Estilo de vida e vulnerabilidade social dos adolescentes no Bairro de Felipe Camarão, Natal/RN, 2005

Este estudo descreve o estilo de vida e vulnerabilidade dos adolescentes do bairro Felipe Camarão em Natal-RN, a fim de compreender seus comportamentos, conforme vulnerabilidades identificadas. Foram aplicados 145 questionários semi-estruturados entre os adolescentes de 12 a 18 anos, no período de janeiro, a abril de 2005. O estilo de vida descrito, conforme os dados colhidos, informa que 92,4% sabem da importância de se alimentar bem, 86,9% têm sono preservado; 76,5% têm boa relação com seus pais. Porém, 86,9% afirmaram não haver área de lazer/diversão no bairro, enquanto os 31,0% não responderam sobre higiene corporal; 41,4% consomem drogas lícitas (maioria álcool), enquanto 37,9%, as ilícitas (maioria cola); 51,7% dizem que não conversam sobre sexo, enquanto 30,3% conversam com suas mães; 38,0% estão sexualmente ativos, iniciados entre 13 a 16 anos. Os comportamentos de alguns adolescentes estudados indicam um estilo de vida saudável, enquanto outros demonstram justamente o contrário, através de práticas como: pouca participação no lazer, por falta de opção; consumo de drogas lícitas e ilícitas; a falta de diálogo com os pais sobre sexo; relacionamento sexual precoce, somados às condições econômicas e sociais desfavorecidas que os expõem à adoção de um estilo de vida que implica em vulnerabilidade

Indicações para o projeto arquitetônico de edifícios multifamiliares: uma análise pósocupação em Natal/RN

Confirming the Brazilian tendency in the field, the multifamily vertical condominium habitats in Natal are defined as buildings with three or more floors which have been an increasingly used solution. In the mentioned project, the connection between the projectarchitects and the user/ buyers are spread out, by which the first people conceive the realestate property as a creation for the market and not the individual client in specific. Such situation along with technical and financial limitations of the project lead to the adoption of standard solutions to be utilized by clients with different profiles. Besides that, there are various legal and urban parameters by the City Director Plan showing elements of great influence in the final solution adopted by the mentioned edifices. Moving to this subject in general, this project is focused on the case study of the Ed. Ville de Montpellier, having as a base of Post Occupancy Evaluation (POE), considered an efficient tool to analyze and keep up with the progress of the construction of the building, including technical approvals, the application of surveys with the local residents and the creation of informal interviews. The data shows that with time some items that initially motivated the acquisition of the realestate property (with a social common area) move to being less valued, and that the residents quickly alter the pre constructed space, thus seeking to alter the property in a more personal and conforming manner. The possibility of a new emphasis for projects on the mentioned space should also be in discussion, the created project calls for the attention of projected conceptual aspects and interdependence within project and construction which permits the indication of some recommendations for the projection of multifamily residential buildings within the studied realm

Nitretação em plasma com gaiola catódica: investigação do mecanismo e estudo comparativo com a nitretação em plasma de tensão contínua

The ionic plasma nitriding is one of the most important plasma assisted treatment technique for surface modification, but it presents some inherent problems mainly in nitriding pieces with complex geometries. In the last four years has appeared a plasma nitriding technique, named ASPN (Active Screen Plasma Nitriding) in which the samples and the workload are surrounded by a metal screen on which the cathodic potential is applied. This new technique makes possible to obtain a perfect uniform nitrided layer apart from the shape of the samples. The present work is based on the development of a new nitriding plasma technique named CCPN (Cathodic Cage Plasma Nitriding) Patent PI 0603213-3 derived from ASPN, but utilizes the hollow cathode effect to increase the nitriding process efficiency. That technique has shown great improvement on the treatment of several types of steels under different process conditions, producing thicker and harder layers when compared with both, ASPN and ionic plasma nitriding, besides eliminating problems associated with the later technique. The best obtained results are due to the hollow cathode effect on the cage holes. Moreover, characteristic problems of ionic plasma nitriding are eliminated due to the fact that the luminescent discharge acts on the cage wall instead of on the samples surface, which remains under a floating potential. In this work the enhancement of the cathodic cage nitriding layers proprieties, under several conditions for some types of steels was investigated, besides the mechanism for nitrides deposition on glass substrate, concluding that the CCPN is both a diffusion and a deposition process at the same time

