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.

Aumento da jornada de trabalho :qual a repercussão na vida dos trabalhadores da enfermagem?

The worker of the public service is loosing your acquisitive power by means of the politics of fiscal settlement. The ways out that were found in the health sector, especially in nursing, is being the increasing workday for beyond 40 or 20 hours established in the link of the work with the state. This survey has the object to identify the possible repercussion of the increasing workday in daily life workers from nursing in the public service of Rio Grande do Norte. The theory reference used was the work of Marx (1982) and Antunes (2000,2001) and the daily living in Heller (1991,1992). The methodology used was a qualitative survey in the exploration kind. The informations were gathered through interviews with open questions almost structured with workers of nursing, managers and representatives of entity. The analysis of informations were made through general categories, work, and daily life, using elements from dialetics-hermeneutics according to Minayo (1992,2002). In the analysis, it was identified that the ways that were found for the overcoming of the loss of acquisitive power were the many-employment; the extra scale of shift; the subletting of work posts and the substitution of friends in scales of work, and all of them being changed in increase. Other aspect realized was the move of rights, like vacation and medical license for the workers that act in extra scale. The tiredness, stress, and bad humor are influents factors in the development of work.. The reduction of free time makes in the workers ahguish because of the familiarity decreasement just as time to dedicate themselves to the technical-scientific improvement and for the cultivation of other aspects of subjectivity, as leisure, care and culture. The low salary and the non reajustment are the reasons for the adoption of part workers for the increasing workday, and government has been responsible for this situation. The conclusion was that the increasing workday has strong repercussions in the professional and personal daily life workers that made part of the survey

Concepções de policiais militares sobre cuidados com a saúde

A ausência de cuidados do homem com a saúde representa um fenômeno significativo, pois contribui para o aumento da morbidade e mortalidade masculina por causas evitáveis. Essa realidade torna-se mais relevante quando se trata do policial militar, devido às peculiaridades do seu processo de trabalho. Visto isso, considera-se que os cuidados de saúde adotados por policiais militares atrelam-se ao entendimento de que possuem sobre os agravos à saúde, o qual perpassa por concepções de gênero e da profissão. Isso levou ao seguinte questionamento: Como o policial militar concebe os cuidados com a saúde. Objetivou-se analisar concepções de policiais militares sobre cuidados com a saúde. Trata-se de um estudo exploratório e descritivo, com abordagem qualitativa, desenvolvido junto a um Batalhão Militar do Comando de Policiamento de Natal, Rio Grande do Norte, Brasil. A coleta de dados foi realizada no período de junho a julho de 2013. Essa etapa foi antecedida pela anuência do Comandante Geral da Polícia Militar do Rio Grande do Norte, sob a aprovação do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, com o CAAE nº 15449713.7.0000.5537, e autorização formal dos entrevistados mediante a assinatura do Termo de Consentimento Livre e Esclarecido (TCLE), atendendo às exigências da Resolução 466/2012, do Conselho Nacional de Saúde, no que se refere à pesquisa com seres humanos. Participaram do estudo 21 policiais militares, do sexo masculino, que trabalhavam no policiamento ostensivo, não estavam de licença médica e apresentaram condições psicológicas e/ou físicas favoráveis para responder aos questionamentos. Os dados foram coletados por meio de entrevista semiestruturada mediante um roteiro constituído de duas partes: a primeira com questões sociodemográficas com vistas à caracterização dos participantes da pesquisa e a segunda com duas questões norteadoras relativas ao objeto de estudo. Os depoimentos foram tratados conforme o método de análise de conteúdo na modalidade de análise temática segundo Bardin. Desse processo, emergiram três categorias: hábitos de vida de policiais militares, repercussão do trabalho na saúde de policiais militares e atitudes de policiais militares em frente dos problemas de saúde. A análise dos dados foi subsidiada pelo referencial teórico do Modelo de Crenças em Saúde (Health Belief Model), de acordo com as variáveis vulnerabilidade e barreiras . Para respaldar a discussão dos resultados, buscou-se na literatura conhecimentos acerca da saúde do homem e do policial militar. Os resultados apontaram que os entrevistados procuram cuidar da saúde com práticas de exercícios físicos, alimentos saudáveis e preservação do sono. No entanto, vivenciam dores de coluna, ganho de peso, dificuldades para dormir, estresse e sofrimento psicológico. Diante disso, eles buscam apoio quando acometidos por agravos à saúde e reconhecem a necessidade de medidas de segurança durante o serviço. Portanto, notam a sua condição de vulnerabilidade em decorrência de seu ofício, porém enfrentam dificuldades na adoção de práticas preventivas de agravos a saúde. Mediante os resultados, faz-se necessário que o enfermeiro atuante junto a este público elabore, implemente e acompanhe estratégias de atenção a sua saúde

