Prevalência de sintomas do climatério em mulheres dos meios rural e urbano no Rio Grande do Norte, Brasil

OBJETIVO: avaliar a sintomatologia climatérica e fatores relacionados entre mulheres dos meios urbano e rural do Rio Grande do Norte. MÉTODOS: estudo transversal, descritivo, envolvendo casuística de 261 mulheres climatéricas residentes em Natal e Mossoró (grupo urbano; n=130) e Uruaçu, em São Gonçalo do Amarante (grupo rural; n=131). A sintomatologia climatérica foi avaliada pelo Índice Menopausal de Blatt-Kupperman (IMBK) e Escala Climatérica de Greene (ECG). A análise estatística constou de comparações das medianas dos escores entre os grupos e regressão logística. Defi niram-se como “muito sintomáticas” as pacientes com escores ≥20, para ambos instrumentos (variável dependente). As variáveis independentes foram: idade, procedência, alfabetização, obesidade e prática de atividade física. RESULTADOS: o grupo urbano apresentou escores signifi cativamente superiores ao grupo rural, tanto para o IMBK (medianas de 26,0 e 17,0, respectivamente; p<0,0001), quanto para a ECG (medianas de 27,0 e 16,0, respectivamente; p<0,0001). Na amostra total, evidenciou-se que 56,3% (n=147) das mulheres foram classifi cadas como “muito sintomáticas”. Na comparação intergrupos, essa prevalência foi signifi cativamente mais elevada nas mulheres urbanas em relação às rurais (79,2 e 33,6%, respectivamente; p<0,05). Pela análise de regressão logística, evidenciou-se que a chance de pertencer ao grupo defi nido como “muito sintomáticas” foi maior para mulheres do meio urbano [odds ratio ajustado (OR)=7,1; 95% intervalo de confi ança a 95% (IC95%)=3,69-13,66] e alfabetizadas (OR=2,19; IC95%=1,16-4,13). A idade superior a 60 anos associou-se com menor chance de ocorrência de sintomas signifi cativos (OR=0,38; IC95%=0,17-0,87). CONCLUSÕES: a prevalência de sintomas climatéricos signifi cativos é menor em mulheres do meio rural, demonstrando que fatores socioculturais e ambientais estão fortemente relacionados ao surgimento dos sintomas climatéricos em nossa população.___________________________________ABSTRACT PURPOSE: to evaluate climacteric symptoms and related factors in women living in rural and urban areas of Rio Grande do Norte, Brazil. METHODS: a cross-sectional study involving 261 women in the climacteric was performed. A total of 130 women from Natal and Mossoró (urban group) and 131 from Uruaçu, in São Gonçalo do Amarante (rural group), were studied. Climacteric symptoms were assessed by the Blatt-Kupperman Menopausal Index (BKMI) and Greene Climacteric Scale (GCE). Statistical analysis involved comparison of median between groups and logistic regression analysis. Patients were defi ned as “very symptomatic” when the climacteric score was ≥20 for both questionnaires (dependent variable). Independent variables were: age, living area, schooling, obesity and physical activity. RESULTS: the urban group had signifi cantly higher scores than those of the rural group, both for BKMI (median of 26.0 and 17.0, respectively; p<0.0001) and for GCE (median of 27.0 and 16.0, respectively; p<0.0001). For the entire sample, a total of 56.3% (n=147) of the women were classifi ed as “very symptomatic”. This prevalence was signifi cantly higher in urban than in rural women (79.2 and 33.6%, respectively; p<0.05). Logistic regression analysis showed that the likelihood of belonging to the group defi ned as “very symptomatic” was greater for urban women [adjusted odds ratio (OR)=7.1; confi dence interval at 95% (95%CI)=3.69-13.66] who were literate (OR=2.19; 95%CI=1.16- 4.13). Individuals over the age of 60 years had less chance of having signifi cant symptoms (OR=0.38; 95%CI=0.17-0.87). CONCLUSIONS: the prevalence of signifi cant climacteric symptoms is less in women from a rural environment, showing that sociocultural and environmental factors are strongly related to the appearance of climacteric symptoms in our population

