Cuidado formal em saúde bucal: percepção de senescentes

Ações promotoras de saúde e independência para pessoas idosas são indispensáveis. Compreender essa construção no cotidiano da provisão dos cuidados talvez estimule o desenvolvimento de capacitações ao bem estar nesta população. O objetivo deste estudo foi Identificar a repercussão da provisão do cuidado formal em saúde bucal na percepção de senescentes. Desenvolvemos uma pesquisa de base qualitativa com abordagem fenomenológica, onde realizamos entrevistas semiestruturadas e individuais com 30 pessoas de idade superior a 50 anos (22 mulheres e 08 homens), em um Centro de Convivência na cidade de Natal/Rio Grande do Norte, no nordeste do Brasil. Os relatos obtidos foram analisados em cinco estágios: transcrição dos discursos sem preocupação interpretativa; limpeza de erros linguísticos e repetições; leitura repetitiva e exaustiva para apreensão do sentido das informações coletadas; seleção das unidades significativas dos discursos, correspondendo aos trechos relevantes no horizonte do fenômeno em estudo; e compreensão da ideografia elaborada pelos participantes por grupos temáticos simbólicos. Assim, identificamos as essências temáticas de: determinante social e iniquidade em saúde bucal; e provisão de cuidados de saúde bucal e mal-estar físico, mental e social. Concluímos que a prestação de cuidados agregando abordagem humanístico-ética pode levar a vivências dignificantes no processo de envelhecimento, destacadamente quando estimula a promoção da segurança pessoal. O âmago desse trabalho descortina uma vertente multidisciplinar que perpassa a saúde, a educação e a ética

Validação do instrumento dos indicadores observáveis da qualidade do cuidado em instituições de longa permanência para idosos

The Nursing Homes are an important alternative care in the world, but Brazil still has no valid instrument to monitor the quality these institutions. In the United States, the Observable Indicators of Nursing Home Care Quality Instrument (OIQ) is used to assess the quality of Nursing Home care using 30 indicators of structure (2 dimensions) and process (5 dimensions) related to quality person-centered care. The present study aimed at cross-culturally adapting the OIQ in order to evaluate the quality of Nursing Home care in Brazil. Conceptual and item equivalence were determined to assess the relevance and viability of OIQ in the Brazilian context, using the Content Validity Index (CVI) and a group of specialists composed of 10 participants directly involved in the object of study. Next, operational, idiomatic and semantic equivalence were carried out concurrently. This consisted of 5 phases: (1) two translations and (2) their respective back translations; (3) formal appraisal of referential and general meaning; (4) review by a second group of specialists; (5) application of the pretest at three Nursing Homes by different social entities: health professionals, sanitary surveillance regulators and potential consumers. Measurement equivalence was evaluated by the Cronbach’s alpha test to verify the internal consistency of the instrument. To measure inter-evaluator agreement, the General Agreement Index (ICG) and Kappa coefficient were used. Timely compliance and 95% Confidence Interval of indicators, dimensions and total construct were estimated. The CVI obtained high results for both relevance (95.3%) and viability (94.3%) in the Brazilian context. With respect to referential meaning, similarity was observed, ranging between 90-100% for the first back translation and 70-100% for the second. In relation to general meaning, version 1 was better, classified as “unchanged” in 80% of the items, whereas in version 2 it was only 47%. In the pretest, the OIQ was easy to understand and apply. The following outcomes were obtained: a high Cronbach’s alpha (0.93), satisfactory ICG (75%) and substantial agreement between the pairs of evaluators (health professionals, regulators from the Superintendency of Sanitary Surveillance –SUVISA-, and potential consumers), according to the Kappa coefficient (0.65). It´s possible take the operational equivalence held since it preserved the original layout in the Brazilian version from the maintenance in application mode, response options, number of items, statements and scores. The performance of nursing homes obtained approximate average scores of 87, a variation 55-111 considering a range from 30 to 150 points. The worst outcomes were related to process indicators with a mean of 2.8 per item, while structure was 3.75 on a scale of 1 to 5. The lowest score was obtained for the care dimension (mean 2). The OIQ version was deemed to be a valid and reliable instrument in the Brazilian context. It is recommended that health professionals, regulators and potential consumers adopt it to access and monitor the quality of Nursing Home care and demonstrating opportunities for improvement.

