Centros de especialidades odontológicas: avaliação da atenção de média complexidade na rede pública da Grande Natal

The Specialized Dental Care Centers (CEO) were developed to provide specialized dental care to the population, given the accumulated needs of health since the past. They must operate as units of reference for the Oral Health Team of the Primary Care, complementing the dental procedures performed at this level of attention. This study aims to assess the performance of CEOs of the Grande Natal Health Region as a strategy of Secondary Care consolidation in oral health through users, dentists and managers. For this to try to identify factors about access, hosting and satisfaction with the service, the actions developed in these centers, integration between the CEOs and the Basic Health Units (UBS), considering the reference and counter reference. Data were collected through semi-structured interview, conducted in four CEOs, among 253 users, 31 dentists and 4 managers. It was submitted to descriptive statistical analysis and to content analysis by software ALCESTE 4.5. The results revealed that the specialties of prosthesis, endodontics and surgery were the most sought by 38.2%, 23.7% and 21.7% of respondents, respectively. It was noticed that among users aged 18 to 30 years-old the greatest demand is for the specialty of endodontics (44.4%) and over 50 years for prosthesis (76.4%). There is a weakness in the reference and counter reference between UBS and CEO, because part of users goes directly to the centers without going before to the Primary Care and the majority does not want to return to the dentist of Health Unit. Satisfaction with care was reported by 90.9% of users, because they resolved the problems needed and were welcomed by the team. But the delay in care was the main factor for not satisfaction. For most dentists, some users could solve their problems completely in Primary Care, which shows the existence of unnecessary referrals to the CEOs, however they consider the existence of limiting factors in UBS that compromise the service. Most dentists revealed that some users do not get to CEOs with the basic dental treatment done, and some of them do not counter reference users. It can be concluded that the studied CEOs are being resolutive for those who access them, offering necessary care for the population, and if they don t account with this service, will encounter obstacles to resolution of problems, ranging seek care service in particular, in another public sector, or even giving up treatment. However, it is perceived the need of professionals training to understand the importance of the reference and counter reference, to that they can better serve and guide users. It is also important that cities offer better conditions to UBS and CEOs, so they can work together, with complementary actions of oral health, seeking full care, aiming for better resolution to the users' health problems

A educação em saúde pública na práqtica cotidiana: atuação dos cirurgiões-dentistas do PSF de Natal-RN

Considering education a support to health promotion, care integration and citizenship formation,the purpose of this research was to analyze the perception of the oral surgeons from the Family Health Program of Natal-RN over education in health as well as their performance as educators based on their activities on the program. A qualitative study was accomplished by a semi-structured interview and a Free Association of Words Test with 80 oral surgeons from the Family Health Program of Natal-RN. The instruments were analyzed through the meaning analysis and the Central Nucleus of Vergès Theory. The results showed a lack of planning in health actions so there is no standardization on the educative practices done by the oral surgeons which mostly are focused on scholars. There was an agreement among the group according to the oral surgeons´ perception about education in health that education is related to its function of recall prevention ideas to the population. Most part of the context units analyzed by the professionals´ speech show the knowledge of education in health as an inadequate behavior change instrument of the individuals. An interesting point was a quotation cited by some professionals that included actual themes such as citizenship, motivation and life quality, put inside the speech of education in health. To the oral surgeons the biggest difficulties on the development of the educative actions are due to the lack of incentive by the Municipal Health Bureau and to the detachment and lack of valorization of the themes by the population. The oral surgeons consider themselves co-responsible for the formation of a population which is able to request its health. They also mention the knowledge about the need of the community participation on the planning of the Family Health Program actions. Finally, it is notable the need for more encouragement so the oral surgeons can be more capable and have more interest in applying education in health on the perspective of a new model in health, because once capable and stimulated they can awake the population to education importance as a great transformation instrument for people searching for a fair, equalitarian and citizeness society

Influência da idade, do sexo e da hora do dia no desempenho em teste de labirinto

