Ações de profissionais relativas ao banco de leite humano : uma perspectiva de mudança

This is an exploratory and descriptive study that aimed to investigate the actions of professionals in the context of breastfeeding, on the assumption that the actions taken by employees working together to postpartum and newborn are not competing to effect the distribution of pasteurized human milk so that it meets the needs of infants who depend on it. Thus, the study aimed to analyze the actions of medical and nursing staff of the distribution of pasteurized human milk to the newly born. The investigation was developed by action research in a federal hospital, located in the capital the state of Rio Grande do Norte, Brazil, reference assistance to women during pregnancy, childbirth and postpartum high risk in 2010. Study participants were fifty-five professionals chosen from the following inclusion criteria: to act in the NICU or rooming, being a pediatrician and / or neonatologists, nurses and technical nursing. According to the methodology of action research a questionnaire was applied, techniques in focus groups and courses were developed, and, finally, action evaluation. The project was submitted to the Ethics Committee at the Federal University of Rio Grande do Norte and approved with no protocol 448/2009. The problems identified in the responses issued by the social research were grouped into categories according to the similarity between them. The answer to the question of the survey - How is the need for pasteurized human milk for the newborns in neonatal intensive care unit and rooming identified? - Brought subsidies for action planning and implementation of strategies for change in the practice of professionals working in rooming and ICU. Thus, the study has relevance in social care and, when at the local level, will compete for the distribution pasteurized human milk to take effect as best as possible, as recommended by the Ministry of Health. It is also conceived that, in a macro view of society, it could contribute to minimizing the health problem that involves the child population

Atuação do enfermeiro na estratégia de atenção integrada às doenças prevalentes na infância

This study aimed to describe nurses' actions in the strategy of Integrated Management of Childhood Illness in the city of Natal, Rio Grande do Norte. This is a qualitative study with descriptive approach. The universe consisted of nurses from the Family Health Strategy, totaling 16 participants. For the research project was submitted for approval by the Ethics Committee of the Universidade Federal do Rio Grande do Norte, obtaining Opinion No. 187/2012. Data were obtained in two ways: a questionnaire survey to profile the training of nurses and an interview guided by a structured interview. Interviews were treated in the light of analysis of thematic category Bardin. The results showed the central thematic study "Integrated Management of Childhood Illness in the context of nursing activities" category and three analyzes: "Understanding the Integrated Management of Childhood Illness", "Difficulties invibializam use IMCI "and" Working conditions for nurses in the Integrated Management of Childhood Illness. " It is observed that nurses consider the Integrated Management of Childhood Illness useful, effective and important to keep sick children within the logic curative. However disregard the character of health promotion and disease prevention thereof. It was found that the participants still hold the attendance of crinaças within the biomedical model and that these same professionals are subjected to increasingly precarious working conditions and unhealthy due to lack of human and material resources. It was found that the interviewees do not follow the protocols of strategy because of barriers related to prescription medications by nurses, the medical, the lack of incentives, training and supervision by the municipal health and the Regional Nursing Council

Análise crítica dos produtos de mobilidade sentada - cadeiras de rodas - utilizados por crianças e adolescentes com paralisia cerebral em Natal/RN e outros municípios do Rio Grande do Norte

The objective of this work is to critically analyze the seated mobility adaptive equipment, wheelchair, used by non-ambulatory children/adolescents diagnosed with cerebral palsy of the quadriplegy type with ages in between 0-18 years old in the municipal city of Natal/RN and of other ones in the state of Rio Grande do Norte. This study is characterized as descriptive as it took into consideration the individualized conditions of each child/adolescent and of their home environment, and also evaluates the condition of the used seated mobility devices such as wheelchairs or strollers. Thirty three (33) subjects which had a wheelchair prescribed by a healthcare professional specialist in adaptive equipment within the past 3 years were selected. A questionnaire was applied through a phone with the patient s primary care giver or parents. The results obtained showed that all the equipment being used had an anatomical seat and back and the tilt system mechanism and even though most of the patients required small individual adjustments upon receiving the wheelchair in order to accommodate to the patients characteristics. From the point of view of the caregiver/parents interviewed, 97% described satisfied with the equipment and report assistance with mobility (97%), comfort (82%) and good posture (82%) as the main positive aspects from the equipment. The results also describe the aspects related to the maintenance, time used and activities developed that were reported by the patients. The conclusion therefore is that in order to select the equipment to meet the needs of the consumer it is necessary that: an appropriate wheelchair prescription takes place, the up-to-date knowledge of equipment available in the market, the appropriate use of the resources from the concession programs of the government that purchase equipment and the establishment of link in between the manufacturers, patients and the caregivers

