Eficácia do aconselhamento no tratamento das disfunções temporomandibulares

The aim of this controlled trial was to evaluate the effectiveness of counseling in pain, function and well-fare outcomes on the management of patients with temporomandibular disorder (TMD). Therefore, 51 consecutive patients were allocated to one of the research groups. In Group I, was instituted counseling therapy for Group II was conducted treatment as usual with occlusal splint. Patients were followed for returns at 7, 15, 30 and 60 days after baseline. At baseline, all patients were examined and assessed RDC/TMD form, which was administered by a single trained and calibrated examiner, in addition, the patients were referred for specific treatment according to the group to which belonged. The clinical and functional impairment was assessed at each visit through the Temporomandibular Index (TMI). In each session, the patients were also surveyed about pain intensity using a Visual Analogue Scale (VAS). To analyze the impact of pain on quality of life, OHIP-14 questionnaire was used. The results showed 26 patients in Group I with a mean age of 35.15 ± 10.79 years. 25 patients were allocated to Group II. The mean age was 27.36 ± 10.34 years. The counseling was effective in reducing the intensity of pain (VAS), with significant improvement observed at 7 day follow-up (p <0.001). The functional impairment (TMI) showed significant results at 15 days follow-up (p = 0.002). Counseling was also responsible for significant improvement in the impact of TMD on quality of life (OHIP-14) at all times of the analysis (p <0.001). When comparing research groups, no significant difference was observed for any of the analyzed indices (p> 0.05) nor in the short term (7 days) neither in long term (60 days). It was concluded therefore that, for the studied sample, counseling consisted in an effective treatment option for the control of signs and symptoms of TMD, with results in the short and long term similar to the usual treatment group.

O Desenvolvimento local sustentável no semi-árido nordestino: um estudo de caso na comunidade de mirandas, Caraúbas/RN

Brazil s semi-arid region is an immense territory characterized by a mosaic of natural environments and human settlements. Inside this multifaceted framework, there are problems that are specific to the region (the water resources situation, for example) while others are more universal (such as the inequality between men and women). The circumstances that give rise to these problems are complex and require a holistic view so that our understanding can go beyond the simple concept that this is a problem region . The semi-arid must be perceived as a viable area in need of a new analysis, taking into account its successes, limitations, challenges and the strategic public policy framework that guarantees its sustainable development. The dissertation analyzes, from a sustainable local development perspective, the experience of the Northeastern Brazil Groundwater Project (PROASNE), carried out from 2001 to 2003, in partnership with the Waters and Sewers Company of Rio Grande do Norte (CAERN) in the rural community of Mirandas, municipality of Caraúbas/RN, situated in the middle of the northeastern Brazil semi-arid region

Perfil desenvolvimental das funções executivas em crianças de 05 a 08 anos da cidade de Natal - RN

This study aimed to establish the developmental profile of executives components in typical child development. This is a correlational cross-sectional study of predominantly quantitative. The instruments for data collection are the subtests included in the NEPSY-II Attention and Executive Functioning domain. Eighty children between 5 and 8 years of age, of both genders, students from public and private schools in the city of Natal were evaluated. The sample was divided into six-month intervals for subsequent analysis of strategies and types of errors. Analysis of variance (univariate and multivariate) and Tukey and Games-Howell post hoc tests were conducted to verify the effect of age on test performance. Subsequent correlations indicate the strength and direction of the relationship between variables. Were identified two peaks of development in the six-month interval adopted for the skills of selective attention and inhibitory control. The results indicate that there’s no significant influence of sex and type of school on the performance of the sample. The performance of preschool children (5 and 6 years) was lower than the other subgroups in most tests. Highlights the role of autoregulation discourse among preschool children during activities of greater executive demand and the abstraction resource as a resolution strategy between the older. Were identified similar development trajectories among selective attention abilities and inhibitory control. In general, there is a decrease in the number of mistakes and increase of success with the age progression. Future longitudinal research can extend the age range encompassed in this study, investigating the developmental course of executive abilities.

