Análise de conteúdo e validação clínica do diagnóstico de enfermagem autocontrole ineficaz da saúde

The study aims to analyze the content and measures of accuracy of the nursing diagnosis Ineffective Self Health in patients undergoing hemodialysis. Study of nursing diagnosis validation carried out in two stages, namely: content analysis by judges and accuracy of clinical indicators. In the first stage, 22 judges evaluated the setting and location of the diagnosis, clinical indicators and etiological factors and their conceptual and empirical definitions. We used the binomial test to determine the proportion of the judges of the relevance of the components of the nursing diagnosis. In the second stage, we used the Latent Class Analysis for the diagnostic accuracy by evaluating 200 patients in a hemodialysis clinic in northeastern Brazil. Research approved by the Ethics Committee, under the Opinion No 387 837 and CAAE 18486413.0.0000.5537. The results show that the judges evaluated as pertinent clinical indicators 12 and 22 etiological factors. Proposed amendment of the nomenclature of five indicators and six factors and the implementation of a clinical indicator for etiology and three etiological factors for clinical indicators. In conceptual and empirical definitions, judges judged as not relevant the conceptual and empirical definitions of a clinical indicator, the conceptual definitions of two etiological factors and empirical definitions four etiological factors. Still, changes were suggested in the conceptual and empirical definitions of two clinical indicators, the conceptual definitions of 12 etiological factors and empirical definitions of 11 etiological factors. Clinical indicators analyzed in the first stage were validated clinically in patients undergoing hemodialysis. The most frequent clinical indicators were Changes in laboratory tests (100%) and daily life choices ineffective to achieve health goals (81%); and three etiological factors had a higher frequency, they are: unfavorable demographic factors (94.5%), beliefs (79%) and comorbidities (77.5%). From Latent class analysis, diagnosis prevalence was estimated at 66.28%. Clinical indicators that showed the best sensitivity measures for the nursing diagnosis Ineffective Self Health were: daily life choices ineffective to achieve health goals and Expression of difficulty with prescribed regimens. In turn, the clinical indicators of inappropriate medication use, no expression of desire to control the disease, irregular attendance to the dialysis sessions and infection were more specific as to that diagnosis. Non-adherence to treatment was the only indicator that showed confidence intervals with values for sensitivity and specificity, statistically above 0.5, being the one who has better diagnostic accuracy as the inference of the nursing diagnosis Ineffective Self Health in hemodialysis clientele. Thus, it is believed that the improvement of the components of diagnosis in question will contribute to the development of more reliable nursing interventions to the health status of the individual in hemodialysis, providing a more scientifically qualified care.

Análise de conteúdo e validação clínica do diagnóstico de enfermagem autocontrole ineficaz da saúde