Estratégias de avaliação de desempenho dos propagandistas de medicamentos utilizados pela indústria farmacêutica no nordeste do Brasil

A Indústria Farmacêutica é uma das mais competitivas indústrias do mundo contemporâneo, e um dos seus principais desafios está na comercialização de seus medicamentos, que na sua maioria depende da prescrição médica. O objetivo deste estudo é identificar as estratégias de avaliação de desempenho utilizadas pela Indústria Farmacêutica de origem multinacional que atua no nordeste Brasileiro e o papel dos seus gerentes, para avaliar os propagandistas vendedores de medicamentos. Para tanto, buscouse reunir elementos para uma abordagem satisfatória que contemple a complexidade da temática pesquisada: Avaliação de Desempenho, Estratégias da Indústria Farmacêutica, Propaganda Médica e Competências dos Propagandistas de Medicamentos. A temática justifica-se em razão da importância estratégica dos propagandistas de medicamentos para a indústria farmacêutica, que é uma das indústrias que mais investe em pesquisa na atualidade, e contribui para melhorar a qualidade de vida e a saúde humana. A metodologia é caracterizada como um survey, de natureza quali-quantitativa. O objeto de estudo é composto pelas empresas farmacêuticas multinacionais de origem Americanas, Europeias e Asiáticas, associadas à INTERFARMA que atuam no Nordeste do Brasil. A coleta de dados foi realizada através de um questionário fechado (instrumento de pesquisa), composto por 5 perguntas fechadas que abordam a temática central dessa dissertação, 27 afirmativas para medir a concordância(escala likert) e 1 tabela contendo 46 competências, aplicado junto a gerentes da indústria farmacêutica. A análise dos dados foi feita por meio das técnicas de estatística descritiva e uma análise quantitativa para estabelecer o Ranking Médio (RM) para a parte do questionário que utilizou escala tipo Likert de 5 pontos para mensurar o grau de concordância dos respondestes. Através dos resultados desta pesquisa foi possível identificar as estratégias de avaliação de desempenho, utilizadas pelas empresas farmacêuticas, que atuam no Nordeste do Brasil, na gestão dos propagandistas vendedores de medicamentos, e identificar as competências essenciais dos propagandistas de medicamentos, na percepção dos gestores. Os resultados demonstraram que a Indústria Farmacêutica desenvolve e utiliza várias estratégias para medir e avaliar o desempenho dos propagandistas de medicamentos no Brasil, assim como em outros países, e que na percepção dos gerentes da Indústria Farmacêutica existem competências consideradas essenciais ao bom desempenho profissional dos propagandistas de medicamentos da indústria farmacêutica, contribuindo de para avanço do conhecimento deste tema

Alternância no uso dos modos indicativo e subjuntivo em orações subordinadas substantivas: uma comparação entre o português do Brasil e o francês do Canadá

The purpose of this work is to analyze the use of the indicative mood, instead of the subjunctive prescribed by the normative grammar, in complement clauses introduced by the conjunction que in Brazilian Portuguese. Contexts of use of the subjunctive according to grammatical prescription, and contexts of fluctuation on the use of that verbal mood were analyzed, in an attempt to investigate what interferes on the choice of the mood by the user of the language. This study is based on North-American Functional Linguistics theoretical perspective, oriented to analyzing language in use, in the light of the principles of grammaticalization and markedness. The results obtained support that the contexts that favor the indicative over the subjunctive are those composed by a complement clause functioning as a direct object the unmarked clause of all complement clauses and by a verb on the main sentence that belongs to the semantic field of low certainty, corresponding to the epistemic sub-mode the unmarked category of the deontic sub-mode. The results indicate that pragmatics and semantics factors influence the language user on the choice of the verbal mood. This research also presents comparative data on the use of the indicative mood in place of the subjunctive in Brazilian Portuguese and Canadian French, aiming to providing suggestions on language teaching

A dupla poética do silêncio: uma análise de Fogo morto e Cartilha do silêncio.

