Uma avaliação do serviço de atenção domiciliar/programa melhor em casa: o caso do hospital Monsenhor Walfredo Gurgel

This dissertation try to understand how management actions implemented by Monsenhor Walfredo Gurgel Hospital in the city of Natal promote effectively the benefits of Home Care Services / Programa Melhor em Casa . The research is exploratory and descriptive, qualitative approach. Data were collected through document analysis and the interviews with the managers of the Program in Health Department and Hospital beyond the questionnaires with the home care teams and technical management unit of Hospital Jobs. The information were treatment trough categories that analyzed to implemented actions and program objectives. The results show that: the practices carried out by the host teams produce the humanization of care by seeking to ensure access to health services and solving human form; networks of health care are not yet finalized hindering the referral of patients to other units, the networks allow support from other institutions to minimize the problems encountered, the management unit vacancies allows the reduction of costs, mainly by regulating beds and record of health initiatives in home care assists in the monitoring and evaluation process of the Services Home Care / Programa Melhor em Casa primarily the epidemiological profile and patients individual treatment plan. Concludes that most of the actions implemented by the Hospital contribute to the effectiveness of the goals of Programa Melhor em Casa

Fatores associados à condição de saúde bucal de pacientes internados em hospitais públicos do município de Natal-RN

The hospitalization is an event that can attack any person, independent of gender, race, social and economical condition. Last year, the prevalence of hospitalization was 8.1 for 100 inhabitants and the average time of hospitalization was 8.5 days for each patient one in Natal city. Therefore, an important point is whether the attention to the patients during the permanence in these health establishments incorporates the health integral model suggested by the principles proposed by the National Health System in Brazil (SUS), with actions of promotion and protection by different kinds of professionals, beside those called convalescence. Then, the aim of this study was to evaluate the patient s oral health conditions hosted in public hospitals of the Natal city, looking for to establish its relationship with several risk factors by two dimensions: the characteristics of the hospitalization and the patient s general and economical conditions. We accomplished a cross-sectional study with 205 patients distributed among the hospitals Onofre Lopes, Giselda Trigueiro and Monsenhor Walfredo Gurgel, looking for to know the socio-demographic characteristics, the food habits and of oral hygiene and the conditions of oral health, through the Visible Plaque Index and Gingival Bleeding Index. We observed that the conditions of the patient s oral health interned at public hospitals of reference of the municipal district of Natal is bad, existing accumulation of dental plaque and, consequently, a great number of patients with gingival bleeding. However, the time of hospitalization and its reason, the type of medicine used in this time and the toothbrush frequency were not configured as risk factors for this oral health condition

Impacto do Programa de Saúde da Família sobre indicadores de saúde bucal na população de Natal -RN

The aim of this study was to assess the impact of the Family Health Program (FHP) on a number of oral health indicators in the population of Natal, Brazil. The study is characterized as a quasi-random community intervention trial. The intervention is represented by the implementation of an Oral Health Team (OHT) in the FHP prior to the study. A total of 15 sectors covered by the FHP with OHT were randomly drawn and paired with another 15 sectors, based on socioeconomic criteria, not covered by the teams. A few sectors were lost over the course of the study, resulting in a final number of 22 sectors, 11 covered and 11 not covered. We divided the non-covered areas into two conditions, one in which we considered areas that had some type of assistance program such as the Community Agents Program (CAP), FHP without OHT, BHU (Basic Health Unit) or no assistance, and the other, in which we considered areas that had only BHU or no assistance. Community Health Agents (CHAs) and Dental Office Assistants (DOAs) applied a questionnaire-interview to the most qualified individual of the household and the data obtained per household were transformed into the individual data of 7186 persons. The results show no statistical difference between the oral health outcomes analyzed in the areas covered by OHT in the FHP and in non-covered areas that have some type of assistance program, with a number of indicators showing better conditions in the non-covered areas. When we considered the association between covered and non-covered areas under the second condition, we found a statistical difference in the coverage indicators. Better conditions were found in covered areas for indicators such as I have not been to the dentist in the last year with p < 0.001 and OR of 1.64 and I had no access to dental care with p < 0.001 and OR of 2.22. However, the results show no impact of FHP with OHT on preventive action indicators under both non-covered conditions. This can be clearly seen when we analyze the toothache variable, which showed no significant difference between covered and non-covered areas. This variable is one of the most sensitive when assessing oral health programs, with p of 0.430 under condition 1 and p of 0.038 under condition 2, with CI = 0.70-0.90. In the analysis of health indicators in children where the proportion of deaths in children under age 1, the rate of hospitalization for ARI (Acute Respiratory Infections) in those under age 5 and the proportion of individuals born underweight were considered, a better condition was found in all the outcomes for areas with FHP. Therefore, we can conclude that oral health in the FHP has little effect on oral health indicators, even though the strategy improves the general health conditions of the population, as, for example child health

