Gestão de satisfação e fidelidade do cliente: um estudo dos fatores que afetam a satisfação e fidelidade dos compradores de automóveis

This Master s thesis presents a discussion on customer satisfaction models investigating the relations of antecedent variables service quality, price index, complaint handling, image, affective and calculative commitment, with satisfaction and loyalty. The scope of the research is the influence of service dimensions in the car buyer s satisfaction and loyalty. A sample of 91 customers was surveyed among new cars buyers of one brand in Natal city, Brazil, and the data was analyzed using multiple regression analysis. The literature review covers subjects such as customer satisfaction, management system, customer satisfaction measurement index models. The main findings suggest that satisfaction with the car brand is mainly influenced by customization of the service, time for accomplishing servicing, and the way the dealer handle complains. Regarding the dealer itself the main variable related to satisfaction is also time for accomplishing servicing. Considering customer loyalty, the customer satisfaction with the dealer explain strongly the loyalty with the brand/manufacturer. Also, the satisfaction, affective commitment and complains handling were found related to loyalty, as the stronger variables explaining the loyalty variance. One main conclusion is that service provided by dealers is one key factor influencing the customer satisfaction and loyalty in auto industry

Síndrome da fragilidade e fatores associados em idosos comunitários do município de Santa Cruz RN

The frailty in the elderly is characterized by decreased physiological reserves, and is associated with increased risk of disability and high vulnerability to morbidity and mortality. This study is part of a multicentric project on Frailty in Elderly Brazilians (REDE FIBRA). Aims: to investigate characteristics, prevalence and associated factors related to frailty. Metodology: We interviewed 391 elderly patients aged 65 years, selected randomly. Data collection was performed using a multidimensional questionnaire containing information about socio-demographic and clinical variables. To characterize the frail elderly, was considered the phenotype proposed by Fried. Data were analyzed using descriptive statistics, bivariate analysis (χ ²) and binary logistic regression. Results: The prevalence of frailty was 17.1%. In the final model of multivariate analysis, was obtained as factors associated with frailty: advanced chronological age (p <0.001), have comorbidity (p <0.035), show dependence on performing basic activities of daily living (p <0.010) and instrumental (p <0.003) and have poor perception of health status (p <0030). Conclusions: The factors associated with frailty suggest a predictive model helping to understand the syndrome, guiding actions that minimize adverse effects on the aging process

Saúde física e emocional de cuidadores da cidade de Santa Cruz-RN: perfil epidemiológico e fatores associados

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 caregiver´s 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

Análise dos fatores responsáveis pela alta salinidade do aqüífero fissural da microbacia da Riacho do Feijão - Pedro Avelino/RN

The fissures aquifer northeast semi-arid Brazilian, present high text frequently of leave, with of low a hídric availability. The research has as objective main to analyze the components that inside influence in the salinity of the waterbearing fissures of an evaluation physicist-chemistry of the water, leading in consideration the physical interventions of the environment. One used techniques of interpretation of image of Landsat satellite -1999 and delimitation of the micro basin through the topographical map SUDENE. One identified waters of the NaCl type with Ca++ and Mg++ in secondary concentrations. The analyzed wells (15), had presented an average salinity of 5.147 mg/L of STD and a well only supplies drinking waters with 319 mg/L of STD. The recharge of the aquifer one if carries through for infiltration in the open fracture of ortognaisse it migmatization. The type and directions of the fracture do not control the STD. Relations between salinity and out let do not exist. The quality of the well of low salinity is identical the superficial waters (aquifer dam and alluvial). The studies of the meteoric erosion processes had evidenced that in the transformations of the rock in ground, the Ca++ and Na+ are taken for superficial waters. The treatment of the data chemical showed that the grade of Na+, Ca++, Mg++ and Cl-are controlled for the evaporation process, from only water that would have the qualities of superficial waters or the well of low salinity. Already the HCO3-grade is controlled for the precipitation of the dolomite. The STD of this aquifer one would be consequence of the high tax of evaporation of dams constructed in regions of plain topography. You leave them precipitated in deep argillaceous ones dry dams are led for the aquifer in first rains. The research suggests some recommendations for the use and exploitation of the water salinity in piscicultura, carcinicultura, culture of the grass-salt (Atriplex sp), among others

