Avaliação longitudinal do impacto da saúde bucal na estratégia saúde da família em Natal

As a result of the financial incentive provided by the GM / MS 1.444, since 2000, Brazil has experienced a substantial increase in the number of oral health services at the Family Health Strategy. There is, however, evidence that these teams have produced qualitatively different experiences which do not translate necessarily into improved quality of life and health. Thus, evaluative research of great importance. This study aims to assess the impact of the Family Health Strategy in oral health in a longitudinal perspective natalense the years 2006 and 2009. This is an intervention study whose design is a community trial in parallel, nearly randomized. The sample consisted of census tracts covered by oral health teams in the Family Health and the Traditional Model (Basic Health Units and non-FHS Program of Community Health Agents and areas not covered.) The sample was determined by drawing ten census tracts to form the experimental group and ten other sectors for the control group by pairing intentional based on socio-economic and geographic. To check the net effect of the intervention was performed multivariate analysis by Poisson regression. As a result of cross-sectional analysis of year 2009, it was found that the effects of the ESF in Natal were satisfactory only for the variables of injuries and for other purposes without and with negative impact on stock coverage reclaimers. However, the longitudinal analysis revealed that the ESB / ESF improved their performance in dealing with grievances, access and coverage of the type of actions and this fact is independent of age, sex and social and economic conditions. In other employees' words are related to the presence of the Family Health Strategy in the region. However it does not say that both models under study (the Family Health Strategy Model and Traditional) are different in terms of performance and it is pertinent to reflect on the need for further development of evaluation studies that use other approaches able to clarify the dynamics of the process whose results can come to the knowledge of the actors responsible for leading the ESF and encourage them to incorporate the assessment in their routine

O papel das rotas e da obtenção de informações sobre a eficiência no forrageio de dinoponera quadriceps em ambiente natural

In this study, we investigated the role of routes and information attainment for the queenless ant species Dinoponera quadriceps foraging efficiency. Two queenless ant colonies were observed in an area of Atlantic secondary Forest at the FLONA-ICMBio of Nisia Floresta, in the state of Rio Grande do Norte, northeastern Brazil, at least once a week. In the first stage of the study, we observed the workers, from leaving until returning to the colony. In the second stage, we introduced a acrylic plate (100 x 30 x 0,8 cm) on a selected entrance of the nest early in the morning before the ants left the nest. All behavioral recordings were done through focal time and all occurence samplings. The recording windows were of 15 minutes with 1 minute interval, and 5 minute intervals between each observation window. Foraging was the main activity when the workers were outside the nest. There was a positive correlation between time outside the nest and distance travelled by the ants. These variables influenced the proportion of resource that was taken to the nest, that is, the bigger its proportion, the longer the time outside and distance travelled during the search. That proportion also influenced the time the worker remained in the nest before a new trip, the bigger the proportion of the item, the shorter was the time in the nest. During all the study, workers showed fidelity to the route and to the sectors in the home range, even when the screen was in the ant´s way, once they deviated and kept the route. The features of foraging concerning time, distance, route and flexibility to go astray by the workers indicate that decisions are made by each individual and are optimal in terms of a cost-benefit relation. The strategy chosen by queenless ants fits the central place foraging and marginal value theorem theories and demonstrate its flexibility to new informations. This indicates that the workers can learn new environmental landmarks to guide their routes

Estimativa populacional e uso do hábitat do boto-cinza (Sotalia guianensis) no litoral sul do Rio Grande do Norte

