O sofrimento do paciente na UTI : escutando a sua experiência

In tertiary care, the Intensive Care Unit (ICU) is nowadays one of the most complex settings in providing care to critically ill patients and could make the difference in favor of life. Nevertheless, the stigma of death which pervades the imagination when the ICU is mentioned and the excessive importance placed on machines rather than on the human being end up by causing distress to some extent. As the purpose of this investigation is to understand the distress caused to a patient in an ICU, it has been grounded on the following question: What kind of distress does a patient go through during his/her experience in an ICU? This study has, therefore, an analytical and reflexive character embedded in a qualitative dimension of a phenomenological approach based on narratives. To this purpose, five patients were interviewed from November to December 2008. Out of the empirical material gathered from these narratives we were able to identify several factors that cause distress to ICU patients. Among them were: the certainty that they are critically ill and fear death, a closed room, too much lighting, a typical loneliness arising from being isolated from family members and dear ones, lack of communication with the professional staff, and noise; besides having to undergo therapeutic procedures. In summary, although the ICU is seen as a place of distress, in many aspects and in accord with this research, such distress can and should be relieved. On the other hand, being near to death leads them to a redefinition of life, said the patients.

Qualidade de vida de pessoas com úlcera venosa: associação dos aspectos sociodemográficos, de saúde, assistência e clínicos da lesão

Venous ulcer (VU) is a lower limbs injury resulting from inadequate return of venous blood in feet or legs. Although it is not a deadly disease, it causes chronic wounds, which seriously undermine patients´ quality of life (QOL) and sometimes leads to drastic family, social, economic and psychological changes. In this sense, there are several aspects that may influence the venous ulcers patients´ QOL. The study´s objective aimed on the association of socio-demographic and health, health care and clinical injury on UV patients‟ QOL. Analytical studies, which consider the complexity of factors involved in changes in UV patients‟ QOL has a cross-sectional and quantitative approach. The HUOL Ethics Committee approved this project (n.279/09). The collection of data lasted a period of 3 months in 2010 and it took place at the clinic of Angiology at Hospital Universitário Onofre Lopes (HUOL). The data sample consisted of 60 patients treated by UV angiologists in the HUOL Surgical Clinic. The results were analyzed with SPSS 15.0 by descriptive and inferential statistics. The study was based on UV patients that were predominantly female, average age of 61.4 years, that had low education level and low family income, with occupations requiring long periods of standing or sitting, but mostly retired, unemployed or laid off due to the disease and/or due to chronic diseases associated with the UV. The study took also into consideration patients that used inappropriate products, that were improperly treated by a professional caregiver, that lacked of adequate guidance and compression therapy, that performed no lifting of the lower limbs and regular exercise, that the time of injury were greater than or equal to six months, that were missing specific laboratory tests. The study‟s reference were on recurrent lesions, medium to large lesions area, bed of the lesion (injuries) with fibrin and/or necrosis, with amount of exudate with medium to large, odorless and no signs of infection, with tissue loss between 1st and 2nd degree, without collecting swab or biopsy and with pain. In general, QOL of researched individuals were considered low, the maximum score was 69 points, which the areas that were mostly influenced were the total scores of QOL functional capacity (0.021), emotional (0.000) and social functioning (0.080). Of the 60 individuals, 53.3% had scores between 40 and 69 points in SF-36, and they had the best scores in sociodemographic and health variables (ρ = 0.049). In respect to the assistance and injury characteristics, patients who scored between 40 and 69 points in SF-36 had better scores on these characteristics. By combining the socio-demographic variables, health, and handling characteristics of the injury, we observed a significant difference (ρ = 0.032) when linking them with the QOL total scores. When analyzing separately the domains of the SF-36 scores on the quality of life, we find that the areas that showed statistical significance were functional ability (ρ = 0.035), appearance (ρ = 0.019), emotional (ρ = 0.000), and mental health (ρ = 0.050). Among the socio-demographic characteristics studied, gender and marital status contributed more to the reduction of QOL and among the variables of assistance and the injury, orientation, reference and area of UV contributed the most. By analyzing these five variables all together in accordance with the overall score obtained in the quality of life, we found a significant correlation (ρ = 0.002); with 6.23 times more chances of patients have better QOL in the presence of these five positive factors. By conducting the Mann Whitney U test between all the five demographic variables, health, and clinical care, we found that this combination also proved to be significant (ρ = 0.006). Therefore, patients with these five variables positive tend to have a better QOL. Based on these results, we reject the null hypothesis (H0) and accept the alternative hypothesis (H1) proposed in this study because we noted that the QOL of patients with UV is associated with sociodemographic and health, health care and clinical aspects of the injury

