Avaliacão da satisfação do usuário e da qualidade dos tratamentos endodônticos em Centros de Especialidades Odontológicas da Grande Natal-RN

Objective: To evaluate the degree of users satisfaction and technical quality of endodontic treatment in specialized dental clinics (CEO) of Grande Natal / RN between 2006 and 2008. Methodology: evaluated 282 endodontically treated teeth in CEOs through clinical and radiographic examinations. A questionnaire about the clinical condition of the tooth, evaluation of care and satisfaction with treatment was applied. Data on pre-and trans-operative were noted by the patient's clinical record. Endodontically treated teeth were examined by a specialist in endodontics, which compared with previous radiographs and current ones. The collected datas were presented descriptively by absolute numbers, percentages, averages. To determine the association between the independent and dependent variables was carried out through the bivariate association test Chi-square and Fisher exact test. Results: 79.8% presented with radiographic normal and 84.4% without pain symptoms. 8.2% of the teeth were fractured and 3.2% extracted. The persistence of the periapical lesion was associated with initial periapical status (p <0.05). 91.5% of patients are satisfied with the outcome of treatment. Such satisfaction is associated with absence of pain and an adequate esthetic tooth position (p <0.05). Conclusion: endodontic treatment in specialized dental clinics have an adequate technical quality, resulting in the success of endodontic therapy performed in these centers and that users are satisfied with the treatment

Da acusação às professoras pelo aprisionamento do sujeito em um diagnóstico a uma interrogação acerca da posição do analista

This study arises with two questionings: what is the usefulness of a diagnosis in school? And what moves that demand for diagnosis? Such questions were drawn up in answer to a diagnostic demand produced in the context of our internship in Scholar/Educational Psychology. On the perspective of working these issues, we conducted a literature research on diagnosis, with regard to its history, as a review of the psychoanalytic literature about the subject. This venture led us to a new interrogation: what are the elaborations that teachers produce from the child diagnosis, which place her as having special educational needs? The need of deciding the method that would lead us to answer such question, taking as reference the psychoanalytic theory, led us to an incursion to the subject research in psychoanalysis. This tracking points us that, according to Freud, on what comes to psychoanalysis, theory and research go together and that psychoanalysis is not a totalitarian world vision. On Lacan, the research is from the analysand, research that always implies the analyst and its praxis. Such path forced us to position a change to question the positions we occupy, in this experience, guided by an analytical listening. To discuss our position, we started from two cases and submitted them to construction and analysis. As a result, we found out that there is no way to know in advance what will be done from a diagnosis, which will be its uses. Point we used to considerate devastating to a child. So, to us, all children that received a diagnosis would be destined to a tragedy and what the research has shown us is that not always, not all of them. Thus, more than knowing what moves the demand, the important is the subject uses and our position towards it so they can generate a work

Imagem sócio-ambiental do bairro de Cidade Nova, Natal-RN, por seus moradores

This dissertation investigates how the neighborhood of Cidade Nova, located in the western side of the of Natal, is perceived by its residents in order to understand its socio-environmental image, intending to contribute both to define strategies of urban intervention and environmental education in the area and to consolidate a methodology that addresses this kind of problem. The completion of field research used a multimethod strategy to study the socio-environmental image of urban areas. It consists of: (a) review of local history from literature research, data recorded by the City Hall, news published on the city's newspapers and interviews with former inhabitants, (b) application of questionnaires to inhabitants including emotions, visual perception, memory and local social activities, (c) development of a drawing of the district, (d) conducting focus groups with inhabitants, using as a starting point the results obtained in the previous activities. In steps "b" and "c" attended 32 neighborhood residents, 16 of them being Community Health Workers and other 16 persons appointed by them. In step "d" 10 individuals took part, divided into two groups. The result of the research showed a picture of residents coincident with the image conveyed by the media in relation to the issues: violence, garbage, public policy/social support and appreciation of the beauties of environmental (dunes and Parque da Cidade park). Although Cidade Nova has been regarded as a dirty, noisy and dangerous place, most of the participants say they enjoy living on the neighborhood. Overall, the results corroborate and gain theoretical explanations, as they are interrelated. The socio-environmental image is expressed for instance in the elements dunes, dump, railroad tracks and Central Avenue that gain symbolic connotation influenced by time and socio-economic context. The insecurity and other negative characteristics assigned by the inhabitants and the media are parallel to the place attachment, since the environmental legibility, the time/familiarity and territoriality offer inhabitants the preference for place of residence, setting up their social identity.