Four areas are known as of frequent usage by Guiana dolphins (Sotalia guianensis) in the south coast of Rio Grande do Norte state, northeast Brazil: Tabatinga, Pipa, Lagoa de Guaraíras and Baia Formosa. This extension of 40 km of shoreline is under increasing anthropogenic impacts due to continuous development of the coastal areas and vessel traffic. The objective of this study was to investigate aspects of population biology and habitat use of the population of Sotalia guianensis in the south coast of Rio Grande do Norte. It was applied the photo-identification technique and posterior methods of capture-recapture for population estimation (POPAN extension in MARK). The distribution, movement and site fidelity of the dolphins were analyzed trough the geographic information system (GIS) and group characteristics and behavior trough non-parametric statistics. Field work was conducted on board a 10m motor vessel from March 2008 to March 2009. Photo-identification effort was 329h with 113h of direct observation of the dolphins. The population estimatives for each area: Tabatinga: 75 (63-92); Pipa 105 (88-129); Lagoa de Guaraíras: 27 (18-54) e Baia Formosa: 112 (89-129) individuals. Total population estimative was: 223 (192 a 297). High site fidelity was detected for only part of the population (<15%) as low site fidelity and transients individuals were also detected (>20%). It was observed frequent movements between Tabatinga, Lagoa de Guaraíras and Pipa, but not Baía Formosa. This suggests a division in two communities along this shore extension: one in Pipa and other in Baía Formosa. Group size was small, most groups with up to 10 dolphins. The areas were use intensively, only in Lagoa de Guaraíras dolphins were not seen in all field trips. Lagoa de Guaraíras is an area used by small groups exclusively for foraging. In Tabatinga and Pipa dolphins concentrated close to the shore, in the inner sector of the area and the main activity is also foraging. Significant larger groups were seen in socializing behavior but there was no difference in group size between the inner and external sectors of the area. The presence of calves and juveniles were significant greater in the inner areas of Tabatinga and Pipa, confirming the hypothesis that these beaches are also used for parental care. In Baia Formosa dolphins concentrated in the outer sector and foraging was also predominant. Significant larger groups were seen in the outer sector, mainly engaged in mixed behaviors of travel/foraging, possibly in some kind of group foraging. Calves and juveniles were significant more present in the outer sector where group size was also larger. In general there was no difference in area usage and period of the day. Sotalia guianensis has characteristics that make the species vulnerable to human activities such as small population concentrated in patches of suitable habitats restrict to coastal areas. We hope that this study bring new information for the species and help for the adequate management of the area in order to assure the presence of the dolphins as well as its behavior pattern and gene flow betweencommunities.

Entendendo as propriedades do arenito Botucatu e sua utilização como meio poroso para estudos envolvendo o deslocamento de fluidos poliméricos

The development of products whose purpose is to promote blockages in high permeability zones as well as to control the hydrate or scale formation also needs some tests in porous media before using the product in the field, where attempts and unavoidable operational errors costs would able to derail any projects. The aim of this study was to analyze and compare the Botucatu and Berea sandstones properties, involving problems related to loss permeability. It was observed that even cores of Berea, without expansible clays in their composition had their permeability reduced, as soon as the salinity of brine reached a lower limit. As expected, the same happened with the Botucatu sandstone samples, however, in this case, the sensitivity to low salinity was more pronounced. In a second phase, the research was focused on the Botucatu Sandstone behavior front of dilute polymer solutions injection, checking the main relationships between the Rock / Fluid interactions, considering the Mobility Reduction, Resistance and Residual Resistance Factors, as well as adsorption/desorption processes of these polymers, and the polymer molecules average size and porous sandstone average size ratio. The results for both phases showed a real feasibility of using the Botucatu sandstone in laboratory tests whose objective is the displacement of fluids through porous media

Hidrocarbonetos policíclicos aromáticos no meio ambiente: diferenciação de fontes em sedimentos e metabólitos em bile de peixes

