Avaliação do desempenho funcional de crianças com paralisia cerebral de acordo com níveis de comprometimento motor

Contextualization: Several studies have examined the mobility of this group of children, however little is known about the impact of motor function in activities of daily living, considering the seriousness of their neuromotor damage. Objective: Identify the functional differences of children with Cerebral Palsy with different levels of motor dysfunction and correlate these differences with the areas of mobility, self-care and social function in functional ability and caregiver´s assistance of these children. Methods: An l analytical cross-section search was developed, which were part 70 children / families aged from 4 to 7.5 years, in the Rehabilitation Center for Children. As tools were used the Pediatric Evaluation Disability Inventory (PEDI) and the Gross Motor Function Classification System (GMFCS). Data analysis was performed by ANOVA and Pearson's correlation tests. Results: The results show the functional variability of children CP in different severity levels of motor disfunction This variation was observed in the areas of mobility, self-care and social function. The results also showed a strong correlation between the domains mobility and self-care, mobility and social function. Conclusions: The variability shown by the children with CP, suggests the use of PEDI and GMFCS as this association appears to increase the understanding of how the gross motor functions are related to activities of daily living, describing the best commitments and their degree of impact on functional activities. This correlation demonstrates how mobility is crucial to evaluate the performance and guide the therapeutic practice, to develop the children´s potencial, and guide the caregiver in stimulation

A Short Physical Performance Battery (SPPB) como preditora da fragilidade em idosos residentes na comunidade

Introduction: The SPPB provides information about physical function and is a predictor of adverse events in the elderly. Frailty is a multidimensional syndrome that increases susceptibility to diseases and disability. However it may be possible to prevent or postpone frailty if is identified early. Our objective is to analyze SPPB s ability in screening for frailty a community-dwelling young elderly from cities with distinct socioeconomic conditions. Methods: Data were originated from community dwelling adults (65-74 years old) in Canada (Saint Bruno; n = 60) and Brazil (Santa Cruz; n = 64). SPPB was used to assess physical performance. Frailty was defined as the presence of ≥ 3 of these criteria: weight loss, exhaustion, weakness, mobility limitation and low physical activity. One point was given for each criterion met, totalizing a frailty score ranged from 0 to 5. The Linear Regression and Receiver Operating Characteristics analyses were performed to evaluate the SPPB s screening ability. Results: Mean age was 69.48, 10.0% of the Saint Bruno s sample and 28.1% of Santa Cruz s were frail (p = 0.001), the SPPB score means were 9.6 and 8.5 respectively (p = 0.01). SPPB correlated with the frailty score (R2 = 0.33), with better results for Saint Bruno. A cutoff of 9 in SPPB had good sensitivity and specificity in discriminating frail from non frail in Saint Bruno (AUC = 0.81) but showed fair results in Santa Cruz (AUC = 0.61). Conclusion: The SPPB has moderate ability in predicting frailty among older adult s population, and is an useful test to identify people with good functionality and low frailty when SPPB scores are ≥9

Avaliação de efetividade do centro de reabilitação de adultos - CRA/NATAL/RN

Public services with an emphasis on rehabilitation treatment of disabled people, as established law, have aimed to ensure quality and equity assistance in a rehabilitation way to the segment highlighted. As for people with physical disabilities, the Unified Health System (hereby SUS) through the directive GM/ MS No. 818 of 2001, requires the creation of hierarchical and regionalized services networks at different levels of complexity to ensure appropriate assistance. This study whose title is Evaluation of effectiveness of the Adult Rehabilitation Center in Rn: elements for a discussion aimed to evaluate the effectiveness of rehabilitation services that institution, reference in the State of Rio Grande do Norte, has directed its patients, more specifically those who have had a stroke and therefore are disabled ones. From the standpoint of methodological conduction, it was prioritized a qualitative and empirical theoretical research which was carried out from the following courses: literature references with authors who are the themes pertaining to rehabilitation, inclusion, public policy evaluation, health policy and disability; documentary research through Regulation of Technical Procedures, files, records, informative booklets that were of great importance to the knowledge of the institution, as well as its functioning and dynamics of field research that was materialized with the managers, rehabilitation staff and Center s users, through the application of semi-structured interviews as a tool for data collection. The information obtained was analyzed from the critical analysis of discourse. As a result, it was identified some technical, administrative and financial difficulties which have obliterated the effectiveness of services provided, such as: lack of many professionals to meet existing demand, poor quality of equipment and the physical structure, limits on autonomy management as a result of dependence along with the SESAP/RN; besides the excessive bureaucratization in the administrative processes compromising Center s problem-solving needs. However, in the narratives of managers, rehabilitation staff of patients, despite the difficulties, treatment made by Centre has effectiveness to the extent that has been contributing even in a limited way to improve their quality of life