Percepção de estigma e qualidade de vida em crianças com neoplasia

The increase in survival time and cure requires more extensive care about the quality of life of cancer patients, which begins soon after diagnosis. Thus, it seems reasonable to the emphasis on development of studies covering the psychosocial variables, such as stigma, treatment of childhood cancer aiming thereby to the attention of the overall needs of the child. Thus, this research aims to investigate the perception of stigma and quality of life in children with cancer. This is a cross-sectional research and understanding of the descriptive type, the type specimen being adopted for convenience. This consisted of thirty children with cancer and thirty children without chronic disease. The instruments used were the Quality of Life Questionnaire, the Perceived Stigma Scale and Technical Drawing Story with a Theme. The results indicate that the chronic condition, no interfered significantly in satisfaction with the quality of life in children with cancer and identified that the quality of life is not related to the stigma. Comparison with children with no chronic disease with infants with cancer, no significant differences were observed. However, the group mean contrast was lower, suggesting a greater impairment in quality of life of children with cancer compared to those without chronic disease. It is worth noting that the psychosocial effects and the limitations imposed by disease and treatment are presented as important factors in the design mode of subjective manifestations of children with cancer. Therefore, it is expected that knowledge elucidated by this study will assist, greatly to the promotion of improved emotional, biological and social development itself and the involvement of children with cancer treatment

Impacto da cárie precoce severa na infância na qualidade de vida relacionada à saúde bucal de pré-escolares sob privação social

Early childhood caries, especially in its severe form, which is characterized by an acute and aggressive nature, can have negative impacts on thequality of life of a child, due to effects such as difficulty in chewing, decreased appetite, weight loss, insomnia, changes in behavior and a decreased performance in school, among others. Moreover, the quality of life of the child`s family can also be affected, as the pain and discomfort caused by this type of caries result in loss of working days of parents, spending on dental treatments, changes in sleep patterns and stress. The aim of this study was to evaluate the impact of severe early childhood caries in the Oral Health-Related Quality of Life (OHRQoL) of public daycares`s preschool children through the Escala de Impacto da Saúde Bucal na Primeira Infância, a Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS). A single calibrated examiner (kappa=1.0) evaluated, through the dmfs index, the oral health of 116 children aged between 3 and 5, which were included in one of three study groups: "caries-free", "not-severe early childhood caries" and "severe early childhood caries". The parents responded to ECOHIS, to assess their perception regarding the OHRQoL of their children, and a questionnaire on socioeconomic conditions. The OHRQoL was measured through the total scores and domains of ECOHIS. Descriptive analysis, Mann-Whitney test, Kruskal-Wallis test, chi-square test and Poisson multiple regression with robust variance were used. Among the children observed, 38.8% were caries-free, 27.6% showed not-severe early childhood caries and 33.6% showed severe early childhood caries. Regarding the total score of ECOHIS, severe early childhood caries had a greater negative impact on OHRQoL, compared to caries-free and not-severe early childhood caries groups (p <0.001). Regarding the child subscale, there was significant difference between the "severe early childhood caries" group and the other groups in all domains, except for theone of self-image / social interaction. In the family subscale domains, there was statistical significance between the severe early childhood caries and the caries-free groups in all domains (p <0.001), whereas between the "severe early childhood caries and not-severe early childhood caries groups there was a statistically significant difference only in the domain of parental anguish (p <0.001). Multivariate analysis showed that early childhood caries and the parent`s age were significantly associated to OHRQoL (p <0.05), independently of the other variables in the model. The presence of severe early childhood caries resulted in greater negative impact on OHRQoL (AdjPR= 6.016; 95%CI = 3.12 11.56; p<0.001), while older parents reported better OHRQoL (AdjPR = 0.603; 95%CI = 0.428 - 0.850; p = 0.004). The presence of severe early childhood caries had a negative impact on OHRQoL of preschool children and their families.

