As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Aconselhamento em HIV/AIDS: ações e reflexões dos profissionais do Centro de Testagem e Aconselhamento (CTA)

The counseling on HIV/Aids consists in a prevention strategy that contributes to increase the diagnosis of HIV and start earlier the treatment. The counseling has as pillars the emotional and educational support, risks evaluation that aim at the adoption of safe practices and the individual s responsibility for his own health. To accomplish these results, it is necessary that health workers understand counseling as a unique educational moment that stimulates the user s critical-reflection when it comes to his role as an active subject in this process. This study aimed to analyze the counseling on HIV/Aids conducted by the professionals of the Testing and Counseling Center (CTA), based on the educational perspective of Paulo Freire . This is a descriptive qualitative study with a critical reflexive design based on the principles of Action-Science. All the professionals acting as counselors in the Joao Pessoa, PB CTA, eight in total, took part in the study. Data were collected during the month of March, 2011, through non participative observation and semi-structured interviews with a critical-reflexive focus, analyzed according to the tenets of the critical-reflexive methodology, and discussed taking into consideration the Paulo Freire s pedagogy and pertinent literature. It was observed that most of the professionals expressed the work philosophy of CTA as the diagnosis and prevention of the disease, associated with the utilization and demonstration of condoms. However, upon observation of their counseling sessions, these ideas were not converted in actions. Educational themes were not covered and the condom wasn t offered at any time. The counseling actions focused on the provision of information and filling out the paper forms which are necessary for attendance. The sessions were conducted with brief dialogues and little opportunity for the users to expose or complement their thoughts and needs. The professionals mentioned as facilitating conditions for counseling, the team interaction and physical structure. The difficulties focused on the users low cognition, the large demand for attendance, aspects related to the service organization, and the counselors absences and delays. After reflecting about the actions observed in the counseling, the majority of professionals admitted the need to modify their practice in the incorporation of educational principles for the achievement of a broader prevention, and seemed to be willing to work in this perspective. In conclusion, although the counselors show ideas consistent with the purposes of CTA, these ideas are limited when it comes to the understanding of the meaning of prevention in HIV/Aids. Taking into consideration that they express a certain comprehension and act differently during the counseling, they demonstrate a lack of bond between the theories in use and the proposed ones, in accordance with the contribution of the action-science theory. The counseling, as an educative practice, doesn t materialize in the counseling itself and the orientation for reflection is not given during the attendance. These findings suggest the need to include the process of reflection in the execution of the actions of counseling, so that these practices are guided by reflexive practice, aiming at transforming the way of thinking and acting into a more educational perspective toward a more democratic and holistic assistance.

A intenção e o gesto :ações gerenciais de enfermeiros em espaços hospitalares

The present study analyses the supervisory practice of the nurse in the hospital environment. It has, as its main objective identify the use of planning, supervision and evaluation, as managerial instruments in the daily nursing practice. It tries also to identify the importance given to these instruments in their supervisory actions and the difficulties encountered in their use. It deals with an exploratory and analytical investigation with a qualitative approach having as its main point of analysis the principles of strategic planning. In order for it to be done 10 nurses were interviewed, distributed in three public hospitals in the city of Natal/RN. The results show that, although the nurses recognize the importance of the managerial instruments, they do not put them into practice in an effective and systematic way. They justify it because of the existence of personal, professional and institutional difficulties. On the other hand we could conclude from what they say that there is the desire to overcome the eminently burocratic vision of the management. Thus, they express a feeling for change and point in the direction of looking for ways that will contribute to innovate this practice

Produção pesqueira artesanal: diagnóstico ergonômico e bases para um planejamento nutricional situado e a promoção da saúde dos jangadeiros

The traditional fishing with rafts is characterized by unpredictability, high stakes and inadequate work conditions. The extensive working hours, physical wear, inadequate nutrition, unsanitary conditions, lack of salvage equipment and instruments suitable working, added by the presence of changes in the nutritional status of fisherman, that contribute to the picture of insecurity in high seas, injuries and health. This study aimed to analyze the activity of the fisherman s from Ponta Negra, Natal / RN, and check the conditions of supply of these fishermen and their implications on health and development of their work. To this finality, was used a methodology based on the ergonomic work analysis employing techniques such as observational and interactional conversational action, listening to the answers, observation protocols, photographic and video records. The script conversational dynamic action was developed from literature searches about the artisanal fisheries, culture and food habits of this population, and analyzes the overall situation of focus and two reference situations. To collect data on the usual diet of fisherman as well as quantitative and qualitative analysis that was used for data analysis and 24h recall the Food Frequency Questionnaire (FFQ). The impact of this power to the health of fisherman was evaluated performing a nutritional assessment. The results revealed that the fishermen carry out their activities with poor working conditions, health and nutrition. Feeding practices of these fishermen undertake development work, making it even more stressful, as well contributing to the emergence of Chronic Noncommunicable Diseases. The management of the activity, as well as the current structure of the vessel, also contributes to the adoption of inappropriate feeding practices during the shipment of catch. The results of this indicate the need for adequate interventions in order to assist in recovery and / or maintenance of health of fisherman minimizing reflections of nutritional disorders for the development activity by improving the quality of life in this population

