Qualidade de vida em gestantes no contexto na Estratégia Saúde da Família

The pregnancy as a process in woman's life requires several biological, psychological, relational and socio-cultural changes for the preparation for motherhood. By modifying its capacity and, at the expense of these factors, it is observed that the physical, social and emotional problems experienced by women during pregnancy can affect their quality of life, especially related to health. It had as objectives of this research verifying the quality of life of women in the context of the Family Health Strategy in a municipality in Paraíba, in order to characterize the sociodemographic aspects, lifestyle habits, and obstetric care of pregnant women and to characterize the fields of quality of life of pregnant women according to the WHOQOL-bref. This is a descriptive exploratory study with cross-sectional and quantitative approach. The population consisted of 120 pregnant women in primary care in the municipality of Sousa-PB. Data collection occurred over a period of two months by the own master's degree student and two nursing students in applying a standard form about sociodemographic characteristics, and obstetric care and the WHOQOL-bref instrument. The data collected were organized into an electronic database of the Microsoft Excel application, coded, tabulated and presented in tables, charts and figures with their respective percentage distributions. Of the surveyed, the predominant were age group of 20 to 25 years, Catholic religion, with a steady partner, low education, no employment, wage income of 01 minimum wage. As for the data and obstetric care, almost all had never aborted and reported to the care received as excellent. The most frequent complaints were back pain and in lower abdomen. Regarding quality of life according to the WHOQOL-bref, dissatisfactions that predominated in the areas were in the physical pain and discomfort, sleep, rest, energy and fatigue. In the psychological domain, body image and appearance, memory, concentration and negative feelings. In the field of social relationships, sexual activity and the environment domain, the greatest dissatisfaction with facets scored: financial resources, leisure opportunities and transport. It is concluded that the quality of life of the users interviewed were deemed unsatisfactory for these facets, indicating that assistance to this target audience should be done comprehensively and holistically, in order to accommodate the affected facets to improve the quality of life pregnant women attended in primary care

Proposta de um modelo de medição e avaliação de desempenho como ferramenta de gest ão - um estudo de caso num órgão público

The public sector performance has received much attention in the literature and due to that the purpose of this work is to develop a proposal for a model of performance measurement for a higher education institution unit. First, we performed a theoretical research on public organizations and private institutions of higher education, followed by a literature review on performance measurement and evaluation. This review presents some performance models that are quite frequent in the literature: Total Quality Management (Total Quality Management) - TQM and the PDCA cycle, SMART System, Balanced Scorecard and Môdef Ouanturn. In order to verify the possibility of implementing a performance measurement model for Higher Education Institutions, it was conducted a case study in a support unit of a University, located in the city of Natal, RN, Brazil. The study attempted to identify the key processes of the unit and proposed by the use of Quantum model in order to improve the management and operation of the same. The work aims to contribute to the advancement of knowledge in measurement and performance evaluation in higher education institutions that where still lacks scientific production of this subject compared to other areas. This study also identifies better practices and opportunities for improvement in processes to determine the expected performance indicators to aid a decision-making unit.

Qualidade do serviço em organização do terceiro setor: um estudo na casa de apoio à criança com câncer

The research aimed identify how the quality of services provided by Casa de Apoio à Criança com Câncer Durval Paiva is perceived by its users, giving an opportunity of improve their performance in social services provision pointing out the failures experienced, the institution will have the user as a important partner in fails identification, serving as a subsidy to the actions of correction and improvement to such situations demands. With this work implementation will be observed contributions that will permeate to the fields of theory and practice, enabling progress and enrichment on the subject. The theoretical contribution is observed as this work execution will provide greater advance about the models developed for the third sector. The proposed work will raise awareness issues about the full potential of the social economy, with regard to the quality of services provided by organizations, allowing a better definition of priorities on their development. The study addressed three issues: identifying the people that receive support of the Casa Durval Paiva, identifying what is the level of satisfaction of families served and evaluate the services provided by Casa Durval Paiva that demand improvements in the perception of families assisted. Found a demand for services has been found that the institution has a multidisciplinary team with a high level of professionalism, and supervised with students of various educational institutions and many volunteers to complement the actions of individual professionals. Was measured a high satisfaction of users of the services provided by Casa Durval Paiva

