Avaliação do cuidado na estratégia saúde da família em metrópoles do nordeste brasileiro

Objective: To evaluate the implementation of the Family Health Strategy (FHS) in Brazilian cities of the Northeast, expanding coverage, analyzing the progress, challenges and innovations. Methods: Multicentric Evaluation Research, Studies Baselines in urban centers, using as a case study method. Selected cases of Aracaju, being capital, advanced coverage with extended team, and Fortaleza, capital coverage incipient and minimal staff. In Fortaleza, purposive sample of 11 Units Primary (APS), 03 managers, 53 professionals and 109 users. In Aracaju, 09 units of APS, 02 managers, 36 professionals, and 90 users. Structured interviews for managers, and structured to professionals and users. Descriptive analysis focusing on the political and institutional dimensions, organization and comprehensive care. Results: There was consensus that the ESF is the preferred port users and acts as inducing changes in care. In the case of Fortaleza, the specificities were: care protocols and community activities aimed at chronic conditions (100%) , with greater participation of doctors and nurses (93%) ; conjunction with more complex services, but the teams reported difficulties with the examination center and experts, the long waits and poor access to local services were the main difficulties reported by users., As innovative practice, the therapeutic group of elderly caregivers mentioned by respondents; There was intersectoral initiatives and teams 87 % of users have participated in meetings about health problems. In the case of Aracaju, care protocols were directed to the lines of care and formulated locally, 85 % coverage of the population with FHS counterpart local financing; employees hired by public tender; 70 % of teams with expertise in public health center for continuing education acting; democratization in management; access technologies, welcoming and computerization in different integrated networks, and evaluation matrix. Conclusions: The ESF has promoted access to health care and inclusion of disadvantaged populations. Different perceptions and practices in the organization of care, with distinct trajectories of reorganization. In the case of Fortaleza, predominance of model programs valuing older, with evidence of advances in care practices and teamwork, but restricted to primary care practices and incipient in public policy perspective. In Aracaju, had network integration with technologies related to the family, in which the ESF is consolidated as public policy. It can be argued that the XII APS expanding coverage, exhibited efficacy, despite the challenges inherent to the different degrees of implementation

Entre parentes :cotidiano, religiosidade e identidade na Serra de Portalegre/RN

Si les études sur les groupes noirs ruraux connaissent un essor dans l´Antropologie brésilienne contemporaine, au Nordeste, et spécialement au Rio Grande do Norte, ce genre de recherches restent rares. Ce travail a comme principal objectif de faire une description ethnographique des communautés du Pêga, do Arrojado e do Engenho Novo, dans la commune de Portalegre/RN, désignées comme des descendants africains et dont les membres se reconnaissent comme appartenant a une "grande famille". Ainsi, nous voulons analyser les processus d´élaboration d´une identité collective et comprendre le rôle des relations de parenté dans la vie cotidienne, festive et religieuse de Portalegre. En effet, nous pouvons observer que les "parents" développent des stratégies économiques et affirment leur alterité, reprennant des traits culturels et religieux qui leur sont propres pour se présenter comme un groupe doté d´une grande cohésion face a la société environnante. Nous utilisons la méthode ethnographique et la technique de l´observation participante, alliée à l´analyse des sources historiques primaires dans le but de décrire ces pratiques et stratégies. Nous pensons que la participation des membres du groupe à la production agricole, spécialement dans la confection de la farine de manioc, la construction des relations sociales au quotidien et l´organisation de la danse de São Gonçalo représentent autant d´occasions où la mémoire du groupe se fortifie, l´identité collective se cristallise et où la sociabilité se trouve consolidée. Nous analysons ces pratiques collectives et ces moments festifs comme des moyens de réaffirmation d´une identité locale centrée sur les relations de parenté

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Reinternações psiquiátricas no Rio Grande do Norte: implicações e impacto das novas estratégias de atenção à saúde mental

