Processo de trabalho na estratégia saúde da família: potencialidades e fragilidades da atuação do enfermeiro

The present study aims to analyze the nurse s work process at Family Health Strategy, considering its basic elements and dynamic, and searching to identify aspects that may constitute strengths and weaknesses in its development. This is an analytical case study, with qualitative approach and theoretical-conceptual mark grounded in Dialectic Hermeneutics. Empirical research fields were the Family Health Units of Natal, RN, Brazil. The subjects are nurses working in this Strategy. Data collection was conducted through semi-structured individual interviews combined with field observation. The research was initiated after approval by the Ethics Committee of Universidade Federal do Rio Grande do Norte, according to the guidelines and rules for research involving humans (Resolution 466/12), ensuring proper ethical precepts. The project was approved by register number 398.929, CAAE 19588813.7.0000.5537. From the 9 interviewed nurses, 8 were female and 1 male, average age of 52 years, average graduation time of 27 years and average time they stayed at the same Family Health territory of 7 years. It was found that it is up to the professional nurse in the Family Health care the important role of taking care of human beings in their life, family and community contexts, producing conditions to meet their needs through therapeutic act in health, using for such purpose both materials and immaterial instruments. It was possible to relate aspects that characterize strengths and weaknesses in the work process of nurses in the ESF, according to the speech of the interviewed workers, including the meanings and contradictions. Among the potentialities observed, it was possible to highlight the wide role of the nurse at Family Health; the perception of nurses about teamwork; the relative autonomy of nurses; the commitment of professionals to work; Humanization as a technology; the presence of other agents at work, such as directors and officers at the primary health units; the professional s experience time and contract type in the case studied. As weaknesses in the work process of nurses at Family Health Strategy, were highlighted the limited skills of the workforce; the difficulty in 10 identifying specific limits of the work of nurses in this scenario; the disturbances that occur in the process, the existing gaps in multiprofessional teams; Structural deficits of the units in the studied case, the low coverage of the Family Health in the county, and the political vulnerability of the work conditions. It is considered necessary to understand the dilemmas experienced in everyday life of nurses at Family Health Strategy as part of multiprofessional teams, facing actual achievement of changes in work processes necessary for the reorientation of health care in Brazil. In accordance, it is necessary to promote proper working conditions and welfare of labor agents which are protagonists the work at the United Health System

Úlceras de pressão: um estudo com pacientes de unidade de terapia intensiva

To characterize patients according to gender, age category, internment time, diagnostical hypothesis and location of the pressure ulcer; to identify the susceptibility conditions, intrinsical and extrinsical factors present on ICU patients and to verify on the existence of association between the susceptibility conditions and the intrinsecal and extrinsecal factors on the occurrence of PU. Methods: It is a descriptive study, of longitudinal design of the panel type, with quantitative approach, performed on two ICU s of a private hospital located in Natal/RN, with 40 patients interned at these units. The data collection was performed on all three shifts through a structured observation and physical exam of the patients' skin form seeking to identify the presence of PU. Results: The greatest occurence of PU was on individuals of the male gender (70%) when compared to the female gender (30%), that difference being statistically significant (p=0,0267), with the male gender presenting 4,3 times greater chance of developing PU than the female; the predominant age category was from 60 years of age on (85%), 60,0% presented 1 to 2 PU s after 7 (seven) days of permanence in the ICU s, the predominant diagnostical hypothesis on the patients with PU were the respiratory diseases (42,3%) and the most frequent locations of PU were the sacral region (40,0%) and heels (36,0%). 25 PU s of stage I were diagnosed on 50,0% of the followed patients, with general incidence of 50,0% on both ICUs. from the 88 variables researched, 75 were identified on the patients from the study, being the predominant conditions (anemia, hypotension, leukocytosis, other diseases hypertension blood pressure, cardiac insuffience, pneumonia - and ansiolythic), the intrinsecal factors (diminished muscular strenght and/or mass, discrete edema, totally compromised mobile coordination and total inability for movement on the bed) and the extrinsecal factors (inadequate mattress type, permanence on a single position for >2 hours, shearing/friction force, bed clothes with folds that leave marks on the body, pressure force) predominated on patients with PU. The male gender variables (p=0,0267,OR=4,3), sedation (p=0,0006,OR=4,1), psychomotive agitation (p=0,0375,OR=5,8) and leukocytosis (p=0,0285,OR=5,0) presented a significant statistical diference when analyzed independently. We verified an association of 17,3%, statistically significant (p=0,0384), between the susceptibility conditions (anemia, leukocytosis and hypotension), the intrinsecal factors (age equal or above 60 years, diminished/absent pain sensibility and smooth, fine or delicate skin) and the extrinsecal factors (inadequate mattress, pressure forces, shearing/friction force, permanence on a single position for more than 2 hours, elevation between 30 to 45 degrees and inadequate bed clothes' conditions), with a chance ratio of 4,6 times the risk of occurrence of PU on the patients that presented the referred association. Conclusion: The incidence of PU detected on the ICU-interned patients was high and we made evident the existence of association between the susceptibility conditions, the intrinsecal and extrinsecal factors on the occurrence of PU s on the ICUinterned patients, and thus we accept the alternative hypothesis proposed on the study