This research presents a reading of the poetics of silence in the profile and actions of characters in Fogo morto, by Paraiba s novelist José Lins do Rego and Cartilha do silêncio, by Sergipe s writer José Francisco Costa Dantas. As a starting point, we intend to demonstrate, through analysis, how the traditional issue of patriarchy, installed in rural areas of Northeast Brazil, live their momentum of rise and decline in different social spaces within narratives. This article shows how man lives tensions caused by the socio-political changes that will gradually be deployed in their environment due to the process of transition from traditional to modern life. From this perspective, this reading encourages a critical reflection on the social space of the mills and farms at the time of their rise and decay, as well as the various gender relationships between the feminine and the masculine world. The analysis indicates that all the changes both in family and social space unfold a world of silent variants and this paper takes as its theoretical basis the concept of silence built from the reflections of Eni Puccinelli Orlandi (2002), Barros Lourival Holland (1990 ), Luiz Costa Lima (1974) and Marisa Simons (1999).

Niilismo e técnica: a caminho da ultrapassagem

Pour formuler une discussion sur le nihilisme, l'enquête sur le premier chapitre examine les preuves historiques et philosophiques de montrer que la réflexion sur le nihilisme comme un problème philosophique, suite à l'analyse et la critique du philosophe Friedrich Nietzsche à partir des principaux concepts au sein de son travail: décrépitude, la mort de Dieu, la dévaluation des valeurs, transvaluation des valeurs, volonté de puissance et éternel retour, ils sont quelques-uns des concepts et servir de cadre au point critique de la métaphysique. Le deuxième chapitre est une analyse des idées qui ont émergé de la lecture de Nietzsche qui sont développées entre le philosophe Martin Heidegger et Ernst Jünger. Un dialogue qui limite le nihilisme et ses ramifications pour l'ère de la technique, et finalement vaincre leur pensée ou dépassement.

Nietzsche e a modernidade: da crítica à metafísica à crítica à democracia

This dissertation presents an interpretation concerning the critical considerations of the German philosopher Friedrich Nietzsche on Modernity, especially Nietzsche s criticism of Modernity, of Christian mores and democracy produced by him in Beyond Good and Evil. Nietzsche attentively analyses details of Modernity, produces a diagnosis of modern man and discovers the sign of decay. We consider that Nietzsche s criticism of modernity is directly linked to the criticism of classic metaphysics. We emphasize questions like: what in us aspires to truth? Christian mores: why and what for? What characterizes modernity? Could it be the appeal to the democratic taste? Is it possible to reinvent Modernity? We stress the relation between the notion of truth, democracy and Christian mores, showing that these mores were also inherited from the Socratic culture. We also intend to clarify Nietzsche s proposal of a new way of doing philosophy, that would be able to surpass the decay which rules in European modern culture. The end of this research points out to the ―philosophers of the future‖ who are able, according to Nietzsche, to claim life beyond the metaphysics opposition, beyond the good and the evil

O Bairro da Ribeira como um palimpsesto: dinâmicas urbanas na Cidade de Natal (1920-1960)

As cidades são textos. Textos escritos pelas sociedades que compõe os espaços. A partir dessa perspectiva, propõe-se aqui uma leitura do bairro da Ribeira Natal/RN. Esse espaço se consolidou no início do século XX como centro comercial e cultural da capital potiguar, lugar de ação e de interação da Zona Central desta sociedade, espaço de inscrição dos signos da modernidade e do progresso então em voga. Contudo, com o decurso do tempo e as transformações por ele exigidas, o panorama da Cidade de Natal sofreu intensas modificações e o bairro da Ribeira foi relegado à margem desse processo, o que culminou na desvalorização, segregação e, posteriormente, na degradação do seu espaço, que se tornou um palimpsesto. Ao abordar a dinâmica urbana que se processou no bairro da Ribeira, esta pesquisa dividiu o fenômeno em três fases distintas: valorização, transição e decadência

Nervos: rede de discursos e práticas de cuidado na atenção básica no município de Natal/RN

