occur when an individual is forced to face situations beyond his/her coping abilities. Personal characteristics and the environment where the person is inserted are important factors in the occurrence and severity of the reactions to the stress process. Its development depends not only on the personality of the individual but also on his/her health state (mental and organic equilibrium) and because of it not everybody shows the same type of reaction to stressful events. Life style, past experiences, attitudes, beliefs, values, illness and genetic predisposition are important factors in the stress process development. From this relation (individual-environment) the individual uses coping resources to modify his/her relation with the environment, controlling or altering the stress-causing event. The coping, which is a response to the stress, corresponds to the cognitive and behavioral efforts oriented to deal with the internal or external demands, which are exceeding or overwhelming the individual resources. This way, the aim of the coping strategies is the reduction, elimination or stress handling according to the evaluation that the individual does of a certain event of his/her life. From the presupposition that the hospital and the provided care to the patient can be developers of stress symptoms, it is believed that studies which provide the evaluation of this event as well as the identification of stressing causes will be able to contribute to minimize and prevent the appearance of stress symptoms in health professionals working in the hospital environment. Objective The purpose of this study was to indentify the presence of stress symptoms in health-care professionals working in the hospital environment and know the main stressing causes at the working environment and the coping resources used by the professionals to deal with stressful situations. Material and methods It is a descriptive transversal study done with professionals who work at the University Hospital of the West of Parana (HUOP) and that provide direct assistance to the in-hospital patients. This hospital, which has 1 73 rooms, is a reference in high complexity in urgency and emergency assistance for the West and Southwest of Parana region and it provides assistance in various clinical specialties. The data was collected from October to December of 2007 together with professionals at the three working shifts. During the collection of the data period, the HUOP had 272 professionals who suited to the criteria to be included in this study, which was to provide direct assistance to the patient. In the definition of the sample size, it was adopted a 5% pattern error and prevalence of stress symptoms of 20%. Besides this, it was predicted a margin of 20% to the size of the sample to cover likely loss of subjects and/or information. Therefore, the calculated size sample was of 155 professionals. To define the professionals who would be included in this study, a stratification proportional to the total number of workers from each professional category was carried out. Moreover, when the number of workers of a certain category was very small (two or three at most), it was decided to include all of them. The research subjects were selected at random, and the two first workers to arrive in the sector at their working shift were invited to participate in this study. Sixteen professional, all technicians and auxiliary nurses, missed to fill the biggest part of the test as well the prepared questions and because of it they were excluded of the study, something which made the effective sample be made up of 139 professionals: 93 technicians and/or auxiliary nurses, 32 nurses, 6 doctors, 2 nutritionists, 2 physiotherapists, 1 sychologist, 1 phonoaudiologist, and 2 social assistance workers. The data was collected through a self-applicable questionnaire, to be filled individually and handed back the same day. The participants took an average of 20 minutes to answer the questionnaires. Two instruments were used; the first one was constituted of two parts, one approaching social-demographic and work related matters and the second with two discursive questions about stressful events in the working environment and the coping strategies used for dealing with them. The second instrument is the Inventory of Stress Symptoms for Adults -ISSL-, which allows us to identify, from the symptomatology shown by the subject, the presence or not of stress; the present type (somatic or psychological) and in which phase of stress the individual is. The data was kept in an Excel data bank, and we used the computer package Statistic 7.2 for the analysis of the variable, and for the calculus of the Fischer Exact Test we used the program SAS 9.1 (Statistical Analysis System). A significance level of 5% was established. For the analysis of the qualitative data, the answers to the discursive questions were grouped in four categories: intrinsic factors/ situations to work; working conditions; interpersonal relations and factors related to assistance. Results One hundred and thirty nine health professionals who provide direct assistance to the patient in hospital environment participated in this study, such as doctors, nurses, nurses technicians, physiotherapists, psychologist, phonoaudiologist, social assistants and nutritionist. The applied Inventory of Stress Symptoms revealed that from the 139 evaluated subjects 60.4% presented stress. From those, 5.7% were in the alert phase; 44.6% in the resistance phase; 7.2% at the close-to-exhaustion phase; and 2.9% in the exhaustion phase. From those who presented stress symptoms, there was a higher incidence of physical symptoms (36.7%), being followed by the physical/ psychological (16.5%) and psychological (7.2%) ones. It was observed a significant association between the presence of stress and the working sector (p = 0.0002) and the working period of time at the same institution (p = 0.0133). In relation to the stressful events, it was observed that the working conditions were pointed with more frequency as stress generators (31.1 %), followed by intrinsic working factors (26.6%), interpersonal relations (26.3%) and assistance related factors (16%). Many forms of coping were identified, and a great majority of the professionals (43.0%) uses as a strategy to deal with stress, alternatives out of the working environment, which means that they deal with the emotional response developed by the stressor event; a considerable part of the professionals (30.7%) uses as a strategy to relieve stress the focus in solving the problem - something that tries to modify the relation of the individual with the environment, promoting changes directly in the situation that causes stress; and, 26.3% did not show coping responses. Conclusions It was pointed an indicative of stress in professionals of various areas, with the prevalence of physical symptoms, in the resistance phase. The events considered as stressors by the professionals, in fact, led to the appearance of stress symptoms, being related to the working environment. Being aware of the stressors and understanding how the caretaker deal with these events support the more effective actions in order to reduce stress and improve the working conditions to these professionals. As it is extremely important that those professionals be in physical and psychological conditions which are favorable so that they can provide a better assistance as well as a proper one to the needs of the patient.