Fatores influenciadores da implementação de ações de gestão de segurança da informação :um estudo com executivos e gerentes de tecnologia da informação das empresas do Rio Grande do Norte

Information is one of the most valuable organization s assets, mainly on a global and highly competitive world. On this scenery there are two antagonists forces: on one side, organizations struggle for keeping protected its information, specially those considered as strategic, on the other side, the invaders, leaded by innumerous reasons - such as hobby, challenge or one single protest with the intention of capturing and corrupting the information of other organizations. This thesis presents the descriptive results of one research that had as its main objective to identify which variables influence the Executives´ and CIOs´ perceptions toward Information Security. In addition, the research also identified the profile of Rio Grande do Norte s organizations and its Executives/CIOs concerning Information Security, computed the level of agreement of the respondents according to NBR ISO/IEC 17799 (Information technology Code of practice for information security management) on its dimension Access Control. The research was based on a model, which took into account the following variables: origin of the organization s capital, sector of production, number of PCs networked, number of employees with rights to network, number of attacks suffered by the organizations, respondent´s positions, education level, literacy on Information Technology and specific training on network. In the goal´s point of view, the research was classified as exploratory and descriptive, and, in relation of the approach, quantitative. One questionnaire was applied on 33 Executives and CIOs of the 50 Rio Grande do Norte s organizations that collected the highest taxes of ICMS - Imposto sobre Circulação de Mercadorias on 2000. After the data collecting, cluster analysis and chi-square statistical tools were used for data analysis. The research made clear that the Executives and CIOs of Rio Grande do Norte s organizations have low level of agreement concerning the rules of the NBR ISO/IEC 17799. It also made evident that the Executives and CIOs have its perception toward Information Security influenced by the number of PCs networked and by the number of attacks suffered by the organizations

Uma fonte chaveada de 50kW com correção de fator de potência para alimentação de uma tocha de plasma Indutiva utilizando técnicas de controle digital

This work deals with the development of an experimental study on a power supply of high frequency that provides the toch plasmica to be implemented in PLASPETRO project, which consists of two static converters developed by using Insulated Gate Bipolar Transistor (IGBT). The drivers used to control these keys are triggered by Digital Signal Processor (DSP) through optical fibers to reduce problems with electromagnetic interference (EMI). The first stage consists of a pre-regulator in the form of an AC to DC converter with three-phase boost power factor correction which is the main theme of this work, while the second is the source of high frequency itself. A series-resonant inverter consists of four (4) cell inverters operating in a frequency around 115 kHz each one in soft switching mode, alternating itself to supply the load (plasma torch) an alternating current with a frequency of 450 kHz. The first stage has the function of providing the series-resonant inverter a DC voltage, with the value controlled from the power supply provided by the electrical system of the utility, and correct the power factor of the system as a whole. This level of DC bus voltage at the output of the first stage will be used to control the power transferred by the inverter to the load, and it may vary from 550 VDC to a maximum of 800 VDC. To control the voltage level of DC bus driver used a proportional integral (PI) controller and to achieve the unity power factor it was used two other proportional integral currents controllers. Computational simulations were performed to assist in sizing and forecasting performance. All the control and communications needed to stage supervisory were implemented on a DSP

Modelos de dispositivos de microondas e ópticos através de redes neurais artificiais de alimentação direta

This dissertation contributes for the development of methodologies through feed forward artificial neural networks for microwave and optical devices modeling. A bibliographical revision on the applications of neuro-computational techniques in the areas of microwave/optical engineering was carried through. Characteristics of networks MLP, RBF and SFNN, as well as the strategies of supervised learning had been presented. Adjustment expressions of the networks free parameters above cited had been deduced from the gradient method. Conventional method EM-ANN was applied in the modeling of microwave passive devices and optical amplifiers. For this, they had been proposals modular configurations based in networks SFNN and RBF/MLP objectifying a bigger capacity of models generalization. As for the training of the used networks, the Rprop algorithm was applied. All the algorithms used in the attainment of the models of this dissertation had been implemented in Matlab