The increase of elderly population in the world and in Brazil has indicated the necessity of health systems capable to evaluate, to diagnose and to intervene in the conditions of health and disease of that segment. During that stage of human development, physical and cognitive changes happen and they are capable to influence the functional acting. It s important to distinguish the limit between the normal and the pathological. Besides the common changes during the aging, biological rhithmicity changes happen, as alterations in the cycle vigil-sleep that can influence in certain tasks performance. This study aimed to verify the influence of the age, of the sex and of the hour in a maze test performance. Eighty individuals were evaluated, 40 youths (20 men and 20 women) and 40 senior (20 men and 20 women). They were separated in 2 different groups that were tested at 9:00 o clock and at 15:00 o clock. Initially they were submitted to health evaluation, cognitive evaluation and of sleep quality and chronotype. They were instructed to accomplish the maze test whose time of execution was timed and registered. Significant differences were observed according to age for the masculine group between elderly in the morning and in the afternoon and in the feminine group between youth and elderly in the test accomplished in the morning and in the afternoon. Significant differences were not observed according to sex and hour of the day and also between attempts. In compare between the 30th and the31st, accomplished in a 15minutes of interval, significant difference was observed just for the elderly group in the morning and in the afternoon. We observed significant correlations in the maze test performance with the cronotype, with the age, with the education and with the cognitive acting. The maze test was capable to detect differences between age in the acting profile and in the evaluation of the information maintenance after 15 minutes, however it was not possible to verify difference between sex and hour of the day. Finally the correlations of the maze test with another varied may indicate your importance as coadjutant instrument in those functions evaluation

A atuação do psicólogo no contexto das referências ambulatoriais em saúde mental de Aracaju - SE

Psychologists‟ insertion in mental healthcare ambulatory clinics occurred during the decade of 1980, in the context of the claims disseminated by sanitary and psychiatric reforms, of the formation of minimum mental healthcare teams and of the retraction of the private clinic. Historically, this migration had been accompanied by the importation of practices traditionally applied at the clinics. Furthermore, the lack of clear guidelines from the Health Ministery occasioned the opening of ambulatory clinics with diversified structures at each city. The objective of this dissertation was to study the practices of psychologists at mental healthcare ambulatory references at Aracaju-SE. Were interviewed psychologists of these services and managers of the municipal health secretary using a semi-structured interview guideline, in addition to the analysis of management reports. It was observed that the mental healthcare references had experienced substantial changes referred to its structures and operation, leading to a present framework of expansion and readjustment. It was realized that there is an effort by the psychologists to maintain individual and group assistance, using adjustments in the frequency of the sessions and in the focus of the activities. Besides the progresses, the relation with the psychiatrist still works basically through the medical record, blocking advances on joint discussions of the cases. Some advances toward the amplified clinic are notable, like the overcoming of the isolated usage of psychiatric diagnostic and the replacement of the line‟ criterion by the urgency one. Sheltering had become an interesting strategy on flux ordination, however the mismatch between offer and demand seems to be a matter which extrapolates the psychologists‟ sphere at the references. For this reason the narrow of the relation with family healthcare centers seems to be the major challenge to be faced by psychologists at mental healthcare ambulatory references

PET-saúde na percepção de estudantes: contribuições para a formação na área de saúde

This dissertation aimed to analyze the perception of students about (EPW Health) Education Program at Work for Health Training in the area of Health. It discusses the proposed theme from the perception of students graduating from the EPW- Health courses participants (dentistry, medicine, physiotherapy, nursing, nutrition, physical education) who have developed their school activities in family health units in the city of João Pessoa between 2009/2011.The program aims policies curricular changes as a potential route of contributions to training in healthcare. Attention is drawn to the new possibilities of working health training contextualized, ethically grounded, socially endorsed. It is pointed out in this process the need to adapt to the demands of professional profiles of SUS (Sistema Único de Saúde). This is an exploratory, descriptive study within a qualitative approach, conducted in the city of João Pessoa in the context of health care courses at the Federal University of Paraiba. The empirical material of this study was treated by the use of technical analysis "Categorical Content Theme" by Bardin. The results indicate prospects for promoting new practices and curricular changes, which highlights the EPW- Health, which has been presenting important experiences in teaching -community -service- with the inclusion of students in the municipal health network. We conclude that the path from collection to data analysis, corroborated with the literature to reaffirm the importance and urgency of change in educational processes with a view to greater proximity to the health needs and the SUS. The EPW- Health project is incipient and requires further investigation in terms of effective interdisciplinary and multidisciplinary character of its proposal

