A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em saúde bucal coletiva

RONCALLI, Angelo Giuseppe. A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em Saúde Bucal Coletiva. raçatuba, 2000. 238p. Tese (Doutorado em Odontologia Preventiva e Social). Faculdade de Odontologia, Universidade Estadual Paulista “Júlio de Mesquita Filho”

Prevalence of orofacial clefts and social factors in Brazil

RODRIGUES, Katamara et al. Prevalence of orofacial clefts and social factors in Brazil. Brazilian oral research, v.23, n. 1, p. 38-42, 2009.Disponivel em: . Acesso em: 04 out. 2010.

Planejameto municipal do turismo: diretrizes e perspectivas - o caso da SETURDE

Given the uncertainties of the environment in today's world, strategic planning is again discussed as an important tool to position the organization in future likely. To address this a more dynamic and less linear, trying to adapt the multiple realities, the method of scenarios can be one of the strategies to anticipate future designs. In the public sphere, an efficient implementation of human resources and financial managers require a new approach to the formulation of strategies. Tourism, in turn, presents itself as an important segment of the national economy shaped up as a major source of funds for the formation of the Gross Domestic Product - GDP - of states and municipalities. This study aims to know the guidelines and perspectives of municipal planning of tourism in the city of Natal/RN from the case by the representatives of the sector. The survey was developed based on a qualitative, exploratory, based on the case in the Secretaria Municipal de Turismo e Desenvolvimento Econômico - SETURDE. The results express that the body goes through a time of changes in its organizational structure and in defining its role with the local tourism. The national plan for tourism and the choice of Christmas as the host city for the World Cup in 2014 have stimulated interest in developing a formal strategic planning in the organization. However, when it comes to more complex tools, such as the method of future scenarios, the technical know its definition and importance for future actions. The results presented support the conclusion that the actions are designed intuitively and without complying with the scientific methods developed for this purpose, as the method of strategic scenarios. However, the evidence beginning to emerge from the plans and documents issued by the federal government, as well as the Secretary's own initiative, direct the actions of the body to coordinate and act as a fulcrum for local action to the increase in tourism

Relações de cooperação em consórcios públicos de regiões metropolitanas: análises do CONDIAM/PB e consórcio grande Recife

With the disorganized decentralization occurred in Brazil after the 1988 Constitution, municipalities have risen to the level of federal entities. This phenomenon became known as "municipalism" also brought some negative effects such as low capacity financial, economic and political of these entities. In the face of this reality , the municipalities sought in models of collaborative features to address public policy issues ultrarregionais, one of these models are the Public Consortia. Characterized as the organization of all federal entities that aim to solve public policy implementation alone that they could not, or spend great resources for such. This reality of the municipalities have an aggravating factor when looking at the situation in Metropolitan Regions (MRs). This is because the RMs has a historical process of formation that does not encourage cooperation, since that were created top-down during the military regime. Furthermore, the metropolitan municipalities have significant power asymmetries, localist vision, rigidity earmarked revenues, different scenarios conurbation, difficulty standardization of concepts and others that contribute to the vision of low cooperation of these metropolitan areas. Thus, the problem of this work is in the presence of collaborative arrangements, such as the Public Consortia in metropolitan areas, which are seen as areas of low cooperation. To elucidate this research was used for analysis the cases of CONDIAM/PB and Consórcio Grande Recife/PE, because they are apparently antagonistic, but with some points of similarity. The cases has as foundation the Theory of Common Resources, which provides the possibility of collective action through the initiative of individuals. This theory has as its methodology for analyzing the picture IAD Framework, which proposes its analysis based on three axes: external variables, the arena of action and results. The nature of the method of this research was classified as exploratory and descriptive. For the stage of date analysis, was used the method of document analysis and content, Further than of separation of the cases according to theur especificities. At the end of the study, noted that the CONDIAM/PB was a strategy of municipal government of Joao Pessoa to attract funds from the Federal Government for the purpose of to build a landfill, and over the years the ideology of cooperation was left aside, the prevailing view localist municipalities. In the case of Consórcio Grande Recife/PE, members act with some degree of cooperation, especially the collaborative aspect of the region, however, still prevails with greater strength the power of the state of Pernambuco in the decisions and paths of the consortium. Thus, was conclude that the Public Consortia analyzed are an experience of collaborative arrangement, from the initiative of members, as the theory of common resources says, but has not actually signed as a practice of collective action to overcome the dilemmas faced by metropolitan areas