Um Estudo de Politicas e Práticas do uso do GNV no transporte público urbano do Brasil

The use of Natural Gas Vehicle has had a fast increase lately. However, in order to have a continuous success this Program needs to develop converting devices of Otto-cycle engines, gasoline or alcohol, to the use of NGV (Natural Gas Vehicle) that presents low cost, maintaining the same original development of the vehicle and low level of emissions, considering the PROCONVE rules. Due to the need to diversify the matrix in order to avoid energetic dependence and due to strict pollution control, it has increased in the Brazilian market the number of vehicles converted to the use of NGV. The recent regulation of the PROCONVE, determining that the converted engines with kits should be submitted to emission testing, comes to reinforce the necessity of the proposed development. Therefore, if we can obtain kits with the characteristics already described, we can reach a major trust in the market and obtain an increase acceptance of the vehicle conversion for NGV. The use of natural gas as vehicle fuel presents several advantages in relation to liquid fuels. It is a vehicle fuel with fewer indexes of emissions when compared to diesel; their combustion gases are less harmful, with a major level of safety than liquid fuels and the market price is quite competitive. The preoccupation that emerges, and the motivation of this project, is to know which are the main justifications for such technology, well accepted in other countries, with a low index or emission, with a high level of safety, where its maintenance becomes low, reminding that for this it is necessary that this technology has to be used properly, and once available in the market will not motivate interest in the urban transportation companies in Brazil, in research centers in general. Therefore this project exists to show the society in a general way the current vision of the main governmental factors, of the national research centers and of the private companies concerning the use of natural gas vehicles in urban transport vehicles, in order to give a major reliability to the population as well as to motivate national market competitiveness with a low cost and reliable product and to enrich the national technology

Uma aplicação de análise de decisão com o método AHP Processo de hierarquia analítica: um estudo sobre adoção de Sistema eletrônico de cobrança no Transporte público urbano

This thesis carries through an application of Analysis of Multicriterion Decision with use of the method of Analytical Hierarchy Process (AHP) in the problematic one of taking of decision of the adoption of electronic collecting in the system of urban transport in the country, a subject that has been controversial. A modeling of criteria and alternatives is carried through and applied a questionnaire based on method AHP the excellent actors in the system of urban transport - Leading of the Managing Agency Public Municipal theatre of Urban Transports, Controller of Company of Bus, Controller of Labor union, Controller of Union of Companies, Communitarian Leader. The considered alternatives were: the maintenance of the current state with collectors, the implementation of electronic collection without collectors, and the implementation of electronic collection with collectors. The used criteria were: job, impact in the fare, control of the system, easiness of use, information. The study was carried through in the city of Natal, RN, where if the adoption of electronic collection argues and where this implementation in some bus lines between Natal and Parnamirim exists, city that integrates the region of the great Natal. The main results of the method evidence in a dimension, the viability of use of method AHP with questionnaire by means of validation of the judgments with analysis of variance beyond proper the normal mechanisms of analysis of consistency to the method, and in another one, the contribution of the analysis boarding multicriterion to become the judgments more clearly. The main results of the analysis help to show that although to models of criteria and distinct judgments of the actors, the method evidenced that it has inclination the adoption of the electronic collection on the current situation, even so with divergences between the maintenance or not of the collector. The research points to the possibility of accomplishment of the application of the AHP in successive rounds of judgments

Limonologia e qualidade ambiental de um corpo lêntico receptor de efluentes tratados da indústria de petróleo

Environmental pollution has become a subject of public interest throughout the world. Not only have developed countries been affected by environmental problems but also the developing nations have started to suffer from the serious impacts of pollution. Within this context it is necessary to collect simplified environmental data to assist in the management of water resources by the appropriate authorities. These data are obtained through an environmental index that allows a space-time comparison of points distributed in the same aquatic body, or between different water bodies, for physico-chemical and bacteriological parameters. The aim of this present study was to determine the environmental status of the Lagoa de Baixo at Guamaré/RN, where a production unit of PETROBRAS RN/CE is located. For this purpose the Water Quality Index (WQI) was used in both an add and multiply form, the Trophic State Index (TSI) and the Environmental Quality Quotient (EQQ), as well as determining the concentrations of metals. The average values obtained for the WQI, in its two forms were 68,67 and 62,76 respectively which were inside the good qualification. According to the TSI the lagoon showed characteristics of a middle trophic state, and an impact level of regular as determined by the EQQ

