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

Atuação profissional e vivência do cirurgião-dentista na estratégia do programa de saúde da família

The purpose of this research was to analyze the working profile of dentists from the Family Health Program (PSF Programa de Saúde da Família, Brasil) of some Municipal Districts of Rio Grande do Norte (Brazil) in order to understand the way they handle the experience acquired with the work developed in that Program. This discussion evolves a reflection about the perspectives of consolidation of the FHP as well as the possible advancements of the Brazilian Unified Health System (SUS - Sistema Único de Saúde). The target population was composed of dentists from the FHP of Rio Grande do Norte. Thus we performed twenty-one interviews orientated by a semi-structured guidebook with open questions and identification data. We opted for recording the speech of all the professionals in order to ensure the accuracy of the information gathered. The main results found were: predominance in the female gender; the majority of dentists has no post graduation courses; in those few cases of dentists with some post-graduation a lack of correlation with Public or Collective Health was observed; the dentists interviewed present a profile directed to clinical activities; the dentists used to develop basic restorative and periodontic treatment, simple surgeries and educative and preventive activities, even though the last two ones are carried out in an extremely traditional way (lectures and topical application of fluoride). In addition, as biggest difficulties to manage the work dentists pointed out the lack of permanent and consumer material, inadequate infrastructure, no transport to take them to distant places, no integration with the Health Family Team, technical difficulty such to perform educative and preventive activities as to provide adequate service to a repressed lawsuit. The results indicate the existence of a necessity to lead them to reflect and redirect their practices. In order to reach this aim it must be considered as initial measure the investment and encouragement toward to permanent education as well as a close follow-up and evaluation of the actions developed by them

Avaliação longitudinal do impacto da saúde bucal na estratégia saúde da família em Natal

As a result of the financial incentive provided by the GM / MS 1.444, since 2000, Brazil has experienced a substantial increase in the number of oral health services at the Family Health Strategy. There is, however, evidence that these teams have produced qualitatively different experiences which do not translate necessarily into improved quality of life and health. Thus, evaluative research of great importance. This study aims to assess the impact of the Family Health Strategy in oral health in a longitudinal perspective natalense the years 2006 and 2009. This is an intervention study whose design is a community trial in parallel, nearly randomized. The sample consisted of census tracts covered by oral health teams in the Family Health and the Traditional Model (Basic Health Units and non-FHS Program of Community Health Agents and areas not covered.) The sample was determined by drawing ten census tracts to form the experimental group and ten other sectors for the control group by pairing intentional based on socio-economic and geographic. To check the net effect of the intervention was performed multivariate analysis by Poisson regression. As a result of cross-sectional analysis of year 2009, it was found that the effects of the ESF in Natal were satisfactory only for the variables of injuries and for other purposes without and with negative impact on stock coverage reclaimers. However, the longitudinal analysis revealed that the ESB / ESF improved their performance in dealing with grievances, access and coverage of the type of actions and this fact is independent of age, sex and social and economic conditions. In other employees' words are related to the presence of the Family Health Strategy in the region. However it does not say that both models under study (the Family Health Strategy Model and Traditional) are different in terms of performance and it is pertinent to reflect on the need for further development of evaluation studies that use other approaches able to clarify the dynamics of the process whose results can come to the knowledge of the actors responsible for leading the ESF and encourage them to incorporate the assessment in their routine

Impacto do Programa de Saúde da Família sobre indicadores de saúde bucal na população de Natal -RN