La institución hospitalaria con su organización particular constituye ambientes peculiares caracterizados por tensión, dolor y sufrimiento. En ese contexto es posible identificar en las acciones de los profesionales aspectos que pueden desencadenar síntomas de estrés, principalmente debido al contacto con situaciones emocionalmente intensas, tales como la vida, la enfermedad y la muerte. El estrés ha sido relacionado a sensaciones de tensión, ansiedad y miedo. Está compuesto de alteraciones psicofisiológicas que ocurren cuando el individuo es forzado a enfrentar situaciones que están más allá de sus habilidades de enfrentamiento. Características personales y el medio en que el sujeto está inserto son factores importantes en la ocurrencia y en la gravedad de las reacciones al proceso de estrés. Su desencadenamiento depende tanto de la personalidad del individuo como del estado de salud en que éste se encuentra (equilibrio orgánico y mental) y, por eso, no todas las personas demuestran el mismo tipo de reacción a eventos estresantes. A partir de esa relación el individuo echa mano de los recursos de enfrentamiento utilizados para modificar su relación con el ambiente, controlando o alterando el evento causante de estrés. Objetivos Identificar la presencia de síntomas de estrés en profesionales-cuidadores en el contexto hospitalario, y conocer los principales estresores del ambiente de trabajo y los recursos de enfrentamiento utilizados por los profesionales para lidiar con las situaciones de estrés. Material y métodos Estudio transversal descriptivo realizado con profesionales que actúan en el Hospital Universitario del Oeste de Paraná (HUOP), Brasil, y que prestan asistencia directa al paciente ingresado. Los datos fueron recolectados en el período de octubre a diciembre de 2007 junto a profesionales de los tres turnos de trabajo, seleccionados aleatoriamente, por medio de preguntas autoaplicables, contestadas individualmente y devueltas en el mismo día. Los participantes tomaron alrededor de 20 minutos para responder a las preguntas. Fueron utilizados dos instrumentos, el primero estuvo constituido por dos partes, una abordó preguntas sociodemográficas y relacionadas con el trabajo, y la segunda conteniendo dos preguntas subjetivas sobre eventos estresantes en el ambiente de trabajo y las estrategias de enfrentamiento utilizadas para lidiar con ellos. El segundo instrumento es el Inventario de Síntomas de Estrés para Adultos (ISSL), el cual permite identificar, a partir de la sintomatología presentada por el sujeto, la presencia o no de estrés, el modelo presente (somático o psicológico) y en cuál fase del estrés se encuentra el individuo. Resultados La aplicación del Inventario de Síntomas de Estrés reveló que de los 139 sujetos evaluados, 60.4% presentaban estrés. De esos, 5.7% estaban en la fase de alerta; 44.6%, en la fase de resistencia; 7.2%, en la fase de casi-agotamiento y 2.9% en la fase de agotamiento. Se observó asociación significativa entre la presencia de estrés y el sector de trabajo (p = 0.0002) y tiempo de trabajo en la referida institución (p = 0.0133). Con relación a los eventos estresantes se observó que las condiciones de trabajo fueron apuntadas con mayor frecuencia como generadoras de estrés (31.1%), seguida de factores intrínsecos del trabajo (26.6%), relaciones interpersonales (26.3%) y factores relacionados a la asistencia (16%). Se identificaron varias formas de enfrentamiento, siendo que la mayor parte de los profesionales (43.0%) utiliza como estrategia para lidiar con el estrés alternativas fuera del ambiente de trabajo, o sea, lidian con la respuesta emocional desencadenada por el evento estresor; una parte considerable de los profesionales (30.7%) utiliza como estrategia para alivio del estrés el enfoque en la resolución del problema - que busca modificar la relación de la persona con el ambiente, promoviendo cambios directamente en la situación generadora de estrés; y, por último, 26.3% no presentaron respuestas de enfrentamiento. Conclusiones Se constató indicativo de estrés en los profesionales de las diversas áreas, prevaleciendo síntomas físicos, de la fase de resistencia. Los eventos considerados como estresores por los profesionales han llevado, de hecho, al surgimiento de síntomas de estrés, estando éstos relacionados al ambiente de trabajo. Conocer los estresores y entender cómo el cuidador lidia con estos eventos favorece el emprendimiento más efectivo de acciones con el objetivo de reducir el estrés y mejorar las condiciones de trabajo de esos profesionales. Es primordial que éstos se encuentren en condiciones físicas y psicológicas favorables para que puedan prestar una asistencia mejor y adecuada a las necesidades del paciente.