Many studies on environmental ecosystems quality related to polycyclic aromatic hydrocarbons (PAH) have been carried out routinely due to their ubiquotus presence worldwide and to their potential toxicity after its biotransformation. PAH may be introduced into the environmet by natural and anthropogenic processes from direct runoff and discharges and indirect atmospheric deposition. Sources of naturally occurring PAHs include natural fires, natural oil seepage and recent biological or diagenetic processes. Anthropogenic sources of PAHs, acute or chronic, are combustion of organic matter (petroleum, coal, wood), waste and releases/spills of petroleum and derivatives (river runoff, sewage outfalls, maritime transport, pipelines). Besides the co-existence of multiples sources of PAH in the environmental samples, these compounds are subject to many processes that lead to geochemical fates (physical-chemical transformation, biodegradation and photo-oxidation), which leads to an alteration of their composition. All these facts make the identification of the hydrocarbons sources, if petrogenic, pyrolytic or natural, a challenge. One of the objectives of this study is to establish tools to identify the origin of hydrocarbons in environmental samples. PAH diagnostic ratios and PAH principal component analysis were tested on a critical area: Guanabara Bay sediments. Guanabara Bay is located in a complex urban area of Rio de Janeiro with a high anthropogenic influence, being an endpoint of chronic pollution from the Greater Rio and it was the scenario of an acute event of oil release in January 2000. It were quantified 38 compounds, parental and alkylated PAH, in 21 sediment samples collected in two surveys: 2000 and 2003. The PAH levels varied from 400 to 58439 ng g-1. Both tested techniques for origin identification of hydrocarbons have shown their applicability, being able to discriminate the PAH sources for the majority of the samples analysed. The bay sediments were separated into two big clusters: sediments with a clear pattern of petrogenic introduction of hydrocarbons (from intertidal area) and sediments with combustion characteristics (from subtidal region). Only a minority of the samples could not display a clear contribution of petrogenic or pyrolytic input. The diagnostic ratios that have exhibited high ability to distinguish combustion- and petroleum-derived PAH inputs for Guanabara Bay sediments were Phenanthrene+Anthracene/(Phenanthrene+Anthracene+C1Phenanthrene); Fluorantene/(Fluorantene+Pyrene); Σ (other 3-6 ring PAHs)/ Σ (5 alkylated PAH series). The PCA results prooved to be a useful tool for PAH source identification in the environment, corroborating the diagnostic indexes. In relation to the temporal evaluation carried out in this study, it was not verified significant changes on the class of predominant source of the samples. This result indicates that the hydrocarbons present in the Guanabara Bay sediments are mainly related to the long-term anthropogenic input and not directly related to acute events such as the oil spill of January 2000. This findings were similar to various international estuarine sites. Finally, this work had a complementary objective of evaluating the level of hydrocarbons exposure of the aquatic organisms of Guanabara Bay. It was a preliminary study in which a quantification of 12 individual biliar metabolites of PAH was performed in four demersal fish representing three different families. The analysed metabolites were 1-hydroxynaphtalene, 2-hidroxinaphtalene, 1hydroxyphenanthrene, 9-hydroxyphenanthrene, 2-hydroxyphenanthrene, 1hydroxypyrene, 3-hidroxibiphenil, 3- hydroxyphenanthrene, 1-hydroxychrysene, 9hydroxyfluorene, 4-hydroxyphenanthrene, 3-hydroxybenz(a)pyrene. The metabolites concentrations were found to be high, ranging from 13 to 177 µg g-1, however they were similar to worldwide regions under high anthropogenic input. Besides the metabolites established by the used protocol, it was possible to verified high concentrations of three other compounds not yet reported in the literature. They were related to pyrolytic PAH contribution to Guanabara Bay aquatic biota: 1-hydroxypyrine and 3-hydroxybenz(a)pyrine isomers

Adolescência e violência: um estudo da medida socioeducativa de prestação de serviço a comunidade no município do Natal

This Project was built to reflect about juvenile violence and the socio-educational´s range of community services provision. It is known that the juvenile violence is a phenomenon inserted on the capitalism system, backed on neo liberal project. Though, it is essential a historical analysis, showing the economical, political, social and cultural mechanisms which determine the juvenile violence personality. On this way, it is seek understand the elements that leads on work world changes, on the State and public politics sphere, that deepens social dissimilarities. On this propose, it is known that there is a relation among the violence, while one of many manifestations of social question on society and the macroestructuals´determinant that lead the teenager to a social rick situation. This research focused on a inquiry quail-quantitative, using the theoric-metodological procedures of observation, interview and documental quest techniques. The universe had been defined by the intentional sample of 22 interviewed on total, during August and October 2008, covering adolescents and their relatives, technical and the coordinator, which subsidized the Socio educational program of community services provision from Natal analysis of limits and their range. The results of this investigation indicate the necessity of development, with the teenagers authors of infringement acts, a care system that is grounded on a professional formation, respect on human rights and citizenship conquest, regarding that children and teenagers are designed as people on development, that have theirs rights and integral protection, being the State, society and family responsibility assure the integral development of them

