117 resultados para MESTRADO EM CUIDADOS CONTINUADOS INTEGRADOS
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Muscle fatigue is a phenomenon that promotes physiological and biomechanical disorders and their changes in healthy subjects have been widely studied and have significant importance for care in preventing injuries, but we do not have many information about its effects in patients after ACL reconstruction. Thus, this study is to analyze the effects of fatigue on neuromuscular behavior of quadriceps after ACL reconstruction. To reach this objective, participants were forty men, twenty healthy (26,90 6,29 years) and twenty after ACL reconstruction (29,75 7,01 years) with a graft of semitendinosus and gracilis tendons, between four to six months after surgery. At first, there was an assessment of joint position sense (JPS) at the isokinetic dynamometer at a speed of 5/s and target angle of 45 to analyze the absolute error of JPS. Next, we applied the a muscle fatigue protocol, running 100 repetitions of isokinetic knee flexion-extension at 90/s. Concurrently with this protocol, there was the assessment of muscle performance, as the peak torque (PT) and fatigue index, and electromyographic activity (RMS and median frequency). Finally, we repeated the assessment of JPS. The statistical analysis showed that patients after ACL reconstruction have, even under normal conditions, the amended JPS compared with healthy subjects and that after fatigue, both have disturbances in the JPS, but this alteration is significantly exacerbated in patients after ACL reconstruction. About muscle performance, we could notice that these patients have a lower PT, although there are no differences between the dynamometric and EMG fatigue index. These findings show the necessity about the cares of pacients with ACL reconstruction in respect of the risks of articulate instability and overload in ligamentar graft
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Taking care for an impaired elderly is a hard and costly task that could affect directly the caregiver health. The purpose of this study was to evaluate the physical and mental health of elderly caregivers from the city of Santa Cruz-RN and analyze the potential correlated factors through an observational analytic design of a crosssectional. A multidimensional questionnaire was used to evaluation of the social demographics characteristics and those related to the care activity, as well as the caregivers physical and mental health. It was realized a descriptive analyze using frequency distribution and measures of the central tendency and dispersion to description of the caregivers. To verify the magnitude of the association between the variables was used the bivariate analysis through the Pearson and Spearman correlations and qui-square test. To evaluation of the association of the correlated factors to the adverse outcome with the caregivers physical and mental health was made a multivariate analysis by logistic binary regression and multiple linear regression models. The final sample was constituted by 304 persons, mostly women with a mean age of 50.3 16.8 years. The principal factors related to the physical health were age, stress and life satisfaction. Be a male caregiver, caring for a little while the elderly with cognitive deficit and not been spouse were related to worse mental health. Have worse physical health, high stress, depressive symptomatology, burden and low levels of satisfaction were also related to the mental health. After adjust through multiple linear regression was observed R2 values of R2=0,21 for Stress, R2 =0,17 for Depressive Symptomatology, R2 =0,21 for Burden and R2 =0,16 for Satisfaction. The attainment of the factors associated with caregivers health can help in the elaboration of specifics politics witch the goal is the integral attention to the elderly and his caregiver. The inability of continuous taking care could result in adverse outcomes such as institutionalization, impairment and death
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Introduction: The frailty in the elderly is the result of a complex interplay between many social and clinical factors involved in its genesis. Although there is an understanding of its association with increased risk of adverse clinical outcomes, still it is unclear whether this syndrome can be aggravated due to lack of social support. So, the objective of this study was to analyze the association between social support and frailty syndrome in elderly community residents. Materials and methods: Observational analytical cross-sectional study, with a sample of 300 elderly living in the city of Natal-RN. Were collected informations about socialdemographic, economics and physical health data. The Social support was assessed by the status of cohabitation; marital status; contact frequency and diversity rate; received and given attendance frequency rate; and Map Minimum Relations of the Elderly. The frailty was assessed using the following criteria: unintentional weight loss, weakness, low physical activity, exhaustion and Slowness. To observe any possible associations, we performed the Pearson chi-square test, the Student t test and multivariate analysis using binary logistic regression, adopting a significance level of 5%. Results: It was observed that there were no associations of frailty with the social support variables, except for housekeeping mode (p = 0.046) of the MMRI. For the sociodemographic, economic, physical health and social support data, only age (p <0.001), sedentary lifestyle (p = 0.002) and poor perceived health (p = 0.001) were the ones that remained in the logistic regression model, with strong association for the presence of frailty. Conclusion: Among the variables related to social support, only to help with housekeeping was significantly associated with frailty. However, more studies need to be developed to characterize the social vulnerability, as well as health services need to recognize the importance of social support as an integral part of care for the elderly
