CAD e engenharia reversa como ferramentas de auxílio na fabricação de cartuchos para próteses ortopédicas

The manufacturing of above and below-knee prosthesis starts by taking surfac measurements of the patient s residual limb. This demands the making of a cartridg with appropriate fitting and customized to the profile of each patient. The traditiona process in public hospitals in Brazil begins with the completion of a record file (according to law nº388, of July 28, 1999 by the ministry of the health) for obtaining o the prosthesis, where it is identified the amputation level, equipment type, fitting type material, measures etc. Nowadays, that work is covered by the Brazilian Nationa Health Service (SUS) and is accomplished in a manual way being used commo measuring tapes characterizing a quite rudimentary, handmade work and without an accuracy.In this dissertation it is presented the development of a computer integrate tool that it include CAD theory, for visualization of both above and below-knee prosthesis in 3D (i.e. OrtoCAD), as well as, the design and the construction a low cos electro-mechanic 3D scanner (EMS). This apparatus is capable to automatically obtain geometric information of the stump or of the healthy leg while ensuring smalle uncertainty degree for all measurements. The methodology is based on reverse engineering concepts so that the EMS output is fed into the above mentioned academi CAD software in charge of the 3D computer graphics reconstruction of the residualimb s negative plaster cast or even the healthy leg s mirror image. The obtained results demonstrate that the proposed model is valid, because it allows the structura analysis to be performed based on the requested loads, boundary conditions, material chosen and wall thickness. Furthermore it allows the manufacturing of a prosthesis cartridge meeting high accuracy engineering patterns with consequent improvement in the quality of the overall production process

Desenvolvimento de métodos construtivos e de novos materiais empregados na confecção de cartuchos de próteses de membros inferiores

The manufacture of prostheses for lower limb amputees (transfemural and transtibial) requires the preparation of a cartridge with appropriate and custom fit to the profile of each patient. The traditional process to the patients, mainly in public hospitals in Brazil, begins with the completion of a form where types of equipment, plugins, measures, levels of amputation etc. are identified. Currently, such work is carried out manually using a common metric tape and caliper of wood to take the measures of the stump, featuring a very rudimentary, and with a high degree of uncertainty geometry of the final product. To address this problem, it was necessary to act in two simultaneously and correlated directions. Originally, it was developed an integrated tool for viewing 3D CAD for transfemoral types of prostheses and transtibial called OrtoCAD I. At the same time, it was necessary to design and build a reader Mechanical equipment (sort of three-dimensional scanner simplified) able to obtain, automatically and with accuracy, the geometric information of either of the stump or the healthy leg. The methodology includes the application of concepts of reverse engineering to computationally generate the representation of the stump and/or the reverse image of the healthy member. The materials used in the manufacturing of prostheses nor always obey to a technical scientific criteria, because, if by one way it meets the criteria of resistance, by the other, it brings serious problems mainly due to excess of weight. This causes to the user various disorders due to lack of conformity. That problem was addressed with the creation of a hybrid composite material for the manufacture of cartridges of prostheses. Using the Reader Fitter and OrtoCAD, the new composite material, which aggregates the mechanical properties of strength and rigidity on important parameters such as low weight and low cost, it can be defined in its better way. Besides, it brings a reduction of up steps in the current processes of manufacturing or even the feasibility of using new processes, in the industries, in order to obtain the prostheses. In this sense, the hybridization of the composite with the combination of natural and synthetic fibers can be a viable solution to the challenges offered above

O programa Saúde da Família pelo olhar do Cirurgião-Dentista

This study tried to know the social representation of dentists surgeons about the Family Health Program (FHP). Where used as methodological instruments a semi-structured interview and direct observation of work process in tive towns that are part of the metropolis region ofNatal city. During the interview some aspects where broached, such as the reasons of dentists surgeons join the FHP, what are the implications ofthe introduction of this program in the everyday practice, what kind of activities are they practicing and what are those professional missing the most in the FHP. In the direct observation where take in account some aspects related to the physic structure of health units, its service organization and demand, relationship amongst dentist and other member of the team, and about patient receptiveness, when they arrives at health unit. This study also identifY the researches subject showing their age, sex, for how they are graduates, what are them specialty and for how long they work for the FHP. The data had been analyzed through the analysis of content of Bardin5. The dentists depict the FHP for the change in assistance model through the preventive proposal of social work that makes possible to work with an ample concept of health. However what makes the FHP more attractive to dentists is the salary questiono The creation of bonds whit the community and the work whit groups and in team had been the main occurred changes in the daily one of the pratices ones of these professionals. The principal activities executed for these professionals inside of the new strategy of assistance in oral health are the carried trough preventive activities achieved in health units and social area. To them, the absence of institutional support and the employment of only one dentist for each team it is one the main point of strangling. There is no doubt that FHP is new strategy and that it is need a better integration amongst the professional, the institution