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

Hipossalivação e seus fatores de risco em idosos funcionalmente independentes e não institucionalizados

The aim of this study was to investigate the risk factors related to hyposalivation among non-institutionalized independently living elderly people, living in Natal-RN, Brazil. The study was a control-case type and the data collection was accomplished by carrying a questionnaire, oral examination and a non-stimulated and stimulated sialometry. The cases were identified by values of salivary flow rate <0,1mL/min and stimulated ≤ 0,5 mL/min, and the controls were by observing the values of sialometry that were bigger than the previously defined parameters. Age and gender were used as pairing variables. The data were analyzed using X2 (α = 0,05) and odds ratio. The sample was composed of 98,1% female and 1,9% male, with mean age 68. There was not association between hyposalivation and the following studied variables: income, schooling, profession, dwelling conditions, domiciliary density, illness, number of teeth and use of prothesis. However, a link was found between hyposalivation and smoking frequency in the passet (OR=5,14), indicating that, referring to elderly people, the tabagism frequency habit was a risk factor to the studied condition. Therefore, refering to non-institutionalized independently elderly people, economic-social-demographic conditions, general and bucal health, diet and habits such as alcoholism have been not risk factors to hyposalivation. However, people that have been smoking have more risk to have the studied conditions

Edentulismo funcional e seus fatores de risco em adultos

The purpose of this study was to investigate the risk factors to the functional edentulism in adults aged 35 a 44 years old of Natal-RN, 278 adults took part in the study. They were all selected from a previous dental loss prevalence study thus being complemented by an active research. The study was a case-control based and data collection was made though a survey as well as with a clinical examination. The cases were identified through individuals with 20 or more teeth. Age and gender were used as variables of pairing off. The data was analyzed through chi-square, significant level of 95% to the checking of its force associations. The independent variables were grouped in three levels. The first one, more macro, is related to the region where the individual lives, which was also related to the second level, the family-based one, linked with a third level, at this low socio-economical level, where the domiciliary density was favorable, living in capital cities, regions with prime sanitary condicitions, with predominant possibility of accessing the public dental service, but in despite of this, only looking for this service when tooth ache is felt, where preferentially an aid dressing treatment is executed in detriment of preventive procedures. From all the samples, less than 25% of the individuals make use of tobacco and alcoholic beverages for quite a number of years. There was an association of functional edentulism with all the studied variables in a regional method. In the family-based with Critério Brasil (OR=4,45) and monthly wages (OR=9,62) and to an to an individual level, the associations took place with the current use of kind of attendance (OR=1,78), looks for dressing treatment (OR=2,51), does not look for preventive treatment (OR=3,31), pain as the main cause of demand (OR=1,92), previous treatment as the demanding reason for dental service (OR+0,28), interval of the last visit to the dental service (OR=1,35) and when advise was received (OR=1,66). It was noticed from the results that the functional edentulism is much more expressive in those families which live in environments with precarious social economical sanitary conditions. Such conditions seem to have a direct influence upon the family social economical conditions which are also shown in detriment to functional edentulism. In the same way, the collection of variants influence the social economical conditions of the individual, as well as the kind of dental service searched by them, the reason of the search and the interval of the last visit to the dental service were strong determiners to the functional edentulism. Beyond that, individual habits like the use of tobacco and its frequency on its previous use influenced in a significant way the existence of functional edentulism in the studied population

Prevalência e fatores de risco à persistência de hábitos bucais de sucção não nutritiva em crianças de 3 a 5 anos de idade