Utilização do controle estatístico do processo para monitoramento do peso médio de cápsulas de Tuberculostáticos: estudo de caso no NUPLAM- RN

This Master Thesis presents a case study on the use of Statistical Process Control (SPC) at the Núcleo de Pesquisas em Alimentos e Medicamentos (NUPLAM). The SPC basic tools have been applied in the process of the tuberculostáticos drugs encapsulation, primarily concerning the objective to choose, between two speeds, which one is the best one to perform the tuberculostatics encapsulation. Later on, with the company effectively operating, the SPC was applied intending to know the variability of the process and, through the tracking of the process itself, to arrive at an estimated limit for the control of future lots of tuberculostatics of equal dosage. As special causes were detected acting in the process, a cause-and-effect diagram was built in order to try to discover, in each factor that composes the productive process, the possible causes of variation of the capsules average weight. The hypotheses raised will be able to serve as a base for deepened the study to eliminate or reduce these interferences in the process. Also a study on the capacity of the process to attend the specifications was carried out, and this study has shown the process´s inaptitude to take care of them. However, on the side of NUPLAM exists a real yearning to implant the SPC and consequently to improve the existing quality already present on its medicines

Análise pelo Supply Chain Management da cadeia produtiva da castanha de caju no Rio Grande do Norte

This work presents the cashew nuts chain in the State of Rio Grande do Norte between 1960 and 2009. The main purpose of this research was to find the reason of the low productivity of the cashew nut in this state, identifying in the cashew's chain production the struggling points which were limiting the commerce of this product through the distribution network. Therefore, the Supply Chain Management was used as a logistic analysis methodology, focusing on relationships management between the nodes of this chain, from the producer until the final customer. Many problems were found: first, the precarious production conditions of the small producer don't lead to reach the demanded productivity by the market. The distance, the lack of communication of the small producers among themselves and an archaic way of dealing with their businesses, may be an explanatory reason for this problem, considering that those factors are the main elements which contribute for the weakening of the small producer placed in the productive chain. Another spotted point was that the business-oriented relationship between the producer and the local trader does not allow the small producer's economical development, which interferes in any technological investment to reach a good quality production that fulfills the market demand. And also, the fact that there is a tendency of the final costumer to require lower prices day-byday, forcing a pressure on the nodes transferring to the other and successively until arriving at the producer who inevitably is suffering the biggest impacts from this mentioned pressure.

Gestão ambiental: um estudo sobre a percepção do problema da desertificação no Estado do Rio Grande do Norte