Estudo paramétrico da recuperação de petróleo pesado por aquecimento eletromagnético resistivo

Electrical resistive heating (ERH) is a thermal method used to improve oil recovery. It can increase oil rate and oil recovery due to temperature increase caused by electrical current passage through oil zone. ERH has some advantage compared with well-known thermal methods such as continuous steam flood, presenting low-water production. This method can be applied to reservoirs with different characteristics and initial reservoir conditions. Commercial software was used to test several cases using a semi-synthetic homogeneous reservoir with some characteristics as found in northeast Brazilian basins. It was realized a sensitivity analysis of some reservoir parameters, such as: oil zone, aquifer presence, gas cap presence and oil saturation on oil recovery and energy consumption. Then it was tested several cases studying the electrical variables considered more important in the process, such as: voltage, electrical configurations and electrodes positions. Energy optimization by electrodes voltage levels changes and electrical settings modify the intensity and the electrical current distribution in oil zone and, consequently, their influences in reservoir temperature reached at some regions. Results show which reservoir parameters were significant in order to improve oil recovery and energy requirement in for each reservoir. Most significant parameters on oil recovery and electrical energy delivered were oil thickness, presence of aquifer, presence of gas cap, voltage, electrical configuration and electrodes positions. Factors such as: connate water, water salinity and relative permeability to water at irreducible oil saturation had low influence on oil recovery but had some influence in energy requirements. It was possible to optimize energy consumption and oil recovery by electrical variables. Energy requirements can decrease by changing electrodes voltages during the process. This application can be extended to heavy oil reservoirs of high depth, such as offshore fields, where nowadays it is not applicable any conventional thermal process such as steam flooding

A representação social do cuidado no Programa Saúde da Família na cidade do Natal

The aim of this study was to learn about the social representations of the care provided by the Family Health Program (FHP) in the city of Natal, Brazil and determine how these representations guide the daily actions of doctors, dentists, nurses, nurse s assistants and oral health assistants during the work process. In this sense, we used the theoreticalmethodological approach to the Theory of Social Representations. For data collection, we used the following instruments: a two-part questionnaire, where the first part recorded sociodemographic data and the second part was adapted to the free word association technique (FWAT), which was applied to 90 professionals belonging to 18 FHP units. Interviews were also used as collection instruments. These were based on inductive stimuli and on direct observations of 30 of these professionals. After a superficial reading of the material, we constructed a corpus from which ten categories emerged. To analyze FWAT we used lexicographic analysis, combining frequency and the mean order of responses. The interviews and sociodemographic variables were analyzed using content analysis and descriptive statistical analysis, respectively. The study showed that the central nucleus of the social representation in question is composed of the elements attention, receptivity and love, revealing that the subjects have different understandings of the FHP care process and that the knowledge accumulated in this respect is supported by an approximate vision of the meaning of care. However, traditional elements with trivializing connotations about care predominate, which compromises the development of strategies to overcome traditional practices. In the set of analyses, we were able to capture the invariance of a contradiction: on one hand, professionals know and affirm the importance of providing care for FHP patients; on the other, the experience of daily practice translates into the negation of this concept. In this contradictory context, professionals build gradual and successive syntheses that allow them to act and affirm themselves by associating information from their academic formation, structured knowledge acquired in other experiences, values and symbols of their daily routine. Thus, they shape and reshape themselves, according to what is concretely and specifically required, at the same time both plural and multiple. The composition of the central nucleus indicates that any measure that intends to modify attitudes that is, the daily actions of FHP professionals with respect to care must take into account and give priority to the debate about the redefining of the semantic fields of the central nucleus (love/attention/receptivity and humanization), especially those of love and attention

A saúde psíquica de quem faz saúde: uma análise crítica sobre a humanização direcionada ao profissional de saúde

