Financiamento e gasto público em saúde: o caso do Rio Grande do Norte

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Satisfação do paciente com a fisioterapia :tradução, adequação cultura e validação de um instrumento de medida

The measurement of patient satisfaction can provide information about the success of the care provider in reaching the values and meeting the expectations of the patient. The purpose of this study was to translate into the Portuguese language and to culturally customize to the Brazilian population the instrument to measure patient satisfaction with physical therapy elaborated by Goldstein et al. The study sample was made up of 279 patients who were undergoing physical therapy treatment at 39 different private clinics in a middle-sized town in northeastern Brazil. For the translation of the survey instrument, the back-translation technique was employed, in association with the bilingual method. The reliability and validity of the Brazilian version of the instrument were both assessed. Reliability analysis, carried out with the computation of Cronbach alpha coefficients, showed that the measures obtained with the instrument have a high degree of internal consistency. The aspects dealing with the patient therapist relationship are the most important predictors of satisfaction, followed by those dealing with courtesy, privacy, and practical aspects such as efficiency of the facility in the patient admissions process, setting up of appointments, and waiting time in waiting room. Items dealing with aspects such as location of the facility and availability of parking facilities may underestimate the reliability of the instrument. This study translated, culturally customized, and validated an instrument to measure patient satisfaction with physical therapy originally developed in English. By so doing, this study has made this instrument available to the Brazilian society, and it has rendered it a useful parameter that can be utilized in our country in the field of physical therapy

Atuação dos profissionais de enfermagem durante o processo transfusional na UTI de um hostital universitário

Prospective descriptive study with quantitative approach, which aimed to analyze the relationship of the knowledge of Nurses and conduct assistance during the process of transfusion, to patients in the ICU of a university hospital in Natal-RN. The sample consisted of 27 professionals from the nursing staff (5 nurses and 22 nursing technicians), climbing in the ICU during the period of data collection. Data collection was through a questionnaire and structured form of observation, in addition to consulting the diary. The results were organized in SPSS 15.0, tabulated, cathegorized and analyzed by descriptive and inferential statistics. The results show a young population, aged between 21 and 32 years (63.0%), female (85.2%). Among those surveyed were the main type of stock, mostly technical, nursing (ρ= 0006), which have little time to experience - up to 2 years (ρ= 0008), did not know the DRC in 153 (ρ= 0019), held greater number of pipelines care in blood (ρ= 0018), the non-participation in training and feel informed about the process of transfusion, showed no significant differences. As for officials, highlighted only the time to experience more than 2 years, carrying out fewer procedures and feel informed about the blood. As for the pipes during the transfusion process, I found that the majority of pipes observed in both the stock and the staff were inadequate, with predominance in the first, both in the pursuit of conduct regarding the shortfall. The averages of inappropriate conduct, predominantly developed by stock, were higher in all stages for appropriate conduct. Analyzing the knowledge about the disease process, the stock market were those who had lower scores of knowledge in three stages. As the relationship between the pipes care and knowledge, we see that at all stages of the process of transfusion inadequate knowledge of the averages were higher, taking a significant difference in the stages pre-transfusion (ρ= 0012). When analyzing the average of pipes behind, we see that in inappropriate conduct were significantly higher (ρ= 0031), who had searched in inadequate knowledge. As for the frequency of total procedures performed, we found a significant predominance (ρ= 0049) of inappropriate conduct (88.9%) of which 81.5% were developed by professionals who had inadequate knowledge, showing moderate correlation (r = 0,516) and odds ratio of 2,750 times the development of inappropriate conduct in trade with inadequate knowledge. We conclude that the professionals surveyed, especially the technicians of nursing stock, showed serious deficiencies with regard to the development of pipelines and knowledge of the transfusion process, showing the inadequacy to develop this therapy. Facing the foregoing, we accept the alternative hypothesis proposed in the study, because we show that the inadequacy of knowledge about the process of transfusion influence in inappropriate conduct implemented by the nursing staff in ICU.

