Avaliação gerontológica multidimensional das condições de saúde de idosos residentes em instituições de longa permanência

Introdução/objetivos: A avaliação do estado de saúde de idosos institucionalizados é considerada prática essencial à promoção e recuperação da sua saúde, a qual deve incluir a investigação de aspectos multidimensionais e multidisciplinares relacionados ao envelhecimento saudável. O estudo objetivou avaliar as condições de saúde dos idosos residentes em instituições de longa permanência (ILPI) do município de Natal RN. Métodos: Trata-se de um estudo descritivo, longitudinal, envolvendo seis ILPI filantrópicas, com uma população de 243 idosos. A coleta de dados se deu por meio de entrevistas com os idosos nas instituições mediante a aplicação de um questionário com informações sócio demográficas, saúde e institucionalização, além de várias facetas multidisciplinares que envolvem a escala de avaliação cognitiva (Mini Exame do Estado Mental); o índex de KATZ, para avaliação das atividades da vida diária e uma análise do estado nutricional com questões antropométricas (peso, estatura, circunferência abdominal) e Índice de Massa Corpórea. Participaram do estudo todos os idosos com idade igual ou superior a 60 anos, que aceitaram responder a entrevista e assinaram o Termo de Consentimento Livre e Esclarecido e/ou a impressão datiloscópica. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, sob parecer n° 164/2011. Resultados: Os participantes do estudo incluem 243 idosos, sendo a maioria mulheres (172 = 70,7%), com média de idade de 79 ± 9,44 anos. 124 idosos são solteiros (51,0%) e 66 viúvos (27,0%). A prática de atividades físicas não é rotina nas instituições, onde a maioria dos idosos (82,7%; n = 201) não realiza nenhum tipo de atividade. 78% dos idosos (n = 192) chegou a instituição sendo levados por familiares, enquanto que apenas 18% (n = 44 idosos) por vontade própria e 4% (n = 7 idosos) não souberam responder. Quanto aos aspectos cognitivos, identificou-se que 64,2% dos idosos (n = 156) apresentaram alterações significativas dentro da pontuação dos escores com restrições em responder aos demais questionamentos durante a entrevista por apresentarem limitações cognitivas e/ou dificuldades senso perceptivas.Conclusão: O presente estudo evidenciou alterações cognitivas na maioria dos idosos institucionalizados impossibilitando-os a continuidade da realização da avaliação global da saúde. A identificação correta da perda cognitiva em idosos é de suma importância para a equipe de saúde a fim de promover a detecção precoce de alterações cognitivas e a adoção de tratamento adequado, no sentido de contribuir para uma melhor qualidade de vida desta população

Desenpenho funcional, carga alostática e biomarcadores do estresse em idosos residentes na comunidade

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Análise cintilográfica da deposição pulmonar de radioaerossol após associação da nebulização através dos dispositivos mesh e jato com a ventilação não invasiva em indivíduos normais e com pneumopatias obstrutivas crônicas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Fatores associados à mortalidade dos idosos com as condições de vida da população do Nordeste do Brasil