Ser-no-mundo com a criança portadora de câncer compreendendo a experiência de psicólogos nos serviços de oncologia pediátrica de Natal-RN

Cancer goes on to be a frightening disease by humanity, simetimes,it is considered as death, suffering and stigma synonym. Occurring at childhood, this meaning seems to acquire a more intense conotation, having in view of the perplexity and godliness feeling in the presence of the precocity of events, nearly always associated to the death. A psychologist co-existence with the cancer children is going acquiring, thus, a permeated sense by incognitas , fears and fantasy, which raised us the following question: how does the psychologist that answers children with cancer lives this experience? Therefore, the aim this research was to understand this co-existence experience. Our theoretical perspective comes from an existencial fenomenology and, more specifically, the Humanistic Approach and Martin Heidegger Existencial Ontology. The metodology is qualitative of phenomenological character. The access instrument to the experience was the narrative, such as purpose by Walter Benjamin. They were carried out nine semi-open interviews with psychologists who work on pediatric oncology services of Natal-RN city. Such interviews were recorded in cassette, transcripted and later, re-educated. These interviews were recorded, transcribed and later on edited with the help of the interviewee and turned into a text. The narrative comprehension was carried out on Heidegger Existencial Ontology, on dada exaustive reading and the clipping of indicative passages of experience sense of being psychologist on this area. The research suggests that the experience is oriented of clinic kowing-doing, being crossed by implications of key thematics which indicate the care as central ontologic element that orientates the way as these professionals come being in the world in association with the clientèle. Besides, the caring experience of these children acquire the sense of true living experience, since the cancer undoes the immortality illusion, launching the psychologist to his/her condition of being to the death and with that, calling him/her the authenticity. Is is only not dealt with to experience the anguish and the death imminence, but above all, re-meaning them in favour of a continual learning, of quality answering , besides other possibilities. Working with child cancer brings news perspectives and world views, making the psychologist a more human people and sensitive to the distracted needs. And we believe that, regardless of area which actuates, being psychologist is a particular way which choose to be citizen. Is is a project that will be delimited by society, history and culture and after all, by us like human being. Therefore, we understand that the results this research suggest the discussed thematic deepening on this intervention field in order to new sense possibilities can arise giving origin to other reflections about the clinical practice, the professional formation in Psychology and other possible developments

Atenção precoce do câncer de mama :um olhar sobre o cotidiano institucional de uma unidade de saúde de Natal

Breast cancer has been considered a grave global public health problem due to its increase in incidence, in women s mortality and in the amount of financial resources spent on the therapeutic interventions used in the treatment of this neoplasia. However, this scenario presents some variations. In developing countries, the incidence of breast cancer is increasing but, on the other hand, the mortality is declining among patients because of public health actions toward early diagnostic that also result in cure of patients and decreasing levels of physical and psychosocial stress. In Brazil, we face of both the increasing number of breast cancer incidence and number of mortalities. Almost always the reason for that is a delayed detection that will provide a late diagnostic. The early detection of breast cancer has been studied in several researches. Some of them are concerned with women s experiences. Despite that, there is a lack of researches on dynamic comprehension of early attention to breast cancer from the health professionals points of view. The present research was carried out at the Unidade Mista de Felipe Camarão (UMFC) and it was conducted with 11 professionals who work in the Family Health Program (PSF). The aim was to understand how early diagnostic and attention to breast cancer is being planned, discussed and accomplished by health professionals in their day-to-day actions. Semi-structure interviews were held individually with each professional, in a way that they could feel free to express their ideas about several issues. All the information from these interviews was analyzed and discussed using an Institutional Ethnographic approach. It was observed that the actions of health professionals working with early detection of breast cancer does not take place in a vacuum; they occur within institutional, relational and social ways. This interdependence influences their actions and points of view on the theme