O Prêmio Nacional de Qualidade e as políticas e práticas de recursos humanos :um estudo em empresas do setor de transporte público por ônibus da região metropolitana de Natal/RN

This work has goal of analyzing the practices of Human Resources in the per missionary enterprises of urban transportation, by bus, in the metropolitan region of de Natal, based on the standard person of the National Program of Quality 2004 and points if they are able to take part as prize-winning in this standard. Also this work aims, through a theoretical evolution of people management and its current practices, the history of the National prize Quality and its main standards, the importance of the urban transportation, its characteristics and the system itself in the metropolitan region of Natal. The research was carried out in 11 enterprises that operated in the area, with several dimensions and forms of management. The research variations were based on the standard person of the 2004 NPQ that deals with the system of work, preparation and development and life quality. In the statistical treatment, discriminated and exploiting analyses were applied. The main obtained results through the research, we can verify an administrative centralization in managers and owners hands; that 45% of the enterprises don t have a Human Resources Department, however, on the other hand, they practice some human Resources politics, indicated by the variations; as to the items system of work, 55% of the enterprises are able; preparing and development, 43%

Uma contribuição à avaliação dos impactos da gestão de estoque na satisfação e fidelização pós-vendas de clientes de concessionárias de automóveis : um estudo empírico em Natal-RN

This paper aims to conduct a study to evaluate and measure the possible impact that the unavailability of spare parts can have on customer satisfaction for car dealerships in the post-sales. A theoretical-conceptual review on the subject of satisfaction and loyalty, on the backdrop of the reality of the automobile market, allowed the construction of a research tool dedicated to collect opinions of car owners, to allow an analysis empirical relationship between the availability of parts, repairs or scheduled service possible, and change or stay on the mark on the occasion of change of vehicle. 236 forms were applied to car owners in the city of Natal / RN. The results obtained in this survey allowed the identification of the unavailability of parts as a significant factor, among others, the motivation for the customer to switch brands. Collaterally, we could also conclude that the dynamics of change in marks, whatever its motivation, is reflected in the perceived positions of the different brands as the market share both in strictly quantitative terms and in terms of relative positioning, with significant changes in the ranking of consumer preferences for different brands available