The study aims to analyze the content and measures of accuracy of the nursing diagnosis Ineffective Self Health in patients undergoing hemodialysis. Study of nursing diagnosis validation carried out in two stages, namely: content analysis by judges and accuracy of clinical indicators. In the first stage, 22 judges evaluated the setting and location of the diagnosis, clinical indicators and etiological factors and their conceptual and empirical definitions. We used the binomial test to determine the proportion of the judges of the relevance of the components of the nursing diagnosis. In the second stage, we used the Latent Class Analysis for the diagnostic accuracy by evaluating 200 patients in a hemodialysis clinic in northeastern Brazil. Research approved by the Ethics Committee, under the Opinion No 387 837 and CAAE 18486413.0.0000.5537. The results show that the judges evaluated as pertinent clinical indicators 12 and 22 etiological factors. Proposed amendment of the nomenclature of five indicators and six factors and the implementation of a clinical indicator for etiology and three etiological factors for clinical indicators. In conceptual and empirical definitions, judges judged as not relevant the conceptual and empirical definitions of a clinical indicator, the conceptual definitions of two etiological factors and empirical definitions four etiological factors. Still, changes were suggested in the conceptual and empirical definitions of two clinical indicators, the conceptual definitions of 12 etiological factors and empirical definitions of 11 etiological factors. Clinical indicators analyzed in the first stage were validated clinically in patients undergoing hemodialysis. The most frequent clinical indicators were Changes in laboratory tests (100%) and daily life choices ineffective to achieve health goals (81%); and three etiological factors had a higher frequency, they are: unfavorable demographic factors (94.5%), beliefs (79%) and comorbidities (77.5%). From Latent class analysis, diagnosis prevalence was estimated at 66.28%. Clinical indicators that showed the best sensitivity measures for the nursing diagnosis Ineffective Self Health were: daily life choices ineffective to achieve health goals and Expression of difficulty with prescribed regimens. In turn, the clinical indicators of inappropriate medication use, no expression of desire to control the disease, irregular attendance to the dialysis sessions and infection were more specific as to that diagnosis. Non-adherence to treatment was the only indicator that showed confidence intervals with values for sensitivity and specificity, statistically above 0.5, being the one who has better diagnostic accuracy as the inference of the nursing diagnosis Ineffective Self Health in hemodialysis clientele. Thus, it is believed that the improvement of the components of diagnosis in question will contribute to the development of more reliable nursing interventions to the health status of the individual in hemodialysis, providing a more scientifically qualified care.

Observação da ação na reabilitação do membro superior de pacientes com acidente vascular cerebral: uma revisão sistemática com metanálise

Background: stroke causes long-term impairments, limitation of activities and restriction in participation in daily life situations, especially for upper limb impairment (UL). Action Observation (AO) has been used for the rehabilitation of UL in these patients. It's a multisensory therapy which consists in observing a healthy subject performing a motor task, followed by physical practice. Objectives: assess whether the AO improves motor function of UL and dependence for activities of daily living (ADLs) of stroke patients or cause any adverse effects. Search methods: a search strategy was words and terms used for the identification of articles, in the following scientific basis Cochrane Central Register of Controlled Trials; MEDLINE; PsycINFO; CINAHL and LILACS. In addition to manual search of the references of articles and search for theses and dissertations in Portal Capes and LILACS. The identification of the studies was conducted from October to December 2015, being the last search on December 3. Selection criteria: randomised controlled trials (RCT) involving adults with stroke who had deficits in upper limb function and used AO as an intervention. Data collection and analysis: the data extracted from the studies were used to analyze the risk of bias, the effect of the treatment and the quality of the body of evidence. Main results: 6 studies were included, totaling 270 patients. The primary outcome analyzed was the motor function of MS. Were combined in meta-analyzes studies comparing AO versus placebo or an active control, considering the immediate and long-term effect (n=241). Regarding the motor function of the arm (5 trials), the estimated effect for the therapy was not significant. However, when considering the hand function estimating the effect was favorable to the group that conducted the AO, in short (mean difference = 6.93, 95% CI 1.48 to 12.39; P = 0.01) and long-term (mean difference = 7.57; 95% CI 1.34 the 13.80; p = 0.02). Unable to perform the analysis for functional dependency. The studies showed a low or uncertain risk of bias, but the quality of evidence the body was considered low and very low quality. Authors’ conclusions: AO was effective in improving hand function of stroke patients. Despite the low quality evidence that the use of OA in clinical practice should not be discouraged. RCT new studies should be conducted with greater methodological rigor and larger samples, covering important outcomes such as functional dependence for ADLs.