O consumo de álcool entre os adolescentes estudantes de escolar privadas católicas de Natal-RN

This study has an object the understanding of the alcohol phenomenon consumption that occurs among teenagers. It is adopted as research locus catholic private schools of Natal - RN, which receive pupils proceeding from the social groups pertaining to the classes taken from Natal private schools. The researched public corresponds to 87 teenagers, who had answered to a mixing questionnaire, with open and closed questions. The research uses as a procedure the intentional election, which for the access easinesses privileges subjects who, at the moment of the research accomplishment, reveal to be in condition to participate of it. The study presents quantitative and qualitative character. It presents the following objectives: 1-Identify in which circumstances the teenagers make alcoholic beverage use; 2 -To identify the knowledge that the teenagers have on the alcohol effects; 3 -To identify the performance role of the school institution on the prevention of alcohol use by teenagers. The analysis method used corresponds to the one called answers interpretation method. Regards to the theoretical-methodological support, the Social Control Theory and the Symbolic Interactionism Theory are adopted as referential. Its contained chapters are organized in the following way: The first chapter approaches the situation of drugs adolescent consumption in general and the social confrontation of this situation. The second chapter presents sociocultural aspects of the alcohol consumption and the description of some of the researched public characteristics. The third chapter emphasizes the school and its performance next to the teenagers and the society in general, towards the prevention and combat of the alcohol use, as well as of other drugs

Câncer de mama: vivência das usuárias dos serviços prestados pela Liga Norte Riograndense Contra o Câncer

This study is about the users' experiences of the services offered by League Against Câncer that are in treatment of breast cancer, focusing on how the health/illness process develops. It is distinguished, in this context, the National Politics of Health, approaching the sprouting, implantation and consolidation process of the Unified Health System and its shocks on the installment of health services to the low-income population as a legit right from Citizen Constitution. It has as an objective to analyze how the social-economic extract of these women intervenes with such process, the aspects who involve the cancer while a pathology, approaching the signals, symptoms, forms of prevention, diagnosis, among other aspects that configure themselves as important points to the understanding of these experiences, since the diagnosis, treatment and control phases. The research was carried out with 25 women, between the months of January and February of year of 2005. The used technique was the scriptstructured interview, whose universe was defined through intentional sample. The following distinguishes as a result of the research: The majority of the women has its origins on the interior of the state, possesses a familiar income from one to three minimum wages and didn't make any kind of prevention before diagnosis, currently make treatment, beyond other aspects. It becomes necessary posterior studies on this social problematic, with respect to the personal, professional, familiar and social daily behavior of these women. It is worth mentioning that the role of the social assistant in the developed work with these women, understanding all the impediments associated with such experiences, as well as giving information about the rights of the patients with cancer, conquered through the years

Criação de empresas à luz do modelo de decisão effectuation: um estudo com mulheres empreendedoras no município de Currais Novos/RN

This study analysed the creation of businesses by entrepreneur women in the Currais Novos city, looking for verifying if they used making decision processes aligned to the Effectuation logic throughout the creation of their companies. To this, was accomplished a multiple cases and exploratory study, whit a qualitative approach of analyse, using the thematic life history technique that match accounts and semi-structured interview route, being accomplished like a long interview, where the researcher interact with the informer continuously. The semi-structured interview route was created by the adaptation of the interview route used by Tasic (2007). The present study appealed to a intentional selection of individuals in function of their importance in relation to the boarded theme. This means that the individuals were chosen in function of their social and theoretical representatively inside the considered situation. The participant individuals of this research were five entrepreneur women that act in the Currais Novos city, owners of five different companies. To the data treatment and analyse, was chosen the content analyse technique. This study worked with a priori theoretical categories. The categories of analyse in this study was obtained with base in the Effectuation approach (SARASVATHY, 2001a, 2001b, 2008), that is an alternative model of making decision to the classic model based in the causality principle. These categories are Clarity of Initial Aims , Tolerance to the Lost and Initials Investments , Control of Resources ( who I am , what I know and who I know ) and Promoting Over Contingencies . As result, the entrepreneur women researched, in a general way, hadn t clear initial aims at the companies creation moment, hadn t aversion to the risk to lose the time and the money that they were investing in the company in formation, they highlighted the products and services identity that offered with a strong link with Seridó region, they had experience in the field of activity in which they decided to open their companies, had the commitment of partners in the beginning of the business and they knew to transform the initial difficulties in opportunities. By the end, this study conclude that the entrepreneur women studied used, in a big part, making decision processes aligned to the Effectuation logic throughout the creation of their companies