A inserção do técnico em saúde bucal na estratégia saúde da família no estado do Rio Grande do Norte

An oral health technician is a profession in odontology whose own functions are defined in FEDERAL LAW NUMBER 11889, which can act for prevention, recovery and promotion of oral health. According to the web site, Of Primary Health Attention Department. Health Ministry Of Brazilian Federal Republic, you can see through historical cover, as regards Health Family Strategy that, in Rio Grande Do Norte, There are nowadays eight TSB equipments in use. Objective: The aim of this study is to find out the reasons of the inclusion of those technicians in public service, no matter the importance of this work. Method: It is about a quantitive study and a kind of exploring type, taking into account that there are not any similar previous ones. We divide it into two parts: as regards the first one, these technicians were registered in a map using the information of the Formation Schools and Class Counsel to know how and where they are. During the moment of this study, an application (or no application) of the mouth health equipments was done. They tried to discover in this process which elements contribute to the efficiency (or not) of this technical work done all together in equipment work. As regards the second part, the coordinators of Municipal Mouth Health answered to a survay that contained open and closed questions through telephone calls. The sample was defined by a raffle taking into account the work contained in municipalities. Results: There are 1053 technicians.94,3% of them are women, devided in all the health regions. As regards interview, 96,9% of oral health coordinators considered that it is very important to have an oral health technician in odontology. 92,2% would reccomend its inclusion in equipments related to mouth health, dealing to familly health . 76% have never talked before to the Health Secretary in this municipality. this spreading out could be related to financial resources and 51,6% mentioned the importance of improving the physical structure to make this spreading out possible. Conclusions: Oral Health technicians in Rio Grande Do Norte are not being adequatly used by public service, because they do not introduce themselves or act as Oral Health auxiliaries. It is important to increase concience about the importance of this category in odontology. we also say it is necesasary to invert money in a reform of the Basic Health Unities and the inclusion of these workers. On the other hand the role of the state and the public health militancy is questioned in the fulfilment of this process

Universalização do acesso à saúde e regulação dos planos privados de assistência à saúde: a atuação regulatória da ANS como instrumento de harmonia contratual e viabilização do papel suplementar da iniciativa privada na efetivação do direito social à saúde

While essential to human nature, health and life have been protected since ancient times by various areas of knowledge, particularly by the Law, given its dynamics within the regulation of social interactions. In Brazil, health has been granted major importance by the Federal Constitution of 1988, which, disrupting the dictatorial authoritarianism, inaugurating a Social State and focusing on the values of freedom and human dignity, raises health to the condition of a social right, marked predominantly by an obligational bias directed, primarily, to the State, through the enforcement of public policies. Although, given the limitation of the State action to the reserve for contingencies, it turns clear that an universalizing access to public health is impossible, seen that the high cost of medical provisions hinders the State to meet all the health needs of the rightholders. As a result of the inefficiency of the State, the effort of the Constituent Assembly of 1988 in creating a hybrid health system becomes nuclear, which, marked by the possibility of exploration of healthcare by the private initiative, assigns to the private enterprise a key role in supplementing the public health system, especially through the offer of health insurance plans. At this point, however, it becomes clear that health provisions rendered by the private agents are not unlimited, which involves discussions about services and procedures that should be excluded from the contractual coverage, for purposes of sectoral balance, situation which draws the indispensability of deliberations between Fundamental Rights on one hand, related to the protection of health and life, and contractual principles on the other hand, connected to the primacy of private autonomy. At this point, the importance of the regulation undertaken by the ANS, Brazilian National Health Agency, appears primordial, which, by means of its seized broad functions, considerable autonomy and technical discretion, has conditions to implement an effective control towards the harmonization of the regulatory triangle, the stability and development of the supplementary health system and, consequently, towards the universalization of the right to health, within constitutional contours. According to this, the present essay, resorting to a broad legislative, doctrinal and jurisprudential study, concludes that economic regulation over the private healthcare sector, when legitimately undertaken, provides progress and stability to the intervening segment and, besides, turns healthcare universalization feasible, in a way that it can not be replaced efficiently by any other State function.

A formação da habilidade de explicar no contexto do ensino médio: o que dizem os livros? o que pensam os professores?