The starting point of this investigation consists of assuming the multiplicity of signification that the concept of violence implies, and conflicts that mean semantic vagueness for social life. The multiplicity of significations is in regard to the great variety of phenomena social life that are understood by concept of violence, here we find individual actions as well as institutions and the state. The problem of vagueness, on the other hand, sends a dangerous confusion between two different planes of the use of discourse for the legitimation of power. These can be marked by the following way: the first sends a set of beliefs that justify the authority of power because its exercise redounds in a material benefit of life conditions of the collective, while the second one is that where set of beliefs is manipulated and controlled by rhetorics that cover forms of domination and alienation of individuals. What is important to analyze here in this paper is the second plane of power justification and the construction of certain knowledge as well as legal forms that cover violence with an appearance of justice and social equity. From the methodological point of view our first work hypothesis will be that concept the concept of violence is not a near tautology, but that thing implies a multiplicity of signification. To explain this we will use the theory of Frege's theory of significations, using the difference between sense and reference. Two conclusions will deducted, first that the concept of violence are descriptive, because each proposition offers new information, and its is not a simply repetition of the same one, and second, that the nature of concept references being treated are neither properties nor function, not even entities that allude to the objective world, being them historical constructions. To prove the latter statement a second hypothesis will be introduced, which ascertains the nirtzschean character of the metaphor, this is a man's inventions to live in society and protect its own interests. Because of this, the metaphorical conception will be developed in Nietzsche's last work On truths and lies in an extramoral sense. In this way the final motive of this work consists in showing that the set of belief allow to manipulate and control through different discourse rhetorical forms individual domination and alienation, force human condition to explode in oppressed in violent behaviour.

El punto de partida en esta investigación consiste en asumir la multiplicidad de significaciones que encierra el concepto de violencia, y los conflictos que conlleva para la vida social dicha vaguedad semántica. La multiplicidad de significaciones es con respecto a la gran variedad de fenómenos de la vida social que son comprendidos por el concepto de violencia, aquí encontramos desde acciones individuales, instituciones, el estado etc... El problema de la vaguedad, en cambio, remite la peligrosa confusión entre dos planos distintos de los usos del discurso para la legitimación del poder. Estos pueden ser demarcados del siguiente modo: el primero remite al conjunto de creencias que justifica la autoridad del poder porque su ejercicio redunda en un beneficio material de las condiciones de vida del colectivo; mientras que el segundo es aquel cuyo conjunto de creencias es manipulada y controlada por retóricas que encubren formas de dominación y alienación de los individuos. Lo que interesa analizar en este trabajo es el segundo plano de la justificación del poder, y sobre la construcción de ciertos saberes y formas jurídicas que encubren la violencia con la apariencia de justicia y equidad social. Desde el punto de vista metodológico nuestra primera hipótesis de trabajo será que el concepto de violencia no es una mera tautología, sino que este encierra una multiplicidad de significaciones. Para explicar esto se recurrirá a la teoría del significado de Frege, usando la distinción entre sentido y referencia. De aquí se extraerán dos conclusiones, primero que los conceptos de violencia son descriptivos, porque cada proposición brinda nueva información y no es una simple repetición de la misma, y segundo, que la naturaleza de los referentes del concepto en cuestión no son ni propiedades, ni funciones, ni entidades que aludan al mundo objetivo, sino que son construcciones históricas. Para probar la afirmación anterior se introducirá la segunda hipótesis, que afirma el carácter nietzscheano de la metáfora, es decir, ésta es una invención de los hombres para vivir en sociedad y proteger sus propios intereses. Para ello se desarrollará la concepción de la metáfora en un escrito póstumo de Nietzsche Sobre verdad y mentira en sentido extramoral. Así el motivo final del trabajo consiste en mostrar que el conjunto de creencias que permite manipular y controlar por medio de retóricas del discurso formas de dominación y alienación de los individuos, hacen estallar la condición humana oprimida en conductas violentas.