Avaliação da qualidade da assistência a pessoas com úlceras venosas atendidas na estratégia saúde da família

A úlcera venosa constitui importante problema de saúde pública, gera repercussão social, econômica e mudanças nos hábitos de vida, dor, sofrimento, acarretando diminuição da qualidade de vida. O estudo objetivou avaliar a assistência prestada às pessoas com úlceras venosas atendidas pela Estratégia Saúde da Família. É um estudo analítico, transversal e quantitativo, realizado com 59 pessoas com úlceras venosas, atendidas em 36 unidades da Estratégia Saúde da Família. O estudo obteve aprovação do projeto de pesquisa pelo Comitê de Ética da Universidade Federal de Alagoas. Para a coleta dos dados utilizou-se instrumento testado, entrevista, exame físico e informações dos prontuários. Os dados foram organizados em planilha do Microsoft Excel 2007, exportados e analisados em software estatístico por meio de estatística descritiva e inferencial, considerando nível de significância estatística de ρ-valor < 0,05. As pessoas com úlcera venosa eram do sexo feminino (71,2%), ≥ 60 anos (67,8%) e estavam em tratamento > 1 ano (69,5%). Possuíam tempo de lesão > 6 meses (64,4%), dor na úlcera/membro (86,4%) e leito com ≤ 30% de granulação/epitelização (78,0%). A qualidade da assistência foi ruim (< 5 aspectos positivos) em 57,6% (ρ=0,000) e os aspectos que mais interferiram foram as seguintes inadequações: profissional que acompanha/realiza curativo (ρ=0,002, coeficiente de contingência (CC) =0,458, razão de chance (RC) =13,9), produtos nos últimos 30 dias (ρ=0,038, cc=0,334, RC=7,3) e acesso a consulta com angiologista (ρ=0,041, cc=0,305, RC=4,1). Os aspectos clínicos que contribuíram para o aumento do tempo de assistência foram: tempo de lesão >6 meses (ρ<0,001), dor (ρ=0,043), recidiva (ρ<0,001); nos aspectos assistenciais: inadequação dos produtos com 83,1% (ρ=0,036). Essas características dificultaram a cicatrização tecidual, prolongando o tempo de tratamento das lesões,que podem ter contribuído para a cronicidade das úlceras

Assistência odontológica diferenciada para crianças de 0 a 3 anos: avaliação de impacto no Serviço Público Municipal em Natal-RN

In Brazil, 0-5 years old children just have an oral health care system since 1990 s. Innumerable experiences of implantation of the attendance to the babies in the cities had appeared throughout the years, but it hasn´t been evaluated the comparative effect between children displayed and not displayed to the program. In this regard, the main of this research was describe the Early Childhood Oral Health Care in public health service in Natal, Rio Grande do Norte, Brazil and evaluate the impact of this specific oral health care for babies by comparison of indicators between exposed and non-exposed children. It was created an experimental group, formed by children covered by program which was paired, based on sex, age and socioeconomic status, with a control group, formed by uncovered children. After filling ethical application, the parents of children were questioned about some risk factors to dental caries and, in sequence, it was accomplish an oral examination in the child. It was verified the Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), dmf-s and verification of caries activity. The sample was 40 children in each group. The results showed, for VPI, a difference of 7 percentile points for the experimental group, however this difference had no statistical significance, obtained by Student s t test (p=0.314). In relation to GBI, the control group showed a low mean (0.8%) comparing with experimental group (2.77%) and this difference was statistically significant (p=0.003). The results for dmf-s and evaluation of caries activity showed no statistical difference between groups. Among the probable reasons for absence of impact of intervention, could be included: (a) the practice model was the same in two groups, or the difference was very weak and (b) the oral health care has intrinsic limitations for to impact on oral health in low income populations

Programa de Erradicação do Trabalho Infantil (PETI) em Natal: uma avaliação na perspectiva da Assistência Social

This research deals with children and teenagers who are in childish work situation like juridical and institutional conquests connected with public politics in order to effects rights and social support about childish work eradication program (PETI) in terms of evaluation context under social work. The analysis of this research records the PETI implantation process at social nucleus in Cidade Nova (Natal/RN) to absorb children and teenagers who come from lixão . It does this based on the two thousands (2005) and presents the program importance linking users and their families such as the investigation of PETI actions, intending to give a contribution in the childish work combat and how they have been developed social-education protection for children and teenagers (seven to fifteens). About quality and quantity it was make a survey of social-economical characterization of the people benefits (to families) through interviews with users. This study (make us) sure brings new subventions which can cooperate to the childish work eradication by others public politics articulations