The aim of this study was to assess the impact of the Family Health Program (FHP) on a number of oral health indicators in the population of Natal, Brazil. The study is characterized as a quasi-random community intervention trial. The intervention is represented by the implementation of an Oral Health Team (OHT) in the FHP prior to the study. A total of 15 sectors covered by the FHP with OHT were randomly drawn and paired with another 15 sectors, based on socioeconomic criteria, not covered by the teams. A few sectors were lost over the course of the study, resulting in a final number of 22 sectors, 11 covered and 11 not covered. We divided the non-covered areas into two conditions, one in which we considered areas that had some type of assistance program such as the Community Agents Program (CAP), FHP without OHT, BHU (Basic Health Unit) or no assistance, and the other, in which we considered areas that had only BHU or no assistance. Community Health Agents (CHAs) and Dental Office Assistants (DOAs) applied a questionnaire-interview to the most qualified individual of the household and the data obtained per household were transformed into the individual data of 7186 persons. The results show no statistical difference between the oral health outcomes analyzed in the areas covered by OHT in the FHP and in non-covered areas that have some type of assistance program, with a number of indicators showing better conditions in the non-covered areas. When we considered the association between covered and non-covered areas under the second condition, we found a statistical difference in the coverage indicators. Better conditions were found in covered areas for indicators such as I have not been to the dentist in the last year with p < 0.001 and OR of 1.64 and I had no access to dental care with p < 0.001 and OR of 2.22. However, the results show no impact of FHP with OHT on preventive action indicators under both non-covered conditions. This can be clearly seen when we analyze the toothache variable, which showed no significant difference between covered and non-covered areas. This variable is one of the most sensitive when assessing oral health programs, with p of 0.430 under condition 1 and p of 0.038 under condition 2, with CI = 0.70-0.90. In the analysis of health indicators in children where the proportion of deaths in children under age 1, the rate of hospitalization for ARI (Acute Respiratory Infections) in those under age 5 and the proportion of individuals born underweight were considered, a better condition was found in all the outcomes for areas with FHP. Therefore, we can conclude that oral health in the FHP has little effect on oral health indicators, even though the strategy improves the general health conditions of the population, as, for example child health

Ritmo circadiano de atividade motora e distribuição diária dos comportamentos afiliativos ao longo da fase juvenil em saguis (callithrix jacchus)

The temporal allocation of the active phase in relation to light and dark cycle (LD) changes during puberty in humans, degus, rats and rhesus. In marmosets, the animal model used in several biomedical researches, there is evidence of a delay at the beginning of the active phase and an increase in total daily activity after onset of puberty. However, as this aspect was evaluated in animals maintained in natural environmental conditions, it was not possible to distinguish between the effects of puberty and of seasonality. Furthermore, as motor activity is the result of different behaviors in this species, it is also important to characterize the diurnal distribution of other behaviors in juvenile stage. With the aim of characterizing the circadian rhythm of motor activity and the diurnal profile of affiliative behavior in marmosets, the motor activity of 5 dyads juveniles between 4 and 12 months of age and their parents was recorded continuously for actímetro. The families were maintained under artificial LD 12:12 h, constant temperature and humidity. The duration of grooming behavior, proximity and social play among juveniles was recorded 2 times a week in sessions of 15 minutes each hour of the active phase. Afetr onset of puberty in juvenile, it was observed that there was no change in the parameters of circadian motor activity rhythm which were common to most animals. Despite the absence of pubertal modulation, it was observed that the circadian activity profiles have stronger synchrony between individuals of the same family than that of different families, which may indicate that the circadian activity rhythm was modulated by the dynamics of social interactions. In relation to age, the total daily activity and the ratio between evening and morning activity (EA/MA) were higher in juveniles than in adults, which may be associated with differences in the circadian timing system between age groups. Furthermore, the onset of the 10 consecutive hours of higher activity (M10) occurred earlier in adult males than in other members of the group, probably as a way to avoid competition for resources in one of the first activities of the day that is foraging. During the juvenile stage, there was an increase in total daily activity that may be associated with increased motor ability of juveniles. In addition to the circadian activity rhythm, the daytime profile of proximity and social play behaviors was similar between the 5th and 12th month of life of juveniles, in which the interval between 7- 10 h in the morning showed the highest values of proximity and lower values of play social. Moreover, the duration of the grooming showed a similar distribution to adults from the 8th month, wherein the higher values occurring at the interval between 11 14 h of day. Considering the results, the parameters of the circadian activity rhythm had a greater influence of social factors than puberty. In relation to age, there were no changes related to the allocation of the active phase in relation to the LD cycle, but total daily activity, the ratio AV/AM and the start of the M10 is possible to observe differences between juveniles and adults

Transferência de alimento aos infantes de Callithrix jacchus em uma situação de escassez de recurso alimentar