A relação gramatical objeto direto : implicações para o ensino de língua materna

This paper attempts to investigate the discourse manifestations of the grammatical relation direct object with respect to the syntactic, semantic and pragmatic properties that underlie this element. The research adopts theoretical orientation of the functionalism from North American and Brazilian schools inspired in Givón (1995, 2001), Hopper and Thompson (1980), Chafe (1979), Furtado da Cunha, Oliveira, Martelotta (2003) inter alia. From functionalism, the research uses principles of iconicity, markedness and informativity and it analize categories of transitivity, grounding and animacy. This research is anchored in prototype model (TAYLOR 1995); construction grammar model (GOLDBERG 1996, 2002). Both theoretical orientations share the view that language is a malleable living organism subject to socio-cultural context. Grammar is then the result of created, maintained, and systematized linguistic patterns developed from and used for language use. According to a functional linguistics and cognitivist linguistics verbs are stored in the speakers lexicon in syntactic-semantic frames which are more frequent. These frames carry information concerning obligatory and optional arguments and the semantic roles these arguments take in the clause. The analysis focuses on the semantic type of the verbs and its relationship with the argument encoded as a direct object observing the aspectual nature of verbs. Direct objects are classified according to their morphology (lexical or pronominal noun phrase), semantic role, informational content and animacy. This study discusses pedagogical implications with relation to how the grammatical concepts touched on this paper are treated in school textbooks. The empirical data come from Corpus Discurso & Gramática: a língua falada e escrita na cidade do Natal (FURTADO DA CUNHA, 1998). This corpus is composed of texts that contain spoken and written modalities. These modalities are in turn organized according to different types: personal narratives, retold narrative, description of preferred place, procedural place, procedural description and report on argumentation. The sample data totals 40 texts produced by four language consultants of the last graduation date. The paper shows that the same syntactic structures (formed through Subject-Verb-Object) correspond to different semantic-pragmatic structures in relation to specific communicative purposes even verb is an event, process or state. The argument structure are not aleatory but are related to experience; that is the way humans conceptualize the world and talk about it

A Short Physical Performance Battery (SPPB) como preditora da fragilidade em idosos residentes na comunidade

Introduction: The SPPB provides information about physical function and is a predictor of adverse events in the elderly. Frailty is a multidimensional syndrome that increases susceptibility to diseases and disability. However it may be possible to prevent or postpone frailty if is identified early. Our objective is to analyze SPPB s ability in screening for frailty a community-dwelling young elderly from cities with distinct socioeconomic conditions. Methods: Data were originated from community dwelling adults (65-74 years old) in Canada (Saint Bruno; n = 60) and Brazil (Santa Cruz; n = 64). SPPB was used to assess physical performance. Frailty was defined as the presence of ≥ 3 of these criteria: weight loss, exhaustion, weakness, mobility limitation and low physical activity. One point was given for each criterion met, totalizing a frailty score ranged from 0 to 5. The Linear Regression and Receiver Operating Characteristics analyses were performed to evaluate the SPPB s screening ability. Results: Mean age was 69.48, 10.0% of the Saint Bruno s sample and 28.1% of Santa Cruz s were frail (p = 0.001), the SPPB score means were 9.6 and 8.5 respectively (p = 0.01). SPPB correlated with the frailty score (R2 = 0.33), with better results for Saint Bruno. A cutoff of 9 in SPPB had good sensitivity and specificity in discriminating frail from non frail in Saint Bruno (AUC = 0.81) but showed fair results in Santa Cruz (AUC = 0.61). Conclusion: The SPPB has moderate ability in predicting frailty among older adult s population, and is an useful test to identify people with good functionality and low frailty when SPPB scores are ≥9

Relação entre a doença periodontal e doença cardiovascular: há uma preocupação por parte dos que fazem clínica médica e odontológica na cidade de Natal?

The relationship between periodontal and cardiovascular diseases is a reality in the current days. The knowledge about the role of periodontal disease as a risk factor to cardiovascular disease from dentistry and physicians is very important to try to eliminate this risk factor. The aim of this work was to investigate, using a questionary, if physicians and dentistry are aware about this relationship and if they think that it is important. These forms were distributed in 4 groups: cardiologists (n=90), physicians from other specialist (POS) (n=110), periodontists (n=35) and dentistry from other specialist (DOE) (n=85). We had a loss off 32,4% of the total sample due to a lack of response of some professionals. Our results showed that all cardiologists, all dentists and 68,2% of POE said that they had gotten information about the relationship between periodontal and cardiovascular disease, and just 6 POS don t believe that this relationship can occur. When questioned if, even when a periodontal disease is diagnosed, there is a habit to treat or orient the patient for treatment, 29,5% of cardiologists answered no, 25,5% of POE also answered that they did not orient and only 1 DOE answered that he did not treat nor orient. All periodontists said that treat their patients when periodontal disease was identify. The physicians seem not to find important the relationship that exist between periodontal and cardiovascular diseases and the dentistry have shown a good knowledge about this subject. Maybe, if physicians and dentistry work together, the incidence of cardiovascular disease decreases