A cultura de índio, seu menino, vem de longe aqui : formação histórica e territorialização dos Tremembé/CE

This dissertation is based on the ethnography of a strategic selection of three Tremembé ethnic situations, which are situated in the backlands of Acaraú and Itarema, municipalities located in Ceará State (Northeast Brazil). My main aims are the following. Firstly, I reconstitute the historical and social formation of three localities, called Lagoa dos Negros, Telhas, and Queimadas, related to a particular origin myth which refers to Almofala, an extinct colonial Aldeamento in the seashore, where the Tremembé indians and other native populations were converted and gathered under missionary administration. According to the origin myth, these three localities were set up after a strong drought which happened in 1888 (the so called three eights) when a group of Tremembé families moved to the countryside and established close to the Lagoa dos Negros and, later on, they were segmented into smaller groups which started to live in other areas and places not far from the former location. Notably, I develop an anthropological approach to understand the historical formation of these three localities. Secondly, I analyze some processes of territorialization, which were emerged from the 1980s and had important consequences to these indigenous families throughout the next two decades. This historical dimension is re-appropriated and ressignified in ethnic terms. A third point of my work is the analysis of the construction of territorialities and also the cultural and symbolic dimensions which are formulated by the Tremembé Indians who live in these localities. Therefore, I investigate some cultural traditions and rituals, such as the Torém dance, but I also examine their multiple semantics, which constitute a transversal direction throughout the history understood by the Tremembé of the different social situations I researched. To sum up, there is a process of cultural actualization, which is still going on and presents itself through the ludic sphere as well as their political and religions dimensions, which are usually associated to the ritual presentation of the Torém

O Litoral e a metrópole dinâmica imobiliária, turismo e expansão urbana na região metropolitana de Natal-RN

The metropolitan regions of Northeast Brazil are being gradually included in a scenario of international investments, which are motivated by the restructuring of both touristic and real-estate sectors. The new capital, real-estate developers and space configurations that result from this process indicate the need for the creation and implementation of public tools which should, at least, allow the mitigation of the urban impacts and environmental losses resulting from this situation. The effects on landscape and on the socio-spatial configuration result from the intensification caused by the dynamism of the "real estate-tourism" sector. There is a regional integration as an expression of the urban expansion of the metropolitan area of Natal. This study investigates the uniqueness of the restructuring and territorial integration of coastal areas and the strategies of the circuit of capital accumulation formed by linking the real estate to tourism. It is intended to increase the understanding about the strategies of tourism, real estate and public policy agents involved in this territorial reconfiguration and in the fund-raising needed for the investments, to understand the existing social and environmental effects and their future trends and also to understand the forms of spatial production as results from the practices of approaching the land transformation and the tourism valorization of the landscape, in a synchronous manner, first in the Northeast region and, as a focal study, in the Metropolitan Area of Natal. Likewise, it is intended to apprehend the current processes of metropolization of the eastern coast of Rio Grande do Norte, in addition to indicate its physical-territorial transformation and the types of projects/developments promoted by the market in the recent period. Based upon analysis undertaken for the Metropolitan Region of Natal RN, this piece of work presents some considerations on possible legal instruments that can be adjusted to the municipalities which are experiencing the impact of this peculiar and recent phenomenon in the region, caused by the arrival of the real estate-touristic capital. It is also intended to point out basic proposals to the forms of public intervention, in a speculative way, starting from a Metropolitan Planning project within a medium and long term

Avaliação da qualidade da água do Rio Piranhas-Açu/RN utilizando a comunidade de macroinvertebrados bentônicos