A representação social do cuidado no programa saúde da família na cidade de Natal

RODRIGUES, M. P.; LIMA, K. C.; RONCALLI, A. G. A representação social do cuidado no programa saúde da família na cidade de Natal. Ciênc. Saúde Coletiva, v. 13, n. 1, p. 71-82. 2008. ISSN 1413-8123.

A representação social do cuidado no programa saúde da família na cidade de Natal

RODRIGUES, Maisa Paulino; LIMA, Kenio Costa de; RONCALLI, Angelo Giuseppe. A representaçao social do cuidado no programa saúde da familia na cidade de Natal. Ciência & Saúde Coletiva, v. 13, n. 1, p. 71-82, 2008.Disponivel em: . Acesso em: 04 out. 2010.

A teoria de Callista Roy, a nanda-i e o cuidado ao paciente prostatectomizado

Trata-se de um estudo descritivo de caso clínico, com abordagem qualitativa, o qual possui como objetivo estabelecer relações entre os diagnósticos de enfermagem da NANDA-I e os problemas de adaptação segundo o Modelo Teórico de Roy em um paciente prostatectomizado. A coleta de dados ocorreu em um hospital universitário localizado na cidade de Natal-RN, no mês de janeiro de 2011, por meio de um roteiro de entrevista e exame físico. Os diagnósticos que apresentaram relações entre a NANDA-I e o Modelo de Roy foram: dor, ansiedade, constipação, sono, atividade, volume de líquido e infecção. Conclui-se que grande parte dos problemas adaptativos segundo o Modelo de Roy, manifestados pelos pacientes no pós-operatório de prostatectomia, possuem semelhança com os diagnósticos da NANDA-I

Outorga onerosa do direito de construir e dinâmica do mercado imobiliário formal: planejamento e descaminhos na expansão urbana de Parnamirim RN (2008-2010)

The `Outorga Onerosa do Direito de Construir - OODC` (Public Concession of Building Rights), instrument instituted by The City Statute in 2001, has as main objective the recovery of urban property, seeking for a fair distribution the urbanization benefits. The possibility of usage of the OODC instrument is linked to the maximum utilization coefficient, determined to specific areas in accordance to existing infrastructure conditions, further taking into account the formal real estate market, expansion axis and crowding. Being an instrument which establishes values to be paid for a better use of land, it maintains a narrow relation to the real estate, incentivizing or discouraging the crowding in specific areas. The present study investigates the relationship between the criteria for the making of the Public Concession of Building Rights instrument and the dynamics of the formal real estate market. It takes as empiric universe Parnamirim (RN), part of the Natal Metropolitan Area (RN), focusing on the application of the OODC in the period of 2008-2010. It seeks to better understand the necessary basis for the formulation of the instrument, about how it works and its relation to the formal real estate market. It aims to depict the formal real estate market by presenting the production of urban space in Parnamirim in terms of intensity and nature of the real estate, furthermore identifying the licensed properties through the application of the municipality instrument. For the conclusion, it is discussed the criteria for the formation of OODC, its relationship to the dynamics of the formal real estate market and its influencing possibilities in the processes of usage and occupation of land in the context of urban planning

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

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

Avaliação do cuidado na estratégia saúde da família em metrópoles do nordeste brasileiro

Objective: To evaluate the implementation of the Family Health Strategy (FHS) in Brazilian cities of the Northeast, expanding coverage, analyzing the progress, challenges and innovations. Methods: Multicentric Evaluation Research, Studies Baselines in urban centers, using as a case study method. Selected cases of Aracaju, being capital, advanced coverage with extended team, and Fortaleza, capital coverage incipient and minimal staff. In Fortaleza, purposive sample of 11 Units Primary (APS), 03 managers, 53 professionals and 109 users. In Aracaju, 09 units of APS, 02 managers, 36 professionals, and 90 users. Structured interviews for managers, and structured to professionals and users. Descriptive analysis focusing on the political and institutional dimensions, organization and comprehensive care. Results: There was consensus that the ESF is the preferred port users and acts as inducing changes in care. In the case of Fortaleza, the specificities were: care protocols and community activities aimed at chronic conditions (100%) , with greater participation of doctors and nurses (93%) ; conjunction with more complex services, but the teams reported difficulties with the examination center and experts, the long waits and poor access to local services were the main difficulties reported by users., As innovative practice, the therapeutic group of elderly caregivers mentioned by respondents; There was intersectoral initiatives and teams 87 % of users have participated in meetings about health problems. In the case of Aracaju, care protocols were directed to the lines of care and formulated locally, 85 % coverage of the population with FHS counterpart local financing; employees hired by public tender; 70 % of teams with expertise in public health center for continuing education acting; democratization in management; access technologies, welcoming and computerization in different integrated networks, and evaluation matrix. Conclusions: The ESF has promoted access to health care and inclusion of disadvantaged populations. Different perceptions and practices in the organization of care, with distinct trajectories of reorganization. In the case of Fortaleza, predominance of model programs valuing older, with evidence of advances in care practices and teamwork, but restricted to primary care practices and incipient in public policy perspective. In Aracaju, had network integration with technologies related to the family, in which the ESF is consolidated as public policy. It can be argued that the XII APS expanding coverage, exhibited efficacy, despite the challenges inherent to the different degrees of implementation