The objective of this study was to investigate the environmental perception of: People with common-sense knowledge on the desertification process in RN. People with scientific knowledge on the desertification process in RN. Focal points in the combat at desertification of the RN and public ministery representant with actions in interinstitutional articulations promoter (and/or relative actions) at the desertification process in the RN. The research was carried in the city of Natal-RN and in two small cities of the Seridó region (RN): Caicó and Currais Novos. The research carried, is classified as exploratory and 22 people were interviewed. The research includes: The propension/intensity of the desertification in the RN and in the Seridó region; Evaluation of the knowledge of those interviewed, concerning the subject desertification ; Problems in order to combat desertification; Causes of desertification; The profile of the interviewed. The results of this present study indicate that the a desertification process is more agressive in the Seridó region than in the state of RN, being the two following: the absence of preocupation of the affected population with the process and the escarcity of governamental recurses, indicates how problems greather in the combat to the phenomen. Decreasing of produtivity in the agriculture and increasing of the migration to the urbans centers have been the main consequences of the process, that have at water scarcity, deforestation and extraction of argil (being this, regional factor), relevant variables in the influence to the surgiment of the desertification process of the RN

Utilização do Balanced Scorecard na gestão pública : um estudo de caso na Polícia Militar do Estado do Rio Grande do Norte

This dissertation deals with the use of the Balanced Scorecard (BSC) in the Military Police of Rio Grande do Norte (PMRN), an organization of service delivery in the area of public safety. For this purpose we sought refuge in the company's own documents, which presented the mission, vision and strategic objectives, which are items essential to the development of the instrument and its prospects. With the general objective of developing the BSC to PMRN, fitting into the methodology in a single case study, that from the desk study and according to their development, we established the classification of goals to the generic models and the BSC then adjusted according to public understanding of the corporation presented by professionals in the process of collection and in-depth interviews. Thus emerged the strategy map PMRN, based on the presentation of the causes and effects between the strategic objectives of each perspective, the value proposition to customers, internal processes needed to meet this value proposition and intangible assets, which are the basis to execute these processes

Análise preditiva a partir da caracterização das emissões gasosas e do óleo lubrificante em frotas com motorização a diesel

This work was motivated by the importance of conducting a study of vehicle emissions in captive fleets with diesel engine, coupled with the predictive maintenance plan. This type of maintenance includes techniques designed to meet the growing market demand to reduce maintenance costs by increasing the reliability of diagnoses, which has increased interest in automated predictive maintenance on diesel engines, preventing problems that might evolve into routine turn into serious situations, solved only with complex and costly repairs, the Reliability Centered Maintenance, will be the methodology that will make our goal is reached, beyond maintaining the vehicles regulated as fuel consumption and emissions. To Therefore, technical improvements were estimated capable of penetrating the automotive market and give the inshore fleet emission rates of opacity of the vehicles, being directly related to the conditions of the lubricating oil thus contributing to reducing maintenance costs by contributing significantly to emissions of pollutants and an improvement in the air in large cities. This criterion was adopted and implemented, em 241 buses and produced a diagnosis of possible failures by the correlation between the characterization of used lubricating oils and the analysis of opacity, with the objective of the aid the detection and solution of failures for the maintenance of sub-systems according to design criteria, and for this to be a deductive methodology to determine potential causes of failures, has been automated to implement a predictive maintenance system for this purpose was used in our study a mobile unit equipped with a opacimeter and a kit for collection and analysis of lubricating oil and the construction of the network diagnostics, we used a computer program in Microsoft Office Access 2007 platform tool is indispensable for creating a database data, this method is being used and successfully implemented in seven (7) bus companies from the city of Natal (RN) Brazil

Análise da bacia hidrográfica do Rio Punaú-Rio Grande do Norte utilizando ferramentas de geoprocessamento