Concepções de policiais militares sobre cuidados com a saúde

A ausência de cuidados do homem com a saúde representa um fenômeno significativo, pois contribui para o aumento da morbidade e mortalidade masculina por causas evitáveis. Essa realidade torna-se mais relevante quando se trata do policial militar, devido às peculiaridades do seu processo de trabalho. Visto isso, considera-se que os cuidados de saúde adotados por policiais militares atrelam-se ao entendimento de que possuem sobre os agravos à saúde, o qual perpassa por concepções de gênero e da profissão. Isso levou ao seguinte questionamento: Como o policial militar concebe os cuidados com a saúde. Objetivou-se analisar concepções de policiais militares sobre cuidados com a saúde. Trata-se de um estudo exploratório e descritivo, com abordagem qualitativa, desenvolvido junto a um Batalhão Militar do Comando de Policiamento de Natal, Rio Grande do Norte, Brasil. A coleta de dados foi realizada no período de junho a julho de 2013. Essa etapa foi antecedida pela anuência do Comandante Geral da Polícia Militar do Rio Grande do Norte, sob a aprovação do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, com o CAAE nº 15449713.7.0000.5537, e autorização formal dos entrevistados mediante a assinatura do Termo de Consentimento Livre e Esclarecido (TCLE), atendendo às exigências da Resolução 466/2012, do Conselho Nacional de Saúde, no que se refere à pesquisa com seres humanos. Participaram do estudo 21 policiais militares, do sexo masculino, que trabalhavam no policiamento ostensivo, não estavam de licença médica e apresentaram condições psicológicas e/ou físicas favoráveis para responder aos questionamentos. Os dados foram coletados por meio de entrevista semiestruturada mediante um roteiro constituído de duas partes: a primeira com questões sociodemográficas com vistas à caracterização dos participantes da pesquisa e a segunda com duas questões norteadoras relativas ao objeto de estudo. Os depoimentos foram tratados conforme o método de análise de conteúdo na modalidade de análise temática segundo Bardin. Desse processo, emergiram três categorias: hábitos de vida de policiais militares, repercussão do trabalho na saúde de policiais militares e atitudes de policiais militares em frente dos problemas de saúde. A análise dos dados foi subsidiada pelo referencial teórico do Modelo de Crenças em Saúde (Health Belief Model), de acordo com as variáveis vulnerabilidade e barreiras . Para respaldar a discussão dos resultados, buscou-se na literatura conhecimentos acerca da saúde do homem e do policial militar. Os resultados apontaram que os entrevistados procuram cuidar da saúde com práticas de exercícios físicos, alimentos saudáveis e preservação do sono. No entanto, vivenciam dores de coluna, ganho de peso, dificuldades para dormir, estresse e sofrimento psicológico. Diante disso, eles buscam apoio quando acometidos por agravos à saúde e reconhecem a necessidade de medidas de segurança durante o serviço. Portanto, notam a sua condição de vulnerabilidade em decorrência de seu ofício, porém enfrentam dificuldades na adoção de práticas preventivas de agravos a saúde. Mediante os resultados, faz-se necessário que o enfermeiro atuante junto a este público elabore, implemente e acompanhe estratégias de atenção a sua saúde

Autoestima e qualidade de vida de pessoas com úlcera venosa atendidas na atenção primária