Promoção da saúde: estratégias para a autonomia e qualidade de vida do sujeito com diabetes

O diabetes é uma doença crônico-degenerativa de grande prevalência na população mundial configurando-se enquanto sério problema de saúde pública. Por ser crônico exige dos sujeitos autocuidado e autogoverno longitudinal. A autonomia, por sua vez, é um direito fundamental e também um dos princípios da bioética mais discutidos na atualidade. Seu conceito é complexo e leva em conta a vida experimentada ao longo dos anos. Quando a discussão sobre autonomia se trata de diabetes, a dependência do outro e os conflitos no controle da doença, diante de novas regras e estilos de vida, nem sempre condizentes com os valores dos pacientes, torna-a fragilizada. Embora a autonomia seja claramente parte integrante do tratamento e alicerce para uma vida digna e de qualidade, observamos que os sujeitos se tornam ainda mais dependentes dos serviços de saúde, quando se deparam com o diagnóstico e não têm confiança para tomar suas próprias decisões diante da patologia limitadora. Por isso, há a necessidade dos serviços de atenção primária à saúde traçarem estratégias para promover a saúde desses sujeitos. Os Grupos de Promoção da Saúde são estratégias recentemente utilizadas para influenciar no nível de autonomia dos sujeitos, pois possibilitam, respeitando os limites éticos, a garantia de participação decisória no grupo, através de estratégias e treinamentos de habilidades com competências claramente definidas, que favorecem o empowerment e o protagonismo dos sujeitos. Desse modo, este trabalho objetiva identificar estratégias no âmbito da promoção da saúde na ESF, que contribuam para melhor autonomia e qualidade de vida dos sujeitos com diabetes mellitus, a partir de sua percepção. E, mais especificamente, analisar o perfil clínico e socioeconômico dos portadores de diabetes da ESF; identificar as experiências, necessidades e expectativas dos sujeitos com diabetes sobre autonomia, autocuidado e qualidade de vida; e realizar um levantamento em conjunto com os sujeitos com diabetes, sobre aspectos que sirvam de evidências para construção de propostas para implantação de um Grupo Estratégico de Promoção da Saúde GEPS, com foco na autonomia. Para isto, foi realizada uma pesquisa exploratória descritiva de abordagem qualitativa e quantitativa, com 65 sujeitos com diabetes acompanhados por uma Unidade de Saúde da Família do Município de Santa Cruz/RN. A pesquisa foi realizada em três etapas interdependentes: 1) coleta de dados clínicos e socioeconômicos, para o qual foi utilizado entrevista estruturada e análise retrospectiva dos registros feitos em seu prontuário; 2) a análise das experiências, necessidades e expectativas dos sujeitos sobre autonomia, autocuidado e qualidade de vida, que se utilizou de entrevista semiestruturada com 6 sujeitos, sendo 3 com mais e 3 com menos complicações autorreferidas e verificadas no prontuário; e 3) a construção coletiva de propostas para melhor autonomia e qualidade de vida dos próprios participantes do estudo, por meio de roda de conversa. Para a análise dos dados utilizamos software de estatísticas simples para os dados das questões fechadas de cunho quantitativo e os dados qualitativos foram analisados através da análise de conteúdo. Observamos que o perfil clínico e socioeconômicos dos sujeitos com diabetes aproximam-se das estatísticas nacionais, embora existam variáveis, como cor da pele, com variação significativa. A autopercepção dos sujeitos diante de algumas complicações divergem de registros encontrados em seu prontuário o que aponta uma possível desvalorização de queixas como hipoglicemia e disfunção sexual, como também baixa adesão ao tratamento por, muitas vezes, não terem suas opiniões valorizadas. As categorias encontradas: vida, qualidade de vida, diagnostico e enfrentamento do problema, autonomia, limites e dependência assim como as práticas coletivas de promoção da saúde, apontam para a necessidade de estratégias por meio de grupos que considerem as crenças e valores dos sujeitos, favoreçam sua emancipação e torne-os protagonistas de sua própria história e de seu processo saúde doença. A autonomia é fundamental para o exercício da cidadania efetiva. É por meio dela que os sujeitos transformam sua realidade e a si mesmo. A contribuição desta pesquisa consiste em identificar estratégicas que se propõe a potencializar a autonomia dos sujeitos, através dos GEPS, norteando a atuação dos profissionais na atenção primária à saúde, que deve sustentarse em ações de prevenção e promoção da saúde e também no incentivo à participação popular e protagonismo dos sujeitos