Uma análise sociodemográfica dos cuidadores formais de idosos institucionalizados no município de Natal/RN, 2012

The aging population and individual have been the subject of a multitude of studies nowadays. This is probably due to the impact of this phenomenon in various sectors of society, like social security, social assistance and public health. The process of aging of the individual imply the demand for specific services, considering the limitations and vulnerabilities of the individual at that stage of life cycle. The growth of the elderly contingent in the last decades raises challenges for policymakers, the family and also for the society at large. In this scenario, long-stay institutions for the elderly (LSIEs) appear as an option to aid and support the elderly and their family, assisting in all or part in the activities of daily living and self-care. Inside these LSIEs we find the professional responsible for the direct care of the elderly, the formal caregiver. In this context, this dissertation presents two main objectives: an analysis of the phenomenon of population aging in a given brazilian municipality Natal / RN, based on the Demographic Censuses of 2000 e 2010; and a social, demographic and economic characterization of the Formal caregiver for the institutionalized elderly in the municipality, evaluating aspects of his quality of life and also analyzing the institutions where they are inserted. Furthermore, we intend to identify demographic, socioeconomic and quality of life factors that are correlated with caregivers quitting the job. The data used in the second part of this work comes from the research project named Long-Stay Institutions for Elderly: abandonment or a family need? . This survey interviewed 92 caregivers in eleven LSIEs in Natal/RN. In the data treatment logistic regressions, cluster analysis and statistical tests were used. The survey revealed that aging in Natal is more pronounced in the older, more traditional districts: Petrópolis, Lagoa Seca and Tirol. It also allowed a broad characterization of the formal caregivers in LSIEs. Most of these professionals are female. The educational level is predominantly complete high school and more. Most caregivers reported being married or in union, or have ever been in a union. Family monthly income is under three times the minimum wage. The mean age is of 37.4 years. The mean time of work as a caregiver was 5.93 years. The associations showed that being woman, not being single, having caregiving training and physical limitations (regarding quality of life) are related to wanting to quit the caregiving job. As for the characterization of the LSIEs, it was found that the philanthropic ones are older and have most (62.5%) of the institutionalized elderly. The institutions managers gave social interaction and affinity with the elderly as the main criteria with which to evaluate and hire caregivers. It is intended with this study to contribute to improving the quality of life of the elderly and their caregiver, providing information on aspects of institutionalization of elderly both in the philanthropic and particular institutions, in Natal/RN; this dissertation may also be used as a starting point for later works

Emprego formal na região nordeste brasileira: seus efeitos na inclusão social

This work aims to study the problem of the formal job in the Brazilian Northeast region and its effect in the social inclusion, taking for base the analysis of variables defined in the Atlas of Social Exclusion, which is based on the 2000 Brazilian Census, choosing the county as unit of analysis. As methodological options, an exploratory data analysis was performed, followed by multivariate statistical techniques, such as weighted multiple regression analysis, cluster analysis and exploratory analysis of spatial data. The results pointed out to low rates of formal job for the active age population as well as low indexes of social inclusion in the Northeast region of Brazil. A strong association of the formal job with the indicators of social inclusion under investigation, was evidenced (schooling, inequality, poverty, youth and income form government transfers), as well as a strong association of the formal job with the new index of social inclusion (IIS), modified from the IES. At the Federative Units, in which better levels of formal job had been found, good indexes of social inclusion are also observed. Highlights for the state of the Rio Grande do Norte, with the best conditions of life, and for the states of the Maranhão and Piauí, with the worst conditions. The situation of the Northeast region, facing the indicators under study, is very precarious, claiming for the necessity of emphasizing programs and governmental actions, specially directed to the raise of formal job levels of the region, reflecting, thus, in improvements on the income inequality, as well as in the social inclusion of the population of Northeastern natives.