The biomonitoring technique for water quality in water bodies has been incorporated increasingly in management of the natural resources, using mainly indices of its aquatic community characteristics. In Brazil the first efforts to use this technique was restricted to the South and the Midwest region of this country. Located in the northeast region, this study was conducted at Rio Grande do Norte state and had as main objective the assessment of water quality in the Piranhas-Açu river using benthic macroinvertebrates community as biological indicators. Thus, were applied two biotic indices, the BMWP (Biological Monitoring Working Party score system) and the IBF (Family Biotic Index). According the requirements of these indices, two periods of sampling were determined as basic methodology, in dry seasons of 2006 and 2007. The sampling sites were around the municipalities of Açu, Ipanguaçu, Alto do Rodrigues and Pendências. Physical-chemical measurements; a protocol of rapid assessment of diversity of habitats, and determination of the degree of tolerance of each taxon to organic pollution were also performed. The most abundant organisms found in the river were tolerant with the prevalence of Chironomidae (Diptera) and Melanoides tuberculata. This results, together with those ones got in indices application, showed a considerable organic pollution in the four sample places and the reaches were classified as modified to impacted. According to the used indices, this study suggest that this river have significant alteration in the biotic community and water quality on the organic pollution, and this fact, occurs in the reach of the river further downstream, where were expected a good water quality. Considering these results, measures aiming the conservation of this water body are needed regarding as it is inserted into a fragile ecosystem with dry season phenomenon, and the water of this river has extremely importance for the local economy

Preferência alimentar e identificação das principais fontes de repasto sanguíneo de fêmeas Lutzomyia (Diptera: Psychodidae) em áreas endêmicas para leishmaniose visceral na grande Natal

Leishmaniasis are endemic diseases wild spread in the New and Old World, caused by the flagelated protozoan Leishmania. In the New World, the distribution of different forms of leishmaniasis is mostly in tropical regions. In the State of Rio Grande do Norte, Northeast Brazil, 85% of the captured sand flies fauna is Lutzomyia longipalpis. The distribution of the sand fly vector in the state overlaps with the disease distribution, where the presence of sand flies is associated with presence of animals shelters. The aim of this study was to analyse the blood meal preference of sand flies vector from the genus Lutzomyia spp. in laboratory conditions, to verify the vector life cicle at different temperatures sets and to identify the main blood meal source in endemic areas for visceral leishmaniasis (VL) at peri-urban regions of Natal. Sand flies samples were collected from the municipalities of São Gonçalo do Amarante and Nísia Floresta where female sand flies were grouped for the colony maintenance in the laboratory and for the analysis of the preferred source of sand fly blood meal in natural environment. The prevalence of blood meal preference and oviposition for the females sand flies was 97% for Cavia porcellus with oviposition of 19 eggs/female; 97% for Eqqus caballus with 19 eggs/female; 98% for human blood with 14 eggs/female; 71.3% for Didelphis albiventris with 8.4 eggs/female; 73% for Gallus gallus with 14 eggs/female; 86% for Canis familiaris with 10.3 eggs/female; 81.4% for Galea spixii with 26 eggs/female; 36% for Callithrix jachus with 15 eggs/female; 42.8% for Monodelphis domestica with 0% of oviposition. Female sand flies did not take a blood meal from Felis catus. Sand flies life cycle ranged from 32-40 days, with 21-50 oviposition rates approximately. This study also showed that at 32°C the life cycle had 31 days, at 28° C it had 50 days and at 22°C it increased to 79 days. Adjusting the temperature to 35°C the eggs did not hatch, thus blocking the life cycle. A total of 1540 sand flies were captured, among them, 1.310 were male and 230 were female. Whereas 86% of the sand flies captured were Lu. longipalpis as compared to 10.5% for Lu. evandroi and, 3.2% for L. lenti and 0.3% for Lu whitmani. The ratio between female and male sandfly was approximately 6 males to 1 female. In Nísia Floresta, 50.7% of the collected females took their blood meal from armadillo, 12.8% from human. Among the female sand flies captured in São Gonçalo do Amarante, 80 of them were tested for the Leishmania KDNA infectivity where 5% of them were infected with Leishmania chagasi. Female Lutzomyia spp. showed to have an opportunistic blood meal characteristic. The behavioral parameters seem to have a higher influence in the oviposition when compared to the level of total proteins detected in the host s bloodstream. A higher Lu. longipalpis life cycle viability was observed at 28°C. The increase of temperature dropped the life cycle time, which means that the life cycle is modified by temperature range, source of blood meal and humidity. Lu longipalpis was the most specie found in the inner and peridomiciliar environment. In Nísia Floresta, armadillos were the main source of blood meal for Lutzomyia spp. At São Gonçalo do Amarante, humans were the main source of blood meal due to CDC nets placed inside their houses