Oralidade e escrita: a presença do discurso reportado em entrevistas jornalísticas

In this work, we intend to discuss results from a research about retextualization in gender journalistic interview, considering speech dialogical approach. Retextualization activity, which implies the production of a new text through one or more basic texts, shows the presence of reported speech as an integral unit of discursive construction. Our corpus had been extracted from a section called Nossos Valores [Our Values], present at the syndical newspaper Adurn Notícias [Adurn News], from Federal University of Rio Grande do Norte (Brazil), which weekly publishes journalistic interviews with active professors from this institution. We describe retextualised text structure by correlating it to the one from the oral text, in order to identify and describe quoted speech, as well as features of the gender in which it is inserted. It was verified that, when it comes to reported speech present in the published interviews, which are representative of the research corpus, diverse incorporation procedures of alien property‟s speech take place, especially those regarding about reported speech use. The waterish presence of the other present in dialoged texts speech transformed in monologue texts demonstrates that there is not a clear demarcation among voices in certain parts of the written text. This is confirmed during analyses of the two interview versions, in which it is not always possible to distinguish the authorship of certain propositions, which in some way can point to Bakhtin‟s concept of intentional hybridity. Beyond Bakhtin‟s contributions (1990; 2000), the theoretical principles of this work are based upon Marcuschi (1986; 1999; 2001), Matencio (2003), Authier-Revuz (1982), and Favero et al. (1997; 1998; 1999; 2000)

Efeitos da laserterapia na atividade biológica de células de carcinoma epidermóide de língua humano

The low level laser therapy (LLLT) has shown to be effective in promoting the proliferation of different cells in vitro, including keratinocytes, osteoblasts, endothelial cells and stem cells. It has been speculated that the biostimulatory effect of LLLT could cause undesirable enhancement of tumor growth in neoplastic diseases, since the malignant cells are more susceptible to proliferative stimuli. Within this context, this study evaluated the effect of LLLT on epidermoid carcinoma of the tongue cell line (SCC25) proliferation and invasion. Cultured cells were irradiated with an InGaAIP diode laser, 660nm, 30mW using two energy densities (0.5J/cm2 and 1.0J/cm2). Proliferative activity was assessed through trypan blue staining method and through cell cycle analysis using flow cytometry. The invasive potential was measured through cell invasion assay using matrigel. Cyclin D1, E-cadherin, -catenin and MMP-9 expressions were analyzed by immunofluorescence and flow cytometry and related to the investigated biological activities. Proliferation curve demonstrated that SCC25 irradiated with 1.0J/cm2 had the highest proliferative rate when compared to the control group and the group irradiated with 0.5J/cm2 (p<0.05). LLLT affected cell cycle distribution and energy density of 1.0 J/cm2 promoted a higher percentage of cells in S/G2/M phases, with statistically significant differences at 24h interval (p<0.05). LLLT, mainly with 1.0J/cm2, revealed significantly higher potential for invasion and influenced the expression of cyclin D1, E-cadherin, -catenin and MMP-9, promoting the malignant phenotype. In conclusion, our results indicate that LLLT has an important stimulatory effect on proliferation and invasion of SCC25 cells, likely due to altered expression of proteins associated with these processes

A experiência do usuário idoso no design de jogo digital para a reabilitação neural de pacientes com quadro de acidente vascular cerebral (AVC)