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Prevalência e fatores associados a lesões labiais e periorais decorrentes da exposição solar em trabalhadores de praia

This study aimed to verify the prevalence of lip and perioral lesions in worker who were under sunshine on the beaches of Natal/RN and to investigate possible associations of these with sociodemographic, occupational and general health variables. For this, 362 individuals who had one of the urban beaches (Ponta Negra / Environment / Redinha) in the city of Natal/RN as a working environment in the study. We excluded people under 18 years old. Data collection was done through epidemiological analysis and extra-oral validated questionnaire with questions that characterize socioeconomic and demographic factors, occupational exposure and general health. The male subjects (72.6%) were the majority in the sample. The people who worked directly exposed to high peaks of ultraviolet radiation, as well as informal workers predominated. Considering the total sample of individuals, ephelides in the perioral region (33.7%) and labial region (24.0%), solar lentigo perioral (15.2%) and actinic cheilitis (13.8%) stood out as the most prevalent lesions. Indoor workers and those who had a habit occurrence of injuries by 19% and 21% respectively higher when compared to outdoor workers and people without habits. The variable use of cap / hat was associated with the presence of cold sores (Qui2 = 1,328, p = 0,058). On the threshold of significance, the type of work was also associated with lesions in lip occurrence (p = 0,042). Men showed a lower incidence of perioral lesions when compared to female workers (PR=0,716, p valor = 0,002). The present study showed high prevalence of lip and perioral lesions. The premalignant lesions were the most identified, both as in lip skin. It is important therefore to be encouraged to adopt protective measures against excessive sun exposure, fairly and consistently

Influência de fatores de risco na prevalência de hábitos bucais deletérios em crianças de 0 a 5 anos na cidade do Natal-RN

Literature has demonstrated to the narrow relation between deleterious habits and the occurrence of malocclusion in minors of 5 years. The existence of these habits, however, already considered as risk factors, having also, its determinative ones, which present cultural dimensions and economic social, many of them related to the parents of the child, having in account that such habits if develop in phases in which the child establish a narrow relation of dependence. This study it had an objective to investigate the prevalence of deleterious buccal habits in children and its relation with the economic social and characteristics of the parents. It was developed an epidemiologist study of transversal character with interview, through daily pay-tested form, with 218 parents in the day of the National Campaign of Vaccination. In the cast of the variable that had composed the study, they had been used, as changeable dependents, the use of the baby's bottle, bottle and the digital suction, being considered as outcomes of the research. Amongst the independent variable, the economic social factors (type of occupation, number of children, civil state, sort, schooling and age) and staffs of the parents (self perception in oral health) had entered as the variable to be analyzed in the problems of the infantile odontology. The collected data had been submitted to the analysis descriptive and inferential statistics, being used the test qui-square and the analysis of the possibility reasons. As main results, it was found that breast feeding before the six months if presents as one of the main factors of risk for the use of baby's bottle (p< 0.001, OR= 2.8, I.C= 1.589 4.906), bottle (p< 0.001, OR= 3.7, I.C.= 2.076 6.624) and digital suction (p< 0.014, OR= 3.5, I.C.= 1.225 10.181). From the data found, one concludes that breast-feeding is considered a primordial factor for not the installation of deleterious oral habits and that the economic social and cultural factors can reflect in central way in the performance of this act

Exprassão imuno-histoquímica dos fatores de reabsorção óssea em lesões centrais e periféricas de células gigantes

