Elaboração e avaliação de indicadores comportamentais de aderência ao tratamento hemodialítico

Introduction: This work intents to characterize behavioral indicators of tack to the hemodialysis treatment in a sample of carrying patients of chronic kidney failure (CKF) in the great Natal/RN. The therapeutical adherence represents the agreement degree between the patient behavior and the health team lapsings. The CKF is the gradual and irreversible loss of the renal function, being the hemodialysis treatment an important alternative to assist or to substitute the kidneys. Method: The sample consisted in 80 chronic kidney patients in hemodialysis treatment in two located clinical centers in the region of the great Natal, RN. It was used as instruments (a) a protocol of clinical data collection, (b) the Millon Index of Personality Styles (MIPS) and (c) a script of halfstructuralized interview. Results: The results show a balance between the genders (51% of female and 48.8% of the male sex), average age and equal average time of dialysis respectively to the 43,4 years (±13,25 years) and 22,04 years (±4,24 years). The marital status of half of the sample is married, predominating basic education (43.6%) and a familiar income until a minimum wage (43.8%). It had been defined six physicianlaboratorial indicators to evaluate the therapeutical adherence, further the use of the evaluation of the health team and the patient themselves. Thus, there was an average adherence around 55.97% of the sample ±18.37%). However only between selfassessment of the patients about the adherence and the assessment made by blood pressure post-dialysis indicated a significant association (p=0,029, qui-square test). On the other hand, there was a significant association (p <0.05, chi-square test) among the criteria for treatment adherence and issues investigated in the interview - the perception on the quality of the health services provided to patients, the difficulties following the prescribed diet, the characterization of the days between dialysis sessions and the perception of patients about the dialysis sessions. It was also noted a significant association (p <0.05, Levene test) between adherence to therapy and scales that constitute the MIPS. The health team characterized the patients more adherent behavior as an attitude of acceptance of the treatment, looking actively for their implementation, for more information and knowledge, and establishing a positive communication with the team and with other patients. Similar results were confirmed by the MIPS evaluation. According to that assessment the more compliant patients adopt a more optimistic attitude, trying to act or adapt themselves to their environment, processing cognitively both concrete and objective information, such as more speculative and symbolic information. In addition they establish a gregarious, cooperative, submissive and flexibly pattern of interpersonal relationships to social demands. These characteristics managed to explain 55.7% of the adherence variation according the health team and 23.3% of the variation according the CaxP laboratory indicator. Conclusions: The MIPS shown to be able to identify the most and least adherent to therapy patients. The use of different adherence indicators is important for an evaluation covering the different facets of this process. The adhesion levels are observed within registered by the relevant literature. There is need for further studies with a larger sample to deepen the data findings in this work

Indicadores associados a acidentes de trânsito envolvendo motoristas de ônibus da cidade de Natal

The purpose of this study was to investigate indicators of urban bus drivers involvement in transit accidents. We analyzed their involvement in accidents in relation to several indicators suggested by the literature, including the temporal dimension of those bus drivers, as expressed in Zimbardo's Time Perspective Inventory (ZTPI), for previous studies have shown that people more present time oriented revealed greater tendency to engage in risk driving. A questionnaire was applied to 457 bus drivers of the city of Natal, RN, Brazil, with questions about participants socio-demographic information, their professional performance and items on time perspective, presented in a five points Likert type scale. Among the indicators analyzed, the best predictors of traffic accidents were: worried about not being on schedule, family problems, and falling asleep; to work overtime, passengers complaints, work while on vacations and medical leaves. In regard to drivers' time perspective, the sub-scale of "combined present" showed a positive relationship with involvement in transit accidents, while the future scale a negative one, in both cases in accordance with the expect direction, even though the effects have not been statistically significant. The selected predictive variable indicate that traffic accidents are mainly associated to situational factors, that could be prevented through the betterment of work conditions of the bus drivers and other organizational and public policies, since transit accidents should be part of initiatives in the areas of health and safety

Indicadores de transtornos de estresse pós-traumático em bombeiros militares

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Hidrocarbonetos policíclicos aromáticos no meio ambiente: diferenciação de fontes em sedimentos e metabólitos em bile de peixes

