Utilização de mapas conceituais como ferramenta de ensino para o desenvolvimento do raciocínio clínico no curso de medicina da Universidade Federal do Rio Grande do Norte

BACKGROUND: Among the wide range of skills displayed by a medical doctor is undoubtedly the need to use cohesive and well grounded clinical reasoning in order for medical care to be indeed effective. It is in this respect that conceptual maps emerge; these are a methodological innovation that allows a comprehensive, panoramic and associative outlook of theoretical content, making it more practical and applicable to the reality of clinical observation. Promoting learning, learning resources and a feedback system between professor and students, as well as assessing and monitoring the performance of students during their academic training, are the main features of this tool. OBJETIVE: Assess the use of conceptual maps as a teaching-learning tool in the training of undergraduate medical students at Universidade Federal do Rio Grande do Norte (UFRN). METHODOLOGY: Interventional, randomized, cross-sectional study conducted with students from the 3rd and 5th periods of the medical course at UFRN, during the second semester of 2014, totaling 86 participants, divided into two groups: GI (intervention – clinical case resolution with a conceptual map) and GII (control – clinical case resolution without a conceptual map) in each period. RESULTS: The use of conceptual maps to teach liver failure syndrome resulted in a statistically significant cognitive gain for G1 students from the 5th period (GI: 6.8±1.6 and 8.0±1.5, p = 0.024; GII: 7.2±2.1 and 8.0±1.7, p = 0.125, pre and post-intermediate means, respectively), a result not observed in the period 3rd (GI: 7.7±1.3 and 8.0±1.4, p = 0.501; GII: 6.7±1.8 and 7.8±1.8; p=0.068, pre and post-intermediate means, respectively). Students in the 3 rd period gave better responses to the first clinical case, with a larger number of suitable concepts and crosslinks, when they used conceptual maps (GI: 91.3±13.15 and GII: 64.84±22.84, p=0,002). Students in the 5th period exhibited better clinical reasoning and more complete responses using the tool (p=0,01). Most of the students were not aware of the tool (53.8% from the 3rd period and 65.3% from the 5th period). Among those who knew about conceptual maps, most (59.3%) had only used them during high school, 14.8% had never used them and only seven students (25.9%) used them during the medical course. Analysis of open responses, obtained in process assessment showed clear satisfaction and enthusiasm with learning about the new tool, and frequent suggestions to use it at other moments in the course. Assessment of learning profile, using the VARK questionnaire, showed that most students from both periods exhibited a multimodal style. CONCLUSION: Despite their scant knowledge regarding the tool, good acceptability and understanding was observed in the study participants. The conceptual maps allowed cognitive gains, better responses and clinical reasoning in teaching liver failure syndrome to 5th period students.

Estudo sobre a mortalidade e sobrevivência de micro e pequenas empresas natalenses e seus impactos nas políticas públicas pró-empreendedorismo

The principal purpose of this research was to investigate discriminant factors of survival and failure of micro and small businesses, and the impacts of these factors in the public politics for entrepreneurship in the State of Rio Grande do Norte. The data were ceded by SEBRAE/RN and the Commercial Committee of the Rio Grande do Norte State and it included the businesses that were registered in 2000, 2001 and 2002. According to the theoretical framework 3 groups of factors were defined Business Financial Structure, Entrepreneurial Preparation and Entrepreneurial Behavior , and the factors were studied in order to determine whether they are discriminant or not of the survival and business failure. A quantitative research was applied and advanced statistical techniques were used multivariate data analysis , beginning with the factorial analysis and after using the discriminant analysis. As a result, canonical discriminant functions were found and they partially explained the survival and business failure in terms of the factors and groups of factors. The analysis also permitted the evaluation of the public politics for entrepreneurship and it was verified, according to the view of the entrepreneurs, that these politics were weakly effective to avoid business failure. Some changes in the referred politics were suggested based on the most significant factors found.