The Giant Cell Lesions, both the Central Giant Cells Lesions (CGCL) as the Peripheral Giant Cells Lesions (PGCL), correspond to a group of oral lesions that are histologically similar entities; however they show a variable clinical behaviour. The purpose of this study was to compare the immunohistochemical expression of bone resorption factors RANK (Receptor Activator of Nuclear Factor kappa B), RANKL (Receptor Activator of Nuclear Factor kappa B Ligand) and OPG (Osteoprotegerin) between CGCL and PGCL. Additionally, these bone resorption factors were examined in terms of aggressiveness of these lesions. The sample consisted of 61 cases, 30 cases of PGCL and 31 CGCL (16 non-aggressive and 15 aggressive). The analysis was performed by quantification of mononuclear cells (MO) and giant multinucleated cells (CG) immunopositive to anti-RANK, anti-RANKL and anti-OPG antibodies in 10 fields. Moreover, according to the proportion between the amount of cells positive for RANKL and OPG, the cases were categorized into: RANKL>OPG, OPG>RANKL e RANKL=OPG. CGCL showed a higher amount of MO (p=0.002) and total cells (p=0.003) both positives to RANKL compared with the PGCL. Additionally, the CGCL revealed a significant association with the ratio of RANKL>OPG (p=0.001). Analysis of the bone resorption factors revealed no significant differences between aggressive and non-aggressive CGCL (p>0.05). It was observed a positive correlation between the markers themselves, and a negative correlation between lesion size and quantity of OPG positive MO cells (p=0,004) and total cells (p=0,009). Through these results, we suggest that the greatest CGCL resorptive potential compared to the PGCL, may have occurred to the high expression of RANKL. Furthermore differences in the biological behavior of aggressive and non-aggressive CGCL appear to be related to the expression of these bone resorption factors

Imunoexpressão de fatores reguladores da osteoclastogênese na doença periodontal em humanos e sua relação com os parâmetros clínicos

Periodontal disease is an infection initiated by oral periodontal pathogens that trigger an immune response culminating in tissue destruction. This destruction is mediated by the host by inducing the production and activation of lytic enzymes, cytokines and the stimulation of osteoclastogenesis. The aim of this study was to compare the immunohistochemical expression of factors involved in bone resorption, RANKL (Ligand Receptor Activator of Nuclear Factor kappa B), OPG (Osteoprotegerin) and TNF-α (tumor necrosis factor alpha) between the gingival healthy, gingivitis and chronic periodontitis and correlate them with clinical parameters. The sample consisted of 83 cases and 12 clinically healthy gums, 42 gingivitis and 29 periodontitis, from 74 adolescent and adult patients with a mean age of 35 years, without systemic changes and non-smokers, predominantly female and race brown. There was no statistically significant difference for the expression of anti-RANKL (p = 0.581) and RANKL / OPG ratio (p = 0.334) when comparing the three conditions, but the anti-OPG and anti-TNF-α showed statistically significant between the types of injury (p = 0.001 and p <0.001, respectively), showing greatest expression in periodontitis. In cases of periodontitis, the variable clinical attachment loss (PIC) was statistically significant and positive correlation, respectively, with immunostaining of anti-RANKL (p = 0.002, p = 0.001 and r = 0.642), anti-OPG (p = 0.018, p = 0.014 and r = 0.451), anti-TNF-α (p = 0.032, p = 0.014 and r = 0.453) and the percentage ratio of RANKL / OPG (p = 0.018, p = 0.002 and r = 0.544). The tooth mobility (MB) showed a statistically significant difference only with immunohistochemical anti-RANKL (p = 0.026), and probing depth (PD) was positively correlated with anti-RANKL (p = 0.028 and r = 0.409), both in cases of periodontitis. Only in cases of gingivitis TNF-α was positively correlated with RANKL (p = 0.012 and r = 0.384) and the RANKL / OPG ratio (p = 0.027 and r = 0.341). Given these results, we conclude that the greatest expression of TNF-α in periodontitis demonstrates a relationship with the progression and severity of periodontal disease and the correlation between all antibodies and clinical attachment loss demonstrates their involvement in periodontal bone resorption

Análise de fatores clínico-demográficos, psicológicos, hormonais e genéticos na síndrome da ardência bucal e ardor bucal secundário

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Fatores de influência na produção de leite bovino sobre os níveis da contagem bacteriana total