The Primary Health Care and one of its main strategies, the Family Health Strategy (ESF), are framed as the gateway to the Public Health System (SUS). Thus, most of the incident and prevalent health problems in the population attended should be solved at this level of care, including psychological suffering, and the so-called complaint of nerves. Nerves and nervous denote a complexity that is not always well comprehended by health workers, in such a way that the care to this kind of problem is usually inadequate. In this line of thought, the general objective of this study is to analyze the network of discourses and the care to the psychological suffering, expressed as nerves, in SUS daily Primary Health Care. Besides and more specifically, it aims at identifying the principles and guidelines of the Primary Health Care in mental health; to investigate health workers positioning before psychological suffering and complaints of nerves, and also analyze different actions and practices of care carried out in different Health Units towards complaints like nerves. Institutional Ethnography was the theoreticalmethodological perspective adopted for the work. This approach seeks to understand and analyze the institutional relationships in a particular context considering sociostructural influences and power relations, as well as daily discourses and practices. Based on interviews with health professionals, informal conversations and observations in six Health Units with ESF teams from different sanitary districts in Natal/RN, it was possible to check that the index of complaint of nerves is high. The referral to psychologists and psychiatrists, as well as the prescription of psychotropic drugs appear as the most common intervention at this level of care. In general, the participants complain that they have poor specialized knowledge about the theme of mental health. They face the problem of bad work conditions and the lack of institutional support, which make actions of illnesses prevention and health promotion even more difficult. Besides, there are different ongoing practices such as meetings for hypertensive and aged people, walk, visit, round-table discussions and community therapy. However, not all of these actions are aimed at the care of psychological suffering. It is observed that the Matrix Support, which is a methodological strategy of supervision and follow up forcases of mental health, hasn t been totally implemented in the municipal system, although it is a tool that has been used by psychologists in some Health Units in the city. It was also verified that the health care practices to the problem of nerves strongly depend on the professional s commitment with the PSF guidelines and on mental health policies, in addition to continued support, when available, from other professional who works as matrix supporter

Sofrimento solitário, mal-estar compartilhado :um estudo sobre a doença dos nervos

Nerves has been perceived as generalized suffering with multiple complaints, such as pain and other physical sensations, usually followed by symptoms of anxiety and/or depression. Even after medications have been prescribed, mainly psychotropic drugs to reduce these symptoms, exams aiming to discover the causes of the disorders, and a significant referral to health services, the problem tends to get progressively worse. The objective of this study is to characterize the diseases of clients who complain of nerves at the Unidade Mista de Felipe Camarão, Natal/RN, through in depth interviews, allowing for the clarification of ideas, beliefs and the meanings attributed to nerves by that person; to identify the symptoms and to know how they interfere in daily activities; to investigate the causes attributed to the problem and their relation to the biographical and psychosocial context of the patient. Thirteen women, health service clients, aged 30 to 59 years old, participated in the research. It was observed that they perceive, feel and act in unique ways with relation to symptoms, as well as to the attributed explanations and treatments given, showing the influence of life conditions, family context and their own subjectivity. Daily concerns and overwhelming responsibilities in the domestic environment, which usually stem from their precarious survival conditions, as well as marital conflicts motivated by the inequity of gender relations, contribute to trigger this type of suffering. The methodology of the research itself proved to be crucial to the comprehension and understanding of the meanings attributed to the complaints as well as to the argumenting process and the redefinition of the illness experience. Therefore, the importance of interdisciplinary intervention must be emphasize and specially the role of listening as relevant intervention resource

Gênero, trabalho e saúde mental entre trabalhadoras rurais assentadas na região do Mato Grande Potiguar

The lack of studies aimed at the mental health of the rural population, the social, economic, familial and emotional impact that mental disorders produce and the vulnerability that women have in this context, lead us to believe in the need to investigate the mental health demands of female rural workers, in order to subsidize the development of more effective and culturally sensitive public health programs and policies that take into account the specificities of this population. The present study aims to investigate the prevalence of common mental disorders (CMD) and the possible factors associated with the emergence of such disorders among women living in a rural settlement in Rio Grande do Norte. This survey has a quantitative and qualitative character with an ethnographic approach. As methodological strategies, we made use of an adapted version of the socio-demographic and environmental questionnaire prepared by The Department of Geology/UFRN s Strategic Analysis Laboratory to evaluate the quality of life of the families from the rural settlement and the mental health screening test Self-Reporting Questionnaire (SRQ-20) to identify the prevalence of CMD in adult women from the community. Complementing the role of methodological tools, we use the participant observation and semi-structured interviews with women who presented positive hypothesis of CMD attempting to comprehend the crossings that build the subjective experience of being a woman in this context. The results point to the high prevalence of CMD (43.6%) and suggest the link between poverty, lack of social support, unequal gender relations and the occurrence of CMD. We also verified that the settled women do not access the health network to address issues relating to mental health and that the only recourse of care offered by primary health care is the prescription of anxiolytic medication. In this context, the religiosity and the work are the most important strategies for mental health support among women

Diagnóstico Ambiental do Processo de Desertificação no município de Lajes/RN.