Venous ulcers (VU) is a chronic injury of the lower extremities and because of its high incidence and recurrence implies long and complex treatments, damaging the quality of life (QOL) and self-esteem (SE) of the people. This study aimed to analyze the association between self-esteem with the quality of life of people with venous ulcers treated in primary care. Cross sectional analytical study with a quantitative approach conducted with 44 people met with VU at 13 primary care units 2 and Mixed units in Natal/RN. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte (UFRN), CAAE: 07556312.0.0000.5537. Held data collection from February to April 2014 and used three instruments: a structured form covering sociodemographic, health care and clinical variables, the Rosenberg Self-Esteem Scale and the SF-36. The collected data were entered into a database and processed on computerized software for descriptive and inferential analyzes. The results showed a predominance of people with UV females (65,9%), with more than 60 years (59,1%), married or in a stable relationship (52,3%), low education (86,4%) without occupation (68,2%) and less than one minimum wage income (81,8%). Regarding assistance characteristics was observed that most patients performed the dressing with appropriate material (72,7%), professional or trained caregiver (61,4%) did not use compression therapy (81,8%), treating the injury for more than 6 months (77,3%), lack of guidelines for the use of compression therapy, elevation of legs, and regular exercise (77,3%) and consulting the angiologist last year (52,3% ). Regarding clinical features of the lesion was found that most of the recurrent lesions are (77,3%), over one year of current lesion (52,3%) medium to large lesions (54,8%), without signs of infection (61,3%) and pain (79,5%). The mean SE of respondents was 9,3 (± 5,1). The relations between the SE and the sociodemographic variables, health care and clinics showed that individuals without a partner (a) (p = 0,01), who did not wear compression therapy (p = 0,04), with more 6 months of treatment (p = 0,01) and larger lesions (p = 0,01) had a lower SE. The mean domain and the dimensions of the SF-36 were lower emphasizing the functional capacity 36.5 (± 27,6) and the physical aspects of 15.3 (± 30,6). There were significant correlations between AE people with VU and the domains and dimensions of the SF-36: physical functioning (r = -0,432), general health (r = -0,415), vitality (r = -0,573), aspects social (r = -0,517), mental health (r = -0,612) and mental health dimensions (r = -0,612) and physical health (r = -0,473). Based on these results it is concluded by rejecting the null hypothesis and accept the alternative proposed in the study in which it was found that there is a negative correlation between the SE and the QOL of people with venous ulcers

Análise da adesão ao tratamento e da qualidade de vida de pessoas com úlcera venosa

The therapeutic adherence is still a big problem among people with venous ulcers (VU) because the treatment is long, expensive and demand changes in lifestyle. In this context, this study aims to examine treatment adherence and quality of life (QOL) of people with VU assisted at primary health care. This is an analytical, cross-sectional study with a quantitative approach to treatment and data analysis. The study had the scenario 13 Family Health Units and 02 Units Mixed of Natal. The target population consisted of 44 persons with UV indicated by the teams of the Family Health Strategy between February and April 2014. Three instruments were used: an instrument to characterize the sociodemographic, health and care aspects, the Multidimensional Scale of Adherence Therapy composed of the dimensions: healthy lifestyle, compressive therapy and neurovascular monitoring and the Charing Cross Venous Ulcer Questionnaire (CCVUQ) that evaluates QOL in persons with VU composed by the domains: Total Score, Social Interaction, Domestic Activities, Aesthetics and Emotional State. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, CAAE: 07556312.0.0000.5537. The data concerning the sociodemographic characteristics showed that there was a predominance of females (65.9%), age range as of 60 years (59.1%) and income of up to 1 minimum wage (81.8%). With the characterization of health, it was evident that most people reported chronic diseases (63.6%), sleep more than 6 hours (81.8%), present pain (81.8%), denying alcoholism (86 4%) and smoking (77.3%) and showed a number greater than or equal to 1 (77.3%) recurrences. Concerning the therapeutic adherence was found that in the dimension compressive therapy there poor adherence. No associations between the domains of adherence and sociodemographic and health variables were found. Was observed, however, better adherence among individuals without pain and with higher schooling. When analyzed the averages of the dimensions of therapeutic adherence with the care characteristics there was statistical significance between: adherence to compression therapy and guidance for use of compressive therapy (p = 0.002) and guidance for regular exercise (p = 0.026). Considering the mean of total score of CCVUQ (mean 51.47, SD 18.33) it is observed that the overall QOL of respondents has approximate value of the median of the scale (50). The mean of the domain Social Interaction (mean 44.23, SD 21.38) and Domestic Activities (mean 45.70, SD 23.21) were those who reported better QOL. There were weak correlations but significant between adherence to healthy lifestyle and Domains Total Score (p = 0.012), social interaction (p-value = 0.048), Aesthetics (p-value = 0.025) and Emotional State (0.017) of CCVUQ. From the data analysis it is concluded that among people with UV, there poor adherence to compressive therapy. Furthermore, we found no statistically significant association between treatment adherence and sociodemographic and health characteristics. It is added that there was a correlation between the healthy lifestyle dimension and domains CCVUQ

