resumo: Investigações experimentais têm sido comumente usadas para melhorar o conhecimento existente sobre o projeto estrutural, apresentando conclusões precisas sobre o comportamento da estrutura. No entanto, considerando as limitações dos estudos experimentais, como quantidade restrita de extensômetros, patologias inesperadas, dificuldades de previsão do correto posicionamento das fissuras ou simples economia de custos, o uso da análise numérica pode apresentar algumas abordagens inovadoras para a compreensão do processo de falha em elementos de concreto, apresentando resultados mais fáceis onde programas experimentais dificilmente podem relatar. Este estudo apresenta a análise numérica de oito vigas experimentadas por Sherwood [26], com dois tamanhos diferentes e agregados de tamanhos variados, buscando-se entender a influência do tamanho do agregado na resistência ao cisalhamento de vigas sem estribos. A abordagem numérica foi usada para avaliar a influência de cada mecanismo de cisalhamento interno e para identificar a quantidade específica de força de pino, transferência de cisalhamento na zona de compressão não fissurada e a parcela de intertravamento de agregados. Os resultados mostraram que resultados razoáveis podem ser obtidos por abordagens de fissuras distribuídas 2D, permitindo a identificação da maior porção de intertravamento do agregado em vigas com maiores tamanhos de agregado graúdo. A comparação do efeito de escala em vigas permitiu concluir que uma maior contribuição do intertravamento de agregados pode ser obtida em vigas grandes, com quase 64% da contribuição total, enquanto as vigas menores tiveram apenas 43%. Os resultados de Sherwood [26] foram comparados com as normas Model Code [23], CSA-A.23.3 [24], NBR 6118 [38] e ACI 318 [39] para avaliar a precisão das normas estudadas. Com relação a previsão da ruptura dos elementos por meio dos mecanismos internos do concreto, as instruções normativas Model Code [23] e CSA A.23.3 [24] resultaram valores mais precisos.

abstract: Experimental investigations have been commonly used to improve the existing knowledge about structural design, presenting accurate conclusions regarding structure behavior. However, considering the limitations of experimental studies, such as restricted amount of strain gauges, unexpected pathologies, difficulties to foresee the correct position of cracks, or simply saving in costs, the use of numerical analysis can present some innovative approaches to understand the process of failure in concrete elements, presenting easier results where experimental programs can hardly report. This study presents the numerical analysis of eight beams experimented by Sherwood [26], with two different sizes and variable aggregate sizes, seeking to understand the influence of coarse aggregate size in shear strength of beams without stirrups. The numerical approach was used to derive the influence of each internal shear mechanism and to identify the specific amount of dowel force, shear transfer by uncracked compression zone and aggregate interlock portion. The results showed that fair results can be obtained by 2D smeared crack approaches, enabling the identification of major aggregate interlock portion in beams with bigger coarse aggregate sizes. Comparing the size effect in beams allowed us to conclude that a higher contribution of aggregate interlock contribution can be obtained in large beams, with almost 64% of the total contribution, whereas smaller beams had only 43%. To evaluate the accuracy of the studied mechanisms, the results of Sherwood [26] were compared with the standards Model Code [23], CSA-A.23.3 [24], NBR 6118 [38], and ACI 318 [39]. Regarding the prediction of element rupture by concrete internal mechanisms, the normative instructions Model Code [23] and CSA A.23.3 [24] were the closest to the experimental results.

Abstract Thirteen years after the publication of the National Policy for the Comprehensive Health of the Black Population (PNSIPN, Política Nacional da Saúde Integral da População Negra), filling out the race/skin color question in the patient identification form remains a challenge. Authors have focused on the need to integrate knowledge from the science of implementation into public policies. The aim of this article is to describe and analyze the implementation of the collection of the race/skin color item carried out by the professionals responsible for the registration of patients at a university hospital in the city of São Paulo. This was an exploratory and descriptive study, structured from three constructs of the Consolidated Framework for Implementation Research (CFIR): intervention, internal scenario and characteristics of individuals. Most records of race/skin color in the observed institution are made by heteroidentification. Based on the CFIR constructs, aspects identified as obstacles and facilitators are identified. The implementation of the collection of the race/skin color item by self-declaration, as provided for in the PNSIPN and in Ordinance n. 344/2017, is still incipient and depends mainly on organizational changes, which can favor its effectiveness.

Resumo Após 13 anos da publicação da Política Nacional da Saúde Integral da População Negra (PNSIPN), o preenchimento do quesito raça/cor na identificação de pacientes permanece um desafio. Autores têm se debruçado sobre a necessidade de integrar os conhecimentos da ciência da implementação às políticas públicas. O objetivo deste artigo é descrever e analisar a implementação da coleta do quesito raça/cor feito pelos profissionais responsáveis pelo registro dos pacientes num hospital universitário do município de São Paulo. Estudo exploratório e descritivo, estruturado a partir de três constructos do Consolidated Framework for Implementation Research (CFIR): intervenção, cenário interno e características dos indivíduos. Resultados: a maioria dos registros do quesito raça/cor na instituição observada é feita por heteroidentificação. A partir dos constructos do CFIR, são identificados aspectos apontados como obstáculos ou facilitadores. A implementação da coleta do quesito raça/cor por autodeclaração, como previsto na PNSIPN e na Portaria 344/2017, ainda é incipiente e depende de mudanças, sobretudo organizacionais, que favoreçam sua efetivação.