It is noticeable that pressure, tension and overwork are frequent in health professionals routine. The work related to the ward area demands deep attention and surveillance. Because of that, it is essential to have a specific look at the humanization directed at health professionals, considering that taking care of other human beings is the essence of their job. This study has analyzed the psychic health levels, as well as the stress health professionals are submitted to, providing a debate about the humanization in 06 public hospitals (03 of them awarded by actions of humanization, and 03 not awarded) in Rio Grande do Norte state, Brazil. A study with 126 active health professionals (doctors, nurses, psychologists, nutritionists and social workers) in ward areas in their respective institutions was carried out. The thesis presented, with multi-disciplinary characteristic, counted on the support of statisticians (to calculate samples and data analysis), psychologists, social workers and administrators (linked to the human resources sector in each hospital). A cross-sectional study was performed, taking into consideration both quantitative and qualitative factors. The tools used for that were a semistructured questionnaire with socio-demographic characteristics, work and humanization; Lipp's Stress Symptoms Inventory for Adults (ISSL), and the Goldberg s General Health Questionnaire (QSG). The workers are predominantly women (84,9%), married (54,8%), between 46 and 55 years old (40,5%), working in the same institution for more than 20 years (22,2%), and between 16 and 20 years (20,6%), respectively. They work 40 hours a week (71,4%) and have multiple jobs (61,9%). Although most of these individuals global psychic health is in a good level, there are a significant number of people that is gradually getting worse concerning psychic stress (F1) showed by QSG (54,7%), and stress showed by ISSL(42,1%). Observing the categories, nurses (41,5%). Nutritionists (20,8%), doctors and social workers (18,9%), were among the most affected. About general health (F6), 63% of the awarded hospitals and 70% of the not awarded ones, presented good health levels (ranging from 5 to 50%). It was also noticed that, in the groups mentioned above, 25 and 20% respectively, were inserted in scores between 55 to 90%, what means that they are in worsening phase. The fact that the hospital is awarded or well recognized doesn t interfere in health professionals stress level and in their psychic health. Through what was heard from these individuals, it was possible to verify that they know little about humanization, once few of them identify or know that the service they offer is in an adoption process by Ministerial Policies. It was also detected the necessity of developing actions aimed at worker s health. Such results showed the importance of have more investments in programs that are directed to workers well-being, because they deal with other people s health and it is known that it is difficult for them to offer high-quality assistance if there are not suitable physical, psychological and material conditions to help them develop their jobs. As a warning, it is fair to say that investments in actions that provide humanized care to health professionals, mainly concerning preventive care for their health and life quality in their work

Significados e percepções de puérperas sobre as síndromes hipertensivas da gravidez e parto prematuro

Hypertensive syndromes in pregnancy (HSP) are configured as one of the major complications in the pregnancy and postpartum period and can lead premature newborn and subsequent hospitalization of the newborn to the Neonatal Intensive Care Unit (NICU). This study aimed to analyze the perceptions, meanings and feelings of mothers on the hypertensive syndromes in pregnancy and premature obstetric labor. The research was qualitative and has a theoretical methodological the Social Representations Theory(SRT) in the approach to the Central Nucleus Theory. The study included 70 women, mean age 29 years, predominantly school to high school, most of them married or in consensual union, primiparous and prevalence of cesarean delivery occurred between 32 and 37 weeks of pregnancy.The data were collected from may to december 2008 in the Maternity School Januário Cicco in Natal , and obtained through the following instruments for data collection: questionnaire including questions about socio-demographic status; the Free Words Association Test (FWAT) and and verbalized mental image construction used three stimuli: such as pregnancy with high blood pressure, preterm birth and NICU, and interview with the following guiding question: what it meant for you to have a pregnancy with high blood pressure and consequently the birth of a premature baby? Data analysis was performed using multi-method obtained from the data processing by EVOC (Ensemble Programmes Permettant L 'Analyze des Évocations) and ALCESTE (Analyse Lexicale par Contexte d'un Ensemble de Segment de Texte) and thematic analysis in categories. The results will be presented in four thematic units under the following representative universes: HSP, prematurity as a result of HSP, NICU and the social representations of mothers on the hypertensive disorder of pregnancy sequenced premature birth and hospitalization of the child in the NICU. The results obtained by multimethod analyses showed similar constructions and point to death as the central nucleus and negative aspects, coping strategies, need of care, knowledge about the disease, fragility and meanings of the NICU as peripheral elements. It is considered that the perceptions, meanings and feelings of puerperal women in relation to HSPs and to premature delivery are a negative social representation, with representational elements that may have influenced the adverse effects on the disease and its consequences. We suggest action on the peripheral elements of this representation, with adequate orientation, early diagnosis, effective conduct, receptive attitude on the part of the team, health promotion measures and effective public policies, in order to improve the care provided to puerperal women, making them feel welcome and minimizing their suffering