Many studies on environmental ecosystems quality related to polycyclic aromatic hydrocarbons (PAH) have been carried out routinely due to their ubiquotus presence worldwide and to their potential toxicity after its biotransformation. PAH may be introduced into the environmet by natural and anthropogenic processes from direct runoff and discharges and indirect atmospheric deposition. Sources of naturally occurring PAHs include natural fires, natural oil seepage and recent biological or diagenetic processes. Anthropogenic sources of PAHs, acute or chronic, are combustion of organic matter (petroleum, coal, wood), waste and releases/spills of petroleum and derivatives (river runoff, sewage outfalls, maritime transport, pipelines). Besides the co-existence of multiples sources of PAH in the environmental samples, these compounds are subject to many processes that lead to geochemical fates (physical-chemical transformation, biodegradation and photo-oxidation), which leads to an alteration of their composition. All these facts make the identification of the hydrocarbons sources, if petrogenic, pyrolytic or natural, a challenge. One of the objectives of this study is to establish tools to identify the origin of hydrocarbons in environmental samples. PAH diagnostic ratios and PAH principal component analysis were tested on a critical area: Guanabara Bay sediments. Guanabara Bay is located in a complex urban area of Rio de Janeiro with a high anthropogenic influence, being an endpoint of chronic pollution from the Greater Rio and it was the scenario of an acute event of oil release in January 2000. It were quantified 38 compounds, parental and alkylated PAH, in 21 sediment samples collected in two surveys: 2000 and 2003. The PAH levels varied from 400 to 58439 ng g-1. Both tested techniques for origin identification of hydrocarbons have shown their applicability, being able to discriminate the PAH sources for the majority of the samples analysed. The bay sediments were separated into two big clusters: sediments with a clear pattern of petrogenic introduction of hydrocarbons (from intertidal area) and sediments with combustion characteristics (from subtidal region). Only a minority of the samples could not display a clear contribution of petrogenic or pyrolytic input. The diagnostic ratios that have exhibited high ability to distinguish combustion- and petroleum-derived PAH inputs for Guanabara Bay sediments were Phenanthrene+Anthracene/(Phenanthrene+Anthracene+C1Phenanthrene); Fluorantene/(Fluorantene+Pyrene); Σ (other 3-6 ring PAHs)/ Σ (5 alkylated PAH series). The PCA results prooved to be a useful tool for PAH source identification in the environment, corroborating the diagnostic indexes. In relation to the temporal evaluation carried out in this study, it was not verified significant changes on the class of predominant source of the samples. This result indicates that the hydrocarbons present in the Guanabara Bay sediments are mainly related to the long-term anthropogenic input and not directly related to acute events such as the oil spill of January 2000. This findings were similar to various international estuarine sites. Finally, this work had a complementary objective of evaluating the level of hydrocarbons exposure of the aquatic organisms of Guanabara Bay. It was a preliminary study in which a quantification of 12 individual biliar metabolites of PAH was performed in four demersal fish representing three different families. The analysed metabolites were 1-hydroxynaphtalene, 2-hidroxinaphtalene, 1hydroxyphenanthrene, 9-hydroxyphenanthrene, 2-hydroxyphenanthrene, 1hydroxypyrene, 3-hidroxibiphenil, 3- hydroxyphenanthrene, 1-hydroxychrysene, 9hydroxyfluorene, 4-hydroxyphenanthrene, 3-hydroxybenz(a)pyrene. The metabolites concentrations were found to be high, ranging from 13 to 177 µg g-1, however they were similar to worldwide regions under high anthropogenic input. Besides the metabolites established by the used protocol, it was possible to verified high concentrations of three other compounds not yet reported in the literature. They were related to pyrolytic PAH contribution to Guanabara Bay aquatic biota: 1-hydroxypyrine and 3-hydroxybenz(a)pyrine isomers

Estudo da descelularização tecidual na produção de arcabouços biológicos para enxertos