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Introduo: A asma se tornou um problema de sade pblica devido aos seus grandes custos em cuidados de sade. Os exerccios respiratrios constituem uma interveno no farmacolgica de baixo custo e baixo risco que vem sendo utilizada por fisioterapeutas em diferentes pases no tratamento de pacientes asmticos. Objetivo: Avaliar a eficcia dos exerccios respiratrios no tratamento de pacientes adultos com asma nos seguintes desfechos: qualidade de vida, sintomas da asma, nmero de exacerbaes agudas, episdios de hospitalizao, mensuraes fisiolgicas (funo pulmonar e capacidade funcional), nmero de consultas mdicas, nmero de faltas no trabalho devido a exacerbaes da doena, avaliao subjetiva do paciente em relao interveno. Mtodo: Reviso sistemtica de estudos controlados randomizados com metanlise realizada em parceria com a Colaborao Cochrane. As seguintes bases de dados foram consultadas: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, e PsycINFO, alm de busca manual em revistas da rea e em resumos de congressos. Os seguintes termos foram utilizados: (breath*) and (exercise* or retrain* or train* or re-educat* or educat* or physiotherap* or "physical therap*" or "respiratory therapy" or buteyko ). As listas de referncias dos estudos selecionados e registros de ensaios clnicos tambm foram consultados. A seleo dos estudos e a avaliao do risco de vis dos estudos includos foram realizadas de maneira independente por dois revisores. O software Review Manager foi utilizado para anlise dos dados, no qual o modelo de efeito fixo foi utilizado. As variveis contnuas foram expressas como diferena de mdia ponderada com um intervalo de confiana de 95%. A heterogeneidade dos resultados dos estudos includos foi realizada por meio da anlise dos Forest plots. O teste qui-quadrado (Chi2) com um P valor de 0.10 foi utilizado para indicar significncia estatstica. O ndice de heterogeneidade (I2) foi implementado com um valor acima de 50% como um nvel substancial de heterogeneidade. Resultados: 13 estudos envolvendo 906 pacientes esto atualmente includos na reviso. Os seguintes desfechos foram mensurados pelos estudos includos: qualidade de vida, sintomas da asma, nmero de exacerbaes agudas e funo pulmonar. Os estudos relataram uma melhora na qualidade de vida, sintomas da asma e nmero de exacerbaes agudas. Seis dos onze estudos que avaliaram funo pulmonar mostraram uma diferena significativa favorvel aos exerccios respiratrios. No houve relato de efeitos adversos. Devido heterogeneidade substancial encontrada entre os estudos, metanlise foi possvel apenas para sintomas da asma, a qual incluiu dois estudos e mostrou uma diferena significativa favorvel aos exerccios respiratrios. A avaliao do risco de vis foi prejudicada devido ao relato incompleto de aspectos metodolgicos pela maioria dos estudos includos. Concluso: Embora os resultados encontrados pelos estudos includos demonstraram individualmente que os exerccios respiratrios podem ser importantes no tratamento da asma, no h evidncia conclusiva nesta reviso para suportar ou refutar a eficcia desta interveno no tratamento de pacientes asmticos. Este fato foi devido s diferenas metodolgicas entre os estudos includos e ausncia de relato de aspectos metodolgicos por parte da maioria dos estudos includos. No h dados disponveis em relao aos efeitos dos exerccios respiratrios nos seguintes desfechos: episdios de hospitalizao, nmero de consultas mdicas, nmero de faltas no trabalho devido a exacerbaes da doena, e avaliao subjetiva do paciente em relao interveno
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Universidade Federal do Rio Grande do Norte
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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
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The contents introduction concerning the individual health cares reveals important since the school education. In this direction, the present study objectified to know an effect of Oral Health education intervention in the oral hygiene and in the schools children information level, of 4 e 5 basic education years. The study was composed by two groups, chosen of random form: control group (n = 115) and experimental group (n = 132), with 247 public net school children in total sample. The experimental group participated of some educative activities in Oral Health, with biweekly frequency, during the 4 months period, given for a surgeon-dentistry. Both the groups were submitted to a clinical examination for a previous verification of the Plaque Index (PI) and of Loe Silness Gingival Index (GI). A questionnaire with closed questions on Oral Health was applied before and after to verify the school children rightness index. After the intervention, the final data, represented for the PI, GI and Rightness Index verification, has been collected for statistical analyses through the chi-square test to a 95 % of reliable level, using the SPSS 10,0 software. The PI and GI were categorized in high and low on the initials index basis medium; already the Rightness Index was categorized in inadequate (< 50%) and adequate (≥ 50%). It was