A evolução do emprego formal industrial nas cidades médias do estado do Ceará (Juazeiro do Norte, Crato e Sobral) no período de 1990 a 2010

The work consists in a discussion of the evolution of formal employment in the industrial cities of Ceará state averages from 1990 to 2010, since this period was marked by important changes. It is emphasized that in order to achieve this aim, the present study was based on a survey of relevant literature on the subject, as well as the use of the Annual Report of Social Information (RAIS), published by the Ministry of Labour and Employment (MTE) and the Brazilian Institute of Geography and Statistics (IBGE). The central question to be considered in this study is how we evolved formal employment industry in medium-sized cities (Juazeiro do Norte, Crato and Sobral) of Ceará? The assumption that guides this work is that given the economic policies of the 1990 and 2000 these policies encouraged the relocation, thus implying significant growth in the formal manufacturing employment in these cities. Regarding the results obtained in the survey, it was found that the industrial sector of these cities, showed considerable dynamism in what refers to the expansion of establishments. When observed in percentage terms medium-sized cities (345.5%) had the highest growth in number of establishments in the 1990s with rates higher than the Northeast region (285.9%) and Brazil (167.5%). The highlight was the city of Juazeiro, with the highest concentration of micro and small footwear companies in the state. Regarding the number of formal jobs created in medium-sized cities, it went from 6.596 in 1990 to 41.660 million formal jobs in 2010, with a growth rate of 532%. The sector contributed most to employment generation was the footwear. Although the levels of minimum wages, the 1990 recorded the lowest levels. In the 2000, there were real gains in levels of minimum wages in all cities, however, it may be noted that over the decades there has been significant momentum. However, this momentum was not enough to prevent the end of the study period CMs-Ceará present low wages

Industrialização e emprego formal: uma análise para os municípios da região metropolitana do Cariri nos anos de 1990 e 2000

The Northeast has a record of fighting to reduce disparities. In late 1950, the state intervened through SUDENE, organizing and planning the promotion of development through industrialization. This study aims to identify the characteristics of the industrialization of the Northeast and evolution of formal employment in the metropolitan area of Cariri, located in the southern state of Ceará, in the case of the municipalities of Crato, Juazeiro do Norte and Barbalha (CRAJUBAR) in decades of 1990 and 2000. The assumption permeates the SUDENE with public policies to encourage the industry, causing profound changes in the cities studied. The results indicate that the Cariri since the 1960 has been benefiting the programs implemented by SUDENE. With the implementation of these programs, with in a set of circumstances based on local vocations and state policies, there was a spatial distribution industry, triggering a growth and development on the provision of formal jobs in the industrial sector

Reconfigurações industriais das regiões metropolitanas do Nordeste: uma análise a partir do emprego formal

Industrial development experienced by Brazil from the 1950s, changed the concentration of population in the country. The process of development of domestic industry, concentrated in urban areas, crowded growing portion of the population.The Southeast region during the first stage of industrialization driven by the state, with the implementation of Plan goals, captained the major industrial projects implemented in the period and became the main industrial center of the country.In the decade from 1960 to 1980 the state action was marked by numerous regional development projects, softening the industrial concentration and Brazilian investment redirected to the Northeast.The second National Development Plan implemented in the 1970s led to major investments Northeast.This period marked the widespread urban growth and institutionalization of the first metropolitan areas in Brazil.The change of this developmental process is altered with the fiscal and financial crisis of the state in the 1980s and 1990s and spending cuts aimed at national development, reorienting the economy to liberal policies of economic liberalization and reduction of activity in the economy.Industrial policy was relegated to local development plans from the 1990s to the federating units fitting the wide use of tax incentives, the "war tax" to the continued industrialization process.In this context of the national economy work seeks to analyze the industrial setting in the metropolitan areas of Fortaleza, Recife and Salvador between 1995 and 2010.Although the metropolitan areas of Fortaleza, Recife and Salvador are the main urban centers of the Northeast, responsible for the advancement of industrial development, reconfigurations occurred between 1995 and 2010 by changing the level of industrial specialization built by regional division of labor in these regions.The work will be carried out by the method of descriptive analysis of the literature review on regional and urban development.Constitute quantitative method as the secondary data analysis of formal employment from the Annual Social Information (RAIS) Ministry of Labour and Employment (MTE).Using data RAIS / MTE analyzes the industrial specialization index using the Locational Quotient (LQ).Thus, it is assumed as a parameter analysis QL> 1, when the region has become specialized in a particular sector or QL <1, when the region does not have expertise in industrial sector analyzed.The conclusion of study indicates that there was in these metropolitan areas maintained the same bias hub.Fiscal policies, the states, was not successful in diversifying the productive structure and the Northeast region itself.This result is demonstrated by the need and dependence on state investments in the region to promote development.Industrial policies of recent years have been positive to meet the objectives of employment generation, but there must be specific policies for better diversification of production, in addition to integrating the economy of the Northeast sector and regionally