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

Medo de dentista em cena: uma análise de produções cinematográficas

The fear related to dental procedures can be acquired through disturbing experiences and/or negative cultural influences related in experiences of previous generations. Such influences may be present in diverse forms of cultural expression: in the cinema, plastic arts, music, literature, and diverse vehicles of printed and visual media. This research aimed investigates the images of fear related to the dental service and dentist in motion pictures. The study has qualitative approach, which used the documentary analysis of movies. The data collection was accomplished through research in the Internet by means of the Google tool (http://www.google.com.br), using the describing words filme and dentista . A total of 44 films were found. Of these, after selective criterion for films with scenes showing interaction between dentist and patient in the execution of clinical procedure, only 24 films were enclosed. Then, these were registered in data base created for this research. After second selective criterion of inclusion (scenes with suggestion of dental anxiety), 15 films remained. As regards cinematographic gender, the films with scenes showing "dental anxiety" varied between comedy (8), horror (3), drama (2), thriller (1) and childish (1). Of these films, scenes with images of situations that suggest fear of the dentist and his job were selected and described. The images were categorized by the identification of negative characteristics that incite "dental anxiety". Then, the classification of the categories was proceeded detaching the most recurrent characteristics in the scenes: situation of fear in the waiting-room; pain; instrument coarse/rudimentary; coarseness of the dentist; torture; and low qualification technique. The waiting-room was observed as a place of great tension, due to the noises coming from the dental attendance. The pain related to the Dentistry was the predominant subject in the majority of films (14), associated to others negative characteristics. The rudimentary aspects of procedures and instruments, and the coarse attitudes of the professional could be observed too. The dentist was characterized as confused, sadist, violent, insensitive, incompetent person and disturbed. Such results suggest that, despite the technological advances of the profession, the image of the dentist and his job is still transmitted in a negative way aspect and reinforces the dental anxiety

Os significados de ludoterapia para as protagonistas do processo: crianças em atendimento

The ludic therapy in a Phenomenological-Existential perspective is conceived as a psychotherapeutic process in which, the listening and talking, mediated by playing activities, allow the child to deal with their grief/suffering. This study is based on the need to broaden the understanding of this modality of clinical intervention by emphasizing the speech of the protagonists in the process: children in therapy. The objective was to understand the ludic therapy from the children s perspective, knowing the meanings assigned to the therapeutic process, to the psychologist and to the involvement of the children in clinical consultations. The main ideas that underlie this research are presented in three theoretical chapters covering, respectively, the suffering of children and the demand for psychotherapy, the Phenomenological-Existential clinical psychology, and the psychotherapy for children, in Brazil, under this theoretical-methodological approach. The study was qualitative, on a phenomenological basis, and included six children as participants, aged between six and ten years, undergoing ludic therapy for at least six months, and referred by their own therapists. In the research s corpus construction, individual meetings were held and mediated by tools to support expressiveness (ludic and pictures/figures boxes), added by the storytelling of an incomplete story about a child s visit to the therapy session, and the request for the elaboration of a message to be passed to a child who will go to see a psychologist. The analysis of the data was based on a variant of the phenomenological method proposed by Amedeo Giorgi. The results reveal a lack of knowledge by the children about the psychologist s activities. Thus, the children develop fantasies about this intervention modality because of lack of information. These observations are consistent with the historical meanings assigned to clinical psychology, involving ideas of normality and guilt. The meanings associated with the motives for a referral to a psychologist highlight the conflict "be a problem versus having a problem" and an elitist conception of clinical psychology. Children understand the characteristics of the therapeutic process, such as the specifics of the therapist-client relationship and the notion of freedom. They also demonstrate remarkable pleasure in the therapeutic process. Finally, it was concluded that the meanings attributed to the ludic therapy by the children are consistent with that proposed in the literature about the children s psychotherapy process in the Phenomenological-Existential perspective. Moreover, the relevance of both the children s experience in the therapeutic setting and the meanings of these proceedings understood by the children are highlighted by the listening to the protagonists in the ludic therapeutic process. The comprehension of these aspects and their transference from the clients experience to the reflective field, promote advances in the understanding of child psychotherapy and indicate the need for further studies with children using this approach.