Construção de modelos multivariados para determinação de lipídios totais e unidade em leite em pó comercial utilizando espectroscopia no infravermelho próximo

In this work calibration models were constructed to determine the content of total lipids and moisture in powdered milk samples. For this, used the near-infrared spectroscopy by diffuse reflectance, combined with multivariate calibration. Initially, the spectral data were submitted to correction of multiplicative light scattering (MSC) and Savitzsky-Golay smoothing. Then, the samples were divided into subgroups by application of hierarchical clustering analysis of the classes (HCA) and Ward Linkage criterion. Thus, it became possible to build regression models by partial least squares (PLS) that allowed the calibration and prediction of the content total lipid and moisture, based on the values obtained by the reference methods of Soxhlet and 105 ° C, respectively . Therefore, conclude that the NIR had a good performance for the quantification of samples of powdered milk, mainly by minimizing the analysis time, not destruction of the samples and not waste. Prediction models for determination of total lipids correlated (R) of 0.9955, RMSEP of 0.8952, therefore the average error between the Soxhlet and NIR was ± 0.70%, while the model prediction to content moisture correlated (R) of 0.9184, RMSEP, 0.3778 and error of ± 0.76%

Beta: uma ferramenta para geração de testes de unidade a partir de especificações B

Formal methods and software testing are tools to obtain and control software quality. When used together, they provide mechanisms for software specification, verification and error detection. Even though formal methods allow software to be mathematically verified, they are not enough to assure that a system is free of faults, thus, software testing techniques are necessary to complement the process of verification and validation of a system. Model Based Testing techniques allow tests to be generated from other software artifacts such as specifications and abstract models. Using formal specifications as basis for test creation, we can generate better quality tests, because these specifications are usually precise and free of ambiguity. Fernanda Souza (2009) proposed a method to define test cases from B Method specifications. This method used information from the machine s invariant and the operation s precondition to define positive and negative test cases for an operation, using equivalent class partitioning and boundary value analysis based techniques. However, the method proposed in 2009 was not automated and had conceptual deficiencies like, for instance, it did not fit in a well defined coverage criteria classification. We started our work with a case study that applied the method in an example of B specification from the industry. Based in this case study we ve obtained subsidies to improve it. In our work we evolved the proposed method, rewriting it and adding characteristics to make it compatible with a test classification used by the community. We also improved the method to support specifications structured in different components, to use information from the operation s behavior on the test case generation process and to use new coverage criterias. Besides, we have implemented a tool to automate the method and we have submitted it to more complex case studies

Usos e percepções de comunidades do entorno de uma unidade de conservação do semiárido nordestino: instrumentos para gestão?

The loss of Earth´s biodiversity is a major concern for the international scientific community and megadiverse countries like Brazil are paramount for discussions about the overall situation of the planet. The Caatinga biome is probably one of the most threatened in Brazil and the implementation of Conservation Units (CU) represents a measure for protecting its natural resources and biodiversity. The Station Ecological of Seridó (ESEC-Serido) is one of the few CU in the Caatinga of Rio Grande do Norte State (NE Brazil) and interacts with several neighboring communities and settlements. However the ESEC does not integrate environmental perception feedback from the local communities in its management plan. Considering this, the present articles aims at identifying the perceptions and concepts of such communities regarding environmental issues and biodiversity as well as indicate strategies to improve the administration of this CU. In order to achieve these goals, a review of the specialized literature was carried out and a research tool based on Environmental Perception was developed in the form of structured interviews applied to the persons from communities neighboring the ESEC. These interviews were later processed through content analysis. The concepts and perceptions obtained through this analysis show that the people from the environs are aware of the main problems faced by ESEC-Seridó, as well as the strategies to address them

Estudo das percepções ambientais e de ações educativas promotoras da biodiversidade em unidade de conservação no Rio Grande do Norte