O trabalho dos assistentes sociais no âmbito hospitalar: as particularidades da sua inserção no Hospital Universitário Onofre Lopes (HUOL), em Natal/RN/

This study aimed to analyze the work of social workers at the Hospital Universitário Onofre Lopes (HUOL), with the analytical approach the contracting process with the HUOL with the National Health System (SUS), which is set from 2004. Thus, this study sought in times of state reform, restructuring and tension between enlargement / reduction of social and labor rights, understanding the limits and possibilities of social work in HUOL, analyzing how these determinations bounce in the practice of social workers included in the collective process of health work. From a theoretical and methodological historical and dialectical materialism, we conducted literature search, in which developed book report and readings of texts, articles, books that focus on the central categories of the study, namely: Work, Social Work, Health, Health Reform , Project ethical and professional politician. Operationalized also a documentary research, on the Brazilian Public Health Policy, (SUS) and of the Education, as well as research field in which we conducted interviews with 11 social workers, employees packed the HUOL. We conclude that social workers did not participate in the discussion process of contracting the HUOL with the Municipal Health Secretariat of Natal, RN, manager of health and full resetting of user access, via reference setting - counter-referral services provided by the hospital brought the main demands on Social Work guidance regarding the functionality of SUS, and the social intervention in the struggle to guarantee such access. However, the data show that the expansion of demands that require the intervention of the social worker at HUOL is not associated with quantitative growth of these professionals need. Such conditions inflect the possibilities of materialization of the professional ethical-political project, even though that these professionals worry and seek the intellectual improvement, quality of service and to guarantee the social rights of users in the professional practice everyday

Deliberação e participação: dinâmica e efetividade do conselho de saúde de Mossoró/RN – 2009/2012

The social participation in Brazil takes a new impetus with the (re)democratization process of the Brazilian society and is strengthened by the resurgence of the civil society and the 1988 Constitution. In this context, the study is conducted with the scope to verify the effectiveness of deliberative Municipal Health Council of Mossoro (CMSM), with theoretical and methodological support based on the following models: the participatory normativity, which measures the degree of institutionalization, democratization and council representation; and the effectiveness of deliberative that, from the calling capacity and agenda of the participants, from the kinds of manifestation, from the decisions and the council’s office, that measures the degree of effectiveness of the deliberative council. It appears, thus, that the council has an average degree of effectiveness deliberative, standing out as means an institution that practice, despite the existence of obstacles and challenges, the role of control over municipal health policies, due, among other factors, the conservative political context, the asymmetry of resources between the counselors, the little substantive participation of the actors who attend its meetings, either counselor or not, and in particular, the reduced influence of the members in its decision-making process. In public management of Mossoro, social participation, especially social control over public actions, face, today, great number of difficulties to be held. The study recognizes that, in such circumstances, the council partially fulfills the role for which it was created, what does not impede, however, be characterized as an important deliberative space, since it allows the participation of representatives of the various segments of the state, society, their demands and intentions. Overcoming such obstacles moves through the interest of civil society to wake up and fight for the spaces in these institutions.