Fatores preditivos da dor em pacientes submetidos à cirurgia cardíaca

A identificação de fatores que interferem na dor pós-operatória é útil para minimizar o sofrimento desnecessário e favorecer a uma intervenção analgésica adequada, evitando generalizações nas condutas terapêuticas. O propósito dessa investigação foi identificar os fatores preditivos da dor em pacientes submetidos à cirurgia cardíaca e a relação existente entre dor, analgesia e personalidade. Trata-se de um estudo prospectivo e analítico, aprovado pelo comitê de ética da UFRN (175/06), o qual proporcionou uma abordagem multidisciplinar ao envolver áreas distintas como: fisioterapia, psicologia, médica e enfermagem (interdisciplinaridade) na elucidação do objeto de estudo relacionado a fatores preditivos da dor. Para caracterização geral dos pacientes foi utilizada uma ficha de avaliação fisioterapêutica; a dor pós-operatória foi avaliada pela escala numérica de dor e questionário para dor McGill e o Inventário Millon de Estilos de Personalidade (MIPS) foi utilizado para identificar e avaliar as manifestações das características comportamentais e de personalidade. Foram acompanhados, do 1º ao 5º dia de pós-operatório (DPO), 160 pacientes submetidos à cirurgia cardíaca, 57,5% do sexo masculino, com idade média de 56,8±14,4 anos, sendo incluídos no estudo aqueles que se queixaram de dor no pós-operatório em pelo menos um dos dias de avaliação e assinaram termo de concentimento livre e esclarecido (TCLE). Os dados foram submetidos ao teste Qui-quadrado, regressão logística multivariada, teste de correlação de Spearman, teste t e ANOVA. Ao serem submetidos à análise de regressão foram encontrados seis fatores preditivos da dor: tempo cirúrgico > 3 horas, dreno mediastinal e lateral, tosse, vômitos, tempo de dreno > 24 horas e sexo feminino. Estes fatores apresentaram uma correlação positiva e significava com a intensidade dolorosa referida pelos pacientes na escala numérica de dor e os pacientes que apresentaram mais fatores preditivos da dor referiram mais dor. 23 Já em relação ao McGill não se obteve diferença significativa entre os pacientes com mais e menos fatores preditivos. Observou-se que foram administrados diferentes tipos de analgésicos, isolados ou associados, sendo estes: paracetamol, paracetamol associado à codeína, dipirona, tramadol, toradol e tilatil. A percepção dolorosa apresentou magnitudes variando de leve a moderada do 1º ao 5º DPO e ao ser relacionada com as características de personalidade, nos pacientes com menos dor, observou-se os fatores: preservação, individualismo, introversão e os com mais dor foram: proteção, extroversão, retraimento, discrepância, afetividade, acomodação, comunicabilidade e firmeza. Evidenciou-se que o comportamento doloroso pós-cirurgia cardíaca é multifatorial e que a determinação da existência de fatores preditivos da dor permite ao profissional da área de saúde fazer o uso adequado dos analgésicos, haja vista que o alívio da dor é responsabilidade de todos os profissionais da saúde. Os aspectos psicológicos enquanto características de personalidade podem influenciar padrões de comportamento como os observados.

Avaliação da atenção à saúde de portadores de HIV no centro de referência para o tratamento da Aids em Natal/RN por profissionais e usuários do serviço

Objective: The aim of this study was to evaluate the health care of HIV/AIDS Reference Center for treatment of AIDS in Natal/RN for professionals and service users. Methods: This is an evaluative study with a quantitative approach, performed in the outpatient Giselda Trigueiro Hospital, in Natal (RN). The target population consisted of 313 patients with HIV and 34 professionals of the center. Data collection occurred from august 2007 to july 2008, with a structured form of interview, validated through a pilot study. The data were analyzed by descriptive and inferential statistics. Results: The evaluation of the service was considered unsatisfactory by 85.6% users. However, 58.8% of professionals considered it satisfactory. There was difference in the evaluation of the following indicators: the relationship professional users, offering support, timeliness of professional guidelines on the treatment. There was similarity in the following indicators: physical structure, respect for privacy, opportunity to make complaints, hospitality, convenience of schedules, availability of ARVs and laboratory tests, and ease of access. Conclusion: The results point to dissatisfaction of the users and professional satisfaction with the health care of people with HIV / AIDS in the service searched. It was found that the indicators used in this study may be considered relevant to evaluate the service in question, as well as monitoringparameters provide acceptable quality of health care by the National STD/AIDS