Ocupando uma área de 665,7km2 (equivalente a 1,25% da superfície estadual), o Município de Lajes até o início do século XX era um pequeno distrito do Município de Jardim de Angicos, localizada na Região Central do Estado do Rio Grande do Norte. Quando decretado município, em 1914, Lajes tornou-se o principal entreposto comercial do estado, uma vez que sua posição geográfica a colocava como rota principal entre os municípios produtores de mercadorias e a capital do estado, Natal, situada a 125km a Leste do município. Esta confortável posição de entreposto comercial cristalizou-se com a construção da estrada de ferro Sampaio Correia, em 1919, que agilizou o escoamento das mercadorias advindas do interior com Natal, principalmente o algodão, que até a década de 1980 era a principal fonte econômica do Estado do Rio Grande do Norte. Com a crise do algodão e a construção de estradas ligando diretamente os mercados produtores com a capital, Lajes perde a condição de principal entreposto comercial do estado, e sua economia entra em decadência. Vastas áreas de caatinga onde outrora se plantava algodão foram abandonadas, deixando os solos destas terras livres para a ação erosiva dos ventos e das torrenciais chuvas de outono. Situada numa porção do estado que sofre direto sombreamento das escarpas da Serra do Feiticeiro, o município de Lajes tem se configurado como um importante laboratório para o estudo da desertificação no Estado do Rio Grande do Norte. A partir de uma análise Geossistêmica, procurou-se diagnosticar o atual quadro da desertificação nesta porção semi-árida do estado. Para tanto, utilizou-se os métodos quantitativos de análise, dentre eles os métodos desenvolvidos durante a elaboração do Pan Brasil, com a construção dos Balanços Hídricos e Índices de Aridez do município. Os dados referentes aos índices de aridez de Lajes apontam para um profundo processo de ressecamento do ar na região, corroborando inclusive com os dados referentes ao aquecimento global divulgados pelo IPCC (Intergovernamental Panel on Climate Change) no mês de fevereiro de 2007

A produção do espaço rural no município de Ceará-Mirim

This research intended to study the process of production of the rural space in the municipal district of Little Ceará-Mirim, looking for to identify the transformations in him happened, above all in the last thirty years. Since the beginning of your historical formation, the area in study had as element modelador and transformer of the physiognomy of your territory the culture canavieira that printed in your economy and in your society marks of a powerful nobility. The sugar-cane is covered of a cyclical character facing acme phases and decadence, as the one that it happens at the present time. Simultaneously, the sphere rural cearimirinense is going by changes by the implantation of modern companies gone back to the papaya production destined to the internal market and more precisely to the external market. Of this context they also consist the supplying farms of this same product. In the group of the establishments in the rural landscape here analyzed, they still interfere the mixed farms, the ones that practice agriculture, the ones that were devoted to the livestock, as well as the farms and the ranches. Another innovation is the caprinocultura developed in modern molds, using the system voisin of pasture rodízio being constituted in a pioneering experience in Brazil. Of that reality they announce other elements, to example of the establishments, being configured as new forms of use of the soil. In the perspective of turning them productive, the challenge resides of overcoming the difficulties in them existent. The reality of the space in screen is replete of lacks in all the instances. It is inferred that the municipal district possesses an enormous potential, however the performance of the administrative components is seen as deficient. He becomes urgent that the municipal public power promotes changes, mainly in what it respects to the social area, with a better attendance to the rural communities, for them to act positively in the process of the development of this municipal district

Avaliação do pré-natal na atenção primária à saúde no Rio grande do Norte: visão das usuárias

ABSTRACT This study aimed to evaluate the quality of prenatal Primary Care in Rio G rande do Norte, Brazil in 2012 under the program Improving Access and Quality of Primary Care. The study was cross - sectional, quantitative. Included 156 mothers of children under 2 years who received prenatal care at the health evaluated. We applied a ques tionnaire on profile, minimum queries, regularity of attendance, laboratory tests, vaccination, participation in educational activities, guidance received, clinical and obstetric procedures and prescription Ferrous sulphate and folic acid. The descriptive analysis of the criteria used Humanization Program Prenatal and Birth. The results showed that 92% of mothers had six or more visits; 85% with the same care was professional; 94% subsequent appointments scheduled. As for tests and procedures the percentage s were: Urine 98%; HIV - 96%; VDRL and 88%; 91% glucose; tetanus vaccination 93%; educational groups 56% with 36% participation, knowledge of the delivery location and 59% achievement breast exam 65%, 33% and preventive gynecological 43%; 98% supplemented wi th 96% Ferrous Sulfate and Folic Acid. It was concluded that there were advances in Rio Grande do Norte concerning assistance and there are weaknesses in the educational practices and conducting some minimal clinical examinations.