O cuidado humanístico como foco institucional: um estudo sobre empatia dos profissionais de saúde na área obstétrica

Empathy is a basic facilitating element of the therapeutic helping relationship and the humanization process in health care. The objectives of this study were to identify the empathy level of health professionals working in the obstetrical sector of a university hospital recognized for its humanistic care and the perceptions of the women under their care regarding the empathic behavior shown by these professionals during hospitalization. We conducted a quanti/qualitative study with 47 health professionals that worked in the obstetrical sector (13 obstetricians, 12 nurses, 22 nurse technicians) and an intentional sample of 101 women that received cared from these professionals during the study period. We collected data by means of the Jefferson Empathy Scale for Health Professioals (JEPS-HR) and the Patient´s Perception of Health Professional Empathy (PPHPE), and two additional open questions designed to obtain the subjective opinion about the empathic behavior during the care. We utilized thematic analysis for the data obtained through the open questions and descriptive and inferential statistics for the quantitative data. We identified five thematic categories that represent the aspects valued by the professionals in their relationship with the women under their care: emotional involvement, communication, warm environment, integral vision and technical/scientific knowledge. The mean score on the JEPS-HR reported for the health professionals was 120,40, being that the maximum possible was 140.The Cronbach Alpha for the JEPS-HR was 0,83, indicating an acceptable level of reliability for this population. We consider therefore, that these professionals presented an acceptable empathy level when compared to other populations observed with the JEPS-HR. The results also indicated that women had statistically significant (p ≤ 0,05) higher scores than men and that professionals with higher working hours tended to have lower scores in the empathy scale (r = -0,288; p ≤ 0,05). The analysis of the subjective responses of the women indicated that they were satisfied with the humanistic care provided by the professionals but they also point out the existence of some power relationships. There were no significant differences in the empathy level of the medical or nursing team perceived by the women who registered means of 41,90 and 41,20 respectively on the PPHPE. In view of these results and considering the relevance of the element of empathy for care based on humanistic values, we reiterate the importance of further in-service training for the health team of the hospital in focus, on the topics of empathy and global aspects of humanized care for the implementation of its mission

Razão e Fé: estudo do grupo de oração como prática complementar na promoção à saúde

The World Health Organization (WHO) has given special attention to therapeutic procedures other than those practiced in conventional therapy, including homeopathy, phytotherapy, spiritual therapies and prayers, making possible the transition from a mere medicalizating model to a holistic view of the human being. This trend, earmarked in 1978 at the Alma-Ata Conference, questions the ability of technological and specialized medicine to solve the health problems of humankind. In Brazil, the onset of the Brazilian unified health system in 1988, introduced changes in the population s health care model where, within the scope of basic care, emphasis has been given to the Family Health Program since 1994. In this scenery, there is a broad area of complementary practices used in promoting health and preventing and treating diseases to support an understanding of the habits and beliefs underpinning popular practices. The purpose of this study was to analyze the perception users participating in the Peace and Balance group of the Family Health Unit of Nova Cidade, in Natal, Rio Grande do Norte, started in 1999, have of the relationship between the experience of prayer and the changes that may have taken place in their lives after joining the group. It is a case study of descriptive nature and qualitative approach. The data were collected during focus group interviews between January and February 2007, using as tools a questionnaire to describe the research participants and a discussion outline. The theoretical support approached the following: religion and the evolution of thought; complementary health practices; and religion as a complementary health practice. Those interviewed reported, as results of such experience, a reduction in stress and depression, an increase in socialization and self-esteem, improved family interaction, comfort, safety, assurance, improved blood pressure levels and a decrease in the use of antihypertension medication and psychopharmacs. Although most professionals do not consider attention to the religious and spiritual aspects an effective therapeutical complement in health care, its understanding and practice may democratize knowledge and relationships, out of which they can learn how to make health production more effective, strengthening assurance and confidence, and developing and expanding soft technologies aimed at health care promotion and wholeness