A relação entre os determinantes sociais em saúde e os investimentos setoriais e a mortalidade infantil em municípios brasileiros com mais de 80 mil habitantes

Investments in health have controversial influence on results of the health of populations, besides being subject rarely explored in literature. Moreover, from the 1970s, the social determinants of health have been consolidated in the disease process as multifactorial factors (social, economic, cultural, etc.) that directly or indirectly influence the occurrence of health problems of populations, as well as mortality rates. This study aimed to evaluate the influence of these investments and the social determinants of health on infant mortality and its neonatal and post-neonatal mortality. This is an ecological study, in which the sample was composed of Brazilians cities with over 80,000 inhabitants, avoiding fluctuations in mortality rates for common small populations, and ensure greater coverage of information systems on mortality and births Brazilians and, therefore, increase data consistency. To isolate the effect of investments in health, we used multiple linear regression. The socioeconomic indicators (p <0.001, p = 0.004, p <0.001), the inequality index (p <0.001, p = 0.001, p = 0.006) and coverage of prenatal visits (p <0.001, p <0.001; p = 0.005) were associated with infant mortality rate total, neonatal and post-neonatal, and the Gross Domestic Product per capita only influenced the overall infant mortality rate and neonatal (p=0.022; 0.045). Investments in health, in this model, lost statistical significance, showing no correlation with mortality rates among children under one year. We conclude that the social determinants of health has an influence on the variation in mortality rates of Brazilian cities, however the same was not observed for indicators of health investment

Generalizações do conceito de distância, i-distâncias, distâncias intervalares e topologia

In this dissertation we present some generalizations for the concept of distance by using more general value spaces, such as: fuzzy metrics, probabilistic metrics and generalized metrics. We show how such generalizations may be useful due to the possibility that the distance between two objects could carry more information about the objects than in the case where the distance is represented just by a real number. Also in this thesis we propose another generalization of distance which encompasses the notion of interval metric and generates a topology in a natural way. Several properties of this generalization are investigated, and its links with other existing generalizations

Em direção a uma representação para equações algébricas :uma lógica equacional local

The intervalar arithmetic well-known as arithmetic of Moore, doesn't possess the same properties of the real numbers, and for this reason, it is confronted with a problem of operative nature, when we want to solve intervalar equations as extension of real equations by the usual equality and of the intervalar arithmetic, for this not to possess the inverse addictive, as well as, the property of the distributivity of the multiplication for the sum doesn t be valid for any triplet of intervals. The lack of those properties disables the use of equacional logic, so much for the resolution of an intervalar equation using the same, as for a representation of a real equation, and still, for the algebraic verification of properties of a computational system, whose data are real numbers represented by intervals. However, with the notion of order of information and of approach on intervals, introduced by Acióly[6] in 1991, the idea of an intervalar equation appears to represent a real equation satisfactorily, since the terms of the intervalar equation carry the information about the solution of the real equation. In 1999, Santiago proposed the notion of simple equality and, later on, local equality for intervals [8] and [33]. Based on that idea, this dissertation extends Santiago's local groups for local algebras, following the idea of Σ-algebras according to (Hennessy[31], 1988) and (Santiago[7], 1995). One of the contributions of this dissertation, is the theorem 5.1.3.2 that it guarantees that, when deducing a local Σ-equation E t t in the proposed system SDedLoc(E), the interpretations of t and t' will be locally the same in any local Σ-algebra that satisfies the group of fixed equations local E, whenever t and t have meaning in A. This assures to a kind of safety between the local equacional logic and the local algebras

Participação social e designação de espécie-bandeira: ações complementares à conservação de um parque estadual em área urbana