Ritmo circadiano de atividade motora e distribuição diária dos comportamentos afiliativos ao longo da fase juvenil em saguis (callithrix jacchus)

The temporal allocation of the active phase in relation to light and dark cycle (LD) changes during puberty in humans, degus, rats and rhesus. In marmosets, the animal model used in several biomedical researches, there is evidence of a delay at the beginning of the active phase and an increase in total daily activity after onset of puberty. However, as this aspect was evaluated in animals maintained in natural environmental conditions, it was not possible to distinguish between the effects of puberty and of seasonality. Furthermore, as motor activity is the result of different behaviors in this species, it is also important to characterize the diurnal distribution of other behaviors in juvenile stage. With the aim of characterizing the circadian rhythm of motor activity and the diurnal profile of affiliative behavior in marmosets, the motor activity of 5 dyads juveniles between 4 and 12 months of age and their parents was recorded continuously for actímetro. The families were maintained under artificial LD 12:12 h, constant temperature and humidity. The duration of grooming behavior, proximity and social play among juveniles was recorded 2 times a week in sessions of 15 minutes each hour of the active phase. Afetr onset of puberty in juvenile, it was observed that there was no change in the parameters of circadian motor activity rhythm which were common to most animals. Despite the absence of pubertal modulation, it was observed that the circadian activity profiles have stronger synchrony between individuals of the same family than that of different families, which may indicate that the circadian activity rhythm was modulated by the dynamics of social interactions. In relation to age, the total daily activity and the ratio between evening and morning activity (EA/MA) were higher in juveniles than in adults, which may be associated with differences in the circadian timing system between age groups. Furthermore, the onset of the 10 consecutive hours of higher activity (M10) occurred earlier in adult males than in other members of the group, probably as a way to avoid competition for resources in one of the first activities of the day that is foraging. During the juvenile stage, there was an increase in total daily activity that may be associated with increased motor ability of juveniles. In addition to the circadian activity rhythm, the daytime profile of proximity and social play behaviors was similar between the 5th and 12th month of life of juveniles, in which the interval between 7- 10 h in the morning showed the highest values of proximity and lower values of play social. Moreover, the duration of the grooming showed a similar distribution to adults from the 8th month, wherein the higher values occurring at the interval between 11 14 h of day. Considering the results, the parameters of the circadian activity rhythm had a greater influence of social factors than puberty. In relation to age, there were no changes related to the allocation of the active phase in relation to the LD cycle, but total daily activity, the ratio AV/AM and the start of the M10 is possible to observe differences between juveniles and adults

Atividade física na terceira idade: Uma análise de sua contribuições para o estilo de vida através das representações sociais

Temáticas emergentes e estratégicas da política de saúde em nível mundial têm suscitado reflexões para ações sócio educativas com idosos. Esta pesquisa questiona as aspirações desse segmento social face às experiências de qualidade proporcionadas pela atividade física. Objetivo: investigar as representações sociais da atividade física na terceira idade. Método: pesquisa de corte transversal com abordagem quanti-qualitativa. A amostra foi nãoprobabilística e por conveniência apoiada na Teoria das Representações Sociais e a Teoria do Núcleo Central. O estudo foi realizado com alunos de um projeto para a terceira idade com sede no Centro Federal de Educação Tecnológica do Rio Grande do Norte (CEFET), no município de Natal/RN, Brasil. Para a coleta dos dados utilizou-se de questionário semi-estruturado, composto de três partes: A Parte I, para a caracterização social da amostra e identificação da percepção da atividade física para a saúde; a Parte II, com evocação livre de palavras e a Parte III, com uma questão aberta. Análise dos dados: A exploração do material deu-se a partir dos seguintes softs: do SPSS para análise de freqüência simples (parte I); do EVOC (parte II) e do ALCESTE (parte III). Complementarmente, foi utilizada a análise de conteúdo a fim de inferir/corroborar sobre os núcleos de sentido da comunicação. Resultados: O núcleo central da representação foi composto por felicidade/saúde/dança e ginástica, revelando diferentes entendimentos e mostrando também que o conhecimento construído da atividade física assume um papel preponderante na vida de idosos, adquirindo gradativamente, a representação de vida com mais saúde e qualidade na velhice . A composição do núcleo central ao considerar elaborações mentais, emoções, práticas e explicações oriundas do cotidiano que se introduzem na constituição da representação social em foco, poderá influenciar as escolhas e estratégias de se desenvolver melhora nos padrões de saúde e na qualidade de vida dos idosos.