The Brazilian Psychiatric Reform based on the desinstitucionalization of the assistance, translated to the emphasis on community/territorial treatment and in the social inclusion of the mental suffering, promoted advances in the psychiatric restructuring. In the Rio Grande do Norte (RN), we can enumerate as advances of the Brazilian Psychiatric Reform the expansion of the mental health care chain and the implementation of some strategies that, together, aims to further the psychosocial attention of the individual with psych suffering and to reduce the indices of psychiatrics readmissions in the state. In the current Brazilian‟s mental health situation we were interesting in answered the following question: what the impact of the substitutes services‟ extension in the revolving door phenomenon? This search aims to analyze the revolving door phenomenon occurrences based on the news strategies of mental health care in the Rio Grande do Norte. This is a descriptive-exploratory study with a qualitative approach, oriented by the theoretical framework of critical-dialectical approach about the Brazilian Psychiatric Reform and using the thematic oral history as method of information collects. The search was realized on the Hospital João Machado (HJM), estate reference in psychiatric treatment, and the participants was 20 professionals that work on it. The collection of information had started after the approval of the UFRN Research Ethics Committee with the opinion number 216/2011 and CAAE number 0021.0.051.000-11 and was realized using the direct observation and semi-structured interview. The study‟s results were categorized in two categories and five subcategories of analysis. CATEGORY 1) Current situation of the mental health care chain in the RN, with the subcategories: 1.1 Impact of the new services of mental health care in the revolving door phenomenon in the RN; 1.2 Implications of the new services of mental health care in assisting user to the HJM; 1.3 Issues the permeate the mental health care chain in the RN. CATEORY 2) Main causes of the revolving door phenomenon in HJM, with the categories: 2.1 Family problems; 2.2 Lack of assistance after discharge from psychiatric hospital. In summary, we conclude that the extension of the mental health care chain contributed for the reduction of the psychiatrics re-hospitalization‟s indices in RN. However, we realized that territorial services of mental health care are not the only responsible for the revolving door phenomenon. Factors as family problems and the disarticulation of the assistance after the discharge from hospital influence on the perpetuation of hospitalizations and re-hospitalizations in the local scenario. To study the revolving door phenomenon that occur in the psychiatrics‟ assistance considering the news strategies of mental health care allowed us to approach the advances and challenges brought by the RPb and by the desinstitucionatization in the state, indicating the need for further discussions and problem-solving strategies of psychosocial care.

Atenção à saúde da pessoa idosa na estratégia saúde da família no município de Santo Antônio/RN: um estudo de caso

According to demographic estimates, by the year 2025 Brazil will be the sixth country in the world in number of elderly. For this reason, it is a purpose of public policies to help people to reach that age being healthier. The current health care model of health surveillance through the Family Health Strategy (EFS, in portuguese) is configured as a gateway into the care of the elderly in the Unified Health System (SUS, in portuguese). It is also an area of development of practices to promote health, prevention and control of chronic nondegenerative diseases. The aim of this study was to analyze the health care of the elderly provided by ESF professionals for the achievement of a full care. The study is descriptive case study with a quantitative approach, performed in the city of Santo Antônio/RN. The population included all health professionals, who are FHS members of the city that agreed to participate of the survey, a total of 80 professionals. Data were collected using a structured questionnaire, having mostly closed questions and divided into two parts: one containing sociodemographic information of health professionals and vocational training and the other, the activities carried on by the professionals in senior care, being analyzed from a database tabulated in a spreadsheet and discussed according to the descriptive statistics in tables, graphs and charts using frequencies, medians and values of central tendency. It was verified a predominance of professionals who finished highschool, mostly female, aged from 30 to 34 years old, with training completed in the last 10 years, without being graduated in the field of geriatrics or gerontology and mostly without training in gerontology. Family members and caregivers were the components of the social support network most identified by the professionals (66.3%).The elderly access to the Family Health Basic Unit was considered by83.8% of professionals as the most important factor that interferes in the activities of health care of the elderly. Considering the inclusion of the family in care: 98.8% of professionals consider the family as one of the goals of care, but 82.5% assist the family to know their role and participate in the care of the elderly, emphasizing that no professional makes use of tools for evaluating the functionality of the family. Regarding the actions taken to assist the elderly, 91.25% have home visits program to the elderly, 88.75% use the host program; 77.5% know the habits of life, cultural, ethical and religious values of the elderly, their families and their community ;51.25% complement the activities through intersectoral actions, 50%participate in groups of living with the elderly; 33.75% keeps track and maintain updated the health information of the elderly; 11.25% of the professionals perform the Single Therapy Planning (PTS, in portuguese) and few implement the actions to promote health according to PTS; there is a deficit in the number of professional categories in the identification and monitoring of the frail older people in their households. It is concluded that the health care of the elderly developed by ESF professionals differs among the professional categories. It was identified weaknesses in the promotion of an active and healthy aging and also in the establishment of an integrated and full care of the elderly. It is recommended the adoption of permanent educational activities by the City Management, initially for ESF professionals in the the perspective of the guidelines of the National Policy of Health Care for the Elderly and later to the other professionals that are part of the health care network of the elderly, at all levels of care in the city for the development of strategies and practices that promote the improvement of the quality of healthcare for the elderly, expecting concrete and effective results in terms of promoting health within Brazilian reality

Evidências de validação de um protocolo para assistência às pessoas com úlceras venosas em serviços de alta complexidade

Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs . After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa ≥ 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity

Proposta de um sistema de segurança eletrônica predial

This work presents a suggestion of a security system of land automation having as objective main the creation of a system capable from easy method, supervise the installations of a building with the goal to preserver security personal and patrimonial necessities, aim at portability low cost and use easiness. Was designed an alarms central and access controller that has digital and analogical inputs for sensors and outputs for buzzer, telephonic dialing and electronic lock. The system is supervised by software that makes solicitations of information to the alarms central through the one computer's serial port (RS-232). The supervisory software was developed in platform LabVIEW with displays the received data on a graphical interface informing the sensors' current states distributed in the building and system events as alarns occurrences. This system also can be viewed through the Internet for people registered by the land security's system administrator

VCO Banda Larga Integrado para Receptor a Cinco Portas

This work presents an wideband ring VCO for cognitive radio five-port based receivers. A three-stage differential topology using transmission gate was adopted in order to maintain wide and linear tuning range and a low phase-noise. Monte-Carlo analysis were performed for phase-shift response of individual stages, which is an important figure of merit in five-port works. It was observed a fairly linear correlation between control voltage and oscillation frequency in the range between 200 MHz and 1800 MHz. The VCO was preliminarily designed for IBM 130nm CMOS technology

Desenvolvimento de antenas de microfita com aberturas nos patches condutores através do método da segmentação

Microstrip antennas are widely used in modern telecommunication systems. This is particularly due to the great variety of geometries and because they are easily built and integrated to other high frequency devices and circuits. This work presents a study of the properties of the microstrip antenna with an aperture impressed in the conducting patch. Besides, the analysis is performed for isotropic and anisotropic dielectric substrates. The Multiport Network Model MNM is used in combination with the Segmentation Method and the Greens function technique in the analysis of the considered microstrip antenna geometries. The numerical analysis is performed by using the boundary value problem solution, by considering separately the impedance matrix of the structure segments. The analysis for the complete structure is implemented by choosing properly the number and location of the neighboor element ports. The numerial analysis is performed for the following antenna geometries: resonant cavity, microstrip rectangular patch antenna, and microstrip rectangular patch antenna with aperture. The analysis is firstly developed for microstrip antennas on isotropic substrates, and then extended to the case of microstrip antennas on anisotropic substrates by using a Mapping Method. The experimental work is described and related to the development of several prototypes of rectangular microstrip patch antennas wtih and without rectangular apertures. A good agreement was observed between the simulated and measured results. Thereafter, a good agreement was also observed between the results of this work and those shown in literature for microstrip antennas on isotropic substrates. Furthermore, results are proposed for rectangular microstrip patch antennas wtih rectangular apertures in the conducting patch

Desenho e Construção de um protótipo gerador de jato de plasma frio a pressão atmosférica para aplicações biomédicas

Research for better performance materials in biomedical applications are constants. Thus recent studies aimed at the development of new techniques for modification of surfaces. The low pressure plasma has been highlighted for its versatility and for being environmentally friendly, achieving good results in the modification of physic chemical properties of materials. However, it is requires an expensive vacuum system and cannot able to generate superficial changes in specific regions. Furthermore, it is limits their use in polymeric materials and sensitive terms due to high process temperatures. Therefore, new techniques capable of generating cold plasma at atmospheric pressure (APPJ) were created. In order to perform surface treatments on biomaterials in specific regions was built a prototype capable of generating a cold plasma jet. The prototype plasma generator consists of a high voltage source, a support arm, sample port and a nozzle through which the ionized argon. The device was formed to a dielectric tube and two electrodes. This work was varied some parameters such as position between electrodes, voltage and electrical frequency to verify the behavior of glow discharges. The disc of titanium was polished and there was a surface modification. The power consumed, length, intensity and surface modifications of titanium were analyzed. The energy consumed during the discharges was observed by the Lissajous figure method. To check the length of the jets was realized with Image Pro Plus software. The modifications of the titanium surfaces were observed by optical microscopy (OM ) and atomic force microscopy (AFM ). The study showed that variations of the parameters such as voltage, frequency and geometric position between the electrodes influence the formation of the plasma jet. It was concluded that the plasma jet near room temperature and atmospheric pressure was able to cause modifications in titanium surface

Jornalismo cultural em texto, imagem e cor

O tema deste trabalho é o Jornalismo Cultural. Uma apresentação e discussão de temas pertinentes ao jornalismo especializado em cultura nas páginas do jornal diário. A partir da leitura de alguns jornais, se traça considerações gerais acerca dos caminhos do jornalismo e dos estudos sobre jornalismo com o objetivo de apresentar o jornal que hoje se produz no Brasil, em texto, imagem e cor. O resultado é a descoberta do jornal como forma, desde o texto, escolhas lexicais e sintáticas, passando pelas imagens, composição, escolha e determinação da pauta, ao arranjo destes elementos na página, em respeito ao projeto editorial de diagramação. A conclusão a que se chega que há vários "eus" que governam o jornal diário, e que fazem o jornalismo cultural inovador, porta de entrada às mudanças no jornalismo.