As condições de vida são usualmente entendidas como importantes fatores intervenientes das causas básicas de mortalidade e da qualidade de vida da população. Ao considerar esta questão em uma população idosa e sua influência nas causas mais relevantes que as levam à morte, teve-se como objetivo principal, estudar a associação da mortalidade dos idosos por doenças cardiovasculares para ambos os sexos, com indicadores que expressam as condições de vida da população do Nordeste, nos anos 2000 e 2010. Para atingir tal propósito foi traçado um desenho de estudo ecológico com cortes transversais nos anos 2000 e 2010 tendo como unidades de análises as microrregiões e a mesorregiões do Nordeste. Utilizou-se a Modelagem de Equações Estruturais (MEE) para explicar essas associações, tomando como base as estatísticas de óbitos por doenças cardiovasculares (construto endógeno) e variáveis socioeconômicas e demográficas (construto exógeno) das microrregiões do Nordeste, para o ano 2000. Utilizou-se o Método dos Componentes Principais como recurso metodológico na construção de um índice sintético que permitiu classificar as condições de vida nas mesorregiões do Nordeste, tomadas como unidades de análises, nos anos 2000 e 2010, de acordo com as condições de vida e as principais causas de mortalidade por doenças cardiovasculares. A aplicação da MEE sugeriu uma forte associação do construto exógeno condições de vida, composto pelos indicadores: anos de estudo dos homens idosos, percentual de idosos em domicílios com banheiro/água encanada e probabilidade de sobrevivência aos 60 anos, com a variável desfecho taxa de mortalidade por doenças cardiovasculares dos homens e mulheres idosos. O índice sintético construído permitiu identificar os diferentes ritmos de envelhecimento populacional entre as regiões e distintos processos de evolução dos níveis de mortalidade pelas doenças cardiovasculares, muitas delas compatíveis com as condições de vida no Nordeste. Os resultados sugerem que o construto condições de vida está fortemente associado por esta causa de morte entre os idosos para ambos os sexos no Nordeste do Brasil. Neste sentido, sugere-se que estes resultados sejam considerados como relevantes para formulação de políticas de saúde regionais voltadas para este contingente populacional do Nordeste do Brasil

Ação da cafeína sobre o rendimento esportivo de ciclistas em condições de calor e umidade

Objetivo: Verificar a ação da cafeína no tempo de rendimento, a taxa de esforço percebido (RPE), os níveis plasmáticos de glicose, sódio e potássio, a temperatura timpânica (Tt), o peso corporal (PC), freqüência cardíaca (FC) e concentração urinária da cafeína com a ingestão de doses de 5 e 9 mg/kg de cafeína e placebo, em provas ciclísticas sob condições de alto risco térmico. Métodos: Foram estudados 8 ciclistas treinados e aclimatizados em 3 provas de 45 km utilizando o modelo experimental e duplo-cego com randomização intra-sujeitos. Resultados: Não foram observadas diferenças significativas entre as variáveis avaliadas, entretanto o tempo de rendimento e a RPE foram menores com as doses de 5 e 9 mg/kg de cafeína que com a dose placebo. Conclusões: Estes dados indicam que as condições de calor e umidade podem ser suficientes para mascarar o benefício ergogênico da cafeína, entretanto deve-se considerar que a cafeína pode exercer influencia sobre a percepção subjetiva de esforço podendo levar à redução dos sinais de fadiga durante o exercício e conseqüente melhora do desempenho esportivo

A influência do tempo de diálise e do paratormônio sobre as condições clínico-radiográficas bucais de indivíduos com insuficiência renal crônica em diálise

Universidade Estadual do Rio Grande do Norte

Avaliação dos parâmetros hematológicos e imunofenotípicos de pacientes com doenças linfoproliferativas crônicas no Rio Grande do Norte

Chronic lymphoproliferative disorders (DLPC) are lymphoid system diseases characterized by the abnormal proliferation of mature lymphocytes that affect B cells, T lymphocytes and NK cells. The aim of the study was to demonstrate the relevance of immunophenotyping by flow cytometry in patients with prolonged lymphocytosis and / or cytomorphological changes compatible with lymphoproliferative diseases. In this study 460 patients (244 men and 216 women) with DLPC were evaluated. Were analyzed by flow cytometry with a panel of monoclonal antibodies consisting of CD3, CD4, CD5, CD8, CD10, CD19, CD22, CD23, CD25, CD38, CD45, CD16/CD56, and HLADR heavy and light chains of immunoglobulins. It also examines information regarding age, gender of patients and laboratory data as leucocytes, cytomorphological analysis, platelet count and hemoglobin determination. The results showed 398 cases of chronic lymphoproliferative disorders and 62 of DLPC B cell lymphoproliferative diseases T. B showed the following distribution : 253 cases of chronic lymphocytic leukemia (CLL), 42 cases of multiple myeloma ( MM ), 37 cases of lymphoma non - Hodgkin lymphoma in leukemic phase (NHL) , 17 cases of pro- B lymphocytic leukemia ( B -PLL), 15 cases of mantle cell lymphoma (MCL ), 12 cases of plasma cell leukemia ( PCL), 9 cases of lymphoma Burkitt (Linf B), 8 cases of leukemia villous cells ( LCV), 3 cases of splenic lymphoma with villous cells (LECV), a case of follicular lymphoma (LF) and a Waldenströn macroglobulinemia ( MW). The diseases source NK / T were 23 cases of peripheral T cell lymphoma (LCTP), 14 cases of T prolymphocytic leukemia (T -PLL), 10 cases of leukemia T of large granular lymphocytes (LGL -T) 9 cases of leukemia cells of adult T (LCTA), 5 cases of Sezary syndrome (SS) and a case of large granular NK leukemia (LGL -NK) lymphocytes. In conclusion, the combined use of the monoclonal antibody panel careful cytomorphological analysis was shown to be essential in immune diagnosis and classification of chronic lymphoproliferative disorders. This study was approved by the IRB - HUOL under number 356 / 09