Cosmoeducação: uma abordagem transdisciplinar no ensino de astronomia

This work proposes a transdisciplinary approach that integrates transpersonal psychology exercises with astronomy teaching, seeking to allow one to reintegrate the sky in his/her daily life, expand his/her environmental awareness and eventually experiment the unity between human and cosmos. This proposal intends to collaborate with the supplying of education, which lacks initiatives of this kind, with the promotion of an integration of the scientific knowledge with the human experience that transcends the materialistic and fragmentary objectives of the current educational system. As a result of that lack, the teachers formation is also poor as for an integral and transdisciplinary approach. Besides, we also approached in this research the necessity to propose alternatives so that the educators may work in a more assertive way with the environmental and anthropological crisis in which we are living. Our working hypothesis is that the contents of astronomy, when they are dealt in a holisticanthropological focus and are related with transpersonal psychology practices, can come to be an efficient cultural-academic vehicle, capable of propitiating an expansion of consciousness and changes in the way one conceives the world. Such changes are necessary so that a more solidary, fair and ecologically balanced life may come to exist and prevail in the planet. Part of the collection of data was done through the ethnographic method, once an anthropological interpretation is inextricably associated with this kind of educational intervention, which will naturally include ethno-visions of the universe as well as specific cultural elements. In the beginning the scope of this research was a group of students attending the Astronomy assignment in an undergraduate Geography course (UFRN), in which we accomplished participant observation, half-open interviews and the first experimental practices mentioned. After the evaluation of the first data collected from that initial group, we elaborated an academic extension course, Laboratory in Cosmoeducation, and we offered it to teachers of the 1st and 2nd cycles of the fundamental level of the Alceu Amoroso Lima State School, located in the North Zone of Natal. We prized self-experimentation in that course, so that the teachers could enrich their repertoire of personal experiences, stimulating meditative reflections and eventual changes in the ways of conceiving the world and in their pedagogical practice. The transdisciplinary attitude permeated all our educational action, because this approach transcends the boundaries of disciplines, seeking essentially the integral development of the human being. The process has made us realize that the practice of looking at the sky , as a way of reintegrating it into daily life, provokes a process of expansion of the consciousness and of reintegration of the self in a wider level of environmental interrelation. According to the results, the occurrence of conceptual and existential changes of the world vision of the participant teachers was evident, reassuring ourselves of the idea that the interface between astronomy teaching and the practices of transpersonal psychology can contribute to the recovery of a holistic relationship between the human being and the cosmos and to inspire the arising of a more wide-ranging ethics, based on universal, impartial and sustainable values

A estratégia didática de resolução de problemas na formação de professores de química

In this work it is presented a research developed in the initial training of teachers of the chemistry graduation course at the Universidade Federal do Rio Grande do Norte (UFRN). The intervention was realized in two classes in the context of a discipline in the curricular structure with nineteen undergraduate students of chemistry. The study utilizes characteristics of the qualitative approach and uses observation, questionnaires, interviews and examination papers. The experiment involved a sequence of activities fundamented on the Problem Solving (PS) teaching strategy to approach chemical concepts. The proposal was planned and organized according to the theoretical presupposition of the work developed by the authors of the Science Education in PS, of teaching experience and from the initial hypotheses of the research. The goal was that the future teachers could experience the strategy and advance to the new meanings. The themes addressed in the activities were the difference between exercises and problems, exercises turning into problems, the steps of problem solving and some implications of the teaching strategy for the work of the teacher. The results showed evidence that through a process of collective reflection, and from the difficulties experienced in the strategy practice, the undergraduates are introduced to new perspectives of reflection and action of teaching practice, and understanding some benefits of innovative proposals for the teaching of chemistry. It also showed that, although this theme is approached, in some moments of the graduation, the future teachers don‟t know when or how to realize activities in this perspective. From the aspects that rose in research we highlighted the difficulties in the problem solving steps, the use of the strategy in school and the knowledge and skills of the teacher for planning activities in Problem Solving

Propriedades dos sistemas de numeração: uma sequência didática em uma abordagem histórica

This paper aims to describe the construction and validation of a notebook of activities whose content is a didactic sequence that makes use of the study of ancient numbering systems as compared to the object of our decimal positional numbering system Arabic. This is on the assumption that the comparison with a system different from our own might provide a better understanding of our own numbering system, but also help in the process of arithmetic operations of addition, subtraction and multiplication, since it will force us to think in ways that are not routinely object of our attention. The systems covered in the study were the Egyptian hieroglyphic system of numbering, the numbering system Greek alphabet and Roman numbering system, always compared to our numbering system. The following teachung is presented structured in the form of our activities, so-called exercise set and common tasks around a former same numbering system. In its final stage of preparation, the sequence with the participation of 26 primary school teachers of basic education