The objective of this study was to evaluate the influence of milking procedures on the levels of total bacterial count (TBC) in bovine milk. In the first study the influences of procedures for hygienic milking, cleaning of milking equipment and milk cooling tanks on the TBC levels were evaluated. Four bulk samples of milk were collected from each tank in eight properties for TBC analysis, employing the flow cytometry method. A questionnaire was applied in each property to assess the current situation of milking procedures on each production system that took part on this research, followed by training of employees in good agricultural practices in the production of milk and monitoring of the TBC measurements. The methodology for analysis of longitudinal data was considered, focusing on random effects models. The results showed that the handling procedures for milking and the cleanliness of the cooling tank contributed to a further reduction in the levels of TBC raw milk cooling tanks. The second study aimed to describe the percentage of the properties that comply with the Normative Instruction Nº 51 (Brazil s IN 51) with regard to total bacterial count (TBC) in bovine milk. The study was conducted from January 2010 to July 2011. Milk samples were collected from the eight properties selected for TBC analysis by the flow cytometry method. Again, on each property a questionnaire was applied to assess the current situation of milking procedures on each production system that took part on this research, followed by training of employees in good agricultural practices in the production of milk and monitoring of the TBC measurements. The methodology of marginal models based on Generalized Estimate Equations (GEEs) was followed in the statistical analysis. The results showed that the handling procedures of the milking and the cleanliness of the cooling tanks contributed to a considerable percentage of the properties that reached the limits of TBC established by IN 51

Influência de fatores individuais e sociais sobre as respostas endócrina e comportamental de callithrix jacchus a desafios ambientais físicos e sociais

Regarding the growing number of human beings with physical and mental pathologies associated to different stressor agents, attempts are being made to validate animal models with a close phylogenetic resemblance to man, to study stress response. Callithrix jacchus has been widely used in biomedical research, including on stress, but there is scarce information in the literature about how individual and social factors modulate stressor response in this species. This study uses 4 approaches to investigate the response of male and female adult C. jacchus, under situations of stress, and in the first we show evidence of the importance of this animal as an experimental model in research involving the hypothalamus-pituitary-adrenal axis. And we investigate if sex and baseline cortisol levels modulate the behavioral and hormonal response to separation. In two additional approaches investigate if type of social support (co-specific parent or non-parent) and social rank interfere in behavioral and hormonal when the animal are exposure to a new environment, paired with a co-specific (F2), exposure of the animal to a new environment, isolated (F3) or during reunion (F4). Finally, we also investigated the androgen levels in the males, with a focus on the challenge hypothesis, referring to environmental responsiveness and male-male exposure to relatives and non-relatives of C. jacchus. It was observed that: (1) the baseline cortisol of the animal is predictive of cortisol reactivity at separation; (2) males and females do not show dimorphism in the response of cortisol to stressors, although the females have higher baseline levels of this hormone and exhibit higher frequencies of anxiety-related behaviors; (3) only social support provided by relatives proved to be effective in buffering the cortisol response. In behavioral terms this response was dimorphic, showing that only the male dyads displayed an attenuated response to stress; (4) the males showed differences in cortisol levels as a function of social rank and study phases, whereas in the females no such alterations were observed. The males with indefinite dominance hierarchy (IDH) had reduced cortisol in F2 and F4, while the IDH females showed an increase in F3 and F4; (5) the males of relative and non-relative dyads did not exhibit variations in androgen levels as a function of a new environment. These results, taken together, (a) corroborate the use of C. jacchus as a good animal model for stress-related studies, given that they exhibit similar behavioral and physiological alterations to those of human beings in response to stressor agents; (b) point to the importance of considering individual and social modulating factors during experiments with stressors; (c) provide more reliable comparison parameters in studies where these primates are used as animal models, and (d) show that androgens vary as a function of genetic proximity (relative or non-relative) when the animals are faced with physical and social environmental challenges, thus providing important information for studying the challenge hypothesis in this species