Mortalidade infantil e condições socioeconômicas nas microrregiões do Nordeste Brasileiro

The study aims to answer the following question: what are the different profiles of infant mortality, according to demographic, socioeconomic, infrastructure and health care, for the micro-regions at the Northeast of Brazil? Thus, the main objective is to analyze the profiles or typologies associated mortality levels sociodemographic conditions of the micro-regions, in the year 2010. To this end, the databases of birth and death certificates of SIM and SINASC (DATASUS/MS), were taken from the 2010 population Census microdata and from SIDRA/IBGE. As a methodology, a weighted multiple linear regression model was used in the analysis in order to find the most significant variables in the explanation child mortality for the year 2010. Also a cluster analysis was performed, seeking evidence, initially, of homogeneous groups of micro-regions, from of the significant variables. The logit of the infant mortality rate was used as dependent variable, while variables such as demographic, socioeconomic, infrastructure and health care in the micro-regions were taken as the independent variables of the model. The Bayesian estimation technique was applied to the database of births and deaths, due to the inconvenient fact of underreporting and random fluctuations of small quantities in small areas. The techniques of Spatial Statistics were used to determine the spatial behavior of the distribution of rates from thematic maps. In conclusion, we used the method GoM (Grade of Membership), to find typologies of mortality, associated with the selected variables by micro-regions, in order to respond the main question of the study. The results points out to the formation of three profiles: Profile 1, high infant mortality and unfavorable social conditions; Profile 2, low infant mortality, with a median social conditions of life; and Profile 3, median and high infant mortality social conditions. With this classification, it was found that, out of 188 micro-regions, 20 (10%) fits the extreme profile 1, 59 (31.4%) was characterized in the extreme profile 2, 34 (18.1%) was characterized in the extreme profile 3 and only 9 (4.8%) was classified as amorphous profile. The other micro-regions framed up in the profiles mixed. Such profiles suggest the need for different interventions in terms of public policies aimed to reducing child mortality in the region

Efeitos do enriquecimento com nutrientes (N e P) em diferentes condições de luz sobre o crescimento do fitoplâncton em um reservatório eutrófico no semi-árido brasileiro

The increasing of pollution in aquatic ecosystems in the last decades has caused an expansion of eutrophication and loss of water quality for human consumption. The increase of frequency and intensity of cyanobacteria blooms have been recognized as a major problem connected to water quality and eutrophication. The knowledge of environmental factors controlling these blooms is a key step towards the management for recovering aquatic ecosystems from eutrophic conditions. Primary productivity in aquatic ecosystems is dependent on light and nutrients availability. In the present work we evaluated the relative importance of the concentration of major nutrients, such as phosphorus and nitrogen, and light for phytoplankton growth in the main water reservoir of Rio Grande do Norte State, named Engenheiro Armando Ribeiro Gonçalves (EARG), which is an eutrophic system, dominated by potentially toxic cyanobacteria populations. Limitation of phytoplankton growth was evaluated through bioassays using differential enrichment of nutrients (N and/or P) under two light conditions (low light and high light) and monthly monitoring of chlorophyll-a and nutrients (total nitrogen and phosphorus) concentrations, and water transparency (Secchi depth) at the pelagic region. Our results confirm that EARG reservoir is an eutrophic system with a low water quality. Results of bioassays on the growth of phytoplankton limitation (N or P) were conflicting with the results predicted by the TN:TP ratios, which indicates that these ratios were not a good indicator of algal growth limitation. Nitrogen was the limiting nutrient, considering both frequency and magnitude. Light and hidrology affected phytoplankton response to nutrient enrichment. The extreme eutrophic conditions of this reservoir, dominated by cyanobacteria blooms, demand urgent managing strategies in order to guarantee the multiple uses for this system, including water supply for human population. Although nitrogen is the limiting nutrient, an effective management program must focus on the reduction of both phosphorus and nitrogen input