Resumo Após 13 anos da publicação da Política Nacional da Saúde Integral da População Negra (PNSIPN), o preenchimento do quesito raça/cor na identificação de pacientes permanece um desafio. Autores têm se debruçado sobre a necessidade de integrar os conhecimentos da ciência da implementação às políticas públicas. O objetivo deste artigo é descrever e analisar a implementação da coleta do quesito raça/cor feito pelos profissionais responsáveis pelo registro dos pacientes num hospital universitário do município de São Paulo. Estudo exploratório e descritivo, estruturado a partir de três constructos do Consolidated Framework for Implementation Research (CFIR): intervenção, cenário interno e características dos indivíduos. Resultados: a maioria dos registros do quesito raça/cor na instituição observada é feita por heteroidentificação. A partir dos constructos do CFIR, são identificados aspectos apontados como obstáculos ou facilitadores. A implementação da coleta do quesito raça/cor por autodeclaração, como previsto na PNSIPN e na Portaria 344/2017, ainda é incipiente e depende de mudanças, sobretudo organizacionais, que favoreçam sua efetivação.

Abstract Thirteen years after the publication of the National Policy for the Comprehensive Health of the Black Population (PNSIPN, Política Nacional da Saúde Integral da População Negra), filling out the race/skin color question in the patient identification form remains a challenge. Authors have focused on the need to integrate knowledge from the science of implementation into public policies. The aim of this article is to describe and analyze the implementation of the collection of the race/skin color item carried out by the professionals responsible for the registration of patients at a university hospital in the city of São Paulo. This was an exploratory and descriptive study, structured from three constructs of the Consolidated Framework for Implementation Research (CFIR): intervention, internal scenario and characteristics of individuals. Most records of race/skin color in the observed institution are made by heteroidentification. Based on the CFIR constructs, aspects identified as obstacles and facilitators are identified. The implementation of the collection of the race/skin color item by self-declaration, as provided for in the PNSIPN and in Ordinance n. 344/2017, is still incipient and depends mainly on organizational changes, which can favor its effectiveness.

resumo: Com o aumento da utilização de lajes lisas e a necessidade da presença de aberturas para a passage de instalações hidráulicas e elétricas, que reduzem de forma acentuada a capacidade resistente à punção, o entendimento da influência de aberturas nesse tipo de estrutura se torna extremamente necessária. A influência no comportamento estrutural de lajes lisas com aberturas em diferentes distâncias do pilar foi investigada por meio de cinco lajes quadradas (1.800 mm x 1.800 mm x 130 mm), apoiadas sobre pilares quadrados (150 mm x 150 mm) e testadas até a ruptura. Os resultados obtidos experimentalmente foram comparados com resultados disponíveis na literatura, bem como com respostas previstas por meio de instruções normativas. Os experimentos mostram concentração elevada de tensões na região critica entre o pilar e a abertura e que a partir de 3d a abertura passa a não ter mais influência na carga de ruptura da laje.

abstract: The increase in the use of flat slabs and the need of the openings for the passage of installations, such as hydraulic and electrical, which significantly reduces the punching shear resistance capacity of the slab, makes the understanding of the influence of openings in this type of structure extremely necessary. The influence in the structural behaviour of flat slabs with openings at different distances from the column was investigated through five square slabs (1,800 mm x 1,800 mm x 130 mm) supported on square columns (150 mm x 150 mm) tested until failure. The results obtained experimentally were compared with results available in the literature, as well as with responses predicted from the normative instructions. The results confirm high stresses concentration in the region between the column and the opening and that opening situated at 3d from the column have no influence on the failure load for the tested slabs.

Abstract Sickle cell anemia, a genetic disease caused by a mutation in the beta-globin gene, can present oral manifestations such as delayed tooth eruption and hypomineralized enamel and dentin. The aim of the present study was to evaluate the prevalence and severity of developmental defects of enamel (DDE) and delayed tooth eruption in children with sickle cell anemia. The sample comprised 56 male and female children with sickle cell anemia aged 6 to 12 years and treated at the Hematology and Hemotherapy Center of Pernambuco, Brazil. The data were collected according to the WHO criteria for DDE and tooth eruption. The prevalence of DDE was 58.2% and increased with age, affecting 43.8% of children aged 6 to 8 years and 66.7% of those aged 10 to 12 years (p>0.05; Pearson’s chi-square test). There was no significant association between DDE and sex; the most prevalent type of DDE was diffuse opacity (6.2%). Tooth eruption was delayed in 18 children (32.1%). The delay increased with age and was detected in 11.8% of children aged 6 to 8 years, in 20.0% of those aged 8 to 10 years and in 54.2% of those aged 10 to 12 years (p<0.05; Pearson’s chi-square test). Delayed tooth eruption was higher in males (36.7%, p>0.05). The prevalence of DDE was high, increased with age and was similar between sexes, while delayed eruption was higher in males and showed a significant association with age.

Abstract Punching shear is a possible type of failure that occurs in reinforced concrete flat slabs, which can develop with an ultimate load below flexural capacity. Several researchers have studied the punching resistance of flat slabs over recent years. Although they have made great advances, there are codes that show different approaches to a singular design. Some codes show that there exist contradictions, even in the simplest situations, such as concentric loads. Most codes prescribe empirical expressions based in a theoretical model to analyze punching strength, but for flat slabs with holes around the column and shear reinforcement there are divergences between codes, justifying research in this area. This paper presents an experimental analysis of nine square reinforced concrete flat slabs under concentric loading (width: 1800 mm; thickness: 130 mm). The main variables used in the tests were: a) two square openings (150 mm) adjacent to the smallest side of the column and b) the use of shear reinforcement containing 3 layers, with 6 or 8 elements in each layer and radially distributed around the column. The research concludes that openings adjacent to the column affect punching shear strength, while the correct use of the shear reinforcement can minimize and even compensate this loss.