Estudo psicossocial das perdas dentárias na terceira idade

The present study seeks to understand tooth loss by investigating the social representations in the daily life of elderly individuals, thus characterizing itself as a comparative and analytic research. It is known that tooth loss is a common occurrence in elderly individuals, interfering at the psychosocial and biological levels, through its functional, esthetical and social implications. The area of oral health in Brazil is lacking studies on this topic, especially with respect to the psychosocial aspects of the elderly. The Theory of Social Representations and the Central Nucleus Theory were selected for theoretical-methodological support. The Free Association of Words Test was used, whose inducing stimulus were the words tooth loss , in which each subject was asked to associate 3 words, to respond to a questionnaire related to socio-economic conditions and containing an investigation of tooth loss, access to odontological services and the need for dental treatment, and to undergo a focus group interview. The study sample consisted of 120 individuals 60 years of age or over, resident in Natal, RN, Brazil and participants of the Live Together to Live Better group of the Basic Health Unit of Felipe Camarão Residential District and Unati (Open University of the Elderly); an interview was performed with 36 subjects. Data analysis was performed by Evoc 2000, SPSS/99, Graph Pad and Alceste softwares. The results demonstrate that the central nucleus of the social representations of tooth loss for the Live Together group emerged from the difficulty in eating categories, showing a relation between physiologic necessity, desire and pleasure from eating, not to mention the pain that resulted from justifying the tooth loss. Besides the central discourses, the following peripheral elements were gathered: difficulty in adapting to the prosthesis, treatment and difficulty in speaking. All of these categories, except the last, also comprised the class themes of the group interview. For the Unati group the central nucleus emerged from the socio-economic difficulties categories, demonstrating a narrow relation between poverty, access to health and education and esthetics, confirming in the discourse of common sense, the association between tooth loss and aging. At the margin of the central discourses was collected the peripheral element difficulty in adapting to the prosthesis, found both in the Live Together and Unati groups, which expresses the resistance of the subject to this new situation and the failure of the rehabilitation treatment in the sense of reviving the memory of their natural teeth. All of these categories also constitute the class themes of the of the group interview. Thus, through the study of the social representations, we can reveal a reality in the perspective of the social subjects, contemplating the multiple facets of the social-cultural reality experienced by these individuals

Avaliação da presença de osteopatia decorremte do diabetes tipo 1 em criança e adolecentes do Rio Grande do Norte

Diabetes Mellitus (DM) and osteoposes are chronic diseases with great socioeconomic consequences, mainly due to the late complications and consequent disabilities. The potential effects of DM on bone metabolism remain a very conroversial issue, and disagreement exists with regard to the clinical implications of diabetic osteopenia and the mechanism of its ocurrence. The issue is further complicated by the contribuicion of the especific factors, such as duration of disease an dthe degree of metabolic control. The objective of this study is to identify the osteopathy in children and adolescents with DM 1 assisted in the hospital of pediatrics, UFRN, through biochemical markers of bone and mineral metabolism and the extent of bone mineral density. The study was composed by 74 diabetics type 1 patients (DM1) of both gender and aged 6 to 20 yars. Normoglicêmic group was composed by 97 healthy subjects of both genders, which showed the same age range of DM1, in addition to same socioeconomic class. These individuals qere students from the networks of public education in the city of Natal-RN, randomly invited to paticipate in our study. Both groups DM1 and NG were divided intofour subgroups, according to the classification of tanner , T1, T2, T3, T4 for achieving a benchmark. Diabetic individuals showed up with a poor glycemic control. the group DN1 T4 showed an incresead value for total protein, albumin, urea and microalbumiuria are predictors of grumelura injury in DM1 patients . The total alkaline phosphatase activitywas kept on high levels for both groups because they are in a stature development age. For osteocalcin there were decreased levels for groups Dm1 T1, T2, and T3 when compared to their NG (s), suggesting that this decrease could be associated with reduction in the number and/or differentiation os osteoblasts thereby contributing to reducing bone formation. There were no changes in the activity of TRAP. The serum concentrations of total and ionized calcium, phosphorus and magnesium were included within the RV. It was observed that the BMD (Z- SCORE ) has always been within the RV for both groups, despite to DM1 T4. Taking all together, our results support the hypothesis that children and adolescents with type 1 DM present the risk in the long run to suffer a reduction in the bone mass, associated to poor glicemic control and disease duration. It could limit the bone growth and increase the probality of development of osteopenia, as well as other complications surch as retinopathy and renal failure

Descompassos nas políticas educacionais: a reorganização da educação rural em Jardim de Piranhas/RN