As condições de trabalho e a satisfação profissional: dimensões do profissionalismo docente no ensino médio

The dissertation is developed in the Research Base of Teacher Training and Professionalization of Universidade Federal do Rio Grande do Norte as a way to discuss the professionalization of High School teachers in Natal. It is a study linked to the research The context of teaching practice and professionalism: the case of high school teachers and sponsored by CNPq, with the objective of characterizing working conditions and job satisfaction as dimensions to the teacher professionalism in high schools. In this study we prioritized the focus on professionalization in national and international discussions, which combines the aspects of teaching in its historical, social, political and economical path, in order to reflect about its evolutional elements in the hierarchy of professions and establish a relation to high school teaching. To develop this relation we elaborated some questions that are considered relevant, such as: How does the high school teacher evaluate his/her working conditions to his/her professional practice? What level of satisfaction does the high school teacher have regarding his/her professional practice? What expectations does the high school teacher have in relation to his/her professional development? The answers to those questions were according to the high school teachers considerations shown in the questionnaire, which was structured with open and closed questions. These questions gave better adequacy to the teachers evaluations about their working place and the situations they experience in their working conditions, provoking job satisfaction and expectations for professional growth. The description of the teachers perception about working conditions, job satisfaction and expectation of professional development can explain the distinct factors that characterize these categories in the working context, although the conclusive results, in general, do not show a direct relationship between the categories studied. Some factors that teachers attribute as causes of bigger difficulties in working conditions and work activity itself are: working time, salary, professional status, school s infrastructure, and school s social context. These factors are similarly related to the degree of job satisfaction, without showing interference in the professional expectations

Inclusão de estudantes com deficiência nas instituíções de ensino superior da cidade do Natal/RN:análise das condições oferecidas no processo seletivo vestibular

The number of disabled students, who have entered the university, in Brazil, since the beginning of this century, is undergoing a speed growth. It is a change that follows a global trend that spreads an inclusive education policy and that has had a profound impact on Brazil, with import results in field researches. This subject has been highlighted due to the significant amount of disabled students enrolled in college institutions (IES), although it is still modest the number of studies about it, especially in what matters the assistance given to the candidates to a university entrance examination. The aim of this paper is to investigate how effectively Natal s IES apply the rules established in Brazilian law concerning disabled students, especially MEC/GM Circular Warning n. 277/96, in what respects the conditions given to disabled students preparing to enter a college. The investigation followed a qualitative methodological approach with support on an exploratory study. The data recollection employed questionnaire, semi-structured interview and documental analyses, and the data have been organized and assessed following Minayo s (1996) stages. What concerns the results, it was observed that none of the ten colleges inquired confirmed to possess places exclusively to disabled candidates; six of them, however, offer Special Examining Board in the selection process of disabled candidates. Among eighteen college bills, only two of them offered specific information related to services and resources offered by IES to the candidates who ask for especial assistance concerning examination. During the interviews, four managers avowed the preoccupation in offering an equal selection process, but two of them proved not dominate the subject. In conclusion, the investigated institutions managers do not still seem to respect the rule that guarantees to disabled candidates equal conditions during all the process of the university entrance examination. With this work, we hope do help changing this focus and contribute to new studies on disabled persons studying for a degree

As condições do trabalho docente: um estudo em escolas da rede municipal de Currais Novos-RN (2009 a 2012)