Provide data and information on watershed becomes important since the knowledge of their physical characteristics, land use, etcetera, allows for better planning and sustainable use of economically, socially and environmentally in this area. The investigation of the physical environment has been commonly given with the use of geoprocessing, which has proved a very efficient tool. Within this context, this research aims at analyzing the river basin Punaú (located in the cities of Touros, Rio do Fogo and Pureza, state of Rio Grande do Norte) in several aspects, using geoprocessing as a tool of work, to provide information about the entire watershed. Specifically, this study aimed to update pre-existing maps, such as geological, geomorphological and land use, generating map of environmental vulnerability, under the aspect of erosion susceptibility of the area, generating map of legal incompatibility, identifying areas that are already being employed in breach of environmental legislation; propose solutions to the occupation of the river basin Punaú, focused on environmental planning. The methodology was based on the use of geoprocessing tools for data analysis and to make maps of legal incompatibility and environmental vulnerability. For the first map was taken into account the environmental legislation regarding the protection of watersheds. For the vulnerability analysis, the generated map was the result of crossing the maps of geology, geomorphology, soils and land use, having been assigned weights to different attributes of thematic maps, generating a map of environmental vulnerability in relation to susceptibility to erosion. The analysis results indicate that agriculture is the most significant activity in the basin, in total occupied area, which confers a high degree of environmental vulnerability in most of the basin, and some agricultural areas eventually develop in a manner inconsistent with Brazilian environmental legislation. It is proposed to consider deploying a measure of revitalization of the watershed in more critical areas and conservation through mitigation measures on the causes of environmental degradation, such as protection of water sources, protection and restoration of riparian vegetation, protection of permanent preservation areas, containment of erosion processes in general, and others listed or not in specific laws, and even the establishment of a committee of basins in the area

Avaliação do desenvolvimento sustentável na bacia hidrográfica do Rio Seridó em face das políticas públicas e da gestão dos recursos hídricos

The reality of water resources management in semiarid regions, such as the Seridó region, has been shaped by a complex chain involving social-cultural, political, economic and environmental aspects, covering different spheres of activity - from local to federal. Because water is a scarce element, the most rational way pointed out by our recent history has been to move towards an increasing emphasis on the need for a truly rational, integrated, sustainable and participatory water resources management, supported by legislation and by a network of institutions that could materialize it. In this sense, despite all the advances in the formulation of public policies in water resources, which ones have indeed lead to significant changes that have occurred or are underway in semiarid regions such as Seridó? What factors may be preventing the realization of the desires rationality embedded in the framers of water policies intents? How to properly manage water resources if the current actors who promote their management and the political, human, cultural and institutional processes that intervene in this management, show strong traces of unsustainability? The research methodology adopted in this paper led to a breakdown of the traditional approach to water resource management, to integrate it into other areas of knowledge, especially to political science and public administration, catalyzed by the concept of "sustainable development". From a broad, interdisciplinary literature review, an exhaustive characterization of the river basin Seridó, a set of interviews with key people in the public administration acting in the region, a series of diagnoses and a set of propositions were made in order to correct the direction of current public policies for the region. From the point of view of public policies, it is in the deployment phase, not in its formulation, which lies a major problem of the lack of significant progress in water management. The lack of coordination between government programs are well characterized, as well as the lack of efficiency and effectiveness of their actions. The causes of this secular model are also discussed, including political factors and social relations of production, which led to a stalemate difficult, but of possible solution. It can be perceived there is a scenario of progressive deterioration of natural resources of the fragile ecosystem and a network of environmental and social consequences difficult to reverse, the result of a persistent and inertial sociopolitical culture, whose main factors reinforce itself. The work leads towards a characterization of the water resources management also from the perspective of environmental, institutional, political and human sustainability , the latter being identified, particularly as investment in the development of people as autonomous beings - not based in ideological directives of any kind - in the emancipation of the traditional figure of the poor man of the hinterland" to the "catalyst for change" responsible for their own decisions or omissions, based upon an education for free-thinking that brings each one as co-responsible epicenter of (self-) sustainable changes in their midst

Simulação do sistema de esgotamento sanitário de Ponta Negra- Natal: mitigação dos riscos ambientais e estratégia de manutenção preditiva