Desenvolvimento de um protótipo para alimentação de pós para aspersão térmica em tocha de plasma

The nanometric powders have special features that usually result in new properties, originating applications or expanding them in various fields of knowledge. Because having a high area/volume ratio, phenomena such as superficial strength of adsorption becomes greater than the weight of the powder which makes more difficult its handling. The high power of agglomeration of these powders requires study and development of equipments to enable its management into the plasma torch. The objective of this work is to develop a powder feeder which can solve the mainly problems about insertion of powder into the thermal spray developed in the laboratory of plasmas, which are carried out with plasma torch arc not transferred (plasma spray). Therefore, it was made a aluminum s powder feeder and tests were performed to verify their operation and determine its rate of deposition by spraying powders of niobium pentoxide (Nb2O5) and titanium dioxide (TiO2) with particle sizes less than 250 mesh (<0.063 mm). We used masses of 0.5 g - 1.0 g and 1.5 g of each powder in tests lasting 15 seconds - 20 to 25 seconds for each mass. The tests were performed in two ways: at atmospheric pressure using argon gas with a flow of 9 l / min as carrier gas and through a Venturi pipe also using argon gas with a flow of 9 l / min as carrier gas and with a flow of 20 l/min as the feed gas passing through the Venturi pipe. The powder feeder developed in this paper is very easy to be handling and building, resulting in feeding rate of 0.25 cm3/min - 1.37 cm3/min. The TiO2 showed higher feeding rates than the Nb2O5 in all tests, and the best rates were obtained with tests using mass 1.5 g and time of 15 seconds, reaching feeding rate of 1.37 cm3/min. The flow of feed had low interference in feeding rate during the tests

Avaliação da aplicação de modelos para a secagem de pastas e suspensões em leito de jorro com alimentação contínua

This work studies the development, implementation and improvement of a macroscopic model to describe the behavior of the spouted bed dryer with continuous feeding for pastes and suspensions drying. This model is based on the CST model (Freire et al., 2009) and the model of Fernandes (2005), whose theoretical foundation is based on macroscopic mass and heat balances for the three phases involved in the process: gas, liquid and solid. Because this technique is quite relevant, the studies of modeling and simulation of spouted bed drying are essential in the analysis of the process as a whole, because through them it is possible to predict and understand the behavior of the process, which contributes significantly to more efficient project and operation. The development and understanding of the phenomena involved in the drying process can be obtained by comparing the experimental data with those from computer simulations. Such knowledge is critical for choosing properly the process conditions in order to obtain a good drying efficiency. Over the past few years, researches and development of works in the field of pastes and suspensions drying in spouted bed has been gaining ground in Brazil. The Particulate Systems Laboratory at Universidade Federal do Rio Grande do Norte, has been developing several researches and generating a huge collection of experimental data concerning the drying of fruit pulps, vegetables pastes, goat milk and suspensions of agro-industrial residues. From this collection, some data of goat milk and residue from acerola (Malpighia glabra L.) drying were collected. For the first time, these data were used for the development and validation of a model that can describe the behavior of spouted bed dryer. Thus, it was possible to model the dryer and to evaluate the influence of process variables (paste feeding, temperature and flow rate of the drying air) in the drying dynamics. We also performed water evaporation experiments in order to understand and to study the behavior of the dryer wall temperature and the evaporation rate. All these analysis will contribute to future works involving the implementation of control strategies in the pastes and suspensions drying. The results obtained in transient analysis were compared with experimental data indicating that this model well represents the process

Estratégias midiáticas na aprendizagem do tema DST/AIDS: ações em rede para reduzir vulnerabilidades de adolescentes e jovens da comunidade de Mãe Luiza, Natal-RN