Impacto da atividade física na qualidade de vida em mulheres de meia idade: estudo de base populacional

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Prevalência de doença arterial obstrutiva periférica (DAOP) e alterações sensoriais em pacientes diabéticos tipo 2: impacto da DAOP sobre a qualidade de vida, nível de atividade física e composição corporal

Diabetes Mellitus (DM) affected approximately 171 million people in the world in the year 2000 as described by the World Health Organization (WHO). Because DM is a multisystem disease it can cause several complications especially those related to the cardiovascular system. The Peripheral Arterial Disease (PAD) of the lower limbs and the Diabetic Distal Symmetric Polyneuropathy (DDSP) can affect the DM patient causing consequences as the diabetic foot and eventually amputations. The main objective of this study was to determine the prevalence of PAD and sensorial impairment in 73 type 2 DM (DM2) patients and also assess the impact of PAD on quality of life, level of physical activity and body composition. For clinical assessment it was used: the ankle-brachial index (ABI); quantitative sensorial test for tactile sensibility (ST), pain (SD), vibration (SV); Achilles tendon reflex (RA); quality of life questionnaire (SF-36); modified Baecke physical activity questionnaire and bioelectric impedance. Prevalence of PAD in the studied population was 13.7%. ABI was inversely correlated to age (p=0,03; rhô= -0,26), diabetes duration (p=0,02; rhô= -0,28) and blood pressure (p= 0,0007; rhô= -0,33). There were lower scores for physical health summary on the SF-36 in DM2 patients; however, the presence of PAD predominantly mild did not significantly impact quality of life, body composition or physical activity level assessed by questionnaire. Fourteen patients (19.2%) present bilateral and symmetrical alterations in two or more sensorial tests compatible to DPN diagnosis. Abnormalities in ST, SD and SV were present in 27.3%, 24.6% and 8.2%; respectively. There was association of results from ST abnormalities with RA and mainly with SD, suggesting the importance of 10g monofilament use in DM2 routine assessment. In conclusion, the prevalence of PAD in subclinical DM2 was slightly higher compared to the general population and in agreement to previously published data in DM patients. The PAD severity was predominantly mild and still without repercussion on quality of life and body composition. Our study demonstrated a significant prevalence of both PAD and DPN in DM2 without previous diagnosis of these complications and indicates the necessity of early preventive and therapeutic interventions for this population

Controle circadiano e homeostático do sono-virgília em pacientes com acidente vascular encefálico e correlações com a qualidade de vida e o nível de atividade física

The cerebral vascular accident is a neurological dysfunction of vascular origin that leds to development of motor sensibility, cognitive, perceptive and language deficits. Despite the fact that the main sleep disorders in stroke patients are well known, it is still necessary to analyze which mechanisms of regulation of sleep and wakefulness are affected. The objective of this study was to evaluate the changes in the circadian and homeostatic control of sleep-wakefulness in stroke patients and the correlations with quality of life and level of physical activity. The study analyzed 22 stroke patients (55± 12 years old) and 24 healthy subjects (57 ±11 years old). The instruments used in this study were questionnaires on sleep quality, daytime sleepiness, quality of life, physical activity level and the actigraphy. The data were analyzed using the Student `t test, Mann-Whitney test, ANOVA and Spearman's correlation tests. The results showed stability in the sleep-wake circadian expression with changes in the amplitude of the rhythm. However, significant changes were found related to the homeostatic component characterized by increased sleep duration, increased latency, fragmented sleep and lower sleep efficiency. Additional data showed decreased quality of sleep and increased daytime sleepiness, as well as decreased quality of life and level of physical activity. The results indicate that the interaction of circadian and homeostatic control of sleep-wake is compromised and the main reason might be because of the homeostatic component and the lower activity level resulting from the brain damage. Thus, further studies may be developed to evaluate whether behavioral interventions such as increased daytime activity and restriction of sleep during the day can influence the homeostatic process and its relation to circadian component, resulting in improved quality of nocturnal sleep in stroke patients