The simulation of SES-Natal Ponta Negra: mitigation of environmental risks and predictive maintenance strategy was developed in the context of several operational irregularities in the pumping stations and sewage systems in the system Ponta Negra. Thus, the environmental risks and complaints against the company due to overflows of sewage into the public thoroughfare became common. This neighborhood has shown in recent years an increase of resident higher than the initial expectation of growth. In this sense presumed the large population growth and generation of sewers higher than expected, associated to the use of corrective maintenance and misuse of the system may be the main causes of operational failures occurring in the SES. This study aimed at analyzing the hydraulic behavior of SES Ponta Negrathrough numerical simulation of its operation associated to future scenarios of occupation. The SES Ponta Negra has a long lengthof collection networks and 6 pumping stations interconnected, being EE 1, 2, 4 coastal way, and beach Shopping interconnected EE3 to receives all sewers pumped from the rest pumping station and pumped to the sewage treatment station of neighborhood which consists of a facultative pond followed by three maturation ponds with disposal of treated effluent into infiltration ditches. Oncethey are connected with each other, the study was conducted considering the days and times of higher inflow for all lifts. Furthermore, with the aim of measuring the gatherer network failures were conducted data survey of on the networks. Thephysical and operational survey data was conducted between January/2011 and janeiro/2012. The simulation of the SES was developed with the aim ofdemonstrating its functioning, eithercurrently and in the coming years, based in population estimates and sewage flow. The collected data represents the current framework of the pumping stations of the SES Ponta Negra and served as input to the model developed in MS Excel ® spreadsheet which allowed simulating the behavior of SES in future scenarios. The results of this study show thatBeach Shopping Pumping Station is actually undersized and presents serious functioning problemsthatmay compromise the environmental quality of surrounding area. The other pumping stations of the system will reach itsmaximum capacity between 2013 and 2015, although the EE1 and EE3 demonstrateoperation capacity, even precariously, until 2017. Moreover, it was observed that the misuse of the network system, due to the input of both garbage and stormwater, are major factors of failures that occur in the SES. Finally, it was found that the corrective maintenance appliance, rather than predictive,has proven to beinefficient because of the serious failuresin the system, causing damage to the environment and health risks to users

Modalização autonímica: um estudo de utilização e apropriação do discurso sobre os conceitos de variação e de mudança na escrita de dissertação de mestrado de 1970 - 2011

Universidade Federal do Rio Grande do Norte

O princípio metafísico da poética de Aristóteles

Aristotle's definition of tragedy indicates a metaphysical project insinuated by a notion of kátharsis. The reconstruction of Aristotle's method of definition is inspired in the concepts of enérgeia and dýnamis taken from Physics, understanding cause as substance. The Doctrine of the Four Causes is the theoretical basis of the definition of tragedy, placing tragedy in the genre of imitation and distinguishing its species: language (material cause), noble and complete action (formal cause), actors (efficient cause) and kátharsis (temporarily identified with the final cause). Nevertheless, there is no final cause in the definition of tragedy. The kátharsis of passions is experienced by the spectator when he witnesses tragedy, which is the imitation of a noble action, executed by actors and not narrated. Aristotle justifies hid proposition in favor of mimesis by assuming that imitation is natural to man since infancy and the view of objects allows whoever contemplates them to identify and learn the originals. As a metaphysical principle, kátharsis is projected to beyond definition of tragedy, where it is manifested cathartically, in the spectator. Research about the spectator brings one back to the definition of tragedy, where the imitation is an imperfect copy which evokes in the spectator the presence of the originals of the imitated sentiments, thus realizing the kátharsis of these emotions. In this way kátharsis reveals itself as selfknowledge and approach of divine truth and perfections.