verified that the PI (p = 0,014; IC 0.24-0.86) and the GI (p = 0,013; IC 0,28-0,84) presented differences statistically significant, after the education activities, when compared to with the control, favoring the experimental group. It was verified too the experimental group got greater rightness index, presenting difference highly significant (p<0,0001; IC 3,73-26,81). It was still observed that there was no association between the oral hygiene indicators and the school children information level. Ahead the results, it can been concluded that education activities related in the school routine were capable to give positives effects in the oral hygiene control and in the information level about Oral Health, however, not necessarily, the individual with bigger information is that one who has practiced an oral hygiene more adjusted. One become necessary, however, that the education in Oral Health occurs of permanent and integrated form with others school actors, for the positive effect does not lose the student s life longterm
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For a complete comprehension of the effect of tooth loss is necessary to listen to the patients that have it. This study, of qualitative approach, investigate, in the dental history of users of SUS, listening to his/her experiences with the services of dental care, the reason that lead his/her to dental lost and the repercussion of this in his/her life. The collect of data was made by narrative interview, obeying to a pre-defined schema. The subjects interviewed were six (three of urban zone and three of rural zone), all of them were users of Family Health Units. The criterions of inclusion were the followings: the presence of tooth lost (total lost in both dental arch or in one of them, or partial lost in at least six elements in one of the arches); age between 25 and 59; male or female; to live in municipal district of So Tom/RN or Natal/RN. Based on previous interviews was elaborated the odontological history of each patient. Such narratives, systemized in odontological history, were analyzed taking as base the studies of Souza71 and the proposal of Schutze, suggested for Jovchelovitch, Bauer34. The results show that toothache was the main reason for the search of odontological care. The patients confront the ache with home-made medicaments, allopathic ones, and searching for dental care. The searching for exodontics was stimulated for geographic access difficulties or for repressed demand, which as a result produced the aggravation of the lesions and the discredit in restoration s treatment. The self-care practice of tooth-brush with ju or toothpaste and the controlled ingestion of sugar was not sufficient to avoid dental lost. Guilty sentiments were identified in relation with lack of care with teeth. The acceptance of dental lost as a natural factor is an important motivation in lack of pain and in the belief that it was a simple part of life in old age. Life with dental prosthesis makes clear the difference between which was natural and which was unnatural, and difficulties with the prosthesis appeared. The limitation of the prosthesis in its functional aspect can be compensated by esthetic restitution, making possible smiling expression. Starting with this study and considering the high number of dental lost, mainly in low-rent population, which live with toothless limitations or bad-quality prosthesis which do not rehabilitate adequately, we suggested the realization of qualitative researches which include, also, another actors in heath care services such as professionals and administrators
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The objective of this study was to evaluate a baby dentistry program which has been in the city of Natal for five years. The research was based on two analysis: a quantitative one, which tried to check caries prevalence in 52 children supported by the program and a qualitative one, which, through interviews carried out with the mothers, using the focus group technique, tried to realize the effect of the program their attitudes related to the care of their childrens oral health. For the quantitative analyses of caries prevalence there was the use of def-s and knutson rates and the values obtained were shown in a descritive and analytical way.The results showed that 4.2% of babies ranging 24 to 36 months old presented carie disease. Children from 36 to 48 months old and above 48 months old presented 18.2% and 16.7% carie prevalence respectively.The def-s averages found in ages 24 to 36, 36 to 48 and 48 to 60 months old were 0.08; 0.40 and 1.16 respectively, considered as being equally low, going along with Knutson rates. The qualitative analyses showed a high level of the mothers` satisfaction, considering the access,practitioner-patient relationship and opportunity to keep the oral health. Children supported by the program showed a low carie prevalence and the program turned out to be effective under the mothers` point of view