Boto cinza (Sotalia guianensis, Van Benédén, 1864) (Cetacea, Delphinidae): Atividade aérea, forrageio e interações inter-específicas, na Praia de Pipa (Tibau do Sul RN) e estudo comparativo entre duas populações do Nordeste do Brasil

Sotalia guianensis is a small cetacean of the Delphinidae family, with coastal habits and whose area of distribution ranges from Florianópolis (27º35'S, 48º34'W), in Brazil, to Honduras (15º58'N, 85º42'W). At Pipa beach, on the south coast of RN state, in Brazil, the species occur throughout the year. The present study was carried out in two bays, which are bordered by cliffs. The animals were monitored from vantage points, using the "Ad libitum" and "all the occurrences" methods; during the years of 1999 and 2004. The study was divided in 4 chapters: Behavioral standards of two populations of gray dolphin, (Sotalia guianensis, Van Benédén, 1864) in the northeast of Brazil; Aerial activity of the gray dolphin: its possible function and the influence of environmental and behavioral factors; The influence of daily and monthly variation of the tides, of the period of the day and group size on the gray dolphin forage activity; kleptoparasitism interactions of frigatebird (Fregata magnificens, Mattheus, 1914) during the gray dolphin forage activity. The results have shown that the gray dolphin has a varied and complex behavioral repertoire. The leap is the most frequent behavior; the aerial activity is diffuse during daylight and is influenced by some factors, such as the level of the tide and social factors. The gray dolphin, when in the bay, most frequently feeds isolate or in small groups. The forage is diffuse during daylight; however, being more frequent in the morning and is influenced by the daily and monthly variation of the tide. At Pipa beach, kleptoparasitarian interactions were registered between the gray dolphin and the frigatebird (Fregata magnificens). The frigatebird forage strategy consists basically of two ways: to fly over great extensions searching for dead fish and to steal food (kleptoparasitism). These interactions were predominantly carried out between immature and female adult birds and adult and immature dolphins, and occurred during daylight. The present study can be considered an initial landmark to a better knowledge on the gray dolphin surface behavior, especially regarding the aerial behavioral repertoire and forage strategy of this species. However, it is necessary to continue these studies, so that we can understand better the complex social life of these animals and thus create effective measures for its conservation

Variação diária e anual de freqüência e atividade do Boto Cinza Sotalia guianensis em Pipa, Nordeste do Brasil

The aim of this study was to investigate the daily and annual variation in frequency and in activity of an estuarine dolphin population, Sotalia guianensis, in Brazilian northeastern. Thus we estimated the daily variation and seasonality in frequency of adult and immature and in behavior of socialization, aerial activity, foraging of a boto equatorial population in the Curral inlet (6º13 00 S; 35º3 36 W). We detect some variation. Thus we associate the daily variation with daily period, tide fluctuation and annual season. And the seasonality variation we associate with the fotoperíodo and precipitation variation. From October 1999 to September 2003, through collect four times at month, we made instantaneous record at each five minute in six hours of survey. The surveys hours were ranged into light time of 24 hours, that is, between 06:00 and 17:00 o clock. These observations were developed simultaneous for two observers in a land-based survey at coastline cliff top of which observer have a fully visualization of whole inlet. We found that animals were more active and frequent during the morning. They were more active during low tide than high tide. However they did not show association with tide. We found yet that in a period from June to November (winter-spring) there was the highest socialization, aerial activity and foraging frequency. However adult and immature individual number did not have significance variation along the year. The larger concentration of this behaviors were not associate with photoperiod neither precipitation in the region. These results showed the existence of behavioral daily variation and seasonality in a species that live in equatorial region

Contribuições da inserção musical para a qualidade de vida no trabalho em ambiente laboral fabril