Implementação da técnica de difração de elétrons de baixa energia

The purpose of this study is to describe the implementation of the Low Energy Electron Diffaction (LEED) technique in the Laboratory of Magnetic Nanostructures and Semiconductors of the Department of Theoretical and Experimental Physics of the Universidade Federal do Rio Grande do Norte (UFRN), Natal, Brazil. During this work experimental apparatus were implemented for a complete LEED set-up. A new vacuum system was also set up. This was composed of a mechanical pump, turbomolecular pump and ionic pump for ultra-high vacuum and their respective pressure measurement sensors (Pirani gauge for low vacuum measures and the wide range gauge -WRG); ion cannon maintenance, which is basically mini-sputtering, whose function is sample cleaning; and set-up, maintenance and handling of the quadrupole mass spectrometer, whose main purpose is to investigate gas contamination inside the ultra-high vacuum chamber. It should be pointed out that the main contribution of this Master's thesis was the set-up of the sample heating system; that is, a new sample holder. In addition to the function of sample holder and heater, it was necessary to implement the function of sustaining the ultra-high vacuum environment. This set of actions is essential for the complete functioning of the LEED technique

Desenvolvimento de um sistema a jato de plasma obtido em cátodo oco para deposição de filmes finos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Quem nasce em campina grande é campinense : futebol e sociabilidade na rainha da borborema (1954-1965)

This study aims to historicize a problem: How Campinense Club, club social of the city of Campina Grande, became a popular club? This guild was founded in 1915 by a group of graduates, which they called "Campinense" a social club dedicated to the enjoyment of the city's elites. To investigate the mechanisms that have led to this popularity, was chosen that includes a period from 1954 to 1965, when it was created a department where the professional football club won a string of six consecutive championships, considered the main achievement of its history sports. Were used as research sources Borborema the Journal, a newspaper founded in 1957 and that during the period in question, was the spokesman of the main political groups in the city, which on many occasions were the sponsors of the clubs the same. This newspaper had a daily sports column and introduced the red-black team to Paraíba. Were used, although the club's meeting minutes taken as official documents, which allowed it to be mounted on a puzzle of the club's events, since the information about the Campinense present rather fragmented. Finally, respondents were fans, athletes and leaders who, through his lines in a way pointed out other possibilities such as a club, believed to be aristocratic, has become a passion among the fans, giving rise to this conception to be one that Campinense broke with the established elites of the city.

A escrita do tempo e a poética do espaço:história e espaço no livro Geografia do Brasil Holandês de Luís da Câmara Cascudo

In 1956, Luís da Câmara Cascudo published his book Geografia do Brasil Holandês. In this book, he studied and described a space - the Dutch Brazil - from a geographical and historical perspective. To do this, he articulated both perspectives from the point of view of his own reading of the History of Nordeste , establishing a dialogue with the historiographical tradition of the study of the Dutch Brazil in Pernambuco. When portraying the Dutch presence in Nordeste, Cascudo articulated a drama in which the Dutch would have their history described as a typically tragic plot, portrayed as if they were already condemned to failure in advance. To this tragedy he opposed a predominantly comic Portuguese plot, as if the Portuguese victory over the Dutch was as desirable as inevitable for the space of Nordeste . When narrating the clash between the Dutch and the Portuguese for the space of Nordeste , however, Cascudo ended up delineating his own place of speech, as a spokesperson for the identity of the potiguar space in opposition to the pernabucano space described by Freyre and Gonsalves de Mello. In this way, the space of Rio Grande do Norte would have its own identity, constructed from de Dutch absence and constituted from the Portuguese legacy contrarily to the space of Pernambuco, narrated from an articulation and a conciliation of the Flemish and Lusitan legacy, even though highlighting the latter. While the Dutch would had been a constant presence in the history of Pernambuco for Freyre and Gonsalves de Mello, they wouldn t have gone beyond legend in the space of Rio Grande do Norte, removed from its geography and erased from its history. When describing de geography of the potiguar space, therefore, Cascudo articulates the inexistence of the History of a time dominated by the Fleming with the search of a Portuguese space, trough the narration of its origins and constitution, as well as the registry of the characteristics of its legacy