Youngsters and teenagers are still a very vulnerable group of DST/AIDS. In order to combat this vulnerability the community intervention project being developed in Mãe Luiza neighborhood in the city of Natal-RN, entitled Strengthening Community Action Network for Prevention in HIV/AIDS: knowledge and Intervene emerged, popularly known as Project Viva Mãe Luiza. The project develops workshops of educomunication whose approach involves the DST/AIDS subject with the following media: video, photography, and theater playbook. This research integrates the activities of the project and has as main objective to investigate how strategies and practices of media communication developed in Project Viva Mãe Luiza through workshops of educomunication, assisted learning for the prevention of DST/AIDS and contributed to the reduction of vulnerability to DST/AIDS among adolescents and young participants of the project residents of Mãe Luiza community. The methodological basis was based on intervention research, with the technique of gathering daily field data, literature and documentary, in-depth interviews and ethnographic observation. The qualitative analysis was based on the monitoring of video workshops, photography, theater and primer, respectively, crossed by transverse to the prevention of DST/AIDS, conducted between June 2012 and December 2013 issues. Interviews with eight multipliers, aiming to understand their perceptions of vulnerability, prevention, multiplication and use of media that were part of the project were conducted. The analyzes show that learning workshops educomunication community health repercussions both in the development of individual skills in communication as changing perceptions about the vulnerabilities to which they are exposed, the awareness about prevention at the individual and differentiated actions multiplication in the community

Percepção ambiental de crianças em ambientes naturais protegidos

This study aimed at exploring and describing children s perceptions in threatened natural settings, specifically, the Rain Forest in Brazil. Several studies point to the significance of perceptions for people s pro-environmental attitudes and actions. We try to understand the person-environment interaction from an ecological perspective, and we present theoretical references for the understanding of how crucial nature is for psychological development and well-being. The children s drawings, individual interviews, discussion groups, photographies and informal and indirect sources, as teachers, brought material for the analysis. Participated in our study, carried on through a multi-method strategy, 209 children from six to eleven years old, living in the neighborhood of the Biological Reserve of Una, State of Bahia, created to protect Rain Forest fragments. The Rain Forest landscape is well portrayed in children s drawings, the vegetal elements prevailing over artificial and human elements. The figured plants and trees, however, are pointed with no precision as to their species. Most of the defined species are eatable. The children seem to be aware of the environment degradation, and of the importance of its conservation, but they describe episodes of hunting and feeding wild threatened animals. Our results indicate a utilitarian trend in the perception of living beings, in terms of their immediate usefulness for people. The multimethod approach seems to be appropriate to the complexity of the theme; the methodological strategies were well accepted by the children, offering them opportunities to express themselves. We observed how children, in different life phases, organize natural elements and processes in their drawings, and how these images relate to the local landscape. We discuss the results in the light of theoretical references of personenvironment studies and from previous investigations about children s perceptions of natural environment

Avaliação das ações do Núcleo de Apoio à Saúde da Família (NASF) em Macaíba/RN

This research evaluated the contribution of the Support Center for Family Health (SCFH) in relation to its effect on the Family Health Units through perception of the Family Health Strategy (FHS) and SCFH professionals, in addition to the satisfaction of users in relation to that role. Data were collected in the public health services of the city of Macaíba-RN in 2012, through semi-structured questionnaire and non participant systematic observation and it counted as investigated subjects 272 individuals (60 FHS professionals, 12 SCFH professionals and 200 users representatives of 20 units). For analysis of the responses of the opened questions was used categorization process and, in relation to the observational method, that was based on checking the space organization, the characteristics of the participating subjects and the specific set of activities performed by SCFH teams through an observation guide. The results point to a good acceptance of the SCFH teams role by most FHS professionals who reported active participation in the health units routine, its integration activities to the FHS teams with resolving based health promotion actions. Regarding the SCFH professionals, they also reported positive contribution by participating actively in the units routine with integrated activities to the ESF teams and developing resolute actions. For users, the SCFH brought assurance services with better access to specialized, resolving and welcoming care. Systematic observation ratified data obtained by questionnaire. It was perceived the need to implement actions related to man`s health, to invest in expanding the number of the SCFH teams, the greater supply of medications, improving the regulatory process and planning together as a key strategy to promote a more effective integration between teams SCFH / FHS

Ações educativas com portadores de diabetes Mellitus através da educação popular em saúde