The discussion about explanation in knowledge has been made for decades. Through this course, we present different ways of understanding about what is to explain the history: the primitive ethnographic description, the chronicler, the positivist construction of a historical science and historiography of the second half of twentieth century. Nowadays this discussion needs to be continued both in the general framework of scientific practice as within educational institutions as cognitive - linguistic ability. The focus of our research is by the second approach, which is the explanation as cognitive - linguistic ability. The formation of skills, among them, the explaining one, has been studied by the authors as: (NÚÑEZ 2012; JORBA et al, 2000; SANMARTÍ and IZQUIERDO 2000). This research had as general purpose: to study the processes of formation of the ability to explain social revolution in history classes in high school, by teachers opinion and by content as this theme among history books, in order to support the continuing education of history teachers for high school. Th e qualitative based research used instruments of data collection and analysis protocol for the books prepared for this study, and interviews with teachers. For this, the techniques of content analysis and discourse referenced in Bardin and Orlandi , respec tively were used. At first, the instruments for data collection were developed and validated, while in the second, the data were collected, organized and analyzed. From the answers to the questions of the study results shows that: a) in the analyzed books - do not express the work with the definition of Social Revolution, considering the processes for the formation of this definition, the predominant type of explanation has characteristics of multicausality; proposals for teaching are characterized as eclec tic; b) while teachers speech - it is important the students know the definition of Social Revolution, the ability to explain is more linked to didactic explanation in the classroom than the explanation through epistemological sense. These results indicate that the formation of the ability to explain Social Revolution based in Cultural History approach, are not expressed in the analyzed books, but they can serve as an important resource for this purpose. The discourse of teachers has a potential pointing to the possibility of teaching organization and learning process, based on training or upgrading the explanation skill from the theory of stepwise formation of mental actions and concepts by P.Ya. Galperin. For this purpose, the research constitutes a contri bution to support the continued education of history teachers in high school.

Reaproveitamento de condensado e vapor flash em uma planta têxtil com ênfase no setor de acabamento

This study focused object a steam generation system, steam distribution and condensate return a textile plant located in Rio Grande do Norte. The work was based on the following objectives: Knowing the use of saturated water vapor in the dyeing and finishing processes in a textile plant; To study the various aspects of a steam distribution system to identify the ways in which energy losses occur; Obtain quantitative information of the main loss in steam generation system and steam distribution and to measure the losses, water and steam system; Using the flash steam as a means of cost reduction. For it was made use of the calculation of financial gains made in their respective improvements. As a database for the development of working registers are used in industrial processes, data from utility systems, laboratory data analysis and on-line analyzers, covering the period 2013. Using the principles set conservation laws mass and energy, those data showed that the loss of water and energy in the steam system are significant and that the environmental and economic gains to be obtained with improvement actions are quite significant. Based on the data and results suggest that future studies deem the continuity approach to steam generation systems, distribution and mainly condensate return.

Mobilização de competências na atividade informal do vendedor ambulante em praia de Natal (RN)

The central issue of this dissertation is to investigate the labor activity of beach hawker, in order to identify the main professional competencies mobilized in this activity, traversed by both the precariousness of the means of labor exercise, as for complex and structured routines. In the town of Natal (RN) the beaches serve as workplace for thousands of informal workers, who use various professional skills, translated into the ability to mobilize and articulate knowledge, skills and behaviors to solve problems in concrete work situations. This research therefore had as main objective to investigate the work of beach hawkers, trying to identify the core competencies mobilized for facing demands and obstacles in such a context. The beach of Ponta Negra (Natal-RN) was chosen as field of observation, in which a group of hawkers took part as voluntary subjects. Methodologically, quantitative and qualitative methods of production and analysis of data were combined in three stages. In the quantitative phase an occupational questionnaire was applied to a sample of 60 subjects, generating a set of data analyzed with quantitative univariate and multidimensional descriptive statistical tools, complemented by inferential statistical analysis. The results of this phase indicate a predominance of men sellers with salary varying in a range from one to two minimum wage Brazilian salary, age and education quite heterogeneous, extended working hours and the choice of only this activity and this beach throughout the year. Concurrently with this step of analysis, unsystematic observations of the activity of vendors were held and then driven to the technique of Instruction Impersonator with four chosen subjects. This phase had a clinicalinterpretive analysis, rooted in historical-cultural Vygotskian psychological perspective and in the french approach of skills and abilities. The main results point to several strategies for overcoming obstacles, use of technics anchored in everyday work experience and practical knowledge, building rules of conduct and collective mobilization of diverse professional skills similar to those found in formal work, such as business and time management, use of communicative tools, flexibility in problem solving, creativity and teamwork competence. We conclude that informality investigated in context can not be seen exclusively as a synonym of precariousness. It also covers skills and knowledge in a complex culture that situates informal labor in a complementary way with respect to formal work. This conclusion, therefore, contributes to overcome the notion of antinomy between formal and informal labor activity, since they both can be considered as a way to achieve job satisfaction, and even a personal representation of well done job, which is an important psychological generator of identity and social place.