Programa de Erradicação do Trabalho Infantil (PETI) em Natal: uma avaliação na perspectiva da Assistência Social

This research deals with children and teenagers who are in childish work situation like juridical and institutional conquests connected with public politics in order to effects rights and social support about childish work eradication program (PETI) in terms of evaluation context under social work. The analysis of this research records the PETI implantation process at social nucleus in Cidade Nova (Natal/RN) to absorb children and teenagers who come from lixão . It does this based on the two thousands (2005) and presents the program importance linking users and their families such as the investigation of PETI actions, intending to give a contribution in the childish work combat and how they have been developed social-education protection for children and teenagers (seven to fifteens). About quality and quantity it was make a survey of social-economical characterization of the people benefits (to families) through interviews with users. This study (make us) sure brings new subventions which can cooperate to the childish work eradication by others public politics articulations

Universalização do acesso à saúde e regulação dos planos privados de assistência à saúde: a atuação regulatória da ANS como instrumento de harmonia contratual e viabilização do papel suplementar da iniciativa privada na efetivação do direito social à saúde

While essential to human nature, health and life have been protected since ancient times by various areas of knowledge, particularly by the Law, given its dynamics within the regulation of social interactions. In Brazil, health has been granted major importance by the Federal Constitution of 1988, which, disrupting the dictatorial authoritarianism, inaugurating a Social State and focusing on the values of freedom and human dignity, raises health to the condition of a social right, marked predominantly by an obligational bias directed, primarily, to the State, through the enforcement of public policies. Although, given the limitation of the State action to the reserve for contingencies, it turns clear that an universalizing access to public health is impossible, seen that the high cost of medical provisions hinders the State to meet all the health needs of the rightholders. As a result of the inefficiency of the State, the effort of the Constituent Assembly of 1988 in creating a hybrid health system becomes nuclear, which, marked by the possibility of exploration of healthcare by the private initiative, assigns to the private enterprise a key role in supplementing the public health system, especially through the offer of health insurance plans. At this point, however, it becomes clear that health provisions rendered by the private agents are not unlimited, which involves discussions about services and procedures that should be excluded from the contractual coverage, for purposes of sectoral balance, situation which draws the indispensability of deliberations between Fundamental Rights on one hand, related to the protection of health and life, and contractual principles on the other hand, connected to the primacy of private autonomy. At this point, the importance of the regulation undertaken by the ANS, Brazilian National Health Agency, appears primordial, which, by means of its seized broad functions, considerable autonomy and technical discretion, has conditions to implement an effective control towards the harmonization of the regulatory triangle, the stability and development of the supplementary health system and, consequently, towards the universalization of the right to health, within constitutional contours. According to this, the present essay, resorting to a broad legislative, doctrinal and jurisprudential study, concludes that economic regulation over the private healthcare sector, when legitimately undertaken, provides progress and stability to the intervening segment and, besides, turns healthcare universalization feasible, in a way that it can not be replaced efficiently by any other State function.

Mortalidade por câncer de boca e condição sócio-econômica no Brasil

BORGES,D. M. L.et al. Mortalidade por câncer de boca e condição sócio-econômica no Brasil.Cad. Saúde Pública, Rio de Janeiro, v.25,n.2, p.321-327, fev, 2009

Comunidades virtuales y producción de inteligencia económica y competitiva

CARVALHO, Andréa Vasconcelos . Comunidades virtuales y producción de inteligencia económica y competitiva. Inteligencia y Seguridad: revista de análisis y prospectiva, v. 3, p. 13-45, 2007