The present thesis aimed at understanding how the insertion of music in the work environment contributes to achieving Quality of Work Life. - QWL, under the perspective of biopsychosocial and organizational well-being. As to music insertion we considered the theoretical-empirical perception about how music is inserted at work and its functions on such place. The context where the study was taken was the manufacturing area of a major textile company, located in Natal, state of Rio Grande do Norte, Brazil, in which music is used during labor activities. The only study case was the research strategy adopted, with exploratory and descriptive purposes. The primary data were collected through the focus group technique, applied to the collaborator in the manufacturing sector. The semi-structured interview was done as a complementary tool, directed to the supervisor in that sector. Respecting the theoretical saturation criterion, we formed four focus groups, each one composed of eight members randomly selected, among the seventy-six collaborators in the sector. The data were analyzed qualitatively, through the content analysis technique, more specifically the category analysis. We identified twenty-eight QWL attributes. Six of them were found present in the four focus groups and in the interview. Among these ones, the attribute of Interpersonal Relationship at Work, contemplating the Psychological and Organizational dimensions, was the only one anticipated in four out of fifteen theoretical models here listed. The attribute Music at Work Environment could be inserted in the four QWL dimensions, highlighting the power and relevance of this attribute for the research participants. The way music has been inserted in the labor environment contributes to promoting well-being at work, which goes against theoretical conceptions, especially when it comes to musical genre. We identified nine functions of music at work, among which, Improving Work Conditions, Improving Interpersonal Relationship at Work and Favoring Motivation for Work had to be emphasized for being associated to three QWL attributes. In the total, we highlighted seven associations. The most affected QWL dimension through the insertion of music at work was the Psychological one, followed by the Organizational one. We conclude that music insertion provides biological, social and, above all, psychological and organizational well-being to the contributors, thus contributing to obtaining QWL at the labor environment researched. However, we should consider the context and proceed to periodical plans and adjustments in the way of music insertion so as to avoid health and well-being problems to those people at work

Relação entre ciclo de vida do produto turístico e estratégias de cooperação na faixa litorânea urbana do município de Natal

Tourism in the Northeast of Brazil was introduced as an alternative economic development for the Region by federal promoting policies that focused primarily in structuring the local geographic area. With the completion of these structuring actions, mass tourism expanding the area, as well as spread actions based on cooperation and formalization of governance institutions. This study aimed to examine the relationship between the life cycle of the tourism product 'Coastal Cities of Natal and the cooperation strategies in a historical perspective. Thus was submitted to the life cycle of the tourism product 'Coastal Cities of Natal ; the major projects of tourism development were mapped, the existing cooperation strategies were characterized, and investigated the influence of the cooperation actions for the current stage of product. The specific theoretical support to tourism was built on the perspective of the Theory of Population Ecology, System of Tourism and Touristic Product Life Cycle. Regarding to cooperation the theoretical foundation addressed issues of strategy, New Forms and Collective Efficiency. The survey consisted of a causal descriptive study, using a case study. We used the qualitative and quantitative methodological approaches, and data collected by consulting of secondary data and semistructured interviews with twelve staff working in tourism in Natal. Results showed that the life cycle graph of product 'Coastal Cities of Natal is moving from one stage of growth to a stage of maturity, with a primary upward trend and with crises that are up over the graph. They have been mapped six of tourism development projects of relevance to the product: The Politics of Mega Projects, PRODETUR/NE, Municipalization National Program of Tourism, Regionalization Program, Urbanization Project Beach do Meio and Actions for the Promotion of Destiny. They have been identified sixty-four participating players in process of tourism development, which twenty were considered relevant to the respondents. The main strategies identified for cooperation were the consortium, collective strategy and clusters. Results indicated that co-operation strategies were adopted so that the benefits were obtained at the collective level, dedicated to the strengthening of Natal Destiny and its products. The main reasons were the need of cooperative marketing, international market entry and actions inducing the state. Finally, it was concluded that strategies for cooperation related to product life cycle 'Coastal Cities of Natal' as that work in the consolidation of projects for development of tourism, when the efficiency of collective action is achieved