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The juvenile period represents the developmental phase between weaning and sexual maturity. Weaning occurs when the youngster does not receive direct care from the caretakers anymore. Individuals in the species Callithrix jacchus live in groups composed by the reproductive pair and successive twin sets. Cooperative care is the rule. Infants are weaned early, and from then on, food is provided by the adults in the group. These animals present high levels of social interactions, through play, grooming and social contact. During infant age, the twin becomes the main partner. There are few studies about the juvenile period, especially on Callithrix gender. The objective of this study was describing the pattern of activities and social interactions of four sets (one single and three twin sets) during juvenile phase in two Callithrix jacchus groups. We used instantaneous and continuous focal sampling for juveniles and scan sampling for adults behavioral recordings. Juveniles presented the same behavioral pattern as the adults relating the activity budget, in particular, foraging along the months. The composition of the diet was the same as that of the adults. Food transfer ended along the juvenile period. Social play as much as grooming were important socializing activities for the juveniles. The young individuals in the group were the main partners in social play, specially the twin. Adults were the main partners in grooming interactions. Scent marking differed between twins in the male/female sets, the female presenting the highest levels of marking. The juveniles were independent from adults in foraging activity. Social interaction varied according to group composition, but in general, interacted more with the twin and with the youngsters (infants and subadults), except in grooming. Even presenting many similarities, juveniles showed some differences between genders, which indicates the differentiation in behavior towards reproductive strategies early in the juvenile period
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Several works characterize the presence of spinner dolphins at Fernando de Noronha Archipelago in the Dolphins Bay. Though, the dolphins abidance inside this cove has decreased and a new area has been occupied by the animals to achieve the same behaviors, that are resting, breeding and nursing. This area comprises the Inside Sea northeast border of Fernando s de Noronha Island, including the opposing Middle and Dog shore area, the San Antonio Bay and the Between Islands region. The aim was to characterize the dolphins occupation and describe their interactions with the tourism in this area. Data were collected in 2008 and 2009 through a fixed point observation. The study area was divided into seven sub-areas, recording: presence/absence of dolphins, days abidance endurance, abidance length in each area, estimated number of individuals, dolphins direction and speed of displacement, boats presence, interaction period, monitoring, boats attitude and velocity. The dolphins abidance time displayed the same pattern during both years of study, with the higher occupancy in the Between Islands region. Groups with farther than 200 individuals were more frequent both 2008 (46.2%) and 2009 (42.3%). Thus the displacement s slow speed as the preferred direction towards Rat Island also showed the same pattern in both years. The Between Islands region also presented the boats major abidance near the dolphins groups. Boats moved farther in slow speed (95%) than at high speed (5%). The legislation s compliance for the cetaceans protection occurred in 89.7% of 2.839 interactions between boats and spinners, in which this variable was recorded. Whenever boats moved at a slow speed during the meetings with spinner dolphins groups, animals also moved at a slow speed (n = 337), significantly more than the fast displacements (n = 128) ix or "porpoise" (n = 4) (X2 = 318.543, p = -0.001). When boats quickly passed by groups, a significant difference between the dolphins displacement speeds was observed (X2 = 18.264, p =- 0.001), however, the slow (47%) and fast (47% ) displacements frequency was equal, noted the difference with the porpoise displacements (6%), which had the lowest frequency. Data indicate the establishment of a new occupation pattern of the spinner dolphins at Fernando de Noronha, with the Between Islands area being of great importance to the dolphins habits and currently the main area of the boats meeting with the dolphins, showing the need of new conservation measures in this area
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Parental investment increases the offspring s survival, though it decreases the opportunities for the parents to invest in a future progeny. In a broad sense, this investment is directed to one s own descendant, but in some cases, such as in adoption, resources are directed to non-relatives even in the absence of fitness benefits. Once there are many factors involved in adoption, this study investigated adopters candidates, aiming to analyze aspects considered by them for adopting, based on the Evolutionary Psychology s perspective. We analyzed the judicial proceedings files people who had been inlisted for adoption at the 2 Childhood and Adolescence Law Court, Natal-RN. The adopter s motivations were classified into biological or social reasons. A relationship between adopters age and kind of motivation was found: requirements of young people were related to biological reasons while requirements of the old ones were related to social reasons. Fertility, mainly female requirers fertility, underlie this relationship, considering that women fertility is strongly influenced by age. The reasons to adopt were also related to the age of the desired child, once that people who wanted children older than 25 months alleged social reasons while those that wanted younger babies alleged biological reasons. There are lots of motives to adopt a child, but the phenomenon of adoption is broadly acknowledged by society as an act of love and the adoptive parents are often regarded as kind and generous people. It was observed, instead, that the reasons to adopt comes from the adopters themselves, related to the fulfillment of personal needs, such as increasing the family, carrying out mother/father role or having a company or someone to care form them in elderly age