Facing environmental problems the planet appears several alternative preventive and control on behalf of the equation between development and environmental protection. One of the alternatives implemented in Brazil to conservation of biodiversity was the creation of protected natural areas regulated by the National System of Conservation Units (SNUC). This is an integrated study of the Comunication / Environmental Conservation, which prioritizes social participation as a complementary in the conservation process, the particular case of the Dunas do Natal State Park, the first conservation area in Rio Grande do Norte, for full protection. It takes into account the roles environmental, scientific and Park, which harbors a unique biodiversity, including endemic species and the fact being located in an urban area. It proposes the use of two complementary instruments, such as strategies for conservation. Considering the various individual experiences, it was analyzed the perception that the community is directly related to the Park. From this promoted the democratization of information about the park, its biodiversity and conservation. As another conservation tool, it was suggested the use of a flagship species for the park, or a body chosen symbol for environmental or social reasons, in order to protect and conserve certain natural environments, from the understanding and co -community participation. In this case, as proposed flag Coleodactylus natalensis species, the lizard-the-litter, to be endemic remnants of Atlantic Forest Park as having the type locality, be one of the smallest species of the world, South America's lowest-dependent shadow of the forest, sensitive to human action and therefore very vulnerable. This suggestion finds support in the degree of public acceptance that interacts directly with the Park, as a result of the evaluation of their perceptions. It was further observed in this study that this symbology to be used in order to promote the democratization of the Park and its biodiversity has an identification result, curiosity and probable involvement of the population with the issues of the Park

Propriedades físicas de planetas extrasolares

ROTATION is one the most important aspects to be observed in stellar astrophysics. Here we investigate that particularly in stars with planets. This physical parameter supplies information about the distribution of angular momentum in the planetary system, as well as its role on the control of dierent phenomena, including coronal and cromospherical emission and on the ones due of tidal effects. In spite of the continuous solid advances made on the study of the characteristics and properties of planet host stars, the main features of their rotational behavior is are not well established yet. In this context, the present work brings an unprecedented study about the rotation and angular momentum of planet-harbouring stars, as well as the correlation between rotation and stellar and planetary physical properties. Our analysis is based on a sample of 232 extrasolar planets, orbiting 196 stars of dierent luminosity classes and spectral types. In addition to the study of their rotational behavior, the behavior of the physical properties of stars and their orbiting planets was also analyzed, including stellar mass and metallicity, as well as the planetary orbital parameters. As main results we can underline that the rotation of stars with planets present two clear features: stars with Tef lower than about 6000 K have slower rotations, while among stars with Tef > 6000 K we and moderate and fast rotations, though there are a few exceptions. We also show that stars with planets follow mostly the Krafts law, namely < J > / v rot. In this same idea we show that the rotation versus age relation of stars with planets follows, at least qualitatively, the Skumanich and Pace & Pasquini laws. The relation rotation versus orbital period also points for a very interesting result, with planet-harbouring stars with shorter orbital periods present rather enhanced rotation

Aquisição, processamento e análise de dados de sísmica de alta resolução na plataforma continental norte do Rio Grande do Norte: Vale inciso do rio açu

On the modern Continental Shelf to the north of Rio Grande do Norte state (NE Brazil) is located a paleo-valley, submerged during the last glacial sea-level lowstand, that marks continuation of the most important river of this area (Açu River). Despite the high level of exploration activity of oil industry, there is few information about shallow stratigraphy. Aiming to fill this gap, situated on the Neogene, was worked a marine seismic investigation, the development of a processing flow for high resolution data seismic, and the recognition of the main feature morphology of the study area: the incised valley of the River Açu. The acquisition of shallow seismic data was undertaken in conjunction with the laboratory of Marine Geology/Geophysics and Environmental Monitoring - GGEMMA of Federal University of Rio Grande do Norte UFRN, in SISPLAT project, where the geomorphological structure of the Rio paleovale Açu was the target of the investigation survey. The acquisition of geophysical data has been over the longitudinal and transverse sections, which were subsequently submitted to the processing, hitherto little-used and / or few addressed in the literature, which provided a much higher quality result with the raw data. Once proposed for the flow data was developed and applied to the data of X-Star (acoustic sensor), using available resources of the program ReflexW 4.5 A surface fluvial architecture has been constructed from the bathymetric data and remote sensing image fused and draped over Digital Elevation Models to create three-dimensional (3D) perspective views that are used to analyze the 3D geometry geological features and provide the mapping morphologically defined. The results are expressed in the analysis of seismic sections that extend over the region of the continental shelf and upper slope from mouth of the Açu River to the shelf edge, providing the identification / quantification of geometrical features such as depth, thickness, horizons and units seismic stratigraphyc area, with emphasis has been placed on the palaeoenvironmental interpretation of discordance limit and fill sediment of the incised valley, control by structural elements, and marked by the influence of changes in the sea level. The interpretation of the evolution of this river is worth can bring information to enable more precise descriptions and interpretations, which describes the palaeoenvironmental controls influencing incised valley evolution and preservation to provide a better comprehensive understanding of this reservoir analog system