Estudo da radiação ultravioleta na Cidade de Natal-RN

There were studied the variation of the solar ultraviolet radiation (UVR) in four wavelengths (305 nm, 320 nm, 340 nm e 380 nm) and erythemic dose, measured in Natal RN Brazil, from January 2001 until December 2007, using the ground ultraviolet radiometer of the Instituto Nacional de Pesquisas Espaciais / Centro Regional do Nordeste INPE-CRN, fixed on the roof of the Laboratório de Variáveis Ambientais Tropiciais LAVAT-INPE-CRN. It was verified that the mean value of the UVR in the city reachs the HIGH index before 09h00 a.m. and VERY HIGH before 09h40 a.m.; it was also verified that, except in the months of June and July, in the other months of the year the UVR reachs the HIGH index before 10h00 a.m., despite of the recommendations broadcasting in the media about the safe time to people stay ashore on the beaches of the city. After 14h30 p.m., the UVR reachs the MODERATE index in any month of the year. These evidence are valid to all years of the period studied, i.e., 2001 to 2007. The year of 2004 presented the lower mean values of UVR indices, and the year of 2007 presented the higher mean values of UVR index. It was prove, by means of the analysis of variance (ANOVA), the variation in the four wavelengths and in the erythemic dose. Considering that the city has high indices of skin cancer and cataract, the results of the research may be use as a data source to studies that intend to support programs of public health. At the same time, the results of the research may be applied to material science and agriculture studies

Síntese e caracterização de tungstatos de cério e estrôncio para fins catalíticos

The main goal of this work was to produce nanosized ceramic materials of the family of the tungstates (tungstates of cerium and strontium), and test them for their catalytic activity in processes involving the transformation of methane (CH4). The methodology used for the synthesis of the ceramic powders involved the complexation combining EDTA-citrate. The materials characterization was performed using simple and differential thermogravimetry, x-ray diffraction, transmission electron microscopy, and energy dispersive spectroscopy (EDS). The microstructure analysis was performed using the refinement by the Rietveld method, and the crystallite size and distribution of the materials was elucidate by the Scherrer and Williamson-Hall methods. The conditions of the synthesis process for the three envisaged materials (SrWO4, SrWO4 using tungsten oxide concentrate as raw material, and Ce2(WO4)3) were adjusted to obtain a single phase crystalline material. The catalytic tests were carried out in the presence of methane and synthetic air, which is composed of 21% O2 and 79% N2. The analysis of the conversion of the reaction was done with the aid of an fourier transform infrared device (FTIR). The analysis showed that, structurally, the SrWO4 produced using raw materials of high and poor purity (99% and 92%, respectively) are similar. The ideal parameters of calcination, in the tested range, are temperature of 1000 °C and time of calcination 5 hours. For the Ce2(WO4)3, the ideal calcination time and are temperature 15 hours and 1000°C, respectively. The Williamson-Hall method provided two different distributions for the crystallite size of each material, whose values ranged between the nanometer and micrometer scales. According to method of Scherrer, all materials produced were composed of nanometric crystallites. The analyses of transmission electron microscopy confirmed the results obtained from the Williamson- Hall method for the crystallite size. The EDS showed an atomic composition for the metals in the SrWO4 that was different of the theoretical composition. With respect to the catalytic tests, all materials were found to be catalytically active, but the reaction process should be further studied and optimized.

Avaliação da disponibilidade hídrica e da demanda hídrica no trecho do Rio Piranhas-Açu entre os açudes Coremas-mãe D´água e Armando Ribeiro Gonçalves

Piranhas-Açu basin is a Federal watershed with a drainage area of 43.681,5 km2, sited at Brazilian northeast semi arid, with 60% of your area in Paraiba State and 40% in Rio Grande do Norte State. The main river, Piranhas-Açu, has strategic importance for development of these states, because it s an essential source for many socio-economics activities developed along watercourse. The river s reach between Coremas-Mãe D`água Dam and Armando Ribeiro Gonçalves Dam has many irrigation projects, and supply many riverside cities. All this activities practiced in this river s reach consumes high water volumes. Due the importance of this stream and the necessity of an adequate management, this work aims for an impartial and detailed evaluation of real water supply conditions in this river s reach, by the application of hydrological modeling, including the arrangement of main dams in tributaries, and storage reservoir water balance. The rainfall-discharge model s applied in each sub-basins it was selected the model MODHISA- Hydrological Model of Semi Arid, that is a concentrated model with easy application. The simulation produced 50 years of inflows into the reservoirs, for which, were constructed the guaranties curves; and produced 50 years of synthetic discharge data in relevant points on the river and on its affluents; so it was constructed the permanence curves. Confronting the available discharge with the current and futures volumes of raw water captured in this river s reach, it was verified that de demands have high guaranties. This work concluded that the MODHISA Model is suitable to reproduce the hydrologic characteristics of Piranhas-Açu sub-basins, and showing good results