This work, named Teaching conditions: a study in municipal schools of Currais Novos RN (2009 to 2012) aims to analyze the status of teaching in schools in the municipality of Currais Novos RN in the period ranging from 2009 - 2012, considering infrastructure, initial and continued training and intensification and casualization of teaching factors in the context of the 1990s educational reformations. It, also, assumes that teaching is a constitutive part of capitalist society, and has been reconfigured with based on the new requirements demanded by the labor market. In order to conduct this study the considered data included the survey research Teaching Work in Basic Education in Brazil (2009 to 2010) , held in seven Brazilian states being: Pará, Rio Grande do Norte, Minas Gerais, Goiás, Paraná, Santa Catarina and Espírito Santo. Specifically selected for deepening of the study, there were schools in the municipality of Currais Novos in which semi-structured interviews were performed with teachers of the said municipality. This research is constituted of a qualitative and quantitative approach whose survey instruments adopted were, namely: documental research, literature review, interviews and surveys. The obtained data analysis allows us to infer that the teaching work performed by teachers in the states which participated in the survey has been influenced the changes in the labor market and educational reformations and has been taking on characteristics such as flexibility, tendency to precariousness and intensification; and this trend is also present in schools that were surveyed in the municipality of Currais Novos. As pertaining to the teachers conditions in classroom, these signs are more evident, considering that they had their duties and responsibilities extended beyond the classroom environment. The data also show that in general working conditions of teachers in national, state and local levels are unprofitable and heterogeneous, increasingly deepening the gap between school units and education networks. Therefore, the implantation of public policies that enhance the teaching work and improve their working conditions in all dimensions that directly interfere in their work are crucial

Úlcera de pressão em pacientes internados em um hospital universitário em Natal/RN: condições predisponentes e fatores de risco

The pressure ulcers (PU), also known as decubitus ulcers, are defined as injuries caused by the constant pressure exerted on a particular point of the body, causing impairment of blood supply with a decrease or interruption of tissue irrigation, causing occlusion of blood vessels and capillaries, ischemia and cell death. This is a descriptive study with longitudinal design, and panel type, with quantitative approach that aimed to examine the association between predisposing conditions (PC), intrinsic factors (IF) and extrinsic factors (EF) with the occurrence of PU, in hospitalized patients in the Intensive Care Unit (ICU), pain clinical, surgical clinical and neurology wards of a university hospital. The study population was composed of all patients who were restricted to bed during the period from December 2007 to February 2008. The study was approved by the Ethics Committee of HUOL / UFRN (No 135/07). The data-collection took place through a structured formulary of observation, data from medical records and physical examination of patients skins. The results were organized in SPSS 15.0 software, tabulated, categorized and analyzed by descriptive and inferential statistics. Of the 30 patients studied, 43.3% had been hospitalized in the pain clinical and surgical clinic wards, 20.0% in the ICU, 20.0% in the ICU / ward and 16.7% in neurology, being the length of hospitalization in those units of 7 to 18 days (63.3%) and from 19 to 30 days (36.7%), predominantly female and aged ≥ 60 years (60.0%). 19 PU were diagnosed in 43.3% of patients monitored, being 38.5% with one PU between 7 to 18 days and 46.2% with two or more between 19 to 30 days of hospitalization, showing significant relationship (ρ-value = 0029) between length of hospital stay and the number of PU. Was found an association of 35.7% of the PC (cardio-respiratory, hematological, metabolic and psychogenic), IF (age group, oedema, skin changes in humidity and change of body temperature) and EF (type of mattress and strength of body pressure) for all patients studied, statistically significant (ρ-value = 0001), between the average scores in patients with and without PU, with reason chance to 12.0 for the development of PU and there was moderate correlation ( r = 0618) in the presence of this association. Results show the influence of the multiplicity of factors and conditions on the occurrence of PU, which brings us to reflect on the assistance focused on prevention and reduction of these injuries which will encourage the reduction of hospitalization length, physical and psychological suffering, and the possibility of improving the clinical condition of the patient.