The present work has as aim to analyze the reorganization process of the rural education in Jardim de Piranhas-RN, on the context of the education policies, in particular of the period of 1999-2006, having as reference the transformations in the political, cultural and socio-economic setting in the national, regional and local level, above all from the decade of 1990. The studies carried out in diverse sources made possible to understand from the context in which they had developed the education policies, in particular, that one directed for the rural way, as well as the mediation of this with the education reorganization in the local scope. Besides these research procedures, we carry out interviews - semi-structuralized - with managers and teachers, and we analyze documents from the produced ones in national level to those local ones. From the viewpoint theoretician-methodological, we focus the national discussion that comes developing under a new ideological political configuration and, being entitled by the Field Education, understood as a policy directed to education specifities in this sector and consolidated in the Operational Guidelines for the Basic Education in the Field Schools (CNE/MEC/2002). As particularity of this object in Jardim de Piranhas-RN, we emphasize events occurred that had marked the rural education reorganization in that city, especially from the creation of the Rural Education named Center Teacher Maria Edite Batista. Studies make possible to realize that until the Center creation, the schools functioned in rather precarious infrastructure and physical conditions, that is, without electric energy and water supplying, as well as the lack of school snack and the management structure. There was not a project or specific pedagogical accompaniment for the sector. Moreover, the teachers worked predominantly with several grade classes and still they fulfilled the manager functions, caretakers, and cook- in some cases as school secretary. However, exactly with the creation of the Rural Education Center, the education municipal system did not become capable to overcome problems as of the evasion and school failure, as well as decreasing the work overload of teachers, neither to give greater consistency to the pedagogical project of the field schools in that city

Impacto urbano ocasionado por empreendimentos da construção civil no entorno da zona de proteção ambiental (zpa-6), Vila de Ponta Negra, Natal/RN

The process of urbanization in recent decades has generated considerable seriousness of problems relating to the use and occupation physical environment of cities. The concentration of population, economic activities and technological standards have reinforced an existing urban environment highly degraded as a consequence of the development style that leads to the predatory use of natural resources. In this context, cities as centers of production and consumption, have the most serious problems of environmental degradation. This study investigated the impacts of the municipal building projects to large-scale vertical in the town of Vila de Ponta Negra, Natal-RN, given the proximity to the Environmental Protection Area (ZPA-6) and considering its environmental importance , scenic, landscape and tourism for the city of Natal-RN. The fragility of the licensing process and the failure of the assumptions in the analysis, objective and subjective, for the granting of environmental permits for the building construction projects, specifically those set out in the surroundings of the Environmental Protection Area (ZPA-6) and fundamental importance of landscape and tourism for the city of Natal, has aroused the concern of local people in and of itself the Government, faced with the probable impacts that will affect greatly the Vila de Ponta Negra. The methodology used to achieve the intended objectives will be the literature review, questionnaire to the surrounding population and the Government, as well as findings on the spot, through the photographic record. The beneficiaries of the license, if the entrepreneurs, have been affected because of the granting of licensing act of investing large amount of capital in the works. Additionally, with distrust of the population, since they are to discredit the public system of environmental management have guessed by the probability of imbalance to the environment and structural damage to the Vila de Ponta Negra, where such failure to support energy, lack of regular supply of water , lack of sanitation and access roads sufficient for the flow of motor vehicles in these areas, among other factors. Thus, this work will contribute to the diagnosis and solutions to the problem in question, so that the Government will effectively fulfill its social management of ecologically balanced environment of continuing urban development in Natal, Brazil

Mudanças climáticas globais e o compromisso pró-ecológico de adolescentes natalenses

In recent years, much has been discussed about global climate changes (GCCs), popularly known as global warming. The scientific evidences point out to the influence of human actions for its drastic intensification. Therefore, studies of the psychological aspects involved become relevant. This study aimed at the investigation of the views of adolescents concerning GCCs, and the possible relations between those views and their pro-ecological commitment. Such commitment is measured by willingness for engagement in pro-environmental behaviors; environmentalism attitudes, like ecocentric and anthropocentric; consideration of future consequences; and ecological worldviews. Participants were 348 adolescents who answered a questionnaire containing questions about socio-demographic data, open questions about the practice of environmental care, and about GCCs, and the scales of Ecocentric and Anthropocentric Environmentalism, the Consideration of Future Consequences and the Ecological Worldviews assessment scale. From the inter-relationships between variables, procedures carried out by means of descriptive and correlacional statistics, it was observed that 55% of teenagers said that they did not engage in actions of environmental care, which was associated with apathyanthropocentric, immediatism, and individualism. The consideration of future consequences joined the practice of environmental care, corroborating evidence from the literature. It was evident that views concerning GCCs were superficial; adolescents perceive it as a generic environmental problem, and are confused with other problems such as pollution. This study found no association between views about GCCs and the indicators of pro-ecological commitment, perhaps due to the conceptual confusion about the subject. However, the lack of environmental care actions and other indicators of non-commitment (apathy-anthropocentric, individualism and immediatism) were associated with conceptually poor or incomplete responses (with no indication of cause, consequence or responsibility for the problem), demonstrating diminished knowledge and the failure to consider these issues