Resposta imune à saliva de flebotomíneos (diptera: psychodidae) em indivíduos residentes em áreas urbana e periurbana no nordeste do brasil

Visceral leishmaniasis (VL) has a wide geographical distribution in tropical and subtropical areas of the planet, which is a protozoan parasite of the genus Leishmania. This pathogen is transmitted to the host through the sandflies bite, with its saliva, the immune response that leads to both. In the state of Rio Grande do Norte, 85% of the sand flies captured is Lutzomyia longipalpis, but the second most abundant, Lutzomyia evandroi, it deserves emphasis because its wide distribution and eclectic behavior. The exposure of people living in endemic areas for the insect vector VL greatly increases the chances of infection. This study aimed to evaluate aspects of the epidemiological profile of VL in endemic areas of human and nonendemic in the metropolitan area of Natal, as well as verify the abundance and seasonal fluctuations of sandflies species in two counties endemic for VL. Were collected in the municipalities of Nísia Floresta, Parnamirim, São Gonçalo do Amarante and Macaíba, of which groups of females were separated for further dissection of the salivary glands and identification of species. The blood samples used were from individuals of two Natal s districts where it has never been reported cases of VL and neighborhoods of Parnamirim applicants who present cases of VL. In the municipality of Nísia Floresta, the most abundant species was L. evandroi with 38.39%, followed by L. longipalpis with 36.22%, L. walkeri 19.67% L. lenti 3.81%, L. wellcomei 1.39% and L. whitmani 0.52%. Already in Parnamirim the proportions were L. walkeri with 73.15%, L. evandroi with 10.55%, L. wellcomei 7.63%, L. longipalpis 6.37%, L. whitmani 1.46%, L. sordellii 0.52%, L. intermedia 0.21 and L. shanonni 0.1%. In both municipalities was observed higher abundance of species distributed in the initial months of the year, as February and March. The study showed that no difference in exposure to the vector of VL among individuals from endemic and non endemic area for this disease. But there are differences in exposure between individuals of L. longipalpis and L. evandroi, confirming the great powers of the first vector. It was also characterized as predominant phenotype in the population of endemic areas who had negative serologic responses to antigens of Leishmania and result in negative Montenegro skin test (DTH), indicating that much of the population hasn t been bitten by infected insects

Uso de resíduo e de minerais de pegmatito da região do seridó RN e de argilas portuguesas em formulações de grês porcelanato

In the State Rio Grande do Norte, Brazil, the most significant deposits of minerals in the production of granite and pegmatite are Seridó region. Municipalities of Parelhas and Equador are the main responsible for the production of feldspar, quartz, kaolin and granite. The ceramic industries are always in search of competitiveness by investing in new products or improving existing techniques. The stoneware is a type of pottery that stands in the market because it presents technical and aesthetic characteristics superior to other existing products. Characteristics of the raw materials initially obtained with chemical analysis and mineralogical analysis are crucial in getting a product that satisfies the conditions in a manufacturing process and is, in principle, directly related to the firing cycle. This research aimed at developing new formulations for the mass production of ceramic stoneware. The raw materials initially characterized were feldspar, quartz, kaolin and granite. As part of the research was developed at the University of Aveiro, in Portugal, we used two clays used in the production of Portuguese ceramics. The raw material Brazilian and Portuguese and the final product, both in Portugal and Brazil, were analyzed for X-ray fluorescence, X-ray diffraction, granulometric analysis, dilatometric analysis, thermal analysis and analysis of scanning electron microscopy (MEV). The specimens prepared at the University of Aveiro (DECV) were sintered at 10000C and 12000C and the specimens prepared in UFRN were sintered at 10000C, 10500C, 11000C, 11500C, 12000C, 12500C and 13000C, but the best results and demonstrating the presence of the mineral mullite were at temperatures of 12000C, 12500C and 13000C. The results showed that the granite waste used may be considered raw material of excellent quality for use in the ceramic industry and coating floors and more accurately by the industry of stoneware. Physical and mechanical tests conducted on samples of the formulations F01 and F02 developed in UFRN showed a water absorption and mechanical strength suitable for the stoneware

Diversidade de invertebrados em cavernas calcárias do oeste potiguar : subsídios para a determinação de áreas prioritárias para conservação.