The regeneration of bone defects with loss of substance remains as a therapeutic challenge in the medical field. There are basically four types of grafts: autologous, allogenic, xenogenic and isogenic. It is a consensus that autologous bone is the most suitable material for this purpose, but there are limitations to its use, especially the insufficient amount in the donor. Surveys show that the components of the extracellular matrix (ECM) are generally conserved between different species and are well tolerated even in xenogenic recipient. Thus, several studies have been conducted in the search for a replacement for autogenous bone scaffold using the technique of decellularization. To obtain these scaffolds, tissue must undergo a process of cell removal that causes minimal adverse effects on the composition, biological activity and mechanical integrity of the remaining extracellular matrix. There is not, however, a conformity among researchers about the best protocol for decellularization, since each of these treatments interfere differently in biochemical composition, ultrastructure and mechanical properties of the extracellular matrix, affecting the type of immune response to the material. Further down the arsenal of research involving decellularization bone tissue represents another obstacle to the arrival of a consensus protocol. The present study aimed to evaluate the influence of decellularization methods in the production of biological scaffolds from skeletal organs of mice, for their use for grafting. This was a laboratory study, sequenced in two distinct stages. In the first phase 12 mice hemi-calvariae were evaluated, divided into three groups (n = 4) and submitted to three different decellularization protocols (SDS [group I], trypsin [Group II], Triton X-100 [Group III]). We tried to identify the one that promotes most efficient cell removal, simultaneously to the best structural preservation of the bone extracellular matrix. Therefore, we performed quantitative analysis of the number of remaining cells and descriptive analysis of the scaffolds, made possible by microscopy. In the second stage, a study was conducted to evaluate the in vitro adhesion of mice bone marrow mesenchymal cells, cultured on these scaffolds, previously decellularized. Through manual counting of cells on scaffolds there was a complete cell removal in Group II, Group I showed a practically complete cell removal, and Group III displayed cell remains. The findings allowed us to observe a significant difference only between Groups II and III (p = 0.042). Better maintenance of the collagen structure was obtained with Triton X-100, whereas the decellularization with Trypsin was responsible for the major structural changes in the scaffolds. After culture, the adhesion of mesenchymal cells was only observed in specimens deccelularized with Trypsin. Due to the potential for total removal of cells and the ability to allow adherence of these, the protocol based on the use of Trypsin (Group II) was considered the most suitable for use in future experiments involving bone grafting decellularized scaffolds

A produção das desigualdades: análise da relação entre trabalho infantil e indicadores sociais

The International Labor Organization (OIT) estimates that there are around 118 million children subjected to child labor around the world. In Brazil, there are 3.5 million workers aged between 5 and 17. This exploitation practice constitutes a serious social problem, including of Public Health, since these workers are exposed to a wide range of risks, such as those related to health, physical integrity and even to life, which may cause them to become sick adults and/or interrupt their lives prematurely. Therefore, this research aims to investigate the relationship between the frequency of child labor in the age group of 10 to 13 years and some socio-economic indicators. It is a quantitative research in an ecological study whose levels of analysis are the Brazilian municipalities grouped in 161 regions, defined from socioeconomic criteria. The dependent variable of this study was the prevalence of child labor in the age group of 10 to 13 years. The independent variables were selected after a correlation between the 2010 Census of child labor in the age group of 10 to 13 years and secondary data had been conducted, adopting two main independent variables: funds from the Family Allowance Program (PBF) per 1,000 inhabitants and Funds from the Child Labor Eradication Program (PETI) per a thousand inhabitants. Initially, it was conducted a descriptive analysis of the variables of the study, then, a bivariate analysis, and the correlation matrix was built. At last, the Multiple Linear Regression stratified analysis was performed. The results of this survey indicate that public policies , like the Bolsa Familia Program Features per 1000 inhabitants and Resources Program for the Eradication of Child Labour to be allocated to municipalities with HDI < 0.697 represent a decrease in the rate of child labor ; These programs have the resources to be invested in municipalities with HDI > = 0.697 have no effect on the rate of child labor. Other adjustment variables showed significance, among these the municipal Human Development Index (IDH), years of schooling at 18 years of age, illiteracy at 15 years of age or more, employees without employment contract at 18 years of age and the Gini Index. It is understood that the child labor issue is complex. The problem is associated, although not restricted to, poverty, the social exclusion and inequality that exist in Brazil, but other factors of cultural and economic nature, as well as of organization of production, also account for its aggravation. Fighting child labor involves a wide intersectoral articulation, shared and integrated with several public policies, among them health, sports, culture, agriculture, labor and human rights, with a view to guaranteeing the integrality of the rights of children and adolescents in situation of labor and of their respective families

Utilização de indicadores financeiros e não-financeiros na gestão de hotéis no Rio Grande do Norte: um estudo sob a ótica do Balanced Scorecard