Refletindo dificuldades de aprendizagem de alunos do ensino médio no estudo do equilíbrio químico

This research intends to identify the main conceptual mistakes committed by High School students when studying Chemical Equilibrium and also how the didactic books can influence in their formation. For the data - collecting we applied 150 questionnaires with 11 open questions e 4 restricted ones. Students from three different private schools in Natal-RN were used in this survey. The questionary about the book analysis tried to understand how the subject has been boarded, making it easier or not for the knowledge building. The books were chosen by being usually the most used ones at the chemistry classes in the schools in town. On the didactic book analysis we evaluated 12 items that tried to identify the clarity with which the books would bring up the subjects, the contextualization of the exercises, the analogies used, the amount and the quality of exercises, the connections between the subjects, and the retaken of important concepts. The questionary given to the students tried to get their knowledge about the concepts related to Chemical Equilibrium. The main mistakes found were: the definition of the state of equilibrium in a chemical reaction, the constant, the double headed arrow, confusions between mass and concentration, the representation of a microscopic reaction in equilibrium, partial pressure and total pressure, and the function of the catalyser. The results demonstrated a lot of insecurity or lack of knowledge about the subject when it was realized that there was a big number of blank questions and a considerable percentage of questions with conceptual errors. We concluded that those errors could be eased or even avoided if the didactic books and the teachers boarded the contents in a more conceptual form with the application of a largest number of good quality exercices, watching the building of definitions by the students, avoiding this way the formation of wrong concepts

As práticas exitosas de leitura no ensino fundamental: vozes sociais de professores e de estudantes

The school is the social place which should provide the formation of critical readers. In this context, the role of the teacher is crucial when it comes to teaching reading. Thus, this doctoral research aims to explicit the reading practices evidenced from social voices of teachers and Fundamental School students from state public schools at RN that have successful results, according to IDEB 2009. Moreover, we seek to explicit, through the positions of teachers, the conceptions of reading underlying their reading activities, as well as elucidate the social voices related to teaching of reading that are present in the National Curriculum Guide for 9 years Fundamental School and in the Political-Pedagogical Projects of the educational institutions investigated. In order to accomplish this goal, we carried out observations in the classroom, applied questionnaires with teachers and students in the 9th grade of Fundamental School, in classes of Portuguese Language, and also performed dialogical meetings with the management and pedagogics schools teams. The theoretical foundation that guides the research comes from bakhtinian thinking (2009, 2010), which addresses the dialogical perspective of language and active responsive comprehension. Furthermore, this work is anchored in theoretical reflections of Antunes (2005, 2009) and Geraldi (2003, 2006, 2010) about the reading and writing in the country, which contribute to the resizing of the teaching and learning process of Portuguese Language. This study belongs to the field of Applied Linguistics, which investigates language as social practice in the context of learning mother language or in contexts where relevant questions about the use of language are evidenced. The parameters of qualitative research in a social-historic perspective are adopted seeking to understand the school context by the subjects involved in research. The research corpus is composed of: (i) information constructed through the use of questionnaires with teachers and students; (ii) information constructed from the observed lesson and dialogue with management and pedagogical teams; (iii) a set of selected information, i.e., empiricism built through documentary analysis of the National Curriculum Guide for 9 years Fundamental School (CONSELHO NACIONAL DE EDUCAÇÃO, 2010) and the Political- Pedagogical Projects of the investigated schools. The analysis of the sayings of teachers and students suggest reading practices from various texts, in particular, from the literary sphere, in activities involving discussions, reading and reading comprehension exercises, interviews, songs, seminars organizations, concerts, dramatizations, literary weeks, among other practices. Furthermore, these analyses reveal that teach Portuguese Language requires commitment, responsibility and satisfaction, as well as more grounded theoretical principles, which make teaching practice more efficient. The research also reveals that the success of the teaching-learning process occurs by virtue of the involvement of school s segments in the educational process, creating therefore a network of responsibilities. In this sense, this research may contribute to the production of knowledge that can guide and enrich the teaching and learning of reading, envisioning a pedagogical practice constructed from the relationship with the other, i.e., from the dialogism which provides formation of young people that exercise their citizenship

Efeito da estrutura etária nas taxas de homicídios em regiões metropolitanas brasileiras (Natal - Recife - São Paulo)