Important issues involving the awakening to the need for conservation of biodiversity and the importance of establishing protected areas as a strategy in pursuit of environmental protection, are increasingly being developed in biological and social investigative fields. In this sense, this research aimed to emphasize the use of environmental perception of social agents are significant elements for the understanding of the man / nature, and develop educational activities aimed at raising awareness and changing attitudes towards environmental issues thus promoting reflections on Environmental Education (EE) as a critical and transformative tool for conservation of rich biological diversity. This research covers as a place of study, schools located in the Environmental Protection Area Jenipabu (APAJ), Rio Grande do Norte. Methodology in general, we highlight the use of questionnaires and mind maps as generators of the contents of empirical research, and execution of content analysis for the treatment of data collected. This dissertation has two chapters in the form of scientific articles, where the first is entitled: "Study of the perceptions and evaluation of interactions concerning environmental education in schools in a conservation area of Rio Grande do Norte - Brazil", obtaining thus a primary diagnosis for analysis about the visions that students and teachers from two schools located in APAJ have on the environment. The second article, entitled: "Effective and analysis of educational activities that promote biodiversity in a coastal area of Environmental Protection Northeast - Brazil" provides an analysis of the educational use of biodiversity as a way to raise awareness of the need for environmental conservation. It appears from research that there is a lack of training in EA by teachers, but there is a need for greater involvement of students in conservation areas, however, from the analysis of educational activities, we observed that the effectiveness of such actions acts to promote awareness and change in actors involved. Thus, environmental education needs to take into account the different perceptions found in each individual, and it can not be based solely on transmission of knowledge, so that we reach a model of conservation.

Culicídeos vetores em uma unidade de conservação da caatinga na região do seridó no Rio Grande do Norte aspectos da transmissão de doenças

The scarcity of occurrence records of culicid species, transmitting insects of etiologic agents for arboviruses, protozoan diseases and philarioses, and lack of information about their interactions with the forest environment make the Caatinga one of the most unknown biomes in Brazil. The aim of this study was to identify culicid species in a conservation unit located in a preserved area of the Caatinga and the possible associations with local abiotic factors, as well as characterize the natural and artificial ecotopes present in the Caatinga of Rio Grande do Norte state. The Ecological Station of Serido (ESEC-Seridó) is a Caatinga Conservation Unit located in a rural area of Rio Grande do Norte. The hot and dry climate of the Caatinga, along with a short rainy season, favor the adaptation and resistance of plants, resulting in completely distinct landscapes over the course of the year. The study took place over the course of one year, with monthly collections between 10h-12h, 14h-16h and 18h-20h. Adult mosquitoes were collected in a forest area using a manual suction trap with human bait as attractant at the three times and a Shannon trap for night collections. During the rainy season ovitraps were randomly distributed at different sites. The different capture sites were observed and photographed. Immature and adult insects captured were taken to the laboratory for identification. Of the 5081 insects collected in human-bait and Shannon traps, 75% were Mansonia wilsoni. In addition, Aedeomyia, Aedes, Anopheles, Coquillettidia, Culex, Haemagogus, Mansonia and Psorophora were identified. Of the 92 Haemagogus eggs found, 71 were collected on the banks of a reservoir. Mosquito larvae were found and photographed in an artificial breeding site of a neighboring rural area. Humidity had the greatest influence on culicid density in the Caatinga. Rain was important in the appearance of Haemagogus, Anopheles, Aedes and Psorophora. Temperature had a negative influence on Anopheles triannulatus. The occurence of important vector species of diseases in a little known preserved area of the Caatinga as well as environmental and sociocultural questions are factors that favor the emergence of transmitting insects, making these areas potential subject to the resurgence of diseases

Agroindústria canavieira e unidade de conservação: Impactos Sociais na comunidade de pescadores de Baía Formosa (RN)

The conservation unities emerged in response to the environmental damages. In the Atlantic Forest of the Brazilian Northeast, the most of the damages come from the sugar-cane agro-industry, especially by the deforestation for the introduction of sugar-cane fields and installation of the industry structure. Besides the damages over the biodiversity, there are critical social problems that affect the communities which survive using directly or indirectly the biome from the Atlantic Forest. The objective of this research is to analyze the social impacts on the fishermen of Baía Formosa/RN generated by the changes and socio-environmental transformations occurred starting the installation of a sugar-cane factory and the creation of a conservation area in the municipality of Baía Formosa/RN community. The research is based on a qualitative and diachronic perspective, for both approach, it was used the method of oral history in conjunction with the literature search and some technical and research tools such as direct observation, interview, records images and recordings . The results show that social and symbolic practices of the community in the conservation unit Mata Estrela last more strongly presented. Today fewer natural resources are used, due to factors such as limit access to forest and disappearance of some natural resources by deforestation. It is believed that the loss of free access to space for the community is the most significant negative impact, as promoted changes in the relationship of the community with the Star Forest that contributed to the fading of their social and symbolic practices. The loss of free access caused the decline in the practice of agriculture, which resulted in the loss of one of the means of social reproduction of the community