Stroke is nowadays one of the main causes of death in Brazil and worldwide. During the rehabilitation process, patients undergo physioterapic exercises based on repetition, which may cause them to feel little progress is being made. Focusing on themes from the areas of Human-Computer Interaction and Motor Imagery, the present work describes the development of a digital game concept aimed at motor rehabilitation to the neural rehabilitation of patients who have suffered a stroke in a playful and engaging way. The research hypothesizes that an interactive digital game based on Motor Imagery contributes to patients' raised commitment in the stroke sequel rehabilitation process. The research process entailed the investigation of 10 subjects who live with sequels caused by stroke - it was further established that subjects were over 60 years old. Using as foundation an initial survey regarding target-users' specificities, where an investigation on subjectrelated aspects was carried out through Focus Group (n=9) and Contextual Analysis (n=3), having as subjects elderly individuals, a list with the necessary requirements for the conceptualization of a digital game was fleshed out. The initial survey also enabled the establishment of preliminary interactions for the formulation of game prototypes. At first, low-resolution prototypes were used, with two distinct interaction models for the game - one with a direct approach to the Motor Imagery concept, and another using a narrative with characters and scene settings. The goal was to verify participants' receptivity regarding the addition of playful activities into game dynamics. Prototypes were analyzed while being used by five patients, through the Cooperative Evaluation technique. The tests indicated a preference for option with elements in a playful narrative. Based on these results high fidelity prototypes were created, where concepts close to the game's final version were elaborated. The High Fidelity prototype was also evaluated with four patients through the Cooperative Evaluation technique. It was concluded that elderly individuals and patients were receptive to the idea of a digital game for the rehabilitation from sequels caused by stroke; that, for the success of devices aimed at these cohorts, their contexts, needs and expectations must be respected above all; and that user-centered design is an essential approach in that regard.

A simulação realística como estratégica de ensino-aprendizagem em enfermagem

The study aims to examine the methodology of realistic simulation as facilitator of the teaching-learning process in nursing, and is justified by the possibility to propose conditions that envisage improvements in the training process with a view to assess the impacts attributed to new teaching strategies and learning in the formative areas of health and nursing. Descriptive study with quantitative and qualitative approach, as action research, and focus on teaching from the realistic simulation of Nursing in Primary Care in an institution of public higher education. . The research was developed in the Comprehensive Care Health discipline II, this is offered in the third year of the course in order to prepare the nursing student to the stage of Primary Health Care The study population comprised 40 subjects: 37 students and 3 teachers of that discipline. Data collection was held from February to May 2014 and was performed by using questionnaires and semi structured interviews. To do so, we followed the following sequence: identification of the use of simulation in the discipline target of intervention; consultation with professors about the possibility of implementing the survey; investigation of the syllabus of discipline, objectives, skills and abilities; preparing the plan for the execution of the intervention; preparing the checklist for skills training; construction and execution of simulation scenarios and evaluation of scenarios. Quantitative data were analyzed using simple descriptive statistics, percentage, and qualitative data through collective subject discourse. A high fidelity simulation was inserted in the curriculum of the course of the research object, based on the use of standard patient. Three cases were created and executed. In the students’ view, the simulation contributed to the synthesis of the contents worked at Integral Health Care II discipline (100%), scoring between 8 and 10 (100%) to executed scenarios. In addition, the simulation has generated a considerable percentage of high expectations for the activities of the discipline (70.27%) and is also shown as a strategy for generating student satisfaction (97.30%). Of the 97.30% that claimed to be quite satisfied with the activities proposed by the academic discipline of Integral Health Care II, 94.59% of the sample indicated the simulation as a determinant factor for the allocation of such gratification. Regarding the students' perception about the strategy of simulation, the most prominent category was the possibility of prior experience of practice (23.91%). The nervousness was one of the most cited negative aspects from the experience in simulated scenarios (50.0%). The most representative positive point (63.89%) pervades the idea of approximation with the reality of Primary Care. In addition, professors of the discipline, totaling 3, were trained in the methodology of the simulation. The study highlighted the contribution of realistic simulation in the context of teaching and learning in nursing and highlighted this strategy while mechanism to generate expectation and satisfaction among undergraduate nursing students

Avaliação da atenção humanizada ao abortamento em maternidade-escola, em Natal, Rio Grande do Norte

