Construção e evidências de validação de instrumentos de pesquisa para avaliação da assistência nos centros de atenção psicossocial

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Práticas integrativas e complementares em Currais Novos/RN: uso de plantas medicinais?

The objective of this study is to investigate how the team of health professionals of the Family Health Strategies program and clients in Currais Novos/RN deal with the use (or not) of medicinal plants as one of the complementary and holistic practices in the Individual Health System (SUS in Portuguese). The research is carried out using a qualitative approach, applying semi-structured interviews, related to the proposed objective, as the instruments of data collection. The interviews applied to professionals and clients were based on questionnaires and were recorded, with their permission, then transcribed in a field diary. The subjects of the study were doctors, nurses, dentists and community health agents of the Family Health Strategies team, totaling 24 (twenty four) health professionals, as well as ten volunteers identified in the research as people who use medicinal plants for health care purposes. From this study, we verify the great importance that health professionals and clients attribute to the use of medicinal plants, as well as evidence that family tradition is the main vehicle for the dissemination of knowledge regarding their use. Most medicinal plants had popular indications similar of those used scientifically, however, 70% of the clients reported never having had medical health advice or encouragement to use medicinal plants in their treatments. Half of the group of professionals interviewed reported not feeling safe in prescribing medicinal plants; approximately 25% reported having received information on the subject during their undergraduate program. Expected outcomes of this study include instigating the implementation of treatment protocols by the health professionals, and broadening holistic care practices, as well as access to alternative therapeutic options, client participation, ultimately strengthening the link between primary care and Family Health Strategies

Políticas públicas, desenvolvimento local e participação social nas instâncias de governança associadas ao turismo no Rio Grande do Norte

In contemporary dynamics, a change is observed in the institutional structure of the state, culminating in several policies for the tourist sector which promote a new management format. The from this view, the Tourism Regionalization Macro Program (TRP), considered a significant program to Ministry of Tourism, arose as an answer to this new reality, having as strategy a joint working of structuring and promotion turned at decentralization of actions, valuing the residents participation in the search of the permanent dialogue between peers and revaluation of places and territories, based in the regionalization process. Based on this bias, this study aims to examine the role of the Tourism State Council of Rio Grande do Norte, with regard to the tourism planning, trying to understand it and solve it as governance Instance, through the Tourism Regionalization Program interventions, given the participation context of its actors and agents. For purposes of this study is delimited as time frame the year 2007 at 2014, understanding that it was this time, there was greater council members accession, as well as different types of sectors representation of civil society, as a result of a tourism public policy based on principles of innovation and participation. In relation to the research problem, this study is conceptualized as a qualitative and the chosen method is the materialist dialectic. Still on the methodological options, utilize the Content Analysis. The results show that the institutionalization of governance instance as the Conetur does not contributes, ideally, in the planning and management process of participatory and integrated tourist activity, facing a fair direction of your space production. The research indicates that there are debates, discussions and guidelines (still in a timely and targeted form), but not reverberates practical effects, by act in a conjuncture that Is strategically designed for political and economic power game, setting the hegemonic actors performance, which uses this arena to instill personal desires and wishes, that are decided in absentia to the council.

Validação do instrumento dos indicadores observáveis da qualidade do cuidado em instituições de longa permanência para idosos

The Nursing Homes are an important alternative care in the world, but Brazil still has no valid instrument to monitor the quality these institutions. In the United States, the Observable Indicators of Nursing Home Care Quality Instrument (OIQ) is used to assess the quality of Nursing Home care using 30 indicators of structure (2 dimensions) and process (5 dimensions) related to quality person-centered care. The present study aimed at cross-culturally adapting the OIQ in order to evaluate the quality of Nursing Home care in Brazil. Conceptual and item equivalence were determined to assess the relevance and viability of OIQ in the Brazilian context, using the Content Validity Index (CVI) and a group of specialists composed of 10 participants directly involved in the object of study. Next, operational, idiomatic and semantic equivalence were carried out concurrently. This consisted of 5 phases: (1) two translations and (2) their respective back translations; (3) formal appraisal of referential and general meaning; (4) review by a second group of specialists; (5) application of the pretest at three Nursing Homes by different social entities: health professionals, sanitary surveillance regulators and potential consumers. Measurement equivalence was evaluated by the Cronbach’s alpha test to verify the internal consistency of the instrument. To measure inter-evaluator agreement, the General Agreement Index (ICG) and Kappa coefficient were used. Timely compliance and 95% Confidence Interval of indicators, dimensions and total construct were estimated. The CVI obtained high results for both relevance (95.3%) and viability (94.3%) in the Brazilian context. With respect to referential meaning, similarity was observed, ranging between 90-100% for the first back translation and 70-100% for the second. In relation to general meaning, version 1 was better, classified as “unchanged” in 80% of the items, whereas in version 2 it was only 47%. In the pretest, the OIQ was easy to understand and apply. The following outcomes were obtained: a high Cronbach’s alpha (0.93), satisfactory ICG (75%) and substantial agreement between the pairs of evaluators (health professionals, regulators from the Superintendency of Sanitary Surveillance –SUVISA-, and potential consumers), according to the Kappa coefficient (0.65). It´s possible take the operational equivalence held since it preserved the original layout in the Brazilian version from the maintenance in application mode, response options, number of items, statements and scores. The performance of nursing homes obtained approximate average scores of 87, a variation 55-111 considering a range from 30 to 150 points. The worst outcomes were related to process indicators with a mean of 2.8 per item, while structure was 3.75 on a scale of 1 to 5. The lowest score was obtained for the care dimension (mean 2). The OIQ version was deemed to be a valid and reliable instrument in the Brazilian context. It is recommended that health professionals, regulators and potential consumers adopt it to access and monitor the quality of Nursing Home care and demonstrating opportunities for improvement.