Horticultura no baixo curso do Rio Doce, zona norte do Natal/RN: avaliação da qualidade da água por meio de ensaios ecotoxicológicos

The research is developed in areas of horticulture in the city of Natal, in the neighborhoods of Lagoa Azul, Pajuçara and Redinha, along the Doce River, border area with Extremoz city, Rio Grande do Norte State. The region of the fluvial plain of Doce River is located in an Environmental Protection Zone (ZPA-9). This is one of the ZPA which is not under the regulatory marks and there are several environmental problems caused by use and land occupation, featuring an evident disregard of environmental laws and whose protection is hindered by the lack of specific legal mechanisms. This study aims to provide an overview of the use of pesticides in the lower course of the Doce River, in Natal, Rio Grande do Norte, and to assess environmental degradation in the area through chronic toxicity tests using the microcrustaceous Ceriodaphnia dubia Richard 1894 (Cladocera, Crustacea) as test organism. Visits were made to the area in 2009 and 2010. To obtain information a diagnosis of the local situation was accomplished based on personal observation and non-participatory photographic record, with the aim of assessing the environmental characteristics, population diversity and work processes of horticulturists. During the visits four different points of the Doce River were chosen to collect water for ecotoxicological tests and survey of physico-chemical parameters (dissolved oxygen, pH, chloride, turbidity, conductivity and temperature), which were measured in the field using Multiparameter Probe (TROLL 9500). The adverse effects of pesticide use in the lower course of the Doce River is a major problem for both the environmental and human health, since many of the substances and active principles that enter in the composition of the products are synthesized molecules whose effects can only be evaluated through different studies on their actions and behavior at short, medium or long term

Diagnóstico da degradação ambiental no município de Areia Branca-RN por geotecnologias

The municipality of Areia Branca is within the mesoregion of West Potiguar and within the microregion of Mossoró, covering an area of 357,58 km2. Covering an area of weakness in terms of environmental, housing, together with the municipality of Grossos-RN, the estuary of River Apodi-Mossoró. The municipality of Areia Branca has historically suffered from a lack of planning regarding the use and occupation of land as some economic activities, attracted by the extremely favorable natural conditions, have exploited their natural resources improperly. The aim of this study is to quantify and analyze the environmental degradation in the municipality. Thus initially was performed a characterization of land use using remote sensing, geoprocessing and geographic information system GIS in order to generate data and information on the municipal scale, which may serve as input to the environmental planning and land use planning in the region. From this perspective, were used a Landsat 5 image TM sensor for the year 2010. In the processing of this image was used SPRING 5.2 and applied a supervised classification using the classifier regions, which was employed Bhattacharya Distance method with a threshold at 30%. Thus was obtained the land use map that was analyzed the spatial distribution of different types of the use that is occurring in the city, identifying areas that are being used incorrectly and the main types of environmental degradation. And further, were applied the methodology proposed by Beltrame (1994), Physical Diagnosis Conservationist under some adaptations for quantifying the level of degradation or conservation study area. As results, the indexes were obtained for the parameters in the proposed methodology, allowing quantitatively analyze the degradation potential of each sector. From this perspective, considering a scale of 0 to 100, sector A and sector B had value 31.20 units of risk of physical deterioration. And the C sector, has shown its value - 34.64 units degradation risk and should be considered a priority in relation to the achievement of conservation actions

Impacto da fibromialgia sobre a qualidade de vida e função sexual em mulheres no climatério