Unplanned pregnancy is experienced by millions of women worldwide. Such fact increases the risk of abortion-related morbimortality, which represents a serious public health problem. This study aims to evaluate the advances and challenges of the implementation of Humanized Abortion Care at the Maternity-School in Natal, state of Rio Grande do Norte. The research was evaluative, was preceded by an Evaluative Study, and resulted in a Case Study. The intentional sample totaled 102 subjects (60 users, 39 professionals and 3 managers). The collection techniques included documental analysis, semi-structured interview and observation with a field diary. The documental analysis was descriptive, while the Content Analysis by Bardin was used for semi-structured interviews and field diary. The Evaluative Study observed that Humanized Abortion Care is an evaluative program with preparation and pact of the logical model, of the matrix of indicators and evaluative questions. The Case Study showed that users were satisfied with the problem-solving capacity and access to the service; however, is also showed that they pointed out inadequacy in terms of environment, qualified hearing and reproductive planning. Professionals reported that the inefficiency of service consists of infrastructure and environment, which are considered inefficient and inadequate to humanized care, especially regarding patient accommodation, the lack of hospital beds, the reduced number of rooms in the surgical center and the lack of laboratory inside the maternity. Moreover, reproductive planning does not consist of an institutionalized practice in the service, and integrality with other services or partnership with the community is not in place. The Maternity Board emphasizes that the excessive demand of patients is one of the reasons that hinders the appropriate implementation of the technical standard. We then conclude that although satisfied regarding problem-solving capacity in terms of service and ease of access, there is room for improvement in qualified hearing systems, in the creation of a system to promote team work, implementation of ombudsman and satisfaction surveys. The right of shared choice did not prevail among users and health professionals with regard to the option of uterine evacuation procedure. Environment was the most mentioned category as that requiring more changes, seeing as a limited factor for the development of humanized and welcoming practices. Health professionals do not establish a periodic routine of planning practices, and such practices are not aligned with the Technical Standard. Incorporation of guidelines and availability of a plurality of methods and possibilities of choices for family planning are required. There is no institutionalization of reference and counter-reference, or partnerships with the community, which makes integrality of care not viable. The Standard needs to be included in the action plans of managers as one of the priorities in the construction of care strategies for women's health, in order to enable, allied to other initiatives, the real integration among safe conduct service, primary care network and social organizations. As a result, respect for human rights and adequate humanized care, as a way of attention and prevention of abortion, can be secured.

Geração de padrão de marcha adaptável para uma órtese ativa de membros inferiores

Atualmente com o crescente aumento de dispositivos robóticos destinados para aplicação na área de mobilidade de pessoas que sofreram algum tipo de lesão medular, se faz necessário desenvolver novas ferramentas para tornar tais equipamentos mais adaptáveis, seguros e autônomos. Para que as órteses robóticas que auxiliam na locomoção de pessoas paraplégicas possam desempenhar sua função, estas devem ser capazes de reproduzir os movimentos perdidos com o máximo de fidelidade e segurança em ambientes que eventualmente possam conter obstáculos de diferentes tipos como buracos, escadas e calçadas. As órteses robóticas para membros inferiores têm a capacidade de caminhar, subir e descer degraus, todavia, esses movimentos, na maioria das vezes, não se adaptam ao ambiente, sendo assim, para uma órtese robótica que foi projetada para subir um degrau com uma determinada altura ao se deparar com um degrau maior provavelmente não conseguirá realizar essa tarefa com a mesma segurança. Para solucionar esse e outros problemas, esse trabalho apresenta um Sistema de Auxílio à Locomoção (SAL) dotado de um planejador de passos e um gerador de referências angulares com características antropomórficas para a órtese robótica Ortholeg. O SAL utiliza dados antropométricos do usuário para gerar um padrão de marcha personalizado, dessa forma, a órtese em questão é capaz de adaptar o tamanho do passo para não colidir com obstáculos presentes no ambiente e transpor buracos com diversos tamanhos, subir e descer escadas e calçadas com diferentes valores de altura e comprimento. Para desenvolver o sistema de auxílio à locomoção foram adaptadas técnicas de planejamento de caminho, usadas a princípio em robôs bípedes. São apresentados vários experimentos que mostram a órtese Ortholeg realizando alguns movimentos com características antropomórficas para diferentes distâncias de caminhada e três tipos de obstáculos: degrau, buraco e calçada. A autonomia adquirida com a utilização do sistema de planejamento apresentado facilita a utilização de órteses robóticas como também garante uma maior segurança ao usuário.