Dificuldades de aprendizagem sobre conceitos de genética no ensino fundamental

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Uma história de vida e uma vida de histórias: memória e oralidade no Romanceiro de Dona Militana

Este estudio trata de establecer relaciones sobre la importancia del fenómeno sociocultural que emerge de Doña Militana para la cultura potiguar. Para tanto tomamos sus recuerdos de los romances como parte de un contexto social, relacionados con el tiempo y el espacio, que afecten a la vida material y moral de su grupo social. Resaltamos, por lo tanto, el fenómeno de la memoria individual en su relación con la memoria colectiva. Proponemos, en este sentido, suponer que el mantenimiento y permanencia de estos romances en la memoria de la romancera revelan una dinámica de su grupo social para la formación de su identidad. En este sentido, nos servimos como referencial teórico de los estudios de Maurice Halbwachs, en lo que respecta a los debates sobre la memoria colectiva, en paralelo a los estudios de Paul Zunthor cuando se trata de las funciones de la oralidad para la formación de la identidad. Para llevar a cabo los trabajos es de fundamental importancia, por supuesto, el relato de vida de la propia Doña Militana en confronto con los simbolismo culturales contenidos en los romances, con el objetivo que flagremos las (co)incidencias que demarquen la identidad de sus vínculos de identidad con el universo cultural en que está insertado. Como resultado, se tomó como objeto de análisis desde la deposición presentadas en las entrevistas, hasta los romances en sus aspectos poéticos, lingüísticos y mitológicos, incluyendo los significados que el desempeño de la romancera muestra. Objetivamos, por lo tanto, una comprensión dialógica de la relación entre la memoria individual (el caso de Doña Militana) con la memoria colectiva, sobre la base de un hipotético concepto que subyace a la aparente singularidad de este fenómeno - un hecho aislado en cierta medida - una razón intrínseca y compleja que se revela como la punta de un iceberg, al que convergen motivos históricos inconscientes de un patrimonio cultural

Resistência e performance na arte de João Cota

Researching about the art of tell and the tales told by João Cota is somehow revisiting the oral tradition and social practice in the story-telling art. It takes into consideration the resistance this art still exerts, mainly by using the performance of oral transmission and receptiveness to tales. The study of this practice contributes to the vivacious and dynamcis permanence of this authentic and traditional storyteller of his repertory and of his form to tellin our culture. Story-telling is part of the humankind living heritage communicated by means of popular wisdom. Despite the risk of vanishing into thin air, along with their narrators, the tales still manage to resist the contemporary mass culture model. How long further will stories like the ones narrated by João Cota be able to resist to strong and stronger structures dictated by writing and other communication means? João Cota s practice in story-telling will be studied not only as a proposal to identify the presence of this practice and the oral cultural resistance but also, through the performance prospective, to identify the oral transmission and receptiveness to the tales that are part of this storyteller s repertoire. In other words: what he tells, how he tells it, and why he tells it. The advent of new technologies such as internet, through which people can easily communicate with others in different parts of the world, and the greater and greater expansion in the writing skill concept interfere the maintenance of the oral tradition elements present in João Cota s narratives and inserted in the Brazilian culture. This has become more visible in the latest decades although we still notice the living tradition and permanence of the story-telling practice in several parts of the country through their wise storytellers. Our research target will require - in each of its study stages reference to works by several theoreticians namely Paul Zumthor, Mikhail Bakhtin, Câmara Cascudo, theoreticians from the receptiveness aesthetic, from the written culture history, from oral cultures and reading practices, from tradition and the Brazilian Culture of oral story-telling. In order to get to know and draw a profile of this storyteller, we ve chosen to use the comprehensive interview method by French Sociologist Jean Claude Kaufmann. The originality in the method consists of the qualitative data put together in situ , concentrated on the storyteller s narratives/speeches recorded on tape, which will be the focal point of this study. Our analysis method is based on tireless sessions of listening to interviews out of which we gathered information related to the storyteller, his practice in telling the tales, and his repertoire