Desempenho motor de pacientes com acidente vascular cerebral em um jogo baseado em realidade virtual

The Cerebral Vascular Accident (CVA) is the leading cause of motor disability in adults and elderly and that is why it still needs effective interventions that contribute to motor recovery. Objective: This study was aimed to evaluate the performance of stroke patients in chronic stage using a virtual reality game. Method: 20 patients (10 with injury to the left and 10 to the right side), right-handed, average age 50.6 ± 9.2 years, and 20 healthy subjects with average age of 50.9 ± 8.8, also right-handed participated. The patients had a motor (Fugl-Meyer) and muscle tone assessment (Ashworth). All participants made a kinematic evaluation of the drinking water activity and then underwent training with the table tennis game on XBOX 360 Kinect®, 2 sets of 10 attempts for 45 seconds, 15 minutes rest between sets, giving a total of 30 minutes session. After training the subjects underwent another kinematic evaluation. The patients trained with the right and left hemiparect upper limb and the healthy ones with the right and left upper limb. Data were analyzed by ANOVA, t Student test and Pearson correlation. Results: There was significant difference in the number of hits between the patients and healthy groups, in which patients had a lower performance in all the attempts (p = 0.008), this performance was related to a higher level of spasticity (r = - 0.44, p = 0.04) and greater motor impairment (r = 0.59, p = 0.001). After training, patients with left hemiparesis had improved shoulder and elbow angles during the activity of drinking water, approaching the pattern of motion of the left arm of healthy subjects (p < 0.05), especially when returning the glass to the table, and patients with right hemiparesis did not obtain improved pattern of movement (p > 0.05). Conclusion: The stroke patients improved their performance over the game attempts, however, only patients with left hemiparesis were able to increase the angle of the shoulder and elbow during the functional activity execution, better responding to virtual reality game, which should be taken into consideration in motor rehabilitation

Fisioterapia respiratória em crianças com pneumonia: revisão sistemática

Introduction: Pneumonia is an inflammatory lung disease and it is the greatest cause of deaths in children younger than five years of age worldwide. Chest physiotherapy is widely used in the treatment of pneumonia because it can help to eliminate inflammatory exudates and tracheobronchial secretions, remove airway obstructions, reduce airway resistance, enhance gas exchange and reduce the work of breathing. Thus, chest physiotherapy may contribute to patient recovery as an adjuvant treatment even though its indication remains controversial. Objectives: To assess the effectiveness of chest physiotherapy in relation to time until clinical resolution in children (from birth up to 18 years old) of either gender with any type of pneumonia. Methods: We searched CENTRAL 2013, Issue 4; MEDLINE (1946 to May week 4, 2013); EMBASE (1974 to May 2013); CINAHL (1981 to May 2013); LILACS (1982 to May 2013); Web of Science (1950 to May 2013); and PEDro (1950 to May 2013). We consulted the ClinicalTrials.gov and the WHO ICTRP registers to identify planned, ongoing and unpublished trials. We consulted the reference lists of relevant articles found by the electronic searches for additional studies. We included randomised controlled trials (RCTs) that compared chest physiotherapy of any type with no chest physiotherapy in children with pneumonia. Two review authors independently selected the studies to be included in the review, assessed trial quality and extracted data. Results: Three RCTs involving 255 inpatient children are included in the review. They addressed conventional chest physiotherapy, positive expiratory pressure and continuous positive airway pressure. The following outcomes were measured: duration of hospital stay, time to clinical resolution (observing the following parameters: fever, chest indrawing, nasal flaring, tachypnoea and peripheral oxygen saturation levels), change in adventitious sounds, change in chest X-ray and duration of cough in days. Two of the included studies found a significant improvement in respiratory rate and oxygen saturation whereas the other included study failed to show that standardised respiratory physiotherapy and positive expiratory pressure decrease the time to clinical resolution and the duration of hospital stay. No adverse effects related to the interventions were xvi described. Due to the different characteristics of the trials, such as the duration of treatment, levels of severity, types of pneumonia and the techniques used in children with pneumonia, as well as differences in their statistical presentation, we were not able to pool data. Two included studies had an overall low risk of bias whereas one included study had an overall unclear risk of bias. Conclusion: Our review does not provide conclusive evidence to justify the use of chest physiotherapy in children with pneumonia due to a lack of data. The number of included studies is small and they differed in their statistical presentation