Inclusão e deficiência: em busca das representações sociais na mídia impressa em Natal/RN

This thesis is the result of an extensive research on print media discourse on the inclusion of disabled people in society. Articles published in the newspapers Diário de Natal/O Poti and Tribuna do Norte from 1992 to 2002 have been analyzed. Beginning with the very same questions that moved Moscovici (1978) in his classic study La Psychalyse son image et son public , according to which the media play a predominant role in the formation and propagation of social representations as well as in the construction of human behaviors, we have chosen this mass media as our investigation field. Understanding the importance of the communication theory, we intend to associate it to the social representation theory, since communication, as an aspiration, relates to the fundamentals of all humanity (WOLTON, 2004, p. 56). Moreover, means of communication represent an important space for symbolic production and representational process, allowing the analysis of the circulating discourses on social inclusion and disability. Based on these questions, we have determined social representations present in print media on the subject to be our study object. This objective was elected due to the fact that the thematic of disability and inclusion is scarcely and sporadically found in journalistic speech. The research questions have been: which is the representation of disabled people s condition in print media? What changes have occurred during the analyzed period and which was the role played by print media in this process? The research corpus was composed of newspaper articles about various aspects concerning disability and of free word association by reporters. We have analysed: 1) graphical language promoted by the picture of the substances propagated in the period from 1992 a 2002; 2) free word association experiments carried out with reporters of both newspapers; and 3) texts published from 1996 to 1997 using the high-tech program ALCESTE (Contextual Lexical Analysis of a Set of Segments of Texts). The results revealed that the print media in Natal/RN refer to the topic in a discontinuous way, and depend on specific events to highlight disabled people s fight for their rights. Social inclusion is still a great challenge for these people in all levels. We believe that this incapacity to overcome all kinds of obstacles is established in a dialectic relation between society and the media: society remains silent (the manifestation of interest for the cause only attracts some people s or groups attention) and the media, which selects which information is to be broadcasted, gives no evidence to the issue. This representation may be noticed in the infrequency in which articles about the subject are published, as well as in the emphasis to sports, a more important issue for the media. An implication of this study is that a new perspective is opened for analysis and reflection: the Paralympics games as both an inclusive and a segregating social phenomenon. It would be beautiful to have all of us together!

A pessoa idosa com doença crônica não transmissível atendida em serviços de média complexidade na cidade de Natal/RN

The demographic and epidemiological transition process caused by a declining in birth rates and in mortality, also changes occurred in morbidity and mortality is represented by the increasing of the aging population and the raising of chronic diseases. These diseases are characterized by multiple etiologies, risk factors, long latency period, a prolonged evolution, non-infectious origin and it has association with functional impairment and disability. Thus, elderly with chronic non-communicable disease has priority because they belong to a vulnerable group to get affection of comorbidities in aging, with increased demand and spending on health services. This study is aimed to analyse the understanding of elderly people with chronic non comunicable disease in the medium complexity service as a contribution to the improvement of health care in the city of Natal / RN. This is a descriptive and exploratory study with a quantitative approach, carried out at the Specialized Center for Elderly Health Care and at the Pescadores Hospital. The population was composed of 4,180 persons with a sample of 124 elderly aged above 60 years, attended in these medium complexity services. The instrument, a structured form, adapted from a questionnaire for monitoring risk and protective factors for chronic disease of the Ministry of Health. To collect data was was used the interview form containing demographic data, habits, health status and health care services. The results were processed using the Statistical Package for Social Science, version 18.0, analyzed by simple statistics. It was found that most seniors were female, predominantly between 70 and 74 years old, married, with a brown skin tone and Catholic religion, more than half had incomplete basic education, family income between one to two minimum wages and living with their families. Regarding the interviewers lifestyle, 94.4%, of them ate chicken and 97.6%, fruits, it was observed a reduction in smoking, alcoholism habits and physical activity according to the increasing age, 58.1 and 18.5% had insomnia18,5 % used sleeping pills. The elderly (51.6%) reported using services in times of sickness, seeking primary care at first (30.6%), 52% did not receive referral and was looking for free demand (38.7%). The most reported morbidity was hypertension, followed by musculoskeletal disorders. Regarding the difficulties in seeking health services, the delay in treatment and the waiting line were the most cited by the elderly. Almost all of them reported no activities to promote health in these services and those who received individual counseling on chronic diseases. Almost always, the health professionals who care of them, were mostly doctors followed by nurses. Based on the results presented, it is considered that the health services of medium complexity must undergone a more continuous dialogue with other attention level and focus on actions of health promotion and prevention. It is also recommended the necessity for qualified professionals to delivery health care to elderly and the implementation of protocols by a multidisciplinary health team, intending to provide better and continous care for the elderly with chronic diseases. The healthcare professionals who served them, were mostly physicians, followed by nurses. Through the results presented, it is considered that the medium complexity healthcare services need to perform a more continuous dialogue with the other levels of attention focusing attention to the health promotion and prevention actions. It is also recommended the necessity for qualified professionals to delivery healthcare for the elderly, in addition, a protocol implementation for the multidisciplinary health care team, to provide better care, and also the care continuity to elderly with chronic diseases