Doadores de sangue: qualidade de vida e atendimento em hemocentro de Natal / RN

The context of blood donation in Brazil faces problems since the start of its operations in the 1940, in the beginning the biggest obstacle was obtain safe and qualified blood, and then, established criteria for donations, the barrier is the low number of suitable candidates for donation. This suitability is associated with the good health of those who goes to the services of blood banks and the return of the donor is often conditioned by the way care is given and perceived by the user. The quality of life, defined as a perception that a person has of her/his position in the world, can influence the health and emerges as a way to focus on the subjectivity in a context dominated by objective and practical exams; listen to the views about the received services increases the focus on the user and provides feedback to the institution, guiding and planning its future actions. The purpose of this study was to verify the quality of life in blood donors and their perceptions of care in a blood center in Natal/RN. This is a descriptive cross sectional study conducted with blood donors from Dalton Cunha Barbosa blood center. The used protocols were: a structures questionnaire with questions on sociodemographic and services perception data, and SF-36 quality of life instrument. The sociodemographic and SF-36 data ware analyzed using descriptive and inferential statistics, using the statistical package PASW 18.0; those related to treatment were submitted to thematic content analysis. The results revealed a sample mainly composed by men, married people, who attended high school and had already made previous donations, with the first two groups returning more often for donations. The scores of the SF-36 confirm the certificated of good health of the screens, beind high in all areas and featuring a healthy population; statistically significant differences were denoted between sexes, levels of education and marital status. The speeches about the service were mostly positive and had as main focus acess, agility, technical aspects and subjective feelings. The data regarding the Rio Grande do Norte blood donors profile confirmed some characteristics of the Brazilian ones, those data of the SF-36 were similar to those found in studies with healthy groups and the impressions about the care received show similarities with national and international studies about the attendance at blood banks

A redução de danos no atendimento especializado em álcool e outras drogas

The harm reduction HR is the official policy of Ministry of Public Health to deal with problem derived from alcohol consumption and other drugs AD. The HR refers to policies and support programs whose purpose is to reduce the risks related to the use of AD, without necessarily decrease individual consumption. This research aim was to analyze the HR conceptions and practices at two specialized institutions for AD users: 1) Psychosocial Care Center Alcohol and Drugs III (CAPSad III); 2) Therapeutic Community Fazenda da Esperança (FE) Dom Bosco. This is a qualitative research that used the following methodological tools: semi-structured interview with 21 professionals; socio demographic file and rounds of conversation with 63 participants users; participant observation and field journal. The interviews with professionals have characterized HR as a less complex and cheap treatment. At FE the HR proposal does not make part of their actions, being considered ―against the human being dignity‖. At CAPSad III is understood as an ―inevitable‖ guideline to service, once users do not remain abstinent. The users understand RD as an improvement in healthy conditions, social relations and work that occurs with the decreasing consumption of AD. They use the HR when they avoid situations that facilitate AD consumption, share relapse prevention strategies and, exclusively at CAPSad III, decrease psychotropic consumption. Stands out as an analyzer the HR comprehension as a less efficient treatment that opposes to the objective of both institutions, which is abstinence. The HR is not operationalize in daily routine by professionals and users as a healthy promotion strategy, however, the users are more affected to HR and produce strategies to face the difficulties arising from the AD consumption

Escuta clínica e atitude fenomenológica no atendimento à pessoa surda: reflexões sobre um processo psicoterápico

Psychology uses listening as a work resource. When it comes to psychotherapy, listening establishes communication and makes psychologist-client dialogue easier. This qualitative research aims to discuss the clinic listening in phenomenological attitude in existential-phenomenological psychotherapy with deaf people. This perspective is based on the thinking of German philosopher Martin Heidegger, who considers humane a being-with and being-in-the-world, always unveiling meanings. Regarding the deaf people, Libras is currently the natural language of Brazilian deaf people. In this new language configuration, communication occurs in a visual-spatial modality. Thus, listening and speech gain new dimensions, demanding different ways of understanding in the field of psychotherapy. To the development of this research, we present excerpts from therapeutic sessions narratives with a deaf client, interpreted in the light of Heidegger s hermeneutics. We consider that it is possible for the psychotherapist to listen to deaf people in phenomenological attitude. Such position, which does not naturalize and limit the humane, helps so that the clients do not feel responsible for their existence and can hermeneutically converse in their language. In this context, the psychologist must be qualified to conduct the treatment in Libras. We hope that this research can, somehow, fill the existing gap of the scientific production about such theme in the field of Psychology and, mainly, instigate discussion in the context of Psychology courses on the importance and need to qualify psychologists for the management of clinical practice with deaf people