OBJETIVO: analisar o impacto da fibromialgia sobre os sinais e sintomas climatéricos, qualidade de vida, função sexual em mulheres na fase do climatério. MÉTODOS: Foi realizado estudo observacional analítico de corte transversal, envolvendo 161 mulheres na fase do climatério. As participantes foram divididas em dois grupos: grupo sem fibromialgia (83) e grupo com fibromialgia (78). As variáveis investigadas foram: Qualidade de vida medida através do questionário UQOL (Utian Quality of Life), Função sexual analisada através do questionário Quociente Sexual - versão feminina (QS-F) e sinais e sintomas climatéricos avaliados pelo Índice menopausal de Blatt & Kupperman (IMBK). No estudo estatístico, foi realizada análise inferencial através do método de modelos lineares generalizados. Para análise do UQOL e seus domínios assim como o QS-F e IMBK, foi utilizado uma função de ligação linear de Log Poisson com exposição de contrastes para os níveis dos fatores de exposição. O nível de significância adotado foi de 5%. RESULTADOS: No grupo fibromialgia foram observados escores significativamente inferiores para o domínio ocupacional UQOL (p 0,01) e UQOL total (p = 0,02), em comparação ao grupo sem fibromialgia. O grupo de mulheres com fibromialgia apresentou escores superiores em relação à intensidade dos sinais e sintomas climatéricos (p ˂0,01) e escores inferiores na avaliação da função sexual pelo QS-F (p = 0,01), quando comparado ao grupo sem fibromialgia. As mulheres mais jovens, com trabalhos extra domicílio, maior renda e maior grau de escolaridade apresentaram melhores escores na qualidade de vida em todos os domínios. Quanto aos sinais e sintomas climatéricos, a renda mais alta e maior tempo de escolaridade exerceram associação direta com sinais e sintomas mais leves, entretanto, quanto mais jovens, maior relação com sintomatologia mais intensa. Em relação à função sexual, melhores escores estiveram associados com idade entre 45 a 49 anos e trabalho extra domicílio. CONCLUSÃO: Os resultados obtidos no presente estudo permitem concluir que o diagnóstico de fibromialgia na fase do climatério apresentase como influência negativa no domínio ocupação da qualidade de vida, sinais e sintomas climatéricos e função sexual, sendo esta associação influenciada significativamente por diversos fatores sócio demográficos

Diagnóstico da comercialização de produtos da medicina popular em feiras livres do semiárido do Rio Grande do Norte: avaliações socioeconômicas e sanitárias, com proposta de legislação específica

Historically, man has empirically acquired knowledge about the therapeutic applications of extracted elements of the natural environment in which belonged. Such knowledge over time culminated in the formation of traditional health systems. Among its features, the use of bioactive plant species - medicinal plants - stands out for its efficiency and high popular acceptance. Despite its importance for public health, the population still has in the open-air fairs the main source for the acquisition of the species used. In these spaces, the trade generally occurs informally, under unfavorable conditions to the quality of the products and to the financial sustainability of the business. In this context, this study aimed to characterize the socioeconomic, cultural and sanitary aspects related to the trade of medicinal plants in municipalities of a semiarid region of Rio Grande do Norte, and additionally, proposing a specific legislation to the activity. Socioeconomic data were collected through on-site interviews, guided by structured form. The observations about the hygienic and sanitary adequacy of physical facilities and practices employed at the point of sale /environment were conducted and recorded with the use of assessment tool developed for use in open markets. The adequacy of medicinal plants to consumption was determined by microbiological analysis. The activity was carried out by individuals who are aged between 21 and 81 years of age, low educational level and low-income, predominantly males. The data showed a tendency to extinction of the activity in all the districts studied. It was observed in all the fairs studied hygiene and sanitation inadequacies that characterized very high health risk, representing in this way, the high probability of Food Transmitted Diseases outbreaks Such conditions were reflected in the high percentage of inadequacy to the consumption of the analyzed medicinal plants samples, illustrating the potential health risk to consumers. To contribute to the correction of hygiene and sanitation inadequacies observed in the studied open-air fairs, educational interventions were made to the training of traders in Good Practices. As a complement, was drafted a specific legislation for the marketing of folk medicine's products in open-air fairs. Such actions, products and its developments will contribute significantly to improving the quality of products available to the population and the preservation of activity, potentially reducing the risks to public health.