Validação de instrumentos para avaliação da habilidade e do conhecimento acerca da medida da pressão arterial

This study aimed to validate tools for evaluating the ability and knowledge about blood pressure (BP) among nursing students. It is a cross-sectional, descriptive, quantitative and methodological study accomplished at the Universidade Federal do Rio Grande do Norte (UFRN), Universidade do Estado do Rio Grande do Norte (UERN) and a private university of the state. The sample consisted of 27 judges of research selected from the inclusion criteria: nursing, teachers of the semiology and/or semiotics discipline, with at least 1 year of experience, being from UFRN, EEN, UERN and private university of the state and and agree to participate voluntarily with the signing of the consent form. The research was development in three stages: construction of two instruments based on the scientific literature, resulting in a structured checklist consists of 28 items and a knowledge questionnaire with 12 questions; submission of the instruments to the judges, in the period from June to September 2012, which should evaluate each item in appropriate , appropriate with changes and inappropriate , addition to making an overall assessment of each instrument based on 10 requirements; validation and verification to the level of agreement among the judges, through the application of Kappa and Content Validity Index (CVI). Was used the consensus level greater than 0.61 (good) to the Kappa index and greater than 0.75 for CVI. Was approved by the Ethics in Research / HUOL. After being coded and tabulated, the data were analyzed using descriptive statistics. Of the 27 judges who evaluated the instrument, 77.8% are female, with a mean age of 36.6 (± 9.0) years, 63.0% worked in UFRN, 74.1% had academic master and 63.0% worked exclusively on teaching. Average length of teaching experience was 7.9 (± 8.0) years and in the semiology and/or semiotics discipline of 5.5 (± 6.7) years. In the judgment of structured checklist and questionnaire of knowledge about blood pressure mensurement any item/question was considered inappropriate since all obtained level of agreement within the indices established (CVI> 0,75 E Kappa> 0.61). In relation to structured checklist, of those 28 items present, 9 showed perfect concordance index (CVI = 1.00, Kappa = 1.00) and another 19 were considered appropriate with changes, especially with regard to clarity and vocabulary. In the questionnaire of knowledge, among the 12 questions that comprised, 7 had perfect concordance index and the others were considered appropriate with changes as requirements as clarity, vocabulary, and feasible sequence of instructional topics. In terms of a overall evaluating of instruments, the structured checklist got CVI of 0.94 and Kappa of 0.89 and the knowledge questionnaire, CVI of 0.97 and a kappa of 0.94. Both instruments proved to be valid as to their content, configuring it as clear and objective tools of assessment of knowledge and ability on blood pressure, being of nursing students as well as others students and health professionals, since the use of valid measures seeking to reduce the risk of distorting the results