Impactos sociais da atividade turística: um estudo de caso em Tibau do Sul/RN

This study has been presented for the Master in business of the Universidade Federal do Rio Grande do Norte, the objectives are evaluate the social impacts of the tourism in the community of Tibau do Sul in the state of Rio Grande do Norte. The research is a study of case and the analysis is qualitative and quantitative. The tourism is considerate for many people as an important source of richness, job and an important economic activity. However, for being an activity that involves as main element people, It can cause impacts, could these are beneficial or malign. To evaluate the community's perception about these impacts, it was applied a questionnaire returned to the perceptions of them about the next social indicators: health, job, security, education and life quality. Considering the advent of the tourist activity in a period fifteen year. Through the research could conclude that, of general form the population realizes the changes occurred in the municipal district of positive way. Except for some indicators that receive negative evaluation

De gata borralheira a Cinderela :nova espacialidade decorrente do desenvolvimento turístico, diferenciada pelo estilo de vida em Ponta Negra, Natal, RN

The transformations economical, social and politics in you finish them decades of the century XX brought changes that didn't just limit to the production system. The flexible accumulation took many workers lost her/it their workstations and they look for her/it new survival forms, migrating for administrative activities, of services rendered and for the tourist activity of small and medium load. The State has been investing in the implantation of plans of tourist development in order to create favorable conditions for the reproduction of the tourist activity in Brazil, mainly in the Northeast. A space when it starts to present a predominant economical activity suffers a restructuring in their social and economical relationships. The restructuring of these relationships takes to the construction of a new espacialidade. In the city of Christmas, in Rio Grande do Norte, the neighborhood of Black Tip is the most representative of the public investments for the tourist development. After intense process of tourist urbanization, Black Tip passed interfering in the global context consolidating as the tourist locus in the city. The tourist urbanization of the neighborhood took to the transformation of the space in merchandise that is sold and consumed as such. The recreation of fragments of other cultures brought by social actors, resulting from migratory processes stimulated by the tourist development, it has been presenting ruled social relationships in the informational technology, consumption of global goods and in the fragmentation of the urban space characterized by the internationalization and cosmopolitização. That process has been masking the inequalities partners and cultural as well as the territorial appropriation for an economical elite. The spaces are being appropriate for investors of the tourist section, private investors, agents and real estate producers, where the inequality is not just economical, but also cultural. The local population, mainly of the urban fraction of the Town of Black Tip, it doesn't participate of the productive process in function of the little or any professional qualification and he/she doesn't also have access to the consumption process. To the native ones it remains the fight for the preservation of his/her cultural identity and for the survival

Uma cidade em transformação: a influência da atividade do crediário nas mudanças da paisagem urbana de Tenente Ananias-RN

Studies on the urban landscape and on the changes of the urban space are relevant, since they reveal the economic dynamics and the way of life in the cities. Research on small towns, in particular, can display particular aspects and by so doing broaden the comprehension of this theme. The purpose of this research is to analyze the changes in the urban landscape and in the way of life of the inhabitants of the town of Tenente Ananias-RN that have been taking place since the 1990s up to the present (2013) and which result mainly from the commercial activity of crediário. The study is, therefore, a reflection on the impact of crediário economy on the urban landscape and on the way of life of a small town located in the hinterland of the State of Rio Grande do Norte. For this reason, it was necessary to study the landscape and the way of life found in Tenente Ananias in two moments: a) before the rise of the crediário, a period of time ranging from the town‟s initial emergence until the beginning of the 1990s; b) during the progress of crediário activity, from the beginning of the 1990s, when it starts, up to the present (2013). For this research, primary data (interviews, local survey visits) and secondary data (books, articles, reports, census data) were used. As a result of this study, it was possible to conclude that crediário plays a fundamental role for the explanation of the changes taking place in Tenente Ananias-RN, especially in the urban landscape and in the way of life of people. We have attempted, through this research, to contribute to the studies of a historical, social and economic process related to the urban landscape and space of a small town in the State of Rio Grande do Norte