This study presents the results of a research on the use of financial and non-financial performance indicators used by medium and large hotels. The research was conducted in Rio Grande do Norte, a Brazilian State. The objective is to identify the usage of performance measures by these companies. Hotel industry is one of the most important sectors in the Rio Grande do Norte economy. The research takes the Balanced Scorecard as a conceptual framework, since it represents an original contribution to the literature of managerial accounting, for rethinking old issues, pointing out themes that were forgotten or badly interpreted, to discuss the requirements imposed by the economy environment, dominated by competitive companies, and increasing the understanding of the relationship between strategy and operation. The objective of the research is to investigate if the hotel managers make use of a managerial information system or not, when evaluating the performance of their business unit. The research reveals the usage of performance evaluation using a large variety of measures. Among them is worth mention: the usage of accounting profit altogether with the EVA/MVA, the process cycle time, total quality management, process transformation, strategic mission, vision, strategic measures, measures related to feedback, risk, costs, productivity, incomes, customers retention, customer satisfaction and profitability, measures using time as a component, quality of the process, cost of the processes, employees capabilities, information systems, motivation, empowerment and alignment. The research leads to the conclusion that the usage of the deriving concepts of Balanced Scorecard can improve the performance measurement systems used by hotels

Mídia impressa e meio ambiente: um estudo da cobertura da mortandade de peixes no estuário do Rio Potengi, Natal-RN

Environmental issues are becoming increasingly habitual to the media, particularly when calamities are involved. A feature of environmental disasters is that they disclose both environmental crises and the media limitation in reporting them. The research tried to contribute to the subject through the study of press media coverage of a large fish kill along an estuary in the State of Rio Grande do Norte, Brazil, in 2007. Thematic content analysis of newspaper reports identified the predominance of a superficial and denunciative coverage, lacking an educational perspective, and with little contribution to formation of a critical sense in readers. It also has identified the precarious treatment of those scientific concepts that could substantiate the actual causes of mortality of tons of aquatic fauna

Análise da mobilidade urbana de Natal/RN a partir do uso de indicadores de sustentabilidade

In contemporary times, the urban mobility is presented as one of the main challenges of large and medium-sized Brazilian cities , it presents signs of unsustainability , above all due to the increase in motorized transport system , especially the individual . Thus , it is clear that mobility is considered of special interest for sustainable urban development , is facing a crisis that is reflected in negative externalities , particularly with regard to congestion , accidents , air pollution , social exclusion , among others. The complexity of these problems requires an integrated analysis based on the principles of sustainability . In this sense , trying to understand this problem and in the attempt to minimize its impacts, Costa (2008 ) proposed the Index of Sustainable Urban Mobility (I_SUM) with the goal of providing a methodology capable to assess relevant aspects of mobility , including social dimensions , political, economic and environmental . Given the above, was elected as the main objective of this study is to analyze urban mobility in Natal / RN from the perspective of sustainability . Like specific objectives will seek to analyze Natal´s urban mobility, using the I_SUM like a tool for both the city as a whole and for each of its four administrative regions; evaluate Natal s urban accessibility conditions and verify to what extent the access to urban services and equipment is facilitated or hindered because of the location and incomes of the population . For this, it was necessary to use bibliographic , documentary and field research . The index , which varies from 0.00 to 1.00, revealed for Natal an Global value of 0,510, and that refers to its administrative regions, it was found that there are very small percentage differences from the overall index calculated for the city . The performance of I_SUM by administrative region showed that although there are differences , the results were very similar , varying between 0,494 and 0,537. Particularly in relation to urban accessibility, it appears that Natal presents as an unequal city and this inequity , which is not only income is reflected in the issues related to accessibility and hence urban mobility