Identificação não linear usando uma rede fuzzy wavelet neural network modificada

In last decades, neural networks have been established as a major tool for the identification of nonlinear systems. Among the various types of networks used in identification, one that can be highlighted is the wavelet neural network (WNN). This network combines the characteristics of wavelet multiresolution theory with learning ability and generalization of neural networks usually, providing more accurate models than those ones obtained by traditional networks. An extension of WNN networks is to combine the neuro-fuzzy ANFIS (Adaptive Network Based Fuzzy Inference System) structure with wavelets, leading to generate the Fuzzy Wavelet Neural Network - FWNN structure. This network is very similar to ANFIS networks, with the difference that traditional polynomials present in consequent of this network are replaced by WNN networks. This paper proposes the identification of nonlinear dynamical systems from a network FWNN modified. In the proposed structure, functions only wavelets are used in the consequent. Thus, it is possible to obtain a simplification of the structure, reducing the number of adjustable parameters of the network. To evaluate the performance of network FWNN with this modification, an analysis of network performance is made, verifying advantages, disadvantages and cost effectiveness when compared to other existing FWNN structures in literature. The evaluations are carried out via the identification of two simulated systems traditionally found in the literature and a real nonlinear system, consisting of a nonlinear multi section tank. Finally, the network is used to infer values of temperature and humidity inside of a neonatal incubator. The execution of such analyzes is based on various criteria, like: mean squared error, number of training epochs, number of adjustable parameters, the variation of the mean square error, among others. The results found show the generalization ability of the modified structure, despite the simplification performed

Otimização do controle eletrônico do diagrama de radiação de arranjos de antenas usando algoritmos genéticos com codificação real

Antenna arrays are able to provide high and controlled directivity, which are suitable for radiobase stations, radar systems, and point-to-point or satellite links. The optimization of an array design is usually a hard task because of the non-linear characteristic of multiobjective, requiring the application of numerical techniques, such as genetic algorithms. Therefore, in order to optimize the electronic control of the antenna array radiation pattem through genetic algorithms in real codification, it was developed a numerical tool which is able to positioning the array major lobe, reducing the side lobe levels, canceling interference signals in specific directions of arrival, and improving the antenna radiation performance. This was accomplished by using antenna theory concepts and optimization methods, mainly genetic algorithms ones, allowing to develop a numerical tool with creative genes codification and crossover rules, which is one of the most important contribution of this work. The efficiency of the developed genetic algorithm tool is tested and validated in several antenna and propagation applications. 11 was observed that the numerical results attend the specific requirements, showing the developed tool ability and capacity to handle the considered problems, as well as a great perspective for application in future works.

Análise de polimorfismos dos genes da rota quinureniana em pacientes com meningite bacteriana.

Bacterial meningitis (BM) is still an important infectious disease causing death and disability. Invasive bacterial infections of the central nervous systems (CNS) generate some of the most powerful inflammatory responses known, which contributes to neuronal damage. The DNA microarray technology showed alterations in the kynurenine (KYN) pathway that is induced in BM and other diseases associated with inflammation, leading to brain injury. Our main aim was to search SNPs previously described in the KYN path enzymes to investigate a putative association of this SNPs with imbalanced in this pathway in patients with BM. The patients included in this study were 33 males and 24 females, with ages varying from 02 months to 68 years. SNPs were located inside of the domain conserved in KYNU, IDO, KATI and KATII. Primers were designed for analysis of SNPs already described by PIRA-PCR followed by RFLP. The analysis of KYNU+715G/A SNP found a heterozygous frequency of 0.033. We did not found the variant allele of SNP KYNU+693G/A, KATI+164T/C, KATII+650C/T and IDO+434T/G. Despite of previews studies showing the importance of KYN pathway we did not found one association of these SNPs analyzed with susceptibility or severity of MB in study population.

Critérios comportamentais utilizados por técnicos na avaliação do desempenho esportivo de futebolista das categorias de base