Variação da qualidade da água de chuva no início da precipitação

One of the most evident and actual concern, not only in the scientific means, but also of the public knowledge in general, is the lack problem of the potable water, that come increasing more each time, motivated mainly for the po llution of the sources, the bad use of the water and the increase of the population. In such a way, the necessity of looking for new water sources and the development of techniques to use sources minus explored is becoming even more important and urgent. T he rainwater comes being used since a long time like a supplying source, but, due the few knowledge of its characteristics, the generated preconception and the discrimination around its consumption and to the bad use of the technique of collection and stor age, it comes being little used, wasting consequently a significant parcel of this source. Trying to develop the knowing of some characteristics of the rainwater, the present work looks for to define the curve of variation of the quality of the rainwater i n three points with distinct characteristics of the city of Natal -RN, in the course of the precipitation, in some situations of time and space. For describe the curve of variation of the water s quality, some variables must be analyzed, and to be identifie d when they modify themselves in the endurance of rain, showing in which moment the purification of the water is more or less quickly. The pH, the Turbidity and the Electric Conductivity can be related with a big part of the physicist -chemistries variables found in the water and, like its analyses don't spend any material, they have easy access and measurement. The present work analyzes the curves of decline of these three variables, in three points with distinct characteristics in the city of Natal -RN, being these points: one next to the sea, another one in region with great buildings concentration and the last point in a less polluted area. For the studied region, it was during the five first millimeters of rain that occurs the biggest reduction of the exi sting impurities in the atmosphere, mainly between the first and the second millimeter, and after the five first millimeters the values of the variables stabilize. With exception of the University Campus, where initially the rainwater already has very good quality, the values of Turbidity and Electric Conductivity suffer a brusque reduction after the first millimeter of rain

Avaliação da Qualidade da Água do rio Pitimbu

The Pitimbu River Basin is concern reason, therefore this is one of the mains freshwater sources for the Natal city supplying. The Pitimbu waters river flow into Jiqui pond, as the main supplier of this, that supplies 16% of Natal population and there is a bigger importance despite the supplying of a parcel of Natal city made joining underground waters with the water proceeding from the Jiqui pond, being used for dilution waters of contaminated wells with nitrate. Even with the importance of the Pitimbu, there is a strong pressure of occupation of its edge according to a critical urban growth, becoming the situation worse and increasing the necessity of management of the use and occupation of the ground and keeping the control of the prompt pollution, as punctual as diffuse. There are many studies about Pitimbu River Basin, however they summarize themselves to some months or even in a few years. This work, that gathers these information, increasing the amplitude and making possible an evaluation of the attitude of the water in a period extended for an evaluation of values of variable quality of water referring to the standards, that usually happens about the variable frequency distribution, central tendency and measures of dispersion, as the coefficient of variation, coefficient of skewness and the coefficient of determination of certain variable on another one. This work to evaluates the quality conditions of the Pitimbu river waters by analyzing thirty five (35) variables Physical, chemical and biological in eight (8) points of water course since 1993 to 2007. Given this situation, all knowledge about the waters quality conditions obtained in this work, is a strong subsidy for management of use and ground occupation, considering the river basin as territorial unit of management, and as the water is public good domain, being a priority human use, It is necessary to guarantee to current and the future generations available water resources in appropriate standards of quality as the established standard and identifying possible reasons of pollution through statistics analysis

A influência da poluição difusa e do regime hidrológico peculiar do semiárido na qualidade da água de um reservatório tropical