A experiência do corpo na dança butô: indicadores para pensar a educação

Neste artigo pretende-se refletir, apoiado em alguns ensaios de Merleau-Ponty e com base na fenomenologia, acerca do corpo e das narrativas e saberes que nele se anunciam na dança butô — modalidade que combina dança e teatro, criada no Japão na década de 1950. De modo geral, o corpo foi compreendido como elemento acessório no processo educativo, e essa compreensão ainda é predominante no contexto atual. Nossa reflexão tenta apontar outros caminhos de entendimento do corpo na educação, a partir de uma atitude que busca superar o instrumentalismo e ampliar as referências educativas, ao considerar a fenomenologia do corpo, e sua relação com o conhecimento sensível, como aquela capaz de amplificar a textura corpórea dos processos de conhecimento. Considerando a experiência do corpo na dança butô, apresentamos indicadores para pensar a educação, relacionados à experiência estética. Dentre eles destacamos: a plasticidade do corpo, a sua produção incessante de ressignificações, a sua abertura à inovação, a sua condição mutante, a sua ruptura com a mecanização gestual, a sua não dissociação entre homem e mundo, pensamento e sentimento. Todos esses aspectos que reúnem o saber recursivo, integrativo e criativo do corpo, são indicadores para pensarmos na educação, por tratar-se de uma nova possibilidade de leitura do real, a partir da linguagem do gesto, em que dialogam saberes e práticas inscritos na experiência corporal

Macrofauna de ambientes não consolidados adjacentes à recifes da área de proteção ambiental dos recifes de corais Rio Grande do Norte, Brasil

This study aimed to characterize, for the first time, the benthic invertebrates that inhabit the region of soft bottoms adjacent to the APARC reefs in order to situate them as an important component of infralittoral coastal areas of Northeast Brazil. Soft bottoms areas of APARC corresponds to infralittoral zones vegetated by seagrass Halodule wrightii and unvegetated infralittoral zones, both subjected to substantial hydrodynamic stress. Through scuba diving, biological and sedimentary samples of both habitats were analyzed, with a cylindrical sampler. We identified 6160 individuals belonging to 16 groups and 224 species. The most abundant macrofaunal group was Polychaeta (43%), followed by Mollusca (25%) and Crustacea (14%), what was expected for these environments. In the first chapter, regarding vegetated areas, we tested three hypotheses: the existence of differences in the faunal structure associated with H. wrightii banks submitted to different hydrodynamic conditions; the occurrence of minor temporal variations on the associated macrofauna of banks protected from hydrodynamic stress; and if the diversity of macrofauna is affected by both benthophagous predators and H. wrightii biomass. It was observed that macrofauna associated at the Exposed bank showed differences in structure when comparing the Protected bank, the granulometry of the sediments, that co-varies with the hydrodynamism, was the cause of these variations. The results also pointed to a lower temporal variation in the macrofaunal structure on the Protected bank and a negative relation between macrofaunal and benthophagous fish abundance. At the Exposed bank, a greater faunal diversity was observed, probably due to the higher seagrass biomass. The second chapter compares the vegetated and non-vegetated areas in order to test the hypothesis that due to greater seasonal stability in tropical environments, seagrass structure would act to distinguish the vegetated and non-vegetated areas macrofauna, over time. It was also expected that depositivores were the most representative invertebrates on non-vegetated environments, on the assumption that the seagrass bank would work as a source of debris to adjacent areas, enriching them. Considering all sampling periods, the total macrofauna abundance and diversity were higher in vegetated areas, when compared to non-vegetated ones. Seasonally, the structural complexity provided by Halodule differentiated more clearly the fauna from vegetated and non-vegetated areas, but only at the climatic extremes, i.e. Dry season (extreme climatic stability, with low hydronamism variation) and Rainy season (great hydrodynamism variation and probably vegetated bank burial). Furthermore, the high organic matter levels measured in the sandy banks coincided with an outstanding trophic importance of deposit feeders, proving the debris-carrying hypothesis. The last chapter focused on the non-vegetated areas, where we tested that the hypothesis infaunal halo in tropical reefs depending on local granulometry. In this context, we also tested the hypothesis that benthophagous fish predation would have an effect on the low abundance of macrofaunal groups due to the high hydrographic stress, thus allowing other predatory groups to have greater importance in these environments. Proving the hypothesis, no spatial variation, both on abundance families neither on community structure, occur along distance of the edge reefs. However, we found that complex combinations of physical factors (grain size and organic matter levels originated from local hydronamic conditions) covary with the distance from the reefs and has stronger influence on macrofauna than considered biological factors, such as predation by benthophagous fishes. Based on the main results, this study shows that unconsolidated areas around APARC reefs are noteworthy from an ecological and conservational point of view, as evidenced by the biota-environment and organismal relations, never before described for these areas