The genus Callithrix, like other marmosets, presents a cooperative breeding system, characterized by the contribution of parents and non-breeding individuals of the social group in the care of infants. This care is provided through lactation, transport, supervision of infants and food transfers. In this study, we investigated the care of offspring in Callithrix jacchus through the food transfers in family groups under conditions of abundance and scarcity of food resources. We also attempted to verify the relationship between the participation of individuals in the transport of infants and in the food sharing. We observed four families at the Núcleo de Primatologia of the Universidade Federal do Rio Grande do Norte, in a total of seven infants, six twins and a single infant. Each infant was observed twice a week, from 1st to 20th week of life using the methods focal continuous and focal instantaneous sampling with one minute intervals. The observations were carried by 10 minutes and beginning with the supply of food for each family. Two families were tested under conditions of scarcity of food resources (experimental condition) and two others were subjected to conditions of abundant food, both conditions with restricted access to food supply. The condition of food scarcity did not influence the rate of food sharing with the infants that, in general, was considered low. All shares observed were passive sharings. Only one family showed higher levels of food begging, probably due to the loss of the mother during the period of lactation of her offspring. In this family, the dominant and subadult males were primarily responsible for the food sharing. The experimental condition influenced the distance of infants in relation to food source, so the infants in families that received abundant food remained closer to the source. However, it is believed that the place of food consumption was not influenced by experimental condition. There was no relationship between the participation of individuals in the transport and food sharing with their young. Therefore, it is suggested that, in general, the transfer of food in C. jacchus is characterized by tolerance to the demands of caregivers, represented by the passive sharing. Rates of sharing with infants were low, probably due to intra-group competition for food generated by the experiment.

Ausência do pai ao longo do desenvolvimento ontogenético e indicadores de desconto de futuro: uma contribuição da psicologia evolucionista

The new Evolutionary Psychology (E. P.) paradigm has been trying to understand how the human beings make their decisions over time regarding the most diverse variables, always bearing in mind that such a cognitive process is due to a complex natural selection process that occurred millions of years ago. One of the main topics discussed by this new paradigm is the issue of parental investment, i.e., the care the parents provide to an offspring at the expense of the investment into a new one. The present work sought to integrate these two topics, trying to understand how some variables modulate the process of decision making in a sample of the city of Natal, Rio Grande do Norte state. It was investigated the hypothesis that the presence of both parents, along the individual development, could signal a more favorable environment, providing clues to the individual that he could assume a competitive position at the socio-biological market. His decisions, therefore, could be guided by long-term investments with aims to obtain more robust rewards. On the contrary, those who has suffered for some moment the absence of one the parents could develop theirselves in a not so competitive way, starting to choose immediate benefits - but lesser ones -, since the future would be less predictable due to their worse development conditions. This study involved 152 individuals from three higher education institutions, one of them being public and the others being private ones. In the results found, there was no difference between children of coupled parents and children of deceased or divorced parents concerning discount rates. The levels of hopelessness did not affect the discount rates of children of single parents when compared to children of coupled parents. Not having one of the parents because of divorce made the child to tend to present lower scores in the domain of social relations of WHOQOL - Bref, whilst the absence of the father by death made the scores lower in the domain of environment. The results indicate that loosing one of the parents along the development influences the individual's quality of life perception, but the measurement method of future discounting rates by means of financial choices is not sensitive to this variation

Motivações para adoção: uma perspectiva da Psicologia Evolucionista

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 2ª 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 requirer´s 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