Um percurso sobre o patrimônio e a morfologia urbana do centro de Fortaleza-CE

The incursion into the historical area from Fortaleza´s downtown presents reminiscences of a heritage collection that can be recognized as city built heritage, in architectural and urban aspects. The neighborhood has in its urban tracing a synthesis of the various phases from the Brazilian architecture materialized in its tracing and built goods. This composition mainly covers the eclectic production, passing the time of art déco, including the period of modern production. This paper aims to identify the existing heritage collection. This study aims to identify the existing net assets, the temporality and spatiality that allow to recreate the neighborhood´s form urbain history. Based on the theoretical and methodological support of the urban morphology urban of authors such as Aldo Rossi (1966), Gordon Cullen (1971), José Lamas (1990), Kevin Lynch (1960), and Philippe Panerai (1999) was allowed on a predefined route, to build part of urban memory of Fortaleza. The historical and morphological study runs through a sequenced analysis developed on the articulated subsets, formed by the network neighborhood squares: Praça José de Alencar, Praça Capistrano de Abreu (Lagoinha), Praça Clóvis Beviláquia, Praça do Carmo, Praça Murilo Borges (BNB), Praça Coração de Jesus, Parque das Crianças, Praça do Riacho Pajeú, Praça dos Voluntários (Polícia), Praça do Ferreira, Praça Waldemar Falcão (Correios), Praça General Tibúrcio (Leões), Praça Figueira de Melo, Bosque Dom Delgado (Pajeú), Praça Cristo Redentor, Praça Caio Prado (Sé), Praça dos Mártires (Passeio Público), e Praça Castro Carreira (Estação). Separated the neighborhood based on this square system because it is perceived that there is in these public spaces a path which includes a portion of the urban history of Fortaleza. In addition to this there is a higher concentration of goods in its area in relation to others sectors of the neighborhood, where the loss of the characterization is an imperative of the urban set. In order to find this network of public spaces contained in the study area were proposed two routes based on the city limits of 1875 established by Adolfo Herbster (Fortaleza´s city plan).The path starts by known boulevards (Imperador, Duque de Caxias and Dom Manuel avenues) and the seafront. The study is grounded in the literature review, document and empirical theme, consisting of an overlay of maps, drawings and photographic collection that ratify this net assets as both architectural urban nowadays. Among the results, it was observed that before a current context of loss of locus of the concept of historical-cultural agglomerated, the squares express the strongholds of equity ambience that perhaps stand in urban morphology of the capital from Ceará.

Utilização de mapas conceituais como ferramenta de ensino para o desenvolvimento do raciocínio clínico no curso de medicina da Universidade Federal do Rio Grande do Norte