In semiarid region of northeast Brazil, the majority of reservoirs used for public supply has suffered degradation of water quality affected by diffuse pollution from agricultural and livestock areas of the watershed and by hydrologic regime peculiar to the region, characterized by a rainy season with higher volumes stored in reservoirs and a dry season with a reduction in water level due to high evaporation and increase of eutrophication. The Dourado reservoir, located in Currais Novos city, semiarid region of Rio Grande do Norte state, is one example of a water supply reservoir that can have degradation of water quality and impracticability of their use, due to the high external input of nutrients from non-point sources of watershed during the rainy season and increasing of eutrophication due to decrease the stored volume during the dry period. This study aimed to investigate and quantify diffuse pollution and the hydrologic regime of semiarid region in order to establish standards regarding the water quality of Dourado reservoir. The study period was between the months of May 2011 to March 2012. The diffuse pollution was quantified in terms of watershed from the mass balance of phosphorus in the reservoir, as in relation to areas under different types of land use within the riparian zone of the reservoir from the assessment of soil chemical properties and losses of phosphorus in each area. The influence of hydrological regime on water quality of the reservoir was evaluated from the monthly monitoring of the morphometric, meteorological and limnological features throughout the study period. The results showed that the reservoir has received a high load of phosphorus coming from the drainage basin and presents itself as a system able to retain some of that load tributary, giving an upward trend of the eutrophication process. Diffuse pollution by nutrients from areas under different types of land use within the riparian zone of the reservoir was higher in areas under the influence of livestock, being this area considered a potential diffuse source of nutrients to the reservoir. Regarding the water regime during the rainy season the reservoir was characterized by high concentrations of nutrients and small algal biomass, while in the dry season the reduction of volume and increase of the water retention time of the reservoir, contributing to the excessive growth algal biomass, favoring an increase in eutrophication and deterioration of water quality. In synthesis the water quality of Dourado reservoir is directed by diffuse pollution coming from the drainage basin and the hydrological regime of the peculiar semiarid region, where the rainy season is characterized by high input of allochthonous compounds from the tributaries and erosion of the soil in the reservoir riparian zone, and the dry season characterized by reducing the storage volume due to high evaporation, high residence time of water and consequent degradation of water quality due to the increase of eutrophication process

Diagnóstico do usuário no aprimoramento dos serviços de tecnologia da informação: um projeto de intervenção para o Ministério Público do Estado do Rio Grande do Norte

The information tecnology (IT) has, over the years, gaining prominence as a strategic element and competitive edge in organizations, public or private. In the judiciary, with the implementation of actions related to Judiciário Eletrônico, information technology (IT), definitely earns its status as a strategic element and significantly raises the level of dependence of the organs of their services and products. Increasingly, the quality of services provided by IT has direct impact on the quality of services provided by the agency as a whole. The Ministério Público do Estado do Rio Grande do Norte (MPRN) deployments shares of Electronic Government, along with an administrative reform, beyond these issues raised, caused a large increase in institutional demand for products and services provided by the Diretoria de Tecnologia da Informação (DTI), a sector responsible for the provision of IT services. Taking as starting point strategic goal set by MPRN to reach a 85% level of user satisfaction in four years, we seek to propose a method that assists in meeting the goal, respecting the capacity constraints of the IT sector. To achieve the proposed objective, we conducted a work in two distinct and complementary stages. In the first step we conducted a case study in MPRN, in which, through an internal and external diagnosis of DTI, accomplished by an action of internal consulting and one research of the user satisfaction, we seek to identify opportunities of change seeking to raise the quality perceived of the services provided by the DTI , from the viewpoint of their customers. The situational report, drawn from the data collected, fostered changes in DTI, which were then evaluated with the managers. In the second stage, with the results obtained in the initial process, empirical observation, evaluation of side projects of quality improvement in the sector, and validation with the managers, of the initial model, we developed an improved process, gazing beyond the identification of gaps in service a strategy for the selection of best management practices and deployment of these, in a incremental and adaptive way, allowing the application of the process in organs with little staff allocated to the provision of information technology services

Caracterização comportamental e avaliação da qualidade de leite em caprinos da raça saanen no semiárido nordestino