A ousadia como horizonte: religando vida e ideias na formação em enfermagem

A proposal of formation in health/nursing built on classic science, on reducing thought and flexnerian paradigm is insufficient to comprehend and intervening with an amplified way on health needs of population, given that it is produced by fragmentation of knowledge, rationalization of thought, mechanizing and biological attitudes. It is necessary that formation in health/nursing allows the construction of effectiveness of principles and guidelines of Unique System of Health (Sistema Único de Saúde - SUS). In this context of emergency of a complex formation in health/nursing, life trajectories and formation of the nurses: Abigail Moura, Francisca Valda and Raimunda Germano are examples of transgressor and successful experiences which allow inquietude, changing and transforming formation patterns and self-formation. The present study is built from the comprehension of method as strategy , defended by Morin and complexity sciences. Has as objects building biographies of formation of these three nurses who express a formation model more totalizing and humanitarian, analyzing and discussing starting from the three biographic fragments guiding principles for the current process of formation in health/nursing. From the biographies, the courage and humbleness emerge as landmarking principles of their experiences. Humbleness neither as self-depreciation nor humiliation but as consciousness of our uncompleted and unfinished essence, acceptance of boundaries and potential and reduction of intellectual vanity. Courage, for its part, is the human pulsing, uncertain for nature, which brings us to act, to face and persevere on moments of fear and difficulties. A formation in health and nursing based on courage and humbleness allows the subjects to be taken away from indifference, arrogance, inertia, pragmatism: bets on ethic and political subjects capable of minimizing unequal, inhumane and excluding processes. Na intellectual and Professional attitude which politizes the thought and science is what must be expected from a complex formation in health field, in latu mode on nursing, in particular

Mapeamento digital de análogos a reservatórios petrolíferos: exemplos para depósitos fluviais da Unidade Açu-3 - Bacia Potiguar

In the current work are presented the results about the study of digital mapping of analogs referents the fluvial oil reservoirs in the Açu Formation. With the regional recognizing in the south corner of Potiguar Basin was selected a area of 150 Km square in the west of Assu city. In this area was chosen the outcrops for the digital mapping and from the data fields and remote sensors were done the depositional architectural for the fluvial deposits, which it was named coarse meandering fluvial systems. In the deposits were individualized 3 (three) fluvial cycles, which they was separated by bounding surface of fifth order. Such cycles are preferentially sandy, with fining-upward sequence finished in flood plain deposits. Inner of the sandy levels of the filling channels were characterized least cycles, normaly incomplete, constituted by braided sandy bodies and bounding surfaces of fourth order. In the mapped area was chosen a outcrop with great exposition, where it was possible to see tipical deposits of filling channel and was in this outcrop that was done the digital mapping. In this outcrop was used diverse technics and tools, which they integrated sedimentological, altimetric (GPS, Total Station), LIDAR (Light Detection and Ranging), digital photomosaic of high resolution and of the inner geometries (Ground Penetration Radar) data sets. For the integrating, interpretation and visualization of data was used software GoCAD®. The final product of the outcrop digital mapping was the photorealistic model of part of the cliff (or slope) because the observed reflectors in the radargrams were absents. A part of bar oblique accretion was modeled according to GPR gride of 200x200 meters in the alluvial Assu river probable recent analog. With the data of inner geometries was developed the three-dimentional sedimentary architectural, where it was possible characterize sand sheet deposits and many hierarchy of braided channels. At last, simulations of sedimentary geometries and architectures of the Potiguar Basin Fluvial Reservoirs were done with PetBool software, in order to understand the capacity of this program in simulations with a lot of numbers of conditioning wells. In total, 45 simulations was acquired, where the time and the channel numbers increase in relation of the conditioning wells quantity. The deformation of the meanders was detected from the change of simulated dominion dimensions. The presence of this problem was because the relationship between the simulated dominion and the width of the meander