Este estudio examina el fenómeno de asesinato, desde la perspectiva de cambiar la estructura de edad de la zona metropolitana de Natal, Recife y Sao Paulo, utilizando los datos del Sistema de Información de Mortalidad-SIM/DATASUS, del Ministerio de Salud. Se llevaron a cabo ejercicios teóricos estandarización directa con las estructuras de diferentes edades para evaluar el efecto de los cambios en la estructura de la población en las tasas de mortalidad por homicidio. Los resultados presentados en las pirámides de edad y las cartas apuntan a la población de edad avanzada en las tres áreas metropolitanas de la serie analizada, así como las que muestran un mayor riesgo de victimización en las personas, hombres, de edades comprendidas entre 15 y 39 años. Hemos utilizado diversos ejercicios de las tasas de homicidios con patrones estandarizados de distintas edades, incluyendo una población proyectada para el año 2020 de la Región Metropolitana de São Paulo, cada vez más evidente que cuando la población se vuelve más edad con menos gente en los grupos de mayor riesgo tienden a tener menores tasas de muertes por homicidio, también puede presentar otros resultados siempre la misma línea de razonamiento

Efeito de três tecnicas de alongamento muscular sobre o torque e atividade eletromiográfica

PURPOSE: To examine the acute effects caused by three techniques for stretching the hamstrings muscle on the active concentric peak torque (PT), passive PT and electromyographic activity (EMG). METHODS: Sixty volunteers (mean ± SD age, 22.6 ± 3 years), height 1.64 ± 0.07m and body weight of 58 ± 8.6kg, were randomly allocated into 4 groups of 15 subjects: Control Group (CG) - 5 minutes at rest, Static Stretching Group (SG) - 2 x 30s; Hold-Relax Group (HRG) - 3 x 6s of isometric contraction of hamstrings interspersed by 10s of hamstrings stretching and agonist Hold-Relax Group (AHRG) - 3 x 6s of isometric contraction of the quadriceps interspersed by 10s of hamstrings stretching. Evaluation has been conducted preand post-intervention, which verified the active concentric PT, passive PT EMG activity of IT. The statistical inference was performed by testing intra and inter, significance level at 5%. RESULTS: After intervention, there was a reduction in passive PT on CG, accompanied by a reduction of EMG activity, and an increase in passive PT on SG and AHRG. There was no change in the active concentric PT, or change in EMG activity. CG showed an increase in angle of the PT active, while the other groups showed no change. CONCLUSION: The results suggest that the shortterm stretching: 1) causes acute increase in passive torque, since the muscle does not perform sub-maximal contraction, 2) does not change in electromyographic activity and active torque, ind ependent of the technique

Exercício físico de baixa intensidade na dpoc: comparação dos programas solo e aquático

Physical Exercise (PE) is a necessary component in the management in COPD patients, where respiratory symptoms are associated with reduced functional capacity. Even with the increase in the number of studies that have been published and the therapeutics success using aquatic therapy approach, studies using PE in water in COPD patients are so few. Objective: the aim of this present study was to analyze the effects of low intensity water exercise in COPD patients, developed in two different places aquatic and ground. Methods: This is a randomized clinical trial study, 42 patients with moderate to very severe DPOC were recruited for the study, mean age of 63,2  10,9 years old. Randomized in 3 groups: Control Group (CG), Land Group (LG) and Water Group (WG). The PE protocol was performed in a period of 8 weeks, with frequency of 3 times per week. The CG participated in an educational program. All the patients were assessed twice through spirometry, respiratory muscular strength, the 6-min walk test, the quality of life (SF-36 and SGRQ), the LCADL, the MRC, the BODE index and the upper limbs (UP) incremental test. Results: There was a significant difference after the approaches in DP6 from the WG (p=0,02); in VEF1 in LG (p=0,00) and WG (p=0,01); in MIP in LG (p=0,01) and WG (p=0,02); in MEP in LG (p=0,02) and WG (p=0,01); the MRC decreases in WG (p=0,00). there was an increase of the weight supported by the UP in LG (p=0,00) and WG (p=0,01). The LG showed an increase of the quality of life represented by the SGRQ total score (p=0,00). The BODE index decreased in LG (p=0,00) and WG (p=0,01). In LCDAL, the LG showed a decrease. Conclusion: This data in this present study suggest that both approaches of low intensity exercise showed to be beneficial in moderate to very severe COPD patients. The WG showed additional benefits in physical function, pointing to a new therapeutic modality for COPD patients