BACKGROUND: Among the wide range of skills displayed by a medical doctor is undoubtedly the need to use cohesive and well grounded clinical reasoning in order for medical care to be indeed effective. It is in this respect that conceptual maps emerge; these are a methodological innovation that allows a comprehensive, panoramic and associative outlook of theoretical content, making it more practical and applicable to the reality of clinical observation. Promoting learning, learning resources and a feedback system between professor and students, as well as assessing and monitoring the performance of students during their academic training, are the main features of this tool. OBJETIVE: Assess the use of conceptual maps as a teaching-learning tool in the training of undergraduate medical students at Universidade Federal do Rio Grande do Norte (UFRN). METHODOLOGY: Interventional, randomized, cross-sectional study conducted with students from the 3rd and 5th periods of the medical course at UFRN, during the second semester of 2014, totaling 86 participants, divided into two groups: GI (intervention – clinical case resolution with a conceptual map) and GII (control – clinical case resolution without a conceptual map) in each period. RESULTS: The use of conceptual maps to teach liver failure syndrome resulted in a statistically significant cognitive gain for G1 students from the 5th period (GI: 6.8±1.6 and 8.0±1.5, p = 0.024; GII: 7.2±2.1 and 8.0±1.7, p = 0.125, pre and post-intermediate means, respectively), a result not observed in the period 3rd (GI: 7.7±1.3 and 8.0±1.4, p = 0.501; GII: 6.7±1.8 and 7.8±1.8; p=0.068, pre and post-intermediate means, respectively). Students in the 3 rd period gave better responses to the first clinical case, with a larger number of suitable concepts and crosslinks, when they used conceptual maps (GI: 91.3±13.15 and GII: 64.84±22.84, p=0,002). Students in the 5th period exhibited better clinical reasoning and more complete responses using the tool (p=0,01). Most of the students were not aware of the tool (53.8% from the 3rd period and 65.3% from the 5th period). Among those who knew about conceptual maps, most (59.3%) had only used them during high school, 14.8% had never used them and only seven students (25.9%) used them during the medical course. Analysis of open responses, obtained in process assessment showed clear satisfaction and enthusiasm with learning about the new tool, and frequent suggestions to use it at other moments in the course. Assessment of learning profile, using the VARK questionnaire, showed that most students from both periods exhibited a multimodal style. CONCLUSION: Despite their scant knowledge regarding the tool, good acceptability and understanding was observed in the study participants. The conceptual maps allowed cognitive gains, better responses and clinical reasoning in teaching liver failure syndrome to 5th period students.

Etnobotânica e percepção ambiental de pescadores e coletoras tradicionais submetidos à escassez de recursos vegetais silvestres

In our first chapter was recorded the perception of fishermen and gatherers of Patané about the absence of local forests, was collected a list of species considered locally as strategic use, the ethnoknowledge associated with those, and identify which of these plants are already perceived as scarce in the region. In the second chapter, was studied all species of plants known by the community, the associated knowledge and the various uses. Were used individual interviews, formal and semi-structured, that have been consecutively applied to sampled respondents not probabilistically by snowball. Were collected socioeconomic data of informants. A adequacy test was performed. Guided tours were conducted to gather photographs and samples witnesses of plants, all identified by the usual methods of botany. Excerpts of the interviews on perceptions appear by looking for consensual information. Some data were presented by descriptive statistics. Were mounted two lists of plants, one with the strategic use and one with all the species listed in the study. It was shown that knowledge about plants remains resilient despite the forest resources now no longer be available.

Etnobotânica e percepção ambiental de pescadores e coletoras tradicionais submetidos à escassez de recursos vegetais silvestres

In our first chapter was recorded the perception of fishermen and gatherers of Patané about the absence of local forests, was collected a list of species considered locally as strategic use, the ethnoknowledge associated with those, and identify which of these plants are already perceived as scarce in the region. In the second chapter, was studied all species of plants known by the community, the associated knowledge and the various uses. Were used individual interviews, formal and semi-structured, that have been consecutively applied to sampled respondents not probabilistically by snowball. Were collected socioeconomic data of informants. A adequacy test was performed. Guided tours were conducted to gather photographs and samples witnesses of plants, all identified by the usual methods of botany. Excerpts of the interviews on perceptions appear by looking for consensual information. Some data were presented by descriptive statistics. Were mounted two lists of plants, one with the strategic use and one with all the species listed in the study. It was shown that knowledge about plants remains resilient despite the forest resources now no longer be available.

Inserção de fornecedores locais como fonte de desempenhos em custos de transação e legitimidade: estudo de caso na cadeia produtiva do petróleo e gás do Rio Grande do Norte