Expressão da ética na assistência de enfermagem aos jovens intoxicados

Analisar sobre o processo de cuidar da equipe de enfermagem na visão dos usuários intoxicados por tentativa de suicídio. Metodologia: estudo descritivo exploratório, de abordagem qualitativa, realizada em um centro de assistência ao intoxicado da Paraíba/Brasil, com nove usuários. Como critérios de inclusão, participaram as pessoas que tentaram o suicídio por intoxicação, nos meses de abril e maio de 2010, período de coleta de dados do estudo, e que tivessem condições de responder as questões formuladas. A coleta de dados foi realizada por meio de entrevista semiestruturada com uso de formulário, cujos dados foram tratados pela Análise Temática. A pesquisa foi aprovada conforme avaliação do Comitê de Ética em Pesquisa da UEPB e mediante CAAE nº 0003.0.349.133-10. Resultados: os participantes concentraram-se na faixa etária de 14 a 26 anos, predominando o gênero feminino e o consumo de agrotóxicos na tentativa de suicídio. A análise dos discursos permitiu identificar que todos os integrantes demonstraram-se satisfeitos com a assistência de enfermagem, entretanto, apontaram ausência de comunicação com os profissionais cuidadores e atraso para a realização dos procedimentos. Conclusão: a ética na assistência de enfermagem supõe o estabelecimento da valorização do humano durante as atribuições profissionais, proporcionando o bem-estar daqueles que não enxergam a dádiva maior, que é nesse plano, a vida

Sustentabilidade de EES: contribuições e desafios do PITCPES/UFPA a partir da análise da Cooperativa dos Fruticultores de Abaetetuba COFRUTA

The study aimed to understand how the methodology of hatching contributes to the sustainability of economic enterprises in solidarity. For analysis, we developed a study on the social economy and the incubation methodology, based on the program of teaching, research and extension - Technological Incubator of Popular Cooperatives and Entrepreneurship Solidarity (PITCPES), and as the survey of the Cooperative of Fruit of Abaetetuba - COFRUTA. We started from the exploratory-descriptive approach in a qualitative and quantitative, in order to demonstrate the process of sustainability under the dimensions of different kinds such as: the economic dimension, social dimension, the political dimension, size and scale management training. Based on the analysis of these different dimensions was reached results as: first the recognition that the incubator contributes to the sustainability of COFRUTA, especially with regard to planning, control and the need to diversify production. However, there was suggestion of cooperative for training and technical assistance is continued, to the extent that the performance of projects under the base leaves gaps for the learning and application of social technologies required to the Incubator. It also concluded that the dissertation contributes to the team of the incubator can assess their strengths and weaknesses in their performance

Sustentabilidade de EES: contribuições e desafios do PITCPES/UFPA a partir da análise da Cooperativa dos Fruticultores de Abaetetuba COFRUTA

The study aimed to understand how the methodology of hatching contributes to the sustainability of economic enterprises in solidarity. For analysis, we developed a study on the social economy and the incubation methodology, based on the program of teaching, research and extension - Technological Incubator of Popular Cooperatives and Entrepreneurship Solidarity (PITCPES), and as the survey of the Cooperative of Fruit of Abaetetuba - COFRUTA. We started from the exploratory-descriptive approach in a qualitative and quantitative, in order to demonstrate the process of sustainability under the dimensions of different kinds such as: the economic dimension, social dimension, the political dimension, size and scale management training. Based on the analysis of these different dimensions was reached results as: first the recognition that the incubator contributes to the sustainability of COFRUTA, especially with regard to planning, control and the need to diversify production. However, there was suggestion of cooperative for training and technical assistance is continued, to the extent that the performance of projects under the base leaves gaps for the learning and application of social technologies required to the Incubator. It also concluded that the dissertation contributes to the team of the incubator can assess their strengths and weaknesses in their performance

A assistência técnica nos habitats do MST e o papel do arquiteto e urbanista

This dissertation is about Architect and town planner inserts in the technical support of the Rural establishment and of the possibilities of changes in their habitat. It also looks for its participation through the production of those spaces with or without its performance through two references cases, in Rio Grande do Norte , one called settlement Eldorado de Carajás and another one called Maria da Paz. At first the process represents the model that was adopted systematically by Incra until the middle of the year 2000 with the sub-contracting of their construction work through small companies. These standardized projects which are executed without registration in the system CONFEA/CREA without demand of professional authorship and of technical responsibility of the work. But the process taken place at Maria da Paz s area was configured as one of the first initiatives that stopped with those practices. Consolidated through a partnership among UFRN MST and INCRA/RN, the Architect s technical support and town planner brought new technician-scientific organization and execution of the soil parcels and its habitat. The participation of UFRN was done through a group of studies in land reform and Habitat (GERAH) being this author and coordinator of the methodological proposal, based on the regressive-progressive method and in the inclusion of the conflict as responsible of the ruptures and transductions both done by Henry Léfèbvre and in the research action approached by Carlos Brandão. Therefore it included the process of social learning and collective production of new knowledge and attitudes in relation to the environment in the process called as attended self management in spite of the transformations happened with this new agent s participation. The people re-located to the new areas that got involved in the process and finished their constructions reelaborating the daily practice of the collective effort passed to the self management without technical support. Years later the implantation of those two experiences our research verified that there is a positive image concerning the Architect and town planner, related, most of all to the conception of the activities, orientation and execution of constructions projects and of acceptance of those professionals to the processes of implementation of the Habitats of the Rural establishments. This dissertation analyses this form of performance, from and beyond these images trying to find the professional, specificities or methodological in such a way to demonstrate the importance of its insertion in the formulation and attendance of the more of 100.000 habitats of Rural establishments of the land reform of the country that correspond to most of the housing social interest in the country side