Análise fractal da vasculatura retínica: métodos de segmentação e de cálculo dimensional

Embora tenha sido proposto que a vasculatura retínica apresenta estrutura fractal, nenhuma padronização do método de segmentação ou do método de cálculo das dimensões fractais foi realizada. Este estudo objetivou determinar se a estimação das dimensões fractais da vasculatura retínica é dependente dos métodos de segmentação vascular e dos métodos de cálculo de dimensão. Métodos: Dez imagens retinográficas foram segmentadas para extrair suas árvores vasculares por quatro métodos computacionais (“multithreshold”, “scale-space”, “pixel classification” e “ridge based detection”). Suas dimensões fractais de “informação”, de “massa-raio” e “por contagem de caixas” foram então calculadas e comparadas com as dimensões das mesmas árvores vasculares, quando obtidas pela segmentação manual (padrão áureo). Resultados: As médias das dimensões fractais variaram através dos grupos de diferentes métodos de segmentação, de 1,39 a 1,47 para a dimensão por contagem de caixas, de 1,47 a 1,52 para a dimensão de informação e de 1,48 a 1,57 para a dimensão de massa-raio. A utilização de diferentes métodos computacionais de segmentação vascular, bem como de diferentes métodos de cálculo de dimensão, introduziu diferença estatisticamente significativa nos valores das dimensões fractais das árvores vasculares. Conclusão: A estimação das dimensões fractais da vasculatura retínica foi dependente tanto dos métodos de segmentação vascular, quanto dos métodos de cálculo de dimensão utilizados

Registro de enfermagem no prontuário em um hospital universitário: uma busca pela humanização do cuidado

T he aim of this study is to analyze the view of nurses about nursing records in the patient chart, in perspective of the record of humanized care. This is a case study, with qualitative approach. For its achievement, was sought and granted authorization from the direction of the Hospital Universitário Onofre Lopes (HUOL) and the Ethics Committee in Research of HUOL as Statement No. 422/10. During data collection, interviews were conducted with 20 nurses of the institution. The data analysis was based on the theoretical framework of Minayo to thematic content analysis, grounded in authors who work with themes, nursing records and quality care. With the empirical material, we constructed a framework of analysis, which was identified four categories thus nominated, "Reading and learning from those who register," "nursing records and quality of care," "the essence of nursing records" and "intention and action on the record of the subjective aspects of the patient." The results show that the records are insufficient, even in the case of the procedures performed with the patients often do not inform about the aspects that deal with the subjectivity that surround it, and admit that the records do not represent a parameter for evaluating the quality of care at least at that institution. In summary, the respondents recognize the importance of valuing subjectivity of the patient in their treatment, yet admit to neglect this aspect as significant for comprehensive health care, humane and quality

Fatores capazes de influenciar o apoio dos residentes ao desenvolvimento do turismo religioso em Santa Cruz - RN

This study is about the primary stakeholder management - the resident community, given its participation and support for the development of tourism in touristic destinations. It has as a general aim to analyze the factors that are capable to influence the residents‟ support to the development of religious tourism in Santa Cruz, RN, and the existing interrelationships between factors. In order to achieve this objective, it was necessary to use exploratory and descriptive research, followed by a quantitative approach through questionnaires with 422 residents of Santa Cruz -RN. The study was based on the variables relationship model proposed by Nunkoo and Ramkissoon (2012), it was also used the technique of Structural Equation Modeling - SEM, aiming to explain the relationships between the constructs studied. The results found on the survey suggest that the more residents realize the benefits generated by tourism, as well as trust in government actors in charge of tourism development, the more there will be a propensity to support the development of religious tourism. This result is similar to the one found in the study of Nunkoo and Ramkissoon (2012). We conclude that the structural model that best represents the reality of Santa Cruz -RN is composed of the factors: benefits, costs, and confidence in governmental actors, which are able to influence the support of Santa Cruz‟s residents for the development of religious tourism. It is also noteworthy that it was found a highly significant connection between the factors benefits perceived from tourism and confidence in governmental actors and between both of them, the political support for tourism