Impacto do déficit cognitivo na saúde e capacidade funcional da populção idosa do distrito oeste da cidade do Natal-RN

A incapacidade funcional e o déficit cognitivo são condições relacionadas com o processo de envelhecimento humano. O déficit cognitivo é considerado um importante fator preditor de prejuízos funcionais em populações idosas. Este estudo teve um caráter multidisciplinar na sua elaboração e execução, contando com profissionais de distintas áreas da saúde. Trata-se de um estudo transversal que analisou a associação do desempenho cognitivo na capacidade funcional de uma amostra populacional idosa residente em Natal-RN. Foram avaliados 213 idosos pelo Questionário Multidimensional BOAS e pelo Mini-Exame do Estado Mental (MEEM). Através de análise multivariada, mediante regressão linear, os resultados apontam a idade e o nível de escolaridade como fatores associados ao desempenho cognitivo nos idosos do estudo. O modelo explicativo final elaborado através de regressão logística apresentou o desempenho cognitivo como a única variável associada à incapacidade funcional para as atividades da vida diária, mesmo quando ajustado por variáveis sócio-demográficas. A identificação dos fatores, associados ao declínio do estado funcional dos idosos que vivem na comunidade, poderá reduzir o impacto dessas condições na capacidade funcional através da aplicação de medidas preventivas voltadas para este fim

O discurso religioso no processo migratório para o caldeirão do beato José Lourenço

The Caldeirão is a site located in the city of Crato, in the south of Ceará, belonged to priest Cícero Romão Batista. There, was created a religious community led by blessed José Lourenço, who marked the life of thousands of Northeast country people in 1930s, for represent to them a space of religious conviviality, work and devotion. The Caldeirão s population was about three thousand of people, originated from states of Pernambuco, Alagoas, Paraíba, Maranhão, Piauí, Ceará and Rio Grande do Norte, who share the community s daily activities. The misery caused by the dryness and exploration of these country people by the landlords are indicated as the motivator elements of this migratory flux by the greater number of works published about the Caldeirão, turning the community into a primitive experience of class struggles. This present study proposes other comprehension of this migratory movement by the religious speech of salvation taken to country people by the counselor Severino Tavares. Was used as analysis camp the remaining norte-rio-grandenses that migrated to the Caldeirão, and as theoretical and methodological references the understanding model of investigation, the cultural history and the remaining memorial speech analysis. The work follows that pointing the phenomenon of Caldeirão as an campestral revolt is try to impose to this people the aspirations or wishes of others, besides of deny to them the right and the dignity of act by their believes and their own dreams.

Caminhos e descaminhos dos municípios produtores de petróleo: o papel dos royalties no desempenho das finanças públicas municipais no estado do Rio Grande do Norte

It analyzes the magnitude, the nature and the direction of public revenues and the public expenses in oil and natural gas producing municipalities in the state of Rio Grande do Norte in the post-constituent period, and, more precisely, from the approval of Law 9.478/97, called Oil Law . It argues the fiscal federalism normative theory, the typology and the role of the intergovernamental transferences in the performance of the public finances of the local governments. Shows that the economy of Rio Grande do Norte went through deep social-economic changes in the last few decades, among which includes the discovery of the oil and the natural gas and its importance for the growth of the industrial and services sectors. It points out that the increase of the production and the international price of the oil contributed for the growth in revenues of royalties and the special participation in the beneficiary cities, what did not mean an automatic increase in the resources destined to the investment and in the quality on the provision of the goods and services come back toward the local development. On the contrary, the main conclusion of the work is that the trajectory of the oil producing municipalities is marked by paths and embezzlements in the performance of the public finances and in the provision of public goods and services. Paths, that lead to the improvement of the performance of the public finances and the quality of the public goods and services. Embezzlements, that lead to the inefficiency in the provision of goods and services and the capture of the public resources. That is, the fiscal decentralization is a necessary condition, however not enough to improve the amount and the quality of the public goods and services given by these municipalities. For that it is necessary to advance in the fiscal federalism normative theories, in search of optimum model of federalism in local governments where still predominated by patrimonialism, clientelism, fiscal illusion and the capture of the public resources in benefit of the private interests