A produção audiovisual do #foramicarla: características da apropriação do vídeo nos movimentos sociais em rede

Este trabalho se debruçou sobre a produção audiovisual das movimentações de protesto ocorridas em Natal, capital do Rio Grande do Norte, entre maio e junho de 2011, denominadas #ForaMicarla. Objetivou-se caracterizar esta produção numa tentativa de responder o porquê e como eles lançaram mão do vídeo em suas ações, sob as hipóteses de que a midiatização e o acesso facilitado a estas tecnologias tinham a ver com suas opções. Lançou-se mão de procedimentos histórico-dialético e teoria fundamentada (Fragoso, Recuero e Amaral), a partir das técnicas de observação não-participante, aplicação de questionário e entrevistas em profundidade. Posicionou-se estas movimentações sociais em redes, na conceituação de Castells, dentro de uma perspectiva da contra-hegemonia como uma Mídia Radical (Downing), sendo um Audiovisual de Combate (Bustos). Esta mídia possui as características do Novo Protesto (Assis), inserido no contexto da midiatização da sociedade de Verón e Sodré. Tentou-se também identificar historicamente as origens do poder hegemônico e a estrutura oligárquica, coronelística e familiar que fundou o poder no Brasil, apropriando-se do conceito de Coronelismo Eletrônico de Lima e Lopes e Assistencialismo Midiático de Guareschi, Dias e Hartmann. Através dos dados obtidos houve a emersão das categorias para análise deste tipo de audiovisual.

O som ao redor do baile: retomada e pós-retomada no cinema produzido em Pernambuco

This dissertation uncovers the path of Pernambuco’s independent cinema of the Retomada, of its production in the second half of the 1990s until mid 2012 when the sector manages to secure a funding edict (Funcultura) for its films and at the same time establishes a few symbolic mechanisms which contributed to the consolidation of a new cycle, the post-Retomada, namely: cinephilia and brodagem. Because it is a cinematography (pernambucana) outside the Rio-São Paulo axis, that is, outside the great center of the brazillian culture industry, the cinema produced in Pernambuco built a very specific modus operandi, in which a material basis, the consolidation of Funcultura, intercrossed with two symbolic practices feeding on each other, cinephilia and brodagem. In this regard, we seek not to establish the material perspective as the primary determination as opposed to the symbolic one. Futhermore, we followed the path of cinephilia in its direct commucation with the brodagem, and how both these logics pressured authorities to institute an incentive funding separated from other artforms in the state. From this point of view, we attempted to trace the trajectory of this cinematography in its external nuances, but also taking into account the internal nuances of its works of art (films). Following this, we created categories to define and distinguish the nuances of the Retomada and post-Retomada productions regarding ethical and aesthetical choices made by directors from both generations.

O som ao redor do baile: retomada e pós-retomada no cinema produzido em Pernambuco

This dissertation uncovers the path of Pernambuco’s independent cinema of the Retomada, of its production in the second half of the 1990s until mid 2012 when the sector manages to secure a funding edict (Funcultura) for its films and at the same time establishes a few symbolic mechanisms which contributed to the consolidation of a new cycle, the post-Retomada, namely: cinephilia and brodagem. Because it is a cinematography (pernambucana) outside the Rio-São Paulo axis, that is, outside the great center of the brazillian culture industry, the cinema produced in Pernambuco built a very specific modus operandi, in which a material basis, the consolidation of Funcultura, intercrossed with two symbolic practices feeding on each other, cinephilia and brodagem. In this regard, we seek not to establish the material perspective as the primary determination as opposed to the symbolic one. Futhermore, we followed the path of cinephilia in its direct commucation with the brodagem, and how both these logics pressured authorities to institute an incentive funding separated from other artforms in the state. From this point of view, we attempted to trace the trajectory of this cinematography in its external nuances, but also taking into account the internal nuances of its works of art (films). Following this, we created categories to define and distinguish the nuances of the Retomada and post-Retomada productions regarding ethical and aesthetical choices made by directors from both generations.