A interface entre educação e mercado : uma análise crítica das mudanças socioculturais no contexto educacional

In the context of late modernity, the socio-cultural transformations established new social practices which corroborate discursive changes in dialectic movements, contributing to the order of the educational discourses to be more and more affected by typical market discourses and values which are covered by ideologies, hegemonic struggles and power relations. In this sense, this research study, which is based on the theoretical tenets of the Critical Discourse Analysis in its interdisciplinary branch (FAIRCLOUGH, 2006; ORMUNDO, 2010; PEDROSA, 2010; RAMALHO E RESENDE, 2011), aims at discussing how the sociocultural changes in the context of private education interact with the market proposal of neoliberal and economical policies. The research was methodologically based on the qualitative approach (CHIZZOTTI, 1991; BOGDAN e BIKLEN, 1994; MINAYO, 1994), especially on the principles of contemporary Applied Linguistics (SIGNORINI, 1998; MOITA-LOPES, 2006; MENEZES, SILVA, GOMES, 2009). Data were gathered from advertisements used in campaigns by private educational institutions and agencies in Natal/RN; the advertisements were collected in primary and secondary levels and in language courses from October to December, 2010. The data analysis indicate that education, in the context of globalization and late modernity, has become a market agency and that the new face of the educational discourse of private institutions is interwoven with a social representation of education as a site of struggle and hegemonic dispute. Therefore, the research leads us to infer that, as the educational public policies based on hegemonic economy and on ideological assumptions of international agents (Global Bank, FMI, etc.) have become widespread, education has become an arena of dispute and a powerful economic product to the market of cultural and commercial industry, thus emphasizing a society in which everything is economically based

Em cantos de reis: a tradição discursiva em Autos de Natal

This study incorporates many areas of knowledge to the Linguistics field, as it centers the social historicity of Brazilian and autos potiguares on two analytical proposes: the presence of linguistic formulas - in its macrostructure - into the paradigm of discursive traditions, following Kabatek (2006), Koch and Oesterreicher (2007), besides the theory of Speech Acts, in its microstructure, proposed by Austin (1990) and Searle (1995). Under Zumthor (1993; 1997; 2000; 2005; 2010), the idea of textual variability (mouvance) was alluded, highlighting that the text is always modifying, according to the performance and reception of the language uses. Considering this theoretical framework, we focus on the trinomial linguistic formulas, orality and performance, in order to describe the dynamics of stability, variation and change, emphasizing yet how extra-linguistic social-historic cultural relations influence its composition. Such discuss is inherent more precisely to Textual Analysis in enhancing the orality tradition as a linguistic support. The text, in its turn, becomes effective as an evocation, motivated by the transmission, reception and variability from its conservation and reiteration. Naturally, a methodological support based on quali-quantitative research was chosen, based on Flick (2009), who justifies the corpus composed by Brazilian Folias de Reis chants and Bois de Reis potiguares . Thereby Language dynamics, subjacent to tradition which takes effect by the use of a common social memory, are observed from two dimensions: on the first, it evocates the sacralization (religious) in which they stand their devotion to biblical History; secondly, a dissacralization with identified and ideological values, inherent to a people culture. The chant shows, in this ludic impulse, a contextualized activity which results in the following conclusion: the changing and stability processes in textual macro and microstructures occur, at the same time, by the adjustment to the use of the text accomplishing a social-political function and an ethical-pedagogic one; supposedly, social relationships arise the tradition and it, on its turn, evocates the variability and the nomadism in the text