O impacto do pagamento da participação sobre a produção de petróleo e gás natural sobre a renda familiar e a propriedade no Município de Governador Dix-Sept Rosado no período de 1998 a 2004

This scientific study deals about the oil and natural gas production participation payment impact in the county of Governador Dix-sept Rosado, Rio Grande do Norte, between 1998 to 2004, applied to family income and property. To do so, this analysis focus on the ricardian´s theory exposition which merges from the concept of the mineral income, in concern to the legal establishment of royalties. This paper also shows the world evolution oil exploration, inserting Brazil in this scene as a oil and natural gas producter. It identifies the productive site of oil and natural gas in Rio Grande do Norte as the Potiguar Oil Area, characterizing its components in the demographic, physical and social aspects, to reflect in the focus point of observation which is the Governador Dix-sept Rosado county. The participation payment on oil and natural gas is demonstrated in a qualitative analysis both in Brazil as in Rio Grande do Norte. The payments given to the land owners in this federative unity are shown in the period of analysis of this essay. The study tells, based in a field research, the benefaction impact of the payment to the land owners over the income and property. The family income were highly impacted, causing economic social classes change to some land owners. The property had less or none impact. It was found negative externalities as the income utilization to other county uses, not causing a multiplier effect in the studied county. The fact of the not utilization of the properties on productive investments in order to supply the finite characteristic of oil and this source of royalties, contradicts one of the reasons of its establishment which is the payment for its productive exhaustion of a land resource

A indústria petrolífera nacional e potiguar: uma análise a partir da tecnologia em E&P

O trabalho analisa a Indústria Petrolífera em três ambientes de atuação, mundial, nacional e estadual, a partir da observação de sete variáveis, a saber: caráter do petróleo; risco; economia de escala; integração; barreiras; tecnologia e ambiente. O estudo busca perceber as interações e os transbordamentos das variáveis selecionadas em cada um dos ambientes citados, em razão os aspectos econômicos e institucionais presentes nesta atividade, cujos resultados atingem diversos setores da economia e da sociedade como um todo e balizam o próprio processo de inovação da mesma. O estudo está alicerçado no arcabouço teórico neoschumpeteriano acerca dos aspectos voltados para concorrência e inovação, além da questão institucional, e se apóia em dados da Agência Nacional do Petróleo (A.N.P.), Ministério de Minas e Energia (MME), Movimento de Combate à Corrupção Eleitoral / Tribunal Superior Eleitoral (MCCE/TSE), Organization of the Petroleum Exporting Countries (OPEC), International Energy Agency (IAE), Institut Français Pétrole (IFP), United Nations Development Programme (UNDP). Avalia-se que em termos de caracterização da indústria petrolífera nos três ambientes considerados (mundial, nacional e local), há certa similitude no que se refere ao comportamento destas variáveis, com pequenas modificações suscitadas por fatores como grau de desenvolvimento e complexidade da atividade; resultado do ambiente concorrencial e inovativo; e, pelas influências institucionais acerca de atividades e grau de inserção das mesmas no ambiente socioeconômico onde estão localizadas a atividade produtiva e o seu entorno

A eficiência do gasto e da qualidade da saúde pública: uma análise nos municípios do estado do Rio Grande do Norte (2004 e 2008)

The overall objective of this study is to analyze the efficiency in the use of resources and the quality of public health in the municipalities of Rio Grande do Norte, from 2004 to 2008. It also seeks to identify the determinants of municipal inefficiency and measure the productivity of public spending on health. To this end, three methods of analysis are used: the DEA, the Malmquist index and the Tobit regression model. Among other findings, it appears that municipalities considered more inefficient in the measurement of expenditure on health make the largest expense in this function. On the other hand, from 2004 to 2008, only 13 municipalities showed an increase in the productivity of public spending. It is also noted that municipalities considered efficient in quality of health, although having more physical and human resources, offer fewer health services to the population. In all, the major determinants of health spending inefficiencies are the variables: age of the mayor, coalition, population density, literacy race and budget revenues. Regarding the inefficiency of the health quality, variables such as: coalition, literacy race have strong influence on this behavior. Thereby, the hypotheses proposed by the study have been fully accepted. In other words, for the efficiency of the quality and health spending it is needed more than resources, i.e., the expenditure shows itself as essential, but not enough, for political and economic aspects also interfere with the performance of spent and in the quality of health care offered to the population