The inclusion of local suppliers in production chains has considerable impact on its performance, but most notably in its main actors. The results of this process may be of different kinds and can be analyzed from economic or institutional approaches. This study aimed to verify the existence of different performances of Petrobras due to the inclusion of local suppliers in the oil and gas production chain in the state of Rio Grande do Norte, from the viewpoints of transaction costs and the Institutional Theory. In order to this, were made the characterization of the PROMINP, the description of its actions and results, the mapping of its institutional context of reference, and identification of results obtained by Petrobras in terms of transaction costs and legitimacy. The theoretical framework is based on authors dealing with industrial concentration, as like Marshall, Krugman, Porter and Schmitz, from the sociological perspective of neoinstitucional theory, as like DiMaggio and Powell and Scott and Meyer, and transaction costs, as like Williamson. This is a qualitative research, with data collection done by consulting secondary fonts and semi-structured interviews with nineteen actors of three groups, namely: actors involved in actions of the program, representatives of enterprises and representative of Petrobras. To analyze the content was used the Suchman s model (1995) for categories associated with strategies of legitimation and fourteen variables associated with the three variables assets specificity, bounded rationality and opportunism (Williamson, 1995, 1989) in the case of transaction costs. The results indicate that PROMINP has achieved its objectives by encouraging the increased participation of local companies in the oil and gas production chain, reflecting in the economic development of the state. The Redepetro/RN, fostered and built upon the interaction of the participants, is presented as a solution of continuity to the participation of enterprises in the chain, after the closure of the actions of the program. PROMINP demands responses to coercive, legislative and regulatory pressures of the organizational field, whose institutional context of reference is wide. From the point of view of legitimacy, through strategies to gain cognitive legitimacy and maintaining pragmatic legitimacy, Petrobras can manipulate the environment, ensuring the compliance of the constituents to their technical and institutional demands. Enterprises, in turn, respond to the demands through compliance with technical demands, mainly through the certification of processes, and cultural changes. There aren t clear gains related to the transaction costs, however, gains in legitimacy can be seen as a cumulative capital that can serve as a competitive differential that generates economic gains. In terms of theoretical findings, it was found that, due to its explanatory power for actions that are difficult to explain only in economic terms, Institutional Theory may be used as theoretical support concurrent with other theories. TCE model has limitations in explaining the program actions. In the case, it s emphasized that Petrobras doesn t seek only economic efficiency, but has in its mission the commitment to social development.

Relações entre mecanismos de coordenação e controle com desempenho organizacional: um estudo nas instituições públicas de ensino médio de Natal

This research aimed at relating coordination and control forms to organizational performance. The multicase study was applied in two public high schools: Centro Federal de Educação Tecnológica do Rio Grande do Norte and Floriano Cavalcanti. In order to accomplish these objectives, it was developed a qualitative analysis and considered coordination and control forms of several authors. Also was considered Sander´s (1984) model of organizational performance. The mentioned model considers two criteria to analyze organizational performance: one instrumental (efficiency and efficacy) and other substantive (effectiveness e relevance). The research attempts to show the importance of balancing these criteria in a way that effectiveness and relevance becomes more important at schools. It was proven that the use of bureaucratic coordination forms has the power to influence the evaluation on the instrumental technique. At the same time, it was observed that the use of mechanisms based on the autonomy of the school is related to efficiency and efficacy. The object of this research can be considered successful

Síndrome de Burnout : um estudo com guias de turismo regional em Natal-RN

Burnout is a psychological syndrome triggered in response to continuous exposure to interpersonal stressors. It is considered a multifactorial construct, which is commonly characterized by three dimensions: emotional exhaustion, dehumanization, and lack of personal accomplishment.This study aimed to verify if the three characteristics of burnout (exhaustion, lack of dehumanization and personal accomplishment) are present in people working as guides Tourism in Natal - RN. It is a descriptive and quantitative study. 109 subjects were surveyed. Data collection was done through the use of questionnaires, the instrument used was the characterization of the Burnout Scale (ECB) created and validated in Brazil by Trocoli and Tamayo (2000). In order to analyze data we used descriptive statistics, analysis of core measures, exploratory and confirmatory factor analysis, reliability analysis, cluster analysis, multiple discriminant and Spearman correlation. Factor analysis identified four factors that explain 58.3% of the total variance. Those factors were named exhaustion, deception, avoidance, and dehumanization. The reliability of the instrument, as measured by Cronbach's Alpha was 0.918, which is considered excellent reliability. The 109 subjects were grouped into three cluster, which had the deception, avoidance, and dehumanization as discriminant. It is possible to conclude that the characteristics of burnout syndrome are present in the studied population where 19 people are on the high level of burnout, moderate in 32 and 56 in the light. The correlations between socio-demographic variables studied and the dimensions of burnout, were few and weak. The variable leave for health reasons in the study appeared to be related to feelings of exhaustion and avoidance behavior appeared related to younger individuals and who work only in the activity of Receptive Tourism Guide. Verification of the incidence of burnout in individuals surveyed suggest the need to adopt intervention strategies are individual, organizational and / or combined