Qualidade da assistência e o conhecimento sobre o direito à saúde das pessoas com úlcera venosa crônica

The study aimed to identify the quality of care and knowledge of health rights of people with chronic venous ulcers (VU) in Brasilian National Health Care System (SUS). It is a cross-sectional study, with quantitative approach, performed at the University Hospital Onofre Lopes (HUOL). The study was approved by the Ethics Committee of HUOL (CAAE nº 0148.0.051.000-10). The sample by accessibility was composed for 30 people with VU treated at the outpatient surgical clinic of HUOL. For data collection we used a structured questionnaire composed of two parts: sociodemographic characteristics and of health, of care and the clinical course of VU; and knowledge of people with VU about the rights of health. The results were processed using SPSS 15.0 and analyzed by descriptive statistics. Given the characterizations sociodemographic and health presented, we identified a clientele of users with VU predominantly female (76,7%), aged from 60 years (66,7%), married/ stable union (60,0%), low education level (83,3%), family income lower than a minimum wage (73,3%), unemployeds and with chronic diseases (53,3%), sleep greater than or equal to 6 hours (76,7%) and were not alcoholics or smokers (93,3%). In relation to clinical conditions, were shown the presence of one or more relapses of VU (73,3%), predominance of granulation tissue/epithelialization in the bed of VU (60,0%), exudate serosanguineous (43,3%), in quantity medium/large (60,0%), with no predominance of presence or absence of odor (50,0%), all patients with tissue loss in grade III / IV, no signs of infection (73,3%) and presence of intense pain (50,0%). In the last 30 days the main venue of achievement of dressing was the HUOL (100,0%), the main compression therapy used was the Unna boot (60,0%) and on inability to perform the dressing on the unit were the own patients who made the exchange at home (40,0%). The majority of respondents listed out more positive factors associated with quality of care (56,7%) were satisfied with the care of SUS (76,7%), claimed to have knowledge about their rights (70,0%), but at the same time did not know the meaning of the acronym SUS (90,0%) and classified their level of information as inappropriate (70,0%). We realize that people with VU identified as good the quality of care and demonstrated inadequate knowledge about their rights to health in the SUS, but showed interest in acquiring more information. The basic rights to entry in the SUS are constitutionally guaranteed and need to be disseminated in order to make them known to the population, so it can be implemented and ensured a greater resolution assistance in treating this type of injury

Identificação das condições gerais de conservação dos reservatórios integrantes do sistema de abastecimento de água de Natal

Infrastructure works are included in strategic areas for the social development. For that matter that all of the investments are very important for the social development. When the population has enough water and an acceptable quality, and it includes a wastewater gathering and its treatment, the whole society became less susceptible to the water diseases. Even the Water Supply and the Sewage depend for its perfect operation of reservoirs, or of the accumulation of water to provide the popular necessity, either due to retention or for the treatment wastewarer. These structures present very specific environmental conditions, because the microclimate created around them, like high environmental humidity and for the existence of many harmful substances for the concrete, such as chloride ions presents in water. The reservoir that compose the System of Water Supply of Natal were built between 1970s and 1980s, a period whom the technical and scientific community did not have in-depth studies about the reinforced concrete mechanism of deterioration. Therefore, these reservoirs have been suffered accelerated deterioration progress, and they have been shown many pathological manifestations strikingly visible. In front of all these problems this academic work aims to identify the generally conditions of conservation of all the reservoirs components of the Water Supply System of Natal. This academic work objectives to develop a recuperation plan for use in these reservoirs, in this academic work it was achieved all the survey of pathological manifestation existing in each reservoir. It was made with local visits, photographic recorders of all manifestations viii and realization of in loco tests. The other step consisted in a application of GDE/UnB metodolgy reformulated by Fonseca (2007). In the step of local visits in each reservoir it was evaluated carbonation depth, by spreading a phenolphthalein solution with 1% of concentration; evaluation of contamination of chlorides, by spreading silver nitrate solution with 1% of concentration, and evaluation of width cracks. After the conclusion of all the testings, it was established that all reservoir, studied in this academic work, have showed an advanced deteriorating condition. It´s presents prevalent pathological manifestations as unacceptable cracks, spots, efflorescence and reinforcement corrosion, and in some cases, chlorides contamination. After the conclusion of the testings and its concatenation it was able to implementing, using GDE/UnB methodology, the order of the restoration its service life and initial safety conditions