It is estimated that the Brazilian karst areas sum about 200.000 km2. The caves, one of the main components of karst, are important windows into the biological studies on hypogean environments. In Rio Grande do Norte are known 563 caves, and 476 of them are in the municipalities of Baraúna, Felipe Guerra, Governador Dix-Sept Rosado, Apodi and Mossoró, the Western region of the State. However, like in the rest of the country, the cave fauna of the State is still poorly understood. This study used data from invertebrates harvested in 47 caves and aimed to analyze the effect of environmental change between the dry and rainy seasons in the communities of cave invertebrates, characterize these communities and evaluate the relationships between morphological and biotic variables of the caves and surroundings, and to define priority areas for conservation of cave environments of the study area from biotic parameters. Strong effects were found in the community structure of cave invertebrates due environmental changes between seasons, with values of total richness, abundance, diversity and ecological complexity significantly higher in the rainy season. It was possible to assess how the morphology of the cave and the external environment variables affect the biotic system, so that the variety of resources, forest cover in the vicinity, the area of the cave and its entrance were the variables that best explained the structure communities of cave invertebrates in the region. High values of total richness of invertebrates (36,62 ± 14,04 spp / cave) and troglomorphic species (61 species, mean 1,77 ± 2,34 spp / cave) were found and, given the biological relevance in the context of the area national and the imminent anthropogenic pressures existing, we defined four priority areas for actions aiming cave biodiversity conservation in the region.

Prevalência da infecção por Chlamydia Trachomatis em mulheres atendidas no Programa de rastreamento do câncer de colo do útero

Genital infection with Chlamydia trachomatis is now recognized as one of the most prevalent sexually transmitted infections (STDs). Despite major advances in laboratory diagnosis techniques, primarily the character of asymptomatic chlamydial infection in both men and in women constitutes the basis for the formation of reservoirs that perpetuate transmission and acquisition of this and other STDs. The asymptomatic in women favors the rise of infection to the upper genital tract, causing injuries that can result in infertility. An examination of population screening for early detection and treatment of asymptomatic infections is the key step in combating this major public health problem. The present study aimed to evaluate the prevalence of infection by C. trachomatis in sexually active women attended the screening program for cervical cancer of the uterus in health facilities in municipalities in different regions of the State of Rio Grande do Norte, and identify factors that may contribute to the spread of this pathogen and its relationship with the lesions of the uterine cervix. It is a cross-sectional study aimed at detecting the presence of genital tract infection by C. trachomatis either in isolated form or in association with human papilloma virus (HPV) infection in asymptomatic women. Were included in this study, a total sample of 1,134 women aged 13-76, mean 34.4 years, from March 2008 to September 2012. Specimens containing exfoliated cells of the epithelium of the uterine cervix were analyzed by examining Pap cytology for the detection of possible injuries, and the polymerase chain reaction (PCR) for detection of plasmid DNA from C. trachomatis and HPV. Infection with C. trachomatis was detected with overall prevalence rate of 8.1% in the isolated form and 2.8% in co-infection with HPV. The infection was detected in 7.4% of women with normal cytology 11.5% of those with atypical cells of undetermined significance (ASC-US) and 16.7% of those with low-grade squamous intraepithelial lesion (LSIL). We observed an association between C. trachomatis and incidence of low-grade squamous intraepithelial lesion (LSIL). The genital tract infection by C. trachomatis alone was associated with education level, ethnicity and parity, revealing that women with higher education, those of non-white ethnicity and those who had three or more pregnancies were more likely to acquire infection. Levels very close to statistical significance were observed for chronological age, age at first sexual intercourse and first pregnancy. There was no association with marital status, number of sexual partners. Co-infection with C. trachomatis and HPV was detected in 2.3% of women with normal cytology, who had 5.1% in ASC-US and 10.4% in those with LSIL. No association was found between infection C. trachomatis and increased risk of HPV infection, but women with simultaneous infection by both pathogens showed greater risk for LSIL. Co-infection was more prevalent among single women, who had in the first sexual intercourse under 18 years and those who had two or more sexual partners over a lifetime

Impacto da estratégia saúde da família com equipe de saúde bucal sobre indicadores de saúde bucal: análise em municípios do nordeste com mais de 100 mil habitantes