Inês de Castro no romance contemporâneo português

Ines de Castro is a theme in literature from the fourteenth century. The historical fact of his death, in 1355, became a landmark in the history of Portugal and, since then, several literary texts from various genres, have dealt with this theme, this made the couple Pedro and Ines a myth of love passion, of love beyond the barriers of death, like Tristan and Isolde, Romeo and Juliet, Abelard and Heloise. The literary myth - or any picture that mythologize literature - is always prepared before culturally and works in the same way that so many others, this is, as an element of cultural identity, either collectively or individually, making it also a feature poetic. Thereby, is an archetype confirmed through time and eventually reveals a series of webs of the human psyche. Ines de Castro became the Portuguese myth of eternal love: she became queen after your dead. The persistence of the myth makes the love story of Pedro and Ines continue to produce texts of various literary genres. This study examines six contemporary historical novels, to show that the way actually this kind o novel does a new formulacion of Pedro e Ines mythical, because now it s different view likes the victim in Os lusiadas and other texts from the past. Collaborate to this news relacions between history and literature and a novelist's new stance in relation to historical facts that relate like reffering to novel. The intention is to show, through the novels chosen now Ines de Castro have different profiles than it had before in tradicional historic novels from the period of Romanticism and New Romanticism. Authored by Agustina Bessa-Luís, João Aguiar, António Cândido Franco, Seomara da Veiga Ferreira and Luis Rosa, the six novels studied show the circularity cultural of inesian myth showing this new character of the new person Ines in the contemporany historical novel

Correlação entre os parâmetros do cortisol salivar e o fenótipo de fragilidade em idosos institucionalizados

Introduction: The Frailty Syndrome is characterized by the decrease of energy reserve and the reduced resistance to stressors. Studies indicate that the neuroendocrine markers can be related to the appearance of this syndrome. The main endocrine answer to stress is the increase of cortisol levels. Objective: To analyze the correlation between the frailty syndrome the salivary cortisol in elderly residing in nursing homes. Method: A traversal study was accomplished, in João Pessoa city, PB, with a sample composed by 69 institutionalized elderly. The collected data refer to the frailty phenotype (weight loss, exhaustion, slowness, weakness, and lower level of physical activity) and to salivary cortisol parameters (first measure - 6-7h; second measure - 11-12h; third measure - 16-17h). In the statistical analysis the Pearson s correlation test was used, Chi square Test and Anova and Simple Linear Regression analyses. Results: The sample was composed by 37.7% of men and 62.3% of women, with age average of 77.52 (±7.82). There was a percentile of 45.8% frail elderly. The frail elderly obtained higher cortisol values in the third measure (p=0.04) and the frailty load was significantly associated to the first measure (r=0.25, p=0.04). The simple linear regression analysis presented a determination rate (R2=0.05) between frailty load and first cortisol measure. Conclusion: The largest cortisol values in the morning and before sleeping among the frail elderly supply indications that can have a relationship of cortisol increase levels and the frailty presence in elderly from nursing homes.

Fatores associados à condição de saúde bucal de pacientes internados em hospitais públicos do município de Natal-RN

The hospitalization is an event that can attack any person, independent of gender, race, social and economical condition. Last year, the prevalence of hospitalization was 8.1 for 100 inhabitants and the average time of hospitalization was 8.5 days for each patient one in Natal city. Therefore, an important point is whether the attention to the patients during the permanence in these health establishments incorporates the health integral model suggested by the principles proposed by the National Health System in Brazil (SUS), with actions of promotion and protection by different kinds of professionals, beside those called convalescence. Then, the aim of this study was to evaluate the patient s oral health conditions hosted in public hospitals of the Natal city, looking for to establish its relationship with several risk factors by two dimensions: the characteristics of the hospitalization and the patient s general and economical conditions. We accomplished a cross-sectional study with 205 patients distributed among the hospitals Onofre Lopes, Giselda Trigueiro and Monsenhor Walfredo Gurgel, looking for to know the socio-demographic characteristics, the food habits and of oral hygiene and the conditions of oral health, through the Visible Plaque Index and Gingival Bleeding Index. We observed that the conditions of the patient s oral health interned at public hospitals of reference of the municipal district of Natal is bad, existing accumulation of dental plaque and, consequently, a great number of patients with gingival bleeding. However, the time of hospitalization and its reason, the type of medicine used in this time and the toothbrush frequency were not configured as risk factors for this oral health condition