Popular Health Education in its emancipatory dimension refers to individuals and groups to exchange knowledge and experiences, allowing them to associate health to the outcomes of their living conditions. Under this view, health workers and health users are subjects of the educative process. Thus, this study aims to identify the key clinical and socio sanitary attributes and promote educational activities with patients with Diabetes Mellitus (DM) in a Family Health Care Unit of the Western Sanitary District, in the city of Natal / RN. It is an action research which uses the references of the Theory of Liberating Education, which is based on a problem-solving pedagogy and that values dialogue in the process of understanding oneself and the world. Thirty-six diabetics, who are residents of the area covered by the health care unit, and thirty health workers participated in the survey. Each group had an average of twelve participants, and the meetings took place at the Unit´s hall, using conversation wheels, group dynamics, life narratives, experiences telling, movie exhibition and discussions, music, knowledge telling, desires, limitations, beliefs and values socially constructed. Data collection took place during the second half of two thousand and thirteen through Free Word Association Technique (FWAT), recordings of conversation wheels, participative observation, group dynamics, testimonies, questionnaires, life narratives and photographs. The empirical material was organized and subjected to three analyzes: thematic content (Bardin), textual statistics analysis by software IRAMUTEQ (Ratinaud), and photographic analysis (Edmund Feldman). The data analyses originated words, expressions, categories, themes and creative situations showing that popular health education is in process of construction, but still very incipient in primary care. The National Policy on Popular Health Education shows us the necessary ways for the transformation of health practices and the build of a more shared and solidary society. The meetings could be place to reverse that normative logic that has been happening over the years in primary care, but that by itself is not enough. It is possible to conclude that the use of active practices, increasing of listening and training on Popular Health Education will enable changes in the scenario where users and health workers deal with diabetes mellitus. Thus we see the popular health education is being timidly incorporated to the educational process of the subjects involved in this study, and far away from the principles of participation, organization of political work, increase opportunities for dialogue, respect, solidarity and tolerance among different actors involved in addressing the health problems that are fundamental to the improvement in building healthy practices of primary care

Avaliação da qualidade da atenção primária à saúde da criança no Rio Grande do Norte: visão das usuárias

The study aims to evaluate the quality of the work processes of the teams from the Family Health Strategy regarding the comprehensive health care for children, in the view of users in the state of Rio Grande do Norte. This is a cross-sectional observational evaluative research with quantitative approach. The primary data are part of the External Review from the Program of Improving Access and Quality of Primary Care (PMAQ) in 2012. 190 women were interviewed. The inclusion criteria was the presence in the clinic at the time of the survey, have attended the service in the last 12 months and be a mother or companion of a child up to two years old. A research protocol was developed in the dimensions of Growth and Development, Breastfeeding and nutrition, and health problems and its variables. The results revealed that mothers / companions who responded to the questionnaire 71% were aged between 18 and 35 years, 92.1% were literate, 96.3% had a monthly income and 62.6% received financial assistance from the government. As for the children, 39.4% were aged between 13 to 24 months. In promotion and prevention actions for children, 64.2% had consultation up to the 7th day of life, 91.1% underwent the screening test, 95.3% had a health handbook, 98.9% had a vaccine, 17.9% breastfed or breastfeed from 6 to 24 months. As for link and continuity of care, 86.8% of the children were accompanied by the same professional staff and 59.5% left with next consultation scheduled. In acute situations 42.4% of the children went to the health unit and 64% of these were attended. It is concluded that the actions involving prevention and health promotion of children in RN, are evaluated positively by the service users and meet the requirements of MS, as well as link and continuity of care. The weakness in access and reception of users is evident, indicating the need to adapt the service to the demand of health and planning actions to welcome all who seeks basic health unit-UBS

Extensão universitária: concepções e ações na UFRN sob a temática direitos humanos e justiça no período 2008 a 2010

This paper concerns a study on the University Extension, by reference to the research extension activities under the theme human rights and justice, developed in the period 2008 to 2010 in UFRN. To do so, it tried to learn the concepts of extension in Brazil from the 1970s until the 2000s in contemporary times. This study considered the neoliberal social context of the University, dominated by educational policies focusing on the hegemony of liberal ideas about society, reflecting the great advances of capital on the organization of workers in the last decades and intensified in the 1990s. This research was guided by two great motivations: the opportunity to apprehend a way to enforce the commitment of public institutions of higher education to the disadvantaged sections of society and what role the university extension space plays as a socially committed public university. The general aim of this study is to identify inside the university extension education what does it mean for practitioners and extension activities and what results it produces to society and to the academic training of future professional citizens in the current neoliberal context. The research has been developed from an analytical and critical approach based on quantitative and qualitative data, using observation techniques and semi-structured interviews. We sought to investigate and understand the social reality, the main object of this work, with an interest in identifying the need for a new teaching/learning process and for a new university practice, in order to effectively improve an advanced academic formation. For this, some interviews have been conducted with teachers, students and the external community involved in extension actions in the period defined by the work, i.e., from 2008 to 2010. In this stage, it was observed that the academic work of university extension is essential to civic education. It was recognized too as a privileged space where university fulfills its social commitment towards society, as long as it joins scientific and popular knowledge having in view a new science and a new social order