This study examined in municipalities of Northeast of Brazil with more than one hundred thousand people who incorporation of Oral Health Teams (OHT) into the Family Health Strategy (FHE) the possible impact on oral health indicators. Sought to answer whether implementation OHT brought the best indicators of health problems and coverage, compared to areas without coverage by the FHE through a community trial in parallel, quasi-randomized. In each of the municipalities surveyed were 20 census tracts, 10 were located in areas covered by oral health teams in the ESF and 10 industries in areas not covered. The final sample consisted of 59.221 individuals. We compared oral health indicators related to health problems, access to services and coverage of oral health actions. The analysis strategy was based on the calculation of prevalence ratios and confidence intervals, adjusted for confounding factors through Poisson regression with robust variance. It also has measured the association between an indicator of social inequality for comparison between areas. The best results are associated with indicators of access and coverage of oral health actions at the expense of the indicators of health problems, suggesting a possible maintenance of a traditional model of practice yet. The results also suggest a possible effect of a specific policy in the area of primary care on inequality in access. From the discussions presented throughout this work, we can see that the impact analysis of public policy, obtained by comparing areas with and without the intervention, not only captures the effect on the target population, but other dimensions of organization service and therefore should be understood as one of the analytical possibilities related to the management

Soroprevalência da infecção pelo Trypanosoma cruzi no município de Caicó, RN, e caracterização genética por RAPD do parasito isolado de humanos e de triatomíneos no semiárido potiguar

Trypanosoma cruzi infection was evaluated in 390 resident individuals in different rural communities of Caicó municipality, State of Rio Grande do Norte (RN). Of 28 investigated communities the soroprevalence of T. cruzi infection was 2.8% in eight rural communities individuals. The epidemiological characteristics of seropositive shown that the age ranged from 22 to 64 years, being significantly raised from 31 years (90.9%). The female gender was predominant and low education degree. Those individuals reported that they never donated blood, but they had direct contact with triatomines bug. The isolation of the parasite was performed by blood culture and xenoculture methods to determine the genetic variability of the samples. Twenty seven T. cruzi isolates were analyzed by RAPD as genetic marker using three random primers (M13-40, gt11-F and L15996). The T. cruzi isolates showed 73.7% of shared bands considering the average obtained with the three primers, and were genetically well correlated. Using this marker it was possible to separate the populations of the parasite in three distinct groups. The first group composed by isolates obtained of triatomines and humans from four different districts (Caicó, Caraúbas, Serra Negra doNorte and Governador Dix-Sept Rosado); the second contained isolates obtained of triatomines of two different species (T. brasiliensis and P. lutzi) captured in Caraúbas and Serra Negra do Norte. The third grouped isolates obtained from humans of Angicos and Caicó municipalities. In different localities of distinct mesoregions, State of RN, a profile genetic well correlated was identified among all isolates and the presence of three distinct groups of the parasite circulating among vertebrate and invertebrate hosts

Associativismo nos municípios rurais: uma alternativa de desenvolvimento local em Portalegre/RN

This work aims to study the associations as mediating the process of social change and its importance for local development. The hypothesis is that associations, but bring dynamism to the smaller cities and improve the living conditions of their members, relegated to the background social sustainability, understood this as a permanent exercise of mobilization and participation in community life. The assumptions of the study are that the practice group has influenced the processes of local development in Brazilian rural municipalities through the mediation of government programs and projects aimed at combating rural poverty require social organization for their achievement. The concept of local development in this work was rescued from studies of political economy and sociology. But the concepts of collective action and partnerships advêem studies of political participation and social development of the theory of alternative or solidarity. The party consisted of an empirical case study conducted with four associations of farmers in the municipality of Portalegre-RN. Why choose qualitative study was used the technique of semi-structured interviews with the chairmen I members of associations and other actors considered essential to understanding the study (religious leaders, local political power and chairman of the union of rural workers), a total of 20 interviews, in addition to the observations of field and documentary research in records of the.ir own organizations. The survey results show that the performance of groups of farmers are key components and determinants for the production I marketing of agricultural products and for boosting the economy, as well as security for minimum levels of citizenship. Yet we are still in a space purpose of social change, which comes to confirm the initial hypothesis of this work