Correlação da imunoexpressão do fator de choque térmico 1 (hsf1) com aspectos clinicopatológicos em carcinomas de células escamosas de língua oral

Squamous cell carcinoma of oral tongue shows high rates of morbidity and mortality in the population, therefore, great efforts are being made to classify morphological changes and identify biomarkers that have prognostic value and that are able to group patients in individualized therapeutic options. From this perspective, there is the heat shock factor 1 (HSF1), which is a heat shock factor transcription protein (HSPs) that allows the cancer to deal with stressors associated with malignancy, acting differently in tumor progression. This research aimed to perform a clinico-pathological analysis of 70 cases of oral tongue squamous cell carcinoma (OTSCC) and immunohistochemical study of the expression of HSF1 protein in OTSCC, comparing it with 30 specimens of normal oral mucosa (NOM), and correlating this immunostaining with clinico-pathological aspects of OTSCC. To analyze the association between immunoexpression of HSF1 and clinicophatoloical aspects, the cases were categorized in minor and major overexpression, based in the median immunostaining score. Regarding the cases of OTSCC, 57.1% showed clinical stage III or IV, 82.9% were graded as high grade according to Bryne (1998) and 47.1% as high risk of malignancy according to Brandwein-Gensler et al., (2005). A disease free survival rate of 47.84% and overall survival rate of 68.20% was observed in the analyzed cases, and the high degree of malignancy according to Bryne’s system (1998) (p=0.05), tumor size T3 or T4 (p=0.04), local recurrence (p=0.02), and perineural invasion (p=0.02) determined negative impacts in survival time. We observed also a statistically significant result (p<0.01) when comparing the immunoreactivity of HSF1 between NOM and OTSCC. This significantly increased expression of HSF1 in cases of OTSCC suggests that this protein acts, indeed, in the pathogenesis of this disease. However, there were no statistically significant associations between this overexpression and the clinico-pathological parameters analyzed. This finding may reflect the influence of epigenetic events on HSF1 gene or a possible stability of this protein expression throughout disease progression.

Correlação da imunoexpressão do fator de choque térmico 1 (hsf1) com aspectos clinicopatológicos em carcinomas de células escamosas de língua oral

Squamous cell carcinoma of oral tongue shows high rates of morbidity and mortality in the population, therefore, great efforts are being made to classify morphological changes and identify biomarkers that have prognostic value and that are able to group patients in individualized therapeutic options. From this perspective, there is the heat shock factor 1 (HSF1), which is a heat shock factor transcription protein (HSPs) that allows the cancer to deal with stressors associated with malignancy, acting differently in tumor progression. This research aimed to perform a clinico-pathological analysis of 70 cases of oral tongue squamous cell carcinoma (OTSCC) and immunohistochemical study of the expression of HSF1 protein in OTSCC, comparing it with 30 specimens of normal oral mucosa (NOM), and correlating this immunostaining with clinico-pathological aspects of OTSCC. To analyze the association between immunoexpression of HSF1 and clinicophatoloical aspects, the cases were categorized in minor and major overexpression, based in the median immunostaining score. Regarding the cases of OTSCC, 57.1% showed clinical stage III or IV, 82.9% were graded as high grade according to Bryne (1998) and 47.1% as high risk of malignancy according to Brandwein-Gensler et al., (2005). A disease free survival rate of 47.84% and overall survival rate of 68.20% was observed in the analyzed cases, and the high degree of malignancy according to Bryne’s system (1998) (p=0.05), tumor size T3 or T4 (p=0.04), local recurrence (p=0.02), and perineural invasion (p=0.02) determined negative impacts in survival time. We observed also a statistically significant result (p<0.01) when comparing the immunoreactivity of HSF1 between NOM and OTSCC. This significantly increased expression of HSF1 in cases of OTSCC suggests that this protein acts, indeed, in the pathogenesis of this disease. However, there were no statistically significant associations between this overexpression and the clinico-pathological parameters analyzed. This finding may reflect the influence of epigenetic events on HSF1 gene or a possible stability of this protein expression throughout disease progression.