Caracterização morfológica e sedimentar do talude continental (foz do Amazonas)

Created on 3 december 1997, the REMPLAC (Program for Assessment of Mineral Potencial of the Continental Shelf), this porgram aimed to make the basic survey, systematic geological and geophysical continental shelf, detail, at an appropriate scale, sites geo-economic, and perform the analysis and evaluation of mineral deposits. The REMPLAC should continue the efforts of Global Recognition Program of the Brazilian Continental Margin REMAC closed in 1978, the operations Geophysical Sea (GEOMAR) developed by the Directorate of Hydrography and Navigation and the various initiatives of the Program of Marine Geology and Geophysics (PGGM). Despite the high interest on the Amazon platform, there is little information o their morphology and sediment characterization, and in order to fill this gap, the present work samples sedimentological point followed by seismic acquisition. And the studies were to characterize the possible area of interest as being directly influence by tides, which sediments are reworked throughout the platform featuring grain angle with sharp corners, and the carbonate content increases as it approaches the breakdown the platform, and the bodies found outside the foraminifera and mollusks. However, diverging with organic matter that reduces its concentration as it moves away from the coast. The seismic profiles do not get satisfactory results because of low visibility, however, to correlate with the spot samples, of sediment were possible morphological characterization of the area.

Modelagem estrutural física de semigrábens ortogonais e oblíquos à distenção regional: influência da trama do embasamento e comparação com analógicos no nordeste brasileiro

The physical structural modeling tool is being increasingly used in geology to provide information about the evolutionary stages (nucleation, growth) and geometry of geological structures at various scales. During the simulations of extensional tectonics, modeling provides a better understanding of fault geometry and evolution of the tectonic-stratigraphic architecture of rift basins. In this study a sandbox type apparatus was used to study the nucleation and development of basins influenced by previous structures within the basement, variably oriented as regards to the main extensional axis. Two types of experiments were conducted in order to: (i) simulate the individual (independent) development of half-grabens oriented orthogonal or oblique to the extension direction; (ii) simulate the simultaneous development of such half-grabens, orthogonal or oblique to the extension direction. In both cases the same materials (sand mixed with gypsum) were used and the same boundary conditions were maintained. The results were compared with a natural analogue represented by the Rio do Peixe Basin (one of the eocretaceous interior basins of Northeast Brazil). The obtained models allowed to observe the development of segmented border faults with listric geometry, often forming relay ramps, and the development of inner basins faults that affect only the basal strata, like the ones observed in the seismic sections of the natural analogue. The results confirm the importance of basement tectonic heritage in the geometry of rift depocenters

Práticas integrativas e complementares em Currais Novos/RN: uso de plantas medicinais?

The objective of this study is to investigate how the team of health professionals of the Family Health Strategies program and clients in Currais Novos/RN deal with the use (or not) of medicinal plants as one of the complementary and holistic practices in the Individual Health System (SUS in Portuguese). The research is carried out using a qualitative approach, applying semi-structured interviews, related to the proposed objective, as the instruments of data collection. The interviews applied to professionals and clients were based on questionnaires and were recorded, with their permission, then transcribed in a field diary. The subjects of the study were doctors, nurses, dentists and community health agents of the Family Health Strategies team, totaling 24 (twenty four) health professionals, as well as ten volunteers identified in the research as people who use medicinal plants for health care purposes. From this study, we verify the great importance that health professionals and clients attribute to the use of medicinal plants, as well as evidence that family tradition is the main vehicle for the dissemination of knowledge regarding their use. Most medicinal plants had popular indications similar of those used scientifically, however, 70% of the clients reported never having had medical health advice or encouragement to use medicinal plants in their treatments. Half of the group of professionals interviewed reported not feeling safe in prescribing medicinal plants; approximately 25% reported having received information on the subject during their undergraduate program. Expected outcomes of this study include instigating the implementation of treatment protocols by the health professionals, and broadening holistic care practices, as well as access to alternative therapeutic options, client participation, ultimately strengthening the link between primary care and Family Health Strategies