Estudo comparativo entre antipsicóticos atípicos no tratamento da esquizofrenia e sua influência na qualidade de vida dos pacientes

Schizophrenia is a severe and persistent mental illness; diagnosis occurs mainly during adolescence. The pharmacological treatment is done with typical and atypical antipsychotics. Atypical have the advantage of reduced extrapyramidal effects, which make them promising for the treatment of schizophrenia, furthermore, they have shown significant metabolic and hormonal changes. The objective of this study was to evaluate the influence of atypical antipsychotics, olanzapine and risperidone on the quality of life and on their adverse effects in schizophrenic patients. For this we analyzed the quality of life of patients with implementation of EuroQol-5D-3L instrument and performing biochemical and hormonal tests, blood pressure measurement, and measurement of anthropometric indices, besides the application of Ugvalg scales for Kliniske Undersgelser (UKU) and Simpson-Angus, who evaluated the side effects caused by drugs. Data were analyzed using the Student t test and chi-square test, with 5% significance level. The results showed that the EuroQol the antipsychotic olanzapine causes significant losses associated with personal care (p <0.001). Comparing the two groups of antipsychotics, the average years of quality-adjusted life, known per QALY was favorable for the risperidone group (p <0.032). The results of olanzapine and risperidone groups were compared. In terms of socioeconomic, it was observed that men used, the prevalent form, olanzapine (p <0.008); this same group showed the following results significantly unfavorable, related to anthropometric variables: waist circumference (p <0.01), hip circumference (p <0.02), weight (p <0.02) and blood pressure (p <0.04). The biochemical and hormonal analyzes showed that olanzapine resulted in losses related to the following variables: triglycerides (p <0.04), HDL cholesterol in men (p < 0.02) and cortisol (p < 0.01). In risperidone users, the only negative value was prolactin (p < 0.04). Regarding the analysis of the Simpson-Angus scale, the group treated with olanzapine was handicapped because the average total scores for olanzapine was 0.38, while for risperidone was 0.11 (p < 0.02). In the UKU scale, the following results were obtained also unfavorable for the olanzapine group: fatigue (P <0.02), dystonia (p <0.01) and tremor (p <0.03). According to the UKU scale, the side effects present in the risperidone group included: gynecomastia (p <0.01), ejaculatory dysfunction (p <0.02) and erectile dysfunction (p <0.02). It was concluded that olanzapine users had the worst score of quality of life, higher metabolic risks associated with overweight and inadequate lipid profile and greater tendency to extrapyramidal manifestations. However, risperidone users were more likely to adverse reactions due to hormonal changes.

LCD-OpenPACS: sistema integrado de telerradiologia com auxílio ao diagnóstico de nódulos pulmonares em exames de tomografia computadorizada

Lung cancer is one of the most common types of cancer and has the highest mortality rate. Patient survival is highly correlated with early detection. Computed Tomography technology services the early detection of lung cancer tremendously by offering aminimally invasive medical diagnostic tool. However, the large amount of data per examination makes the interpretation difficult. This leads to omission of nodules by human radiologist. This thesis presents a development of a computer-aided diagnosis system (CADe) tool for the detection of lung nodules in Computed Tomography study. The system, called LCD-OpenPACS (Lung Cancer Detection - OpenPACS) should be integrated into the OpenPACS system and have all the requirements for use in the workflow of health facilities belonging to the SUS (Brazilian health system). The LCD-OpenPACS made use of image processing techniques (Region Growing and Watershed), feature extraction (Histogram of Gradient Oriented), dimensionality reduction (Principal Component Analysis) and classifier (Support Vector Machine). System was tested on 220 cases, totaling 296 pulmonary nodules, with sensitivity of 94.4% and 7.04 false positives per case. The total time for processing was approximately 10 minutes per case. The system has detected pulmonary nodules (solitary, juxtavascular, ground-glass opacity and juxtapleural) between 3 mm and 30 mm.

Avaliação de qualidade da unidade de diálise no Hospital Universitário Onofre Lopes - HUOL