Estudo da Acessibilidade Organizacional aos Serviços de Saúde Bucal de um Município de Pequeno Porte do Nordeste Brasileiro

Objective: This study aimed to evaluate the accessibility to oral health services in Santa Cruz (RN), focusing on the organizational aspect which is characterized by variables like delay in getting consultation, waiting lines, difficulty scheduling appointments, lack of material, among others. Material and Methods: For such purpose, questionnaires were addressed to 194 users’ houses based on census tract. Results: It has been found that 12.9% of the population has never gone to the dentist’s office, and that the service demand has not been affected by users’ individual and socioeconomic characteristics, except for gender. Data have revealed that 36.1% of users went to the dentist’s in less than a year. In addition, the youngest users are among those who seek the dentist’s office more frequently (p<0.05). 63.3% of the interviewees have reported they find some kind of difficulty when seek for dental care, and 43.2% of users have waited three weeks or more for assistance. It is also noteworthy that 7.4% of the interviewees have been finding difficulties in getting access to urgency care, and that long wait for the consultation is the most frequently cited matter. Conclusion: It could be verified that accessibility to oral health services in the municipality of Santa Cruz (RN) has been hampered by factors related to public policies organization, especially with regards to the work process.

Estudo da Acessibilidade Organizacional aos Serviços de Saúde Bucal de um Município de Pequeno Porte do Nordeste Brasileiro

Objective: This study aimed to evaluate the accessibility to oral health services in Santa Cruz (RN), focusing on the organizational aspect which is characterized by variables like delay in getting consultation, waiting lines, difficulty scheduling appointments, lack of material, among others. Material and Methods: For such purpose, questionnaires were addressed to 194 users’ houses based on census tract. Results: It has been found that 12.9% of the population has never gone to the dentist’s office, and that the service demand has not been affected by users’ individual and socioeconomic characteristics, except for gender. Data have revealed that 36.1% of users went to the dentist’s in less than a year. In addition, the youngest users are among those who seek the dentist’s office more frequently (p<0.05). 63.3% of the interviewees have reported they find some kind of difficulty when seek for dental care, and 43.2% of users have waited three weeks or more for assistance. It is also noteworthy that 7.4% of the interviewees have been finding difficulties in getting access to urgency care, and that long wait for the consultation is the most frequently cited matter. Conclusion: It could be verified that accessibility to oral health services in the municipality of Santa Cruz (RN) has been hampered by factors related to public policies organization, especially with regards to the work process.

Avaliação do cuidado de enfermagem na perspectiva da segurança do paciente em unidades de terapia intensiva: na visão de profissionais, pacientes e familiares

Technological advances combined with healthcare assistance bring increased risks related to patient safety, causing health institutions to be environments susceptible to losses in the provided care. Sectors of high complexity, such as Intensive Care Units have such characteristics highlighted due to being spaces designed for the care of patients in serious medical condition, when the use of advanced technological devices becomes a necessity. Thus, the aim of this study was to assess nursing care from the perspective of patient safety in intensive care units. This is an evaluative research, which combines various forms of data collection and analysis in order to conduct a deepened investigation. Data collection occurred in loco, from April to July 2014 in hospitals equipped with adult intensive care unit services. For this, a checklist instrument and semi-structured interviews conducted with patients, families, professionals were used in order to evaluate the structure-process-outcome triad. The instrument for nursing care assessment regarding Patient Safety included 97 questions related to structure and processes. Interviews provided data for outcome analysis. The selection of interviewees/participants was based on the willingness of potential participants. The following methods were used to collect data resulting from the instrument: statistical analysis of inter-rater reliability measure known as kappa (K); observations from judges resulting from the observation process; and added information obtained from the literature on the thematic. Data analysis from the interviews was carried out with IRAMUTEQ software, which used Descending Hierarchical Classification and Similarity analysis to aid in data interpretation. Research steps followed the ethical principles presented by Resolution No. 466 of December 12, 2012, and the results were presented in three manuscripts: 1) Evaluation of patient safety in Intensive Care Units: a focus on structure; 2) Health evaluation processes: a nursing care perspective on patient safety; 3) Patient safety in intensive care units: perception of nurses, family members and patients. The first article, related to the structure, refers to the use of 24 items of the employed instrument, showing that most of the findings were not aligned with the adequacy standards, which indicates poor conditions in structures offered in health services. The second article provides an analysis of the pillar of Processes, with the use of 73 items of the instrument, showing that 50 items did not meet the required standards for safe handling due to the absence of adequate scientific guidance and effective communication in nursing care process. For the third article, results indicate that intensive care units were safe places, yet urges for changes, especially in the physical structure and availability of materials and communication among professionals, patients and families. Therefore, our findings suggest that the nursing care being provided in the evaluated intensive care units contains troubling shortcomings with regards to patient safety, thereby evidencing an insecure setting for the assistance offered, in addition to a need for urgent measures to remedy the identified inadequacies with appropriate structures and implement protocols and care guidelines in order to consolidate an environment more favorable to patient safety.