Goats are social animals which groups are organized from dominance hierarchies, established by agonistic behaviors. The quality and productivity of the goat s milk can be influenced by the dominance hierarchy. In this context, the objectives of our work were describe the social and food behavior of Saanen goats in a semi-extensive production system; characterize the social organization from the assessment of dominance hierarchies in two seasonal periods and correlate the physicochemical quality of the goats milk according hierarchical position. The experiment was conducted in the EMPARN s experimental station, located in the district of Cruzeta/RN. We utilized 17 multiparous goats of the Saanen race, with different age and weight. The observations were performed in precipitation and drought phases. The scan method recorded the trough permanence and agonistic interactions by method "all occurrences" in the pasture the alimentary behaviors of eat, ruminate on foot, ruminate lying, leisure on foot, leisure lying and walk, by the focal animal sampling method. The goats milk was submitted to analyzes of: density, protein, fat, lactose, CSS and total solids. The animals spend most of the time feeding themselves, and the activities that demand greater energy expenditure are done in the morning. The animals changed the hierarchical structure during the seasonal periods because of the withdrawal of some individuals of the group, having more aggressive behavior in the rainy season. The dominant animal the lowet production, the more CSS and the lesser fat, the goat in the middle of the hierarchy was the one that obtained the best production and quality. We conclude that the Saanen goats adapt to the environment and the conditions of the group to ensure better survival and its production is influenced by the internal dynamics of the group

Dependência química em mulheres :um estudo sobre o consumo de medicamentos ansiolíticos no serviço público de saúde de Natal/RN

This work was concerned to investigate the meaning attributed to anxiolytic drugs by women, in public health service. It proposes a joint analysis through a link between three dimensions: the woman, the drug, and public health service itself, in an hegemonic medical assistance model. It is observed that the relation between these elements has a great influence over the use and construction of a particular meaning, by the user. The medication is analysed as a consumption merchandise and as an health symbol. In this way, it reflects a biologized vision, which believes the drug as a solution for all health problems. It tries to analyse the generalized medical prescription for anxiolythics and it s consequences. It focalizes also the production and utilization of public health services by patients, mainly women. The question related to the use of anxiolytics and the meaning construted by women is analysed focusing the way that relations of masculine/feminine gender are organized in our society. At this point of view, it tries to understand the dimension that these questions have in subjectivity production, and how it acts in the health/disease process. Finally, this work tries to understand, in a broad sense, the use of anxiolytics looking at the problem not only as a biological question, but also as a cultural matter. The research was done over seventeen women, all of them anxiolytic users. It was used, as research instrument, semi-structured interview associated with methodological analysis of user s speeches

As praças e a parceria público-privada em Natal/RN

Defined as public space or space open of common use, the square is a fundamental space for the urban life. Its function depends so much of the historical context, as of its location in the city, but general way, it is associated to leisure activities. In spite of its importance, many Brazilian squares are abandoned and degraded, some are used improperly, other they never left the paper and they are wastelands, most of the time, transformed in garbage deposits. The lack of appropriate equipments in the squares or to the precariousness of the same ones, such as banks, illumination and places for the different age groups; the lack of the "nature", in other words, of green; and the maintenance lack is some of the problems observed at the squares of Natal/RN. The maintenance is essential factor for the own existence of the square, so much in relation to the physical quality of the space, as in relation to the presence, or no, of users. In that work, we studied the squares of Natal/RN and the partnership public-private as form of shared administration of the public space. Our objective is to understand as it feels that partnership in the production and maintenance of squares in Natal/RN and which the benefits for the involved parts. For so much, we rescued the production of squares historically in the city of Natal/RN; We analyzed the legislation that regularizes the adoption of squares in some Brazilian municipal districts and the Bill of Adoption of Public Squares and of Sports and Green Areas in Natal/RN; and, last we analyzed three natalenses squares that had private investment in the construction, it reforms and/or maintenance. The "partnerships" involved exchange for land, environmental and social compensations, always assisting to the private interests, and nothing was registered or documented in the competent public organs. With that dissertation we wanted to contribute for the valorization of the squares and the relevance of the construction, renewal and maintenance of those public spaces in the city of Natal/RN, as life spaces, of encounters, of leisure

Avaliação do acesso aos serviços de reabilitação física para vítimas de acidentes de trânsito: caminhos para melhoria da qualidade do sistema de saúde