Currently one of the major concerns in sports is to identify, select, discover and reveal talents in soccer. As principal reasons is perceived the search direct or indirect for resources for players, clubs, media, sports brands and their sponsors. However, high salaries are an exception and not a rule, because the majority of professional players in Brazil receives 1 minimum salary per month. It is also known that on professional clubs, daily, arriving several players to try to be a professional soccer player, however, the majority of clubs - almost all does not present methodological, systematic and analytical aspects to select promising players. The selective processes ("sieves" or "big sieves") developed by technical observers ( olheiros") summarized in the observation of the sportive performance of a big group of players in a period of few minutes given to each player. In this period the target behavior is the ability with the ball. If promising players are identified on that selection, they are referred to the club for a new observation, which will be conducted by the responsible coach of base category in question. It is understood by base categories, the amateur categories (not professional), to serve as a "base" for the formation of the cast of professional clubs. What are sub-13 (under 13 years), sub-15 (under 15 years), sub-17 (under 17 years) and sub-20 (under 20 years). The absence of common criterias and performance indicators of these professionals may hamper the evaluation of promising players, and be a costly activity for the club. This study proposes to identify, characterize and categorize the criterias and methods of behavioral evaluation, used by coaches of base categories of Rio Grande do Norte (RN) to evaluate the sportive performance of young soccer players, with the purpose of to compare the criterias of evaluation of sportive performance of young soccer players, used by coaches with different time of experience in function. The proposal had 2 pilot studies, the first (June and July, 2007) were interviewed 29 coaches, 17 of category sub-13 and 12 of category sub-17. The data were tabulated and organized into spreadsheets in order to describe, and developed a set of descriptors of behavior. And the second (May and June, 2008), with revisions made based on observations, analysis and descriptions found in the first, were interviewed 14 technical of category sub-15. After the results found in pilots, it was possible to outline the study in question, which had 46 coaches base categories of the RN. And from the results show that the characteristic of greatest importance, according to the interviewees was the behavior, the 2nd most important characteristic considered was the motivation, the 3rd was the ability and the 4th was the physical condition and the last was the affiliation. And by analyzing the results to the methods of evaluation of sportive performance used by coaches, it was noted clearly that most uses only the observation to select young soccer players. Therefore, needs a systematization to the selection of soccer players, since there is complexity in the verification of characteristics and aspects involved with purpose to avoid wrong evaluations and selections and the results negligible

As Faces e os Disfaces da Informalidade no Capitalismo Conteporâneo: Um Estudo do Comércio de Rua em Pau dos Ferros/RN

This paper discusses the expression of informality in contemporary capitalism. Thematic of relevance to the analysis of the reality of work today and the logic that moves the capital, its real presence in the lives of individuals. The street trading of Pau dos Ferros town, popularly known as "street market" was chosen as the search space. The main objective is to seize and examine the articulations and logic, present in the configuration of the street trading of this city, located in the state of Rio Grande do Norte, explaining the functionality of informality for capitalist accumulation, but also for the reproduction of segments of the working class. Our analysis is based in the perspective of totality, trying to grasp the historical determinations of the phenomenon in focus. It includes the analysis of the mechanisms used by the capital to reproduce itself in the current historical context, which has been implicated in the composition of the labor markets of different countries and in various forms of exploitation to which workers in general are subject. It also means discussing the development of capitalism in Brazil, the logic that permeates its dependence, and especially the use of over-exploitation of labor, as a lever for internal accumulation. The course of investigation consisted of theoretical research to form the basis of theoretical and methodological analysis and to outline the context in which our research object is inserted, and field research conducted in two phases: systematic observation, which allowed to map traders features and the infrastructure of commerce, and the conduction of interviews with key informants. The material collected was scrutinized according to analytical scheme inspired by the content analysis. Among the main considerations developed from the research process we include: the street trading of Pau dos Ferros remains shrouded in the majority sale of agricultural products, this demonstrates the structural characteristics of the region. However, the supply of this product is no longer restricted to the excess of small local producers. The presence of the dealer changed the distribution of the product, streamlining it. In parallel, business practices are developed, practices in which traded goods (industrial) reflect the moment of capitalist restoration, a larger business network. The reflections also made it possible to show that street trading follows developing on the basis of informal work, which gains functionality to the system, as it is configured as a space commonly used to drain part of the production, of industries (clothing/shoes), especially if the distribution is considered as an essential element of the complex process that aims at capital appreciation. This activity has been functioning as a place of employment and income generation for the subjects who are away from formal employment, masking, this way, unemployment, moreover, they allow them to continue as consumers. Such expressions reflect the ability and the logic of capital to expand and aggregate into so many realities. It is underway today, the logic that has led many workers to join the project of domination of capital, by the illusory chance to become capitalists. The aim has been to turn the subject into a consumer and the worker an enterprising