Avaliação da estratégia saúde da família na capital potiguar

This research aimed to evaluate the Family Health Strategy (FHS) in Natal, Rio Grande do Norte, through its managers, professionals and users, having as its support the Theory of Belief and the Cognitive-Behavioral Theory. This is a multimethod research and is divided into three sub-studies. In the first study, nine managers answered to a semi-structured interview, to verify the knowledge and beliefs on SUS; the quantitative data were analyzed with descriptive statistics with the aid of SPSS software and the qualitative data were submitted to lexical analysis with support of ALCESTE software. In the second study, we have a descriptive correlational research in which the antecedent variables are related to working conditions in the family health units (FHUs) and to the professionals‟ profile; the corresponding variables refer to the evaluations of the FHS; a stratified probabilistic sample with 475 professionals, who answered to two scales, both consisting of three factors: Physical infrastructure, Material resources, and Treatment effectiveness, and data were analyzed using descriptive, bivariate and multivariate statistics, with the aid of SPSS. The third study is a descriptive correlational research in which the antecedent variables refer to the treatment in the FHUs and to the users‟ profile, and the corresponding variables refer to the evaluations of the FHS, with a stratified non-probabilistic sample with 390 users, who contributed to the construction of a new scale with a factor, effectiveness in treatment, analyzed through descriptive, bivariate and multivariate statistics, with the aid of SPSS. The results showed problems which start from management, under the shape of admission due to political indication and lack of knowledge on SUS and the FHS; they pass through the low tenure of professionals and insufficient professional; and they end up spreading all over the analyzed items: infrastructure of FHUs, material resources, professionals‟ training, accessibility and referral system. One concludes that, despite following an ideal model, the FHS is in need of changes with regard to the barriers to its operational reality

Não há você sem mim: histórias de mulheres sobreviventes de uma tentativa de homicídio

The murder-suicide (H / S) has been defined as a shocking crime in which a person takes the life of another and then kills himself within 24 hours. Set up as a gender violence, because men are in majority, the killers and the women victims. This study aims to understand the meanings of the experience of a H / S, from women who have survived this act. This study sets up as a hermeneutic phenomenological research, based on Heidegger`s ontology. We interviewed three survivors of H / S, whose narratives allowed to approach the senses present in their lives. The interviews were transcribed and interpreted in accordance with the hermeneutic circle, as proposed by Martin Heidegger. From the interviews of research participants perceive that these women have built their senses in stocks, represented the family foundation and the presence of a husband and children. This project that moved their lives toward the construction of modes-of-being. We noticed the presence of historicity constructing meanings for the existence of these women. We found reports of an experience of loving relationships characterized by strong jealousy, with the presence of fantasies of betrayal, and marked by a careful affective relationship that put them in the position of object possession of his companions. Reflect that such caring restricted their existence being-for-husband. So the senses that moved their stocks, which aimed his ways existential, was the creation of a family, a reference to their lives, to live a love, and care for the children. Therefore, beyond the already known aspects in studies on violence against women, which made these women continue to choose this relationship was the sense that they had for their existence. It is hoped that this study will contribute to the construction of a new look on violence against women, taking as a basis the Heideggerian hermeneutic phenomenology

Maternidade na adolescência: significados e repercussões

From evidence of an existing divergence of opinion among professionals and adolescents using the prenatal and delivery services at a Public Health Unit, aimed to study meanings and consequences of adolescent motherhood among 26 adolescent mothers living in Felipe Camarão, low income district of Natal, capital do Estado do Rio Grande do Norte. Living in a peripheral neighbourhood with a high rate of adolescent mothers in relation to the total new-born, those girls, with offspring among 8 and 12 months age, during interview and focus groups, expressed a different appreciation of their experience than the hegemonic idea among professionals that considers pregnancy and motherhood as unwanted or undesired. With age among 15 and 20 years old, having 53,8% initiated sexual activity before being 15 years old, revealed that the pregnancy was desired in 73,1% of cases, but showing at the same time a social context marked by strong gender oppression and lack of opportunities as consequence of social class deprivation. Life projects, almost always limited to the constitution of a traditional nuclear family, with a purveyor father and care giver mother, appears with very limited possibilities: 46,2% already lived with her partner before becoming pregnant and for 50% of the participants, the birth of the child did not provoke changes in plans and projects. Lack of economical recourses and precarious public services available, together with an idealized maternity role seems to produce extra apprehension among those girls, resulting in frustration and disillusion. As a fact, 92,3% of those adolescents would recommend other adolescent to postpone the maternity project

Saúde mental na estratégia saúde da família: notas cartográficas sobre processos de trabalho em saúde