Over the years there has been a broader definition of the term health. At the same time it was found also an evolution of the concept of health care which in turn has led to changes in the approach to delivery of health services and hence in its management. In this regard, currently the nephrology services have been searching for quality technical and social need. In view of these innovations and the quest for quality, it elaborated the general objective: to develop a quality assessment protocol for dialysis service Onofre Lopes University Hospital. It is an intervention project effected through an action research, which consisted of 4 steps. Initially was identified through a literature search in scientific literature, which quality indicators would apply to a dialysis unit being selected as follows: infection rate in hemodialysis access site, microbiological control of water used for hemodialysis and Index User satisfaction. Through critical reflection on the theme researched in the previous step, it was drawn up three data collection instruments, interview form type, applied between the months of October and November 2015. In addition to the information obtained, also made up of the use of information retrieval technique. The results were organized in graphs and tables and analyzed using qualitative and exploratory technical approach. Then a reflective analysis of the data obtained and the diagnosis of reality studied was traced and confronted with the literature was performed. The data produced in this study revealed that the Dialysis Unit of HUOL is much to be desired, considering that some weaknesses have been identified in its structure. Faced with this finding have been proposed, as a contribution and aiming to guide the development of future actions, suggestions for improvement that should be implemented and monitored to be assured overcoming these difficulties, allowing an appropriate organizational restructuring, and resulting in improved service public offered. It was concluded that for hemodialysis treatment results are achieved and positive, it is necessary to have physical structure and adequate infrastructure, multidisciplinary team specialized, trained and in sufficient quantity, well designed processes for professionals to have standards to be followed decreasing the chance to err, and a risk management system to detect and control situations that endanger patient safety.

Avaliação de qualidade da unidade de diálise no Hospital Universitário Onofre Lopes - HUOL

Over the years there has been a broader definition of the term health. At the same time it was found also an evolution of the concept of health care which in turn has led to changes in the approach to delivery of health services and hence in its management. In this regard, currently the nephrology services have been searching for quality technical and social need. In view of these innovations and the quest for quality, it elaborated the general objective: to develop a quality assessment protocol for dialysis service Onofre Lopes University Hospital. It is an intervention project effected through an action research, which consisted of 4 steps. Initially was identified through a literature search in scientific literature, which quality indicators would apply to a dialysis unit being selected as follows: infection rate in hemodialysis access site, microbiological control of water used for hemodialysis and Index User satisfaction. Through critical reflection on the theme researched in the previous step, it was drawn up three data collection instruments, interview form type, applied between the months of October and November 2015. In addition to the information obtained, also made up of the use of information retrieval technique. The results were organized in graphs and tables and analyzed using qualitative and exploratory technical approach. Then a reflective analysis of the data obtained and the diagnosis of reality studied was traced and confronted with the literature was performed. The data produced in this study revealed that the Dialysis Unit of HUOL is much to be desired, considering that some weaknesses have been identified in its structure. Faced with this finding have been proposed, as a contribution and aiming to guide the development of future actions, suggestions for improvement that should be implemented and monitored to be assured overcoming these difficulties, allowing an appropriate organizational restructuring, and resulting in improved service public offered. It was concluded that for hemodialysis treatment results are achieved and positive, it is necessary to have physical structure and adequate infrastructure, multidisciplinary team specialized, trained and in sufficient quantity, well designed processes for professionals to have standards to be followed decreasing the chance to err, and a risk management system to detect and control situations that endanger patient safety.

Qualificação de edifícios residenciais verticais em Natal/RN à luz do regulamento técnico da qualidade para o nível de eficiência energética de edificações residenciais (RTQ-R)

The goal of the research was to investigate the energy performance of residential vertical buildings envelope in the hot and humid climate of Natal, capital of Rio Grande do Norte, based in the Technical Regulation of Quality for Energy Efficiency Level in Residential Buildings (RTQ -R), launched in 2010. The study pretends to contribute to the development of design strategies appropriate to the specific local climate and the increasing of energy efficiency level of the envelope. The methodological procedures included the survey in 22 (twenty two) residential buildings, the formulation of representative prototypes based on typological and constructives characters researched and the classification of the level of energy efficiency in the envelopment of these prototypes, using as a tool the prescriptive method of the RTQ-R and the parametric analyzes from assigning different values of the following variables: shape of the pavement type; distribution of housing compartments; orientation of the building; area and shading of openings; thermal transmittance, and solar absorptance of opaque materials of the frontage in order to evaluate the influence of these on the envelopment performance. The main results accomplished with this work includes the qualification of vertical residential buildings in Natal/RN; the verification of the adequacy of these buildings to local climate based from the diagnosis of the thermal energy of the envelopment performance, the identification of variables with more significant influence on the prescriptive methodology of RTQ-R and design solutions more favorable to obtain higher levels energy efficiency by this method. Finally, it was verified, that some of these solutions proved contradictory in relation to the recommendations contained in the theoretical approaches regarding environmental comfort in hot and humid weather, which indicates the need for improvement of the prescriptive method RTQ-R and further research on efficient design solutions