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The years 1990 disclose the consolidation of the Brazilian Psychiatric Reform project, assumed as official politics by the Health Department, also stirring up discussions, lines of direction and new ways of care. Substitutive services to the psychiatric hospital as CAPS, conviviality centers, therapeutical residences and ambulatory clinics are implemented. This work analyzes the relations that the Specialized Ambulatory Clinic of Ribeira establishes to the services of Mental Health of the public system in the city of Natal/RN, as well as its adjustment to the proposal of the Psychiatric Reform. Through semi-structured interviews and observation, it was possible to gather data which allowed picturing a general characterization of the service: activities, technical group, joint with other institutions, daily routine organization. Such institution develops activities that surpass the traditional character of a clinic- in other words, the psychological/medical appointments - and it mainly greets the ones proceeding from CAPS and psychiatric hospitals. It offers group activities, psychiatric appointments, therapeutical workshops, sheltering and strolls, among others. The institution is composed by a multi-professional team of psychiatrists, psychologists, occupational therapists, nurse s aide and art-educator. The joint of this service with others that make part of the Mental Health Assistance network in Natal is incipient. Due to this fact, some actions and activities that could and should be developed together are just not. Although facing difficulties, the professionals of the Ambulatory Clinic of Ribeira are able to achieve good results and establish care in Mental Health that prioritize sheltering, listening and respect to the user s individuality. The Ambulatory Clinic of Ribeira is organized according to the paradigm of the Psychiatric Reform. Therefore, it offers an attention that stimulates the re-socialization of the users and the exercise of the citizenship and autonomy of those
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This study aims to analyzing the implementation of the Matrix Support proposal with professionals of Substitutive Services in Mental Health in the city of Natal/RN. The Matrix Support (MS) is an institutional arrangement which has been recently adopted by the Health Ministry, as an administrative strategy, for the construction of a wide care net in Mental Health, deviating the logic of indiscriminate follow-through changed by one of co-responsibility. In addition to this, its goal is to promote a major resolution as regards health assistance. Integral attention, as it is intended by the unique health system, may be reached by means of knowledge and practices interchange, establishing an interdisciplinary work logic, through an interconnected net of health services. For the accomplishment of this study, individual interviews of semi-structured character were used as instrument, with the coordinators and technical staff of the CAPs. The data collection was done in the following services: CAPS II ( East and West) and CAPS ad ( North and East), in the city of Natal/RN. The results point out that the CAPs to initiate of the discussion the process in the implementation of the MS aiming, to promote the reorganization and redefinition of the flow in the net, thus not acting in a fragmented way. Nevertheless, there is no effective articulation concerning the basic attention services, there is a major focus of the attention in mental health on the specialized services, little insertion in the territory and in the everyday life of the community
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Even with all changes and ruptures related to the social roles that woman had performed, the literature had confirmed that the motherhood still configures it like one of the main roles that she hopes to play in some moment of her life. When the woman did not get pregnant or take ahead a pregnancy, some women find in adoption an alternative to play this role. This research aimed to understand the experience of being mother for adoption in the case of fertile women, but whose partner is infertile. Supported by existential-phenomenological theory, used it the narrative, how methodological instrument. Participated five women, whose adoption process followed the legal ways in the Youngness and Infancy Judgeship of Natal/RN. The results showed that in the selfish training, the woman to see herself how whose role principal is to generate children, although, she think that is natural her participation in others activities go out home too. In male infertile case is a tendency that the woman strikes the infertile status too. The adoption is an alternative to fulfill her desire of being a mother and, meanwhile, please her husband and guarantee the continuity of her love relationship. Through motherly care, the woman discover herself as a mother, what brings a new meaning for her live, independent of to generate a child. Though, exit frustration, sometimes, in association with suffering, on account of the pregnancy and childbirth absence. The end of the research suggests reflections that to become fulfilled herself as mother, the woman does not need, necessarily, to generate a child, being the maternity one of the uncountable possibilities that are shown, and that she can choose, or not, accomplish it