This study aims to map the working process in the health area starting from the meeting between the family and health teams and mental trouble carriers./MTC. The area of research was the Family Health Unit of Ozeas Sampaio, which is located in the county of Teresina-PI. As regard to the methodology procedure, we used a semi-structured interview timetable, aimed to detail the care practices, admittance and diagnostics that those teams realize with their users. Three teams of eleven workers each were interviewed. There was a doctor, a nurse and two health community agents in each team. The other tools we used were a camp logbook, in which we wrote down some informal dialogs, daily observations and feelings of the unit, and also the accompaniment of the staffs in house calls as well as the weekly meetings in the unit. Those meetings allowed us the construction of two analytic axes: 1) description of the establishment (Family Health Unit) of the organization, (municipal foundation of health and the service network), and the institutions and practice of health. 2) Analysis of the meetings between the worker and the user of Mental Trouble Carriers. In the first axis, we verified the repetition of the working logic focused on jobs in the hospital with the maintenance of the hierarchical relations between worker and the work processes which dissociate management and watchfulness in health care. We identified the lack of physical structure, the lack of self-confidence of the worker in the attention of the mental health care. At the second axis, we assess that the meetings, at the Family Health Unit (FHU) or at the dwelling of the users cause nuisance, discomfort and anxiety to the workers because they deal with issues that go beyond what is named as being the health order such as life stories, family conflicts, unemployment, hunger, sexual and psychological violence. As a matter of fact, they involve difficulties for having new relationships, reception and responsibility for this request

A auto-estima da criança que sofre violência física pela família

This research investigates the self-esteem of children who suffered physical violence by family members. Seven children took part in the research: three boys and four girls, aged between six and twelve years old. The analysis were done from the constructed data obtained from: semi-structured interview, activities about human feelings, activities that included facial expressions, unfinished phrases, Pinocchio s story, a drawing of a family and a drawing of their own family. Data were analyzed from the Content Analysis. The Thematic Units were: violence, intrafamily violence, and self-esteem. The synthesis of the categories studied evidenced that the physical violence and the psychological violence present in the lives of children affect the positive development of their self-concept and, consequently, of their self-esteem. Among the results, we emphasize some negative feelings that are present in children s lives such as fear, a sense of guilt, and sadness, arising out of the situations of violence they have experienced

Significados de família para crianças em abrigo

This research explores the meanings of family for institutionalized children. It identifies, more specifically, how the relationship between the child and his/ her family is. The field work was developed at a municipal shelter in Natal/RN, which houses children aged between 7 and 11 years old. The subjects of research consisted of three children: two boys and one girl. Besides age-group criterion, which facilitates the use of oral language and the procedures, we took into consideration another selection criterion: children whose family configurations were similar. In order to achieve the objectives, we used toys, pictures, collages and semi-structured interviews. Data were examined under the Thematic Content Analysis, with three thematic categories previously chosen: Configuration of geographic area, family composition and family s internal dynamics. Among the results, we highlight that, for children, the concept of family is based essentially on existence of affection ties, regardless of kinship. Through this study, we hope to contribute to the discussion on the rights of institutionalized children, concerning their need of experiencing family life and living in community

Compreendendo como as crianças significam o direito de brincar

This research aimed to understand how children mean the right to play. For that, assumes that the children composed a social category generational, with children experiencing their own skills, the result of the mediated relationship with the social and its transformative capacity. Adding to that, they are subject of duties with competence to means your own condition. After a long history of repression and an intense political struggle, the Doctrine of Integral Protection is inaugurated in Brazil and the Citizen (1889), which regulates the fundamental rights of all children and adolescents. Among these rights is the right to play. However, it is sufficient to provide by law, it is necessary to break with the diminishment of the play activity, still present in our society, watching it as a structuring activity of the subject and ensuring the enforcement of this right. Considering the child as the central focus of research, the research was conducted in a public school education. The subjects were six children of six years old, enrolled in 1st year of elementary school. The procedures employed for constituting the corpus of the research were: observation of children at school meetings and dialogue, monitoring of play resources such as drawings, cartoons and representative images of child rights. Also, the parents were interviewed with the goal to enlarge the understanding the context of the child. With the thematic content analysis, we raise two areas: play and children's rights. The results showed that children, however don‟t have a systematized knowledge about child rights , they understand that any elements are important for the children and your development, being the play the most recurrent, followed by education and family. The right to play configure as a necessity of the child, that even if she does not understand conceptually as a right, she feels the importance of living of the play activity