Midgard: um middleware baseado em componentes e orientado a recursos para redes de sensores sem fio

On the last years, several middleware platforms for Wireless Sensor Networks (WSN) were proposed. Most of these platforms does not consider issues of how integrate components from generic middleware architectures. Many requirements need to be considered in a middleware design for WSN and the design, in this case, it is possibility to modify the source code of the middleware without changing the external behavior of the middleware. Thus, it is desired that there is a middleware generic architecture that is able to offer an optimal configuration according to the requirements of the application. The adoption of middleware based in component model consists of a promising approach because it allows a better abstraction, low coupling, modularization and management features built-in middleware. Another problem present in current middleware consists of treatment of interoperability with external networks to sensor networks, such as Web. Most current middleware lacks the functionality to access the data provided by the WSN via the World Wide Web in order to treat these data as Web resources, and they can be accessed through protocols already adopted the World Wide Web. Thus, this work presents the Midgard, a component-based middleware specifically designed for WSNs, which adopts the architectural patterns microkernel and REST. The microkernel architectural complements the component model, since microkernel can be understood as a component that encapsulates the core system and it is responsible for initializing the core services only when needed, as well as remove them when are no more needed. Already REST defines a standardized way of communication between different applications based on standards adopted by the Web and enables him to treat WSN data as web resources, allowing them to be accessed through protocol already adopted in the World Wide Web. The main goals of Midgard are: (i) to provide easy Web access to data generated by WSN, exposing such data as Web resources, following the principles of Web of Things paradigm and (ii) to provide WSN application developer with capabilities to instantiate only specific services required by the application, thus generating a customized middleware and saving node resources. The Midgard allows use the WSN as Web resources and still provide a cohesive and weakly coupled software architecture, addressing interoperability and customization. In addition, Midgard provides two services needed for most WSN applications: (i) configuration and (ii) inspection and adaptation services. New services can be implemented by others and easily incorporated into the middleware, because of its flexible and extensible architecture. According to the assessment, the Midgard provides interoperability between the WSN and external networks, such as web, as well as between different applications within a single WSN. In addition, we assessed the memory consumption, the application image size, the size of messages exchanged in the network, and response time, overhead and scalability on Midgard. During the evaluation, the Midgard proved satisfies their goals and shown to be scalable without consuming resources prohibitively

Encapsulamento de solventes em nanotubos de haloisita para promoção de auto-reparo em polímeros

Micro cracking during service is a critical problem in polymer structures and polymer composite materials. Self-healing materials are able to repair micro cracks, thus their preventing propagation and catastrophic failure of structural components. One of the self-healing approaches presented in the literature involves the use of solvents which react with the polymer. The objective of this research is to investigate a procedure to encapsulate solvents in halloysite nanotubes to promote self-healing ability in epoxy. Healing is triggered by crack propagation through embedded nanotubes in the polymer, which then release the liquid sovent into the crack plane. Two solvents were considered in this work: dimethylsulfoxide (DMSO) and nitrobenzene. The nanotubes were coated using the layer-by-layer technique of oppositely charged polyelectrolytes: cetyltrimethylammonium bromide (CTAB) and sodium polyacrylate. Solvent encapsulation was verified by X-ray diffraction (XRD), Fourier transform infrared (FTIR), analysis thermogravimetry (TGA), adsorption and desorption of nitrogen and scanning electron microscopy (SEM). The introduction of the solvent DMSO into the cavity of the nanotubes was confirmed by the techniques employed. However, was not verified with nitrobenzene only promoted clay aggregation. The results suggest that the CTAB reacted with the halloystite to form a sealing layer on the surface of the nanotubes, thus encapsulating the solvent, while this was not verified using sodium polyacrylate.

Caminhos para a avaliação da formação em odontologia: desenvolvimento, validação e aplicação de critérios