Articulação entre saúde mental infanto-juvenil e atenção básica em Natal-RN: limites e possibilidades

In the case of Brazilian Psychiatric Reformation, mental health juvenile reveals itself as a great challenge, with major gaps in terms of needs, services and actions on mental illness in children and adolescents. This research is a qualitative study of descriptive and exploratory, having to analyze the actions and practices of mental health juvenile articulated between the Psychosocial Care Center juvenile (Caps i) and the basic care in Natal-RN, and specific, identify the limits and possibilities for an important precedent of the care network. After submission to the Research Ethics Committee (CEP) of the University Hospital Onofre Lopes (HUOL) of the Federal University of Rio Grande do Norte (UFRN) obtained approval contained in opinion number 777.067 / 2014. For the data collection, it was initially carried out a documentary research in the Municipal Health Department of Christmas about the phenomenon under study, and subsequently, applied semi-structured interviews with the subjects of the research, which were workers Caps i of Natal-RN. The analysis was woven as the thematic analysis technique, understood within the method of content analysis. The results and discussions were organized by categories and subcategories, namely: CATEGORY 1: Limits and weaknesses in the linkage between the Caps i and basic care, with the subcategories: 1.1 Lack of specialized services and devices articulators in network, 1.2 The diversity of situations in the demand juvenile assisted; CATEGORY 2: possibilities for an effective network, with the subcategory: 2.1 Intersectoral collaboration as a strategy for solving attention. The analysis revealed that the integration and coordination of mental health services juvenile and primary care in the city of Natal-RN, has incipient initiatives and/or inadequate for the resolvability intersectoral, where the devices of attention to health involved cannot establish bonds effective and long-lasting in the perspective of co-responsibility and sharing of care. On the other hand, it appears that the existing shares and practiced, configure an exercise in approximation to the dialog between mental health juvenile and basic care. It is highlighted that the shared care and the establishment of intersectoral collaboration within and outside of the health sector is possibility of facilitating the necessary dialog between the services and professionals involved, thus, enabling a better prospect of resolvability of the Network of Psychosocial Care for the youth in reality being investigated.

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”

Marcas dermatoglíficas, Antropometria e as qualidades físicas básicas dos escolares da rede municipal da cidade de Manaus

The objective of this study of comparative descriptive character went aimed at to analyze the characteristics dermatoglyphics, anthropometrics and the basic physical qualities, in 180 selected scholars in a stratified way, distributed like this: 10 year-old boys = 32; 09 years = 32; 08 years = 32; 10 year-old girls = 28; 09 years = 28; 08 years = 28), studying the fundamental teaching of the School Good Municipal Hope, located in the area east, in the Neighborhood of the Crowned, in the city of Manaus, Amazon. For identification of the dermatoglyphics characteristics collected, was the fingerprints; for evaluation of the corporal mass, height and IMC, they were used a digital scale with an estadiometer of the mark Filizola. The tests: to sit down and to reach flexibility); Horizontal Impulse or I jump in distance stopped (force of inferior members); Flex and extension of the trunk (it Forces abdominal); Flexion and extension of the arms in suspension in the bar (Force of superior members); 30 meters (Speed) and 9 minutes (Resistance applied aerobic) was to evaluate the basic physical qualities. The results demonstrated that differences didn't exist among the goods, in most of the studied variables, and the existent differences among the ages of 8, 9 and 10 years, they demonstrate a normality tendency in the infantile development