Avaliação ecológico-econômica do manguezal de Macau/RN e a importância da aplicação de práticas preservacionistas pela indústria petrolífera local

This work presents the results of a survey in oil-producing region of the Macau City, northern coast of Rio Grande do Norte. All work was performed under the Project for Monitoring Environmental Change and the Influence of Hydrodynamic forcing on Morphology Beach Grass Fields, Serra Potiguar in Macau, with the support of the Laboratory of Geoprocessing, linked to PRH22 - Training Program in Geology Geophysics and Information Technology Oil and Gas - Department of Geology/CCET/UFRN and the Post-Graduation in Science and Engineering Oil/PPGCEP/UFRN. Within the economic-ecological context, this paper assesses the importance of mangrove ecosystem in the region of Macau and its surroundings as well as in the following investigative exploration of potential areas for projects involving reforestation and / or Environmental Restoration. At first it was confirmed the ecological potential of mangrove forests, with primary functions: (i) protection and stabilization of the shoreline, (ii) nursery of marine life, and (iii) source of organic matter to aquatic ecosystems, (iv) refuge of species, among others. In the second phase, using Landsat imagery and techniques of Digital Image Processing (DIP), I came across about 18,000 acres of land that can be worked on environmental projects, being inserted in the rules signed the Kyoto Protocol to the market carbon. The results also revealed a total area of 14,723.75 hectares of activity of shrimp production and salting that can be harnessed for the social, economic and environmental potential of the region, considering that over 60% of this area, ie, 8,800 acres, may be used in the planting of the genus Avicennia considered by the literature that the species best sequesters atmospheric carbon, reaching a mean value of 59.79 tons / ha of mangrove

Estudo da viabilidade econômica em campos maduros

When it comes to oil and gas in Brazil is almost certain that we are referring to activities in deep waters off the coast of Campos, Rio de Janeiro, the main field of action of PETROBRAS and a small number of multinational oil companies . Since the Law 9.478/97 allows, by means of concessions, that other companies other than Petrobras, to explore and produce oil and gas domestically. Soon it moved, then the private companies that want small and medium-sized businesses to invest in such activities, forming a segment of independent producers, as occurs in other countries. In this context, this work aims at making an economic feasibility study, is currently analyzing how this thread and focus on the factors that contribute to its development as well as those that constitute barriers. To this end, we conducted a survey examining some mature fields that are in production in order to capture cost information in the phases of project, operation and abandonment. The work also presents an analysis of the results obtained in the survey, identifying the costs higher. With the results obtained through the study used economic engineering tools such as NPV and IRR, using a variety of design scenarios, to study the economic viability of these fields. In scenario 4 was set a production of 4.0 m³ / d of oil, which is an expected average production for several of these fields, whose minimum value of a barrel of oil, to enable this field, was $ 55.00, this value well below what was being practiced in the market today.

Acesso aos serviços odontológicos e incidência de cárie em adolescentes e fatores de risco em município do Nordeste Brasileiro, 2006