O cotidiano do(a) Assistente Social frente as demandas apresentadas pela paciente portadora do câncer de mama em tratamento no Hospital Doutor Luiz Antônio em Natal/RN

This work deals with an analysis related to the social worker s practice in the oncology area. It aims to identify demands, work conditions as well as current challenges related to this profession. It considers the specificities of breast cancer and relates it to political decisions in the health sector considering the concept of contemporary capitalism. The study analyzes professional action and the demands presented by breast cancer patients who are currently in treatment in Hospital Dr. Luiz Antônio em Natal-Rio Grande do Norte-Brazil. The methodological procedures considered of documental analysis, semi-structured interviews (with two social workers that work with fifteen breast cancer patients) as well as participant observation; which was done counting with my own professional practice in the oncology area. Thus, the research also discusses the breast cancer issue in the life of the users considering their social-economical, cultural and political determinants. Factors such as age in which the diagnosis was known, the relation user/social workers, number of children, rights of the oncology patient, place where he/she lives, education, civil status, (re)insertion of the professional in the work field, perception of self-esteem and bio-psycho-social representation of breast cancer in the lives of these women, all of which were dealt with in this research

Violência e luta por direitos no capitalismo contemporâneo: crítica à configuração do atendimento às mulheres no Rio Grande do Norte

This research analyzes the Rio Grande do Norte care services to women who face violence in the context of contemporary capitalism. To do so, we situate the patriarchy in the set of current social relations and its relationship with the corporate determinations in everyday life. The new functions of the Patriarchy in the capital sociability permeates the lives of individuals and particularizes the relationships of violence which affects women, requiring, in the immediate level, policy-making to face them. The research found an arsenal of contradictory possibilities and limitations in dealing with violence. In this process, forms of struggle and resistance predominate, which appear as possibilities and limits were identified relate to the socio-historical context of regression of the rights, historical moment in which increase the objective difficulties in everyday life to ensure the legal achievements. It is worth to emphasize the achievements and contradictions that characterize the struggle process for rights, linking services to women to the social policies and to the limits they face in opposition to the aims of the State to meet the mandatory requirements of capital, reducing its role as the main guarantor of policies and rights. In this sense, the trajectory of the achievements that have referred to the proclamation of a specific law to deal with combat violence against women, the Maria da Penha Law - 11.340/06, which provides an integrated set of measures that, if implemented, would allow the women protection from relations of violence they experience. We identified in Rio Grande do Norte precarious services that are essential to achieve the Maria da Penha Law. This situation requires a feminist organization to claim the rights that enable women to see themselves as people with rights in the process of collective struggle. This is the historical need for continuity of struggles that accumulate policies for the existence of a new model of social relations of gender. One of the possibilities that are presented in the current context is the impact on the public budget in order to ensure compliance with the budget for public policies for women - woman budget. In this perspective, feminist segments in national and state level have been organized to understand the functioning and monitoring of social policies. This is a condition and prerequisite for ensuring policies to ensure basic rights and the violence combat , which still requires an integrated set of services. The survey results allow us to consider that the struggle for rights is necessary at this historical moment, however it is not sufficient in human emancipation, which requires new forms of social relations that determine substantive equality between men and women. Thus, the feminist movement faces the challenge to organize and strengthen itself in daily life, in order to execute a project that changes the meaning of women's rights, articulated to a corporate project which wants other command in the set of social relations . This study emphasizes the need for a more and more organic connection between feminism and social struggles, to ensure the inclusion of women in anti-capitalist struggle

(In)visibilidade da violência doméstica no atendimento do Sistema Público de Saúde: nos bairros das Quintas e de Felipe Camarão

It analyses the approach given by health professionals (social workers, nurses and doctors) against woman violence at the Medical Unities of Felipe Camarão and Quintas of the City of Natal and searches to identify if the domestic violence is (in)visible at the Public Health Assistance System attendance. and It refers to the grandiosity of this violence and its consequences to the women health, recognizing it as a public health problem. To the comprehension of the relationship between violent acts against women and their health serious damages, exposes the battle history of the feminist movements and the brazilian women, demonstrating the visibility acquired by theses conquests of the questions related to the women and how the gender study becomes the central category to (re) think the social relations involving women and men, specially, the violent relationships between them. It analyses, mainly, those practiced by the husbands, partners, boyfriends or lovers. It refers, at the end, about the public politics of violence combat adopted at police stations at health centers, showing the difficulties to establish the legislation that exists to combat the violence suffered by the women that look for assistance at the health unities. It intends, with this way, to give more visibility to the domestic questions at the marital relations and ask attention from the public power and health professionals between them, the social worker to the (in) visibility of this problems at the attendances practiced