A inserção da equipe da Estratégia Saúde da Família em um Centro Municipal de Educação Infantil na promoção da saúde da criança

The joint enters the teams of the Strategy Health of Family (ESF) and the Municipal Center of Infantile education (CMEI) blunts as a form to assure the monitoring and promotion to the health of the children of 2 the 5 years when entering the day-care center environment/daily pay-school. It was traced as objective: To analyze the actions developed for the team of the Strategy Health of the Family in the promotion the health of the child, taken care of in a CMEI. Description-exploratory is to a study, qualitative nature, the type research-action. Developed in a CMEI and the USF of the quarter of New City, Natal-RN. The population was constituted by the professionals of the team of the ESF and the CMEI and parents. During the stages of the research-action diverse techniques had been used as the individually interview and in group, focal group, comment participant, and daily of field. The analysis of the data occurred by means of the content analysis, in the thematic modality, proposal for Bardin (1977) and description of the stages of the research-action. In the stage of situational diagnosis that it investigates the reality lived deeply for the citizens of ESF and CMEI how much to the health of the child seven categories had emerged that they enclosed: the context of the attention child in the CMEI identifying the actions that already came being developed for the ESF in the CMEI; the functioning of the CMEI and its routine of activities; the paper of the CMEI in the care the child; the daily one of the ESF, how much to the care to the health of the child of 2 the 5 years involving the diverse difficulties faced for the ESF; difficulties faced in daily of the CMEI for the care the child of 2 the 5 years; paper of joint ESF and CMEI for the confrontation of the difficulties; e action of health to be developed that they had subsidized the stage of planning of the research-action. During the stages of planning and implementation of the actions the actions of education in health with professionals of the CMEI and parents had been materialize and the actions of direct attention the health of the child. In the stage of evaluation of the actions for the involved citizens one searched to ahead understand the perception of the actions developed and perspective of continuity of the actions, through 4 boarded subjects for the citizens. For all the passage of the research-action it can be inferred that joint ESF and CMEI is a necessary initiative ahead of the current situation of the services of health for the promotion of an integral attention the health of the child, but that the teams of the ESF not yet make use of material conditions and staff enough to develop actions that exceed the limits of the USF, being necessary for this the reinforcement of the joints mainly with the Federal University of the Rio Grande of the North.

Assistência odontológica diferenciada para crianças de 0 a 3 anos: avaliação de impacto no Serviço Público Municipal em Natal-RN

In Brazil, 0-5 years old children just have an oral health care system since 1990 s. Innumerable experiences of implantation of the attendance to the babies in the cities had appeared throughout the years, but it hasn´t been evaluated the comparative effect between children displayed and not displayed to the program. In this regard, the main of this research was describe the Early Childhood Oral Health Care in public health service in Natal, Rio Grande do Norte, Brazil and evaluate the impact of this specific oral health care for babies by comparison of indicators between exposed and non-exposed children. It was created an experimental group, formed by children covered by program which was paired, based on sex, age and socioeconomic status, with a control group, formed by uncovered children. After filling ethical application, the parents of children were questioned about some risk factors to dental caries and, in sequence, it was accomplish an oral examination in the child. It was verified the Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), dmf-s and verification of caries activity. The sample was 40 children in each group. The results showed, for VPI, a difference of 7 percentile points for the experimental group, however this difference had no statistical significance, obtained by Student s t test (p=0.314). In relation to GBI, the control group showed a low mean (0.8%) comparing with experimental group (2.77%) and this difference was statistically significant (p=0.003). The results for dmf-s and evaluation of caries activity showed no statistical difference between groups. Among the probable reasons for absence of impact of intervention, could be included: (a) the practice model was the same in two groups, or the difference was very weak and (b) the oral health care has intrinsic limitations for to impact on oral health in low income populations