The aims of this study were to analyze the access of dental services by child population, to determine the prevalence of dental caries, gingivitis and malocclusion in resident children from the municipal district of Sobral Ceará and to evaluate the incidence of the dental decay in adolescents associated with the factors related to socioeconomic condition, access to health services and self-perception. This study had as main factor the multidisciplinary represented by the participation of health professional (doctors, dentists, nurses) in the development of the survey's initial reference; student from Human Sciences area to apply the structured questionnaire in domiciliary visits; statistics professionals in the orientation of the analysis to be held and family health team (community health agents, dentists and dental clinic assistants) in the scheduling of domiciliary visits and the accomplishment of oral exam. The sample was determined from the domicile record that included children born between 1990 and 1994 to develop the research Children health conditions in the municipal district of Sobral Ceará . The first sample comprised 3425 parents of children from 5 to 9 years old, living in the urban area at the municipal district of Sobral Ceará, aiming at identifying the most important factors associated to the access to dental service. From this sample, 1021 children were selected in a systematic way, for the accomplishment to the epidemiological study of decay, gingivitis and malocclusion. In the study's third phase, in order to arrange the group to be followed, 688 adolescents were examined and interviewed, by means of the active search from the 1021 individuals that had been previously examined. It was observed that 50.9% of the children had access to dental service at least once in a lifetime. Of this total, 65.3% accomplished it during the last year, and 85.4% of these did in public services, what allows to identify the importance of this sector in the access to dental services. It was observed that the factors that most affected the access to dental 129 services were related to socioeconomic condition, such as the access to health plan, the possession of toothbrush, garbage collecting, mother s schooling, sewerage treatment and malnutrition. In relation to oral diseases, an increase in the DMF-T index according the age was observed, from 0.10 in five years old to 1.66 in the nine years old, while with the dmf-t index, the inverse happened, since the index decreased from 3.59 in five years old to 2.69 in nine years old. In relation to gingivitis, an average 32.7% of the children presented gum bleeding. In what concerns malocclusion, it was observed that 60.3% of the children didn't present any problem, 30.17% had light malocclusion and 9.5% severe malocclusion. The average incidence of dental caries was 1.86 teeth per youngster. Among the studied variables, tooth pain in the last six months, mother's income and school snack, adjusted by the perception about the need of treatment, the mother's schooling and the dentist's appointment at least once in a lifetime, were the variables that presented positive relationship with the high incidence of dental caries on this population by logistic regression. Variables of socioeconomic nature, related to the access to health services and behavior and biological variables presented a relationship with the high caries incidence. The study point out to the need of developing health actions in a humanized way, by an oral health team effectively bound to the population's interest, with the great objective to provide, with the public health services managers, adequate conditions to improve oral health

Dimensões da satisfação do paciente geriátrico com a assistência fisioterapêutica

Introdução: Os idosos constituem os maiores consumidores dos serviços de saúde, especialmente os de reabilitação, tornando imprescindível a avaliação da qualidade da assistência fisioterapêutica prestada. A satisfação do paciente tem sido considerada uma das melhores e mais eficazes formas de avaliar o cuidado e direcionar o provedor do serviço para suprir as necessidades e expectativas do paciente-cliente. O objetivo deste estudo foi investigar os principais aspectos (preditores) que contribuem para a satisfação do paciente geriátrico com o tratamento fisioterapêutico ambulatorial. Métodos: Trata-se de um estudo com enfoque epidemiológico, transversal e descritivo de cunho exploratório. Foi utilizado o instrumento de avaliação da satisfação do paciente com a fisioterapia, desenvolvido e validado para a população brasileira por Mendonça em 2007, com uma escala de satisfação do paciente composta por 23 itens. Os dados foram coletados na sala de espera de 29 clínicas de Fisioterapia da rede privada da capital do RN/Brasil e a amostra selecionada de forma não-probabilística constou de 221 pacientes com idade superior a 60 anos, que realizaram entre 5 e 60 sessões de fisioterapia onde os dados foram coletados, deveriam ser usuários de plano de saúde e ter condições cognitivas preservadas. Resultados: A análise fatorial indicou a existência de quatro fatores com autovalor maior que 1: interação pacienteterapeuta (7 itens) α = 0,901; acesso e atendimento de recepcionista e pessoal de apoio (8 itens) α = 0,888; ambiente físico e satisfação global (5 itens) α = 0,835; e conveniência (3 itens) α = 0,711. Os itens com maiores escores de satisfação completa foram os contemplados nos aspectos de interação paciente-terapeuta, especialmente o respeito e a gentileza do fisioterapeuta. As associações realizadas através do teste do Qui-quadrado e regressão logística binária entre a satisfação do paciente e as variáveis sócio-demográficas, percepção do estado de saúde e capacidade funcional demonstraram que a satisfação do paciente idoso associa significativamente com o sexo e estado civil. Os achados revelam que as mulheres mostram-se mais satisfeitas com a fisioterapia. Conclusão: Os aspectos interpessoais demonstraram ser preditores relevantes para assistência fisioterapêutica satisfatória, especialmente na população idosa que requer atenção além do suporte puramente técnico