The need for universal access to health and the failure of the pedagogical model centered on the transmission of knowledge has led to changes in the training of health professionals. The objective of this study was to provide a new alternative for evaluating dental students through the development, validation and application of evaluation criteria based on the National Curriculum Guidelines (DCN in Brazil). Therefore, the study was conducted in three phases: development and validation of evaluation criteria of Dentistry courses based on the DCN; a pilot study to verify the applicability of the validated criteria and evaluation of the dentistry courses in the Northeast. In the first stage, a logical model was formulated, allowing for the construction of a criteria matrix, validated by a modified Delphi consensus technique. The validated matrix has the following dimensions: Profile of graduates, health care guidance, teaching and service integration, and pedagogical approach. The pilot study was conducted in five dental courses through a documentary study of the pedagogical project course (PPC), and application of validated questionnaires and interviews with course coordinators. The results of the pilot study indicate the possibility of being verified by means of validated criteria and using different methodological proposals, advances and curricular limitations facing the proposed reorientation of training recommended by DCN. The evaluation of Northeast Dentistry courses was carried out by applying a questionnaire validating a matrix of 30 course coordinators, including public and private institutions. The data were submitted to descriptive analysis, and also tested the difference between means and the correlation between the assessment of the coordinators in the dimensions and sub-dimensions with each other, among the general evaluation of courses and between the following variables: administrative category, time since last curriculum updating, participation in reorienting the training of health professionals programs, ENADE and CPC (Preliminary Concepts of the Course) scores in the year 2013. Positive correlation (p <0.01) was found between the means obtained by the perception of the coordinators in most dimensions, and also between them and the overall performance of the course. There were no significant differences between the coordinators’ perception about course performance and the administrative category (public / private). This difference is slightly higher when the average performance is compared with respect to time due to the last curriculum update, getting better performance in courses with the latest updated curriculum, even with there not 11 being this significant difference between dimensions. Better averages of performance were obtained in courses that do not participate in reorientation programs of professional training, with a significant difference (p<0.05) for the overall score and for all dimensions except the dimensions of teaching-service Integration (p = 0.064). There was no significant correlation between the assessment of coordinators in all dimensions, in the overall assessment or ENADE and CPC scores in 2013. The final instrument proposed in this study is a different alternative assessment for health training of both dentists and other professionals, considering that the DCN providing for the training and graduation of professionals is focused on the health needs of the population, integrated with the SUS (the National Brazilian Health System) and based on student-centered learning.

Efeitos dos exercícios aeróbio contínuo e intervalado na variabilidade da frequência cardíaca em adultos jovens saudáveis. Ensaio clínico aleatório

The high-intensity interval exercise has been described as an option for increasing physical activity and its use also being suggested in the therapeutic management of many conditions such as diabetes mellitus and heart failure. However, the knowledge of its physiological effects and parameters that can assure greater safety for interval exercise prescription; especially its effect on short- and medium-term (24 hours after exercise) exercise recovery, need to be clarified. This study objective was to evaluate the effect of continuous and interval aerobic exercise on the cardiac autonomic control immediate and medium term (24 hours), by assessing heart rate variability (HRV). The present study is a randomized crossover clinical trial in which healthy young individuals with low level of physical activity had the VFC 24 hours measured by a heart rate sensor and portable accelerometer (3D eMotion HRV, Kuopio, Finland) before and after continuous aerobic exercise (60-70% HR max, 21 min.) and interval exercise (cycle 1 min. 80-90% HR max, 2 min. at 50-60% HR max, duration 21 min.). HRV was measured in the time and frequency domain and the sympathovagal balance determined by the ratio LF / HF. Nonlinear evaluation was calculated by Shannon entropy. The data demonstrated delayed heart rate recovery immediate after exercise and lower HR after 24 hours compared to pre intervention values, especially in the interval exercise group. There was a tendency to higher predominance and representatives index values of sympathetic stimulation during the day in interval exercise group; however, without statistical significance. The study results help to clarify the effects of interval exercise on the 24 hours following interval exercise, setting parameters for prescription and for further evaluation of groups with metabolic and cardiovascular diseases.

Estudo sobre a mortalidade e sobrevivência de micro e pequenas empresas natalenses e seus impactos nas políticas públicas pró-empreendedorismo

The principal purpose of this research was to investigate discriminant factors of survival and failure of micro and small businesses, and the impacts of these factors in the public politics for entrepreneurship in the State of Rio Grande do Norte. The data were ceded by SEBRAE/RN and the Commercial Committee of the Rio Grande do Norte State and it included the businesses that were registered in 2000, 2001 and 2002. According to the theoretical framework 3 groups of factors were defined Business Financial Structure, Entrepreneurial Preparation and Entrepreneurial Behavior , and the factors were studied in order to determine whether they are discriminant or not of the survival and business failure. A quantitative research was applied and advanced statistical techniques were used multivariate data analysis , beginning with the factorial analysis and after using the discriminant analysis. As a result, canonical discriminant functions were found and they partially explained the survival and business failure in terms of the factors and groups of factors. The analysis also permitted the evaluation of the public politics for entrepreneurship and it was verified, according to the view of the entrepreneurs, that these politics were weakly effective to avoid business failure. Some changes in the referred politics were suggested based on the most significant factors found.