The Physical Rehabilitation services (PR) are of fundamental importance in combating the global epidemic of Traffic Accidents (TA). Considering the numerous physical and social consequences of the survivors, quality problems in access to PR are a hazard to recovery of victims. It is necessary to improve the management of quality of services, assessing priority dimensions and intervening in their causes, to ensure rehabilitation available in time and suitable conditions. This study aimed to identify barriers to access to rehabilitation considering the perception of TA victims and professionals. The aim is also to estimate the access to rehabilitation and their associated factors. This is a qualitative and quantitative study of exploratory nature developed in Natal / RN with semi-structured interviews with 19 health professionals and telephone survey to 155 victims of traffic accidents. To explore barriers to access the speeches were transcribed and analyzed using the Alceste software (version 4.9). During the interviews used the following guiding question: “What barriers hinder or prevent access to physical rehabilitation for victims of traffic accidents?”. The names of classes and axes resulting from Alceste was performed by ad hoc query to three external researchers with subsequent consensus of the most representative name of analysis. We conducted multivariate analysis of the influence of the variables of the accident, sociodemographic, clinical and assistance on access to rehabilitation. Associations with p <0.20 in the bivariate analysis were submitted to logistic regression, step by step, with p <0.05 and confidence interval (CI) of 95%. The main barriers identified were: “Bureaucratic regulation”, “Long time to start rehabilitation”, “No post-surgery referral” and “inefficiency of public services”. These barriers were divided into a theoretical model built from the cause-effect diagram, in which we observed that insufficient access to rehabilitation is the product of causes related to organizational structure, work processes, professional and patients. Was constructed two logistic regression models: “General access to rehabilitation” and “Access to rehabilitation to public service”. 51.6% of patients had access to rehabilitation, and 32.9% in public and 17.9% in the private sector. The regression model “General access to rehabilitation” included the variables Income (OR:3.7), Informal Employment (OR:0.11), Unemployment (OR:0.15), Perceived Need for PR (OR:10) and Referral (OR: 27.5). The model “Access to rehabilitation in the public service” was represented by the “Referral to Public Service” (OR: 23.0) and “Private Health Plan” (OR: 0.07). Despite the known influence of social determinants on access to health services, a situation difficult to control by the public administration, this study found that the organizational and bureaucratic procedures established in health care greatly determine access to rehabilitation. Access difficulties show the seriousness of the problem and the factors suggest the need for improvements in comprehensive care for TA survivors and avoid unnecessary prolongation of the suffering of the victims of this epidemic.

Gasto com a internação de idosos em unidades de terapia intensiva

Introduction: Population aging in Brazil underscores the need to discuss the proper management of the budget allocated in health field, especially in the sectors of high complexity, where coexist costly procedures, limited resources and the need for cost containment. In the other hand, demand is growing in a way directly proportional to the increase in the number of elderly in country. Objective: In this way, this research had as main objective to analyze the costs resulting from the admission of elderly in intensive care units (ICU) and its associated factors. Methods: This is a cross-sectional study with a quantitative approach and featured as a descriptive and exploratory research. Data were collected from medical records of elderly hospitalized in ICU from a brazilian city called Natal-RN, between november first, 2013 and january, 31 of 2014. The variables collected relate to the socio demographic profile, morbidity framework and characterization of hospitalization. The dependent variable was categorized by quartile 75 in high and low expense of hospitalization and submitted to chi-square test with the independent variables of the survey. Associations with p value <0.20 in the bivariate analysis were submitted to the technique of multiple logistic regression. We opted for the construction of three regression models from the above algorithm: general regression model, composed by all 493 hospitalizations in the study, other made with 181 individuals admitted in health public system (SUS) and a third one related to 312 cases from private service in health area. Results: In the general regression model, the variables respiratory diseases, hospitalizations in the private system, disoriented patient and previous stroke were associated with greater probability of high spending in the ICU. In the other hand, in SUS kind of hospitalizations, this probability was associated with disoriented patient, 80 years old or more, sepsis and admission for clinical reason. In the cases from the private network health, the high expenditure was associated with respiratory disease, mechanical ventilation, hospitalization for clinical reason and disoriented patients. Conclusion: The increased expenditure on hospitalization of elderly in intensive care depends on the clinical conditions of individuals. This highlights the importance of avoiding hospitalizations due to diseases sensitive to primary care by health preventive actions and providing comprehensive care to the elderly. In addition, obtaining different explanatory models, according to kind hospital funding, demonstrates the importance of the organization in health services related to composition of costs of hospitalization among the elderly. Another question founded was the need that to improve the funding, we must use rationally the available resources by avoiding unnecessary hospitalizations of elderly people in the extremes of severity. On this kind of precarious funding, ICU hospitalization of elderly non-critical or in a terminal state can compromise the quality of services provided to those who really need intensive care.