Mãe-esposa e professora: educadoras no final do século XIX

This text is organized through discussions undertaken in the area of the History of Education in Rio Grande do Norte, circumscribed to the History of Women from the first decades of the Brazilian Republic, and to the analysis of what was expected of this education. We examined representations of women in Natal, between 1889 and 1914, with the goal of configuring relations between the sexes with the emphasis on moral, intellectual and pedagogical aspects required of these women. As documental sources we utilized the educational, civil and criminal Legislation, on a National scope, as well as on a State and Municipal scope. We circumscribed our search to the newspaper A República, in which we found literature that circulated in Natal in the form of pamphlets, short stories and poetry, as well as other texts by authors that were part of the corpus of analysis of this study, located in public and private archives in Rio Grande do Norte, such as the Historical and Geographic Institute of Rio Grande do Norte (IHGRN) and the State Public Archive of Rio Grande do Norte (APE-RN). The use of the indexing method and the propositions of Cultural History were the appropriate theoretical-methodological framework to complete studies of this nature. This operational perspective permitted us to elaborate nuances about this time of transition from the 19th to the 20th Century, and to spotlight the fire of the women from this period. The basis of the argument that related women to maternity and domesticity, and within the ideals of abnegation and religious leadership, aligned to a demand coming from the increase in the quantity of schools for women, allocated women as the most appropriate for superior in educational performance in the country, based on its foundations: primary education. Beyond the universe of formal education, the other side of women appeared in republican politics. The mother-spouse and the institutionalization of domestic education associated the female gender with the role of educator at home as well. Be it in the public sphere, as a teacher, or in private, as mother-spouse, female care is perceived in this configuration, as an educational base that the Republic, and in transition, bequeathed to the Brazilian 20th Century

Educação ambiental: mediações sociais e políticas e a indolência do Poder Público à sua inclusão no ensino formal

As a result of the prediction of irreversible changes on necessary conditions to maintain life, including human, on the planet, environmental education got the spotlight in the political scenario, due to social pressure for the development of individual and collective values, knowledge, skills, attitudes and competences towards environmental preservation. In Brazil, only in 1999 the right for environmental education was officially granted to people, having the status of essential and permanent component in the country s education. Since then, it has been Government s duty, in each federal branch, to plan actions to make it happen, in an articulate way in all levels and modalities of the education process, both formally and informally. This work of research has environmental education in the school as subject matter, and aims on analyzing social and political mediations established between this National Environmental Education policy and the contexts associated to the legislative production process, the political nature of the conceptions about environmental education that underlie Law 9.795/99 (Brazil, 2009c) and also Rio Grande do Norte Government s actions and omissions related to the imperative nature of the insertion of environmental education in the schools ran by the state, during the ten years this law has been in force. The investigation of the subject matter was led by a social and historical understanding of the social and environmental phenomena, as well as of the education system as a whole, considering that only through a dialectical view we can see the real world, by destroying the pseudo-concreteness that surrounds the topic. While analyzing, we assumed that in face of the dominance of a social organization in which market regulations rule on environmental ones, by developing individual and collective critical conscience, environmental education can become a threat to dominant economical interests in exploiting natural resources. The results of this research suggest that as an educational practice to be developed in an integrated, continuous and permanent fashion in all levels and modalities of formal education, environmental education has not yet come to pass in the state of Rio Grande do Norte, due to the neglect and disrespect of the government when facing the need of promoting the necessary and legally appointed measures to make it present in the basic education provided by the state. The legislators silence when it comes to approving a regulation on environmental education essential to define policies, rules and criteria to teaching the subject in the state and the omission from the public administration regarding critical actions in order to integrate in public schools the activities related to the National Environmental Education Policy, represent a political decision for not doing anything, despite the legal demand for an active position. This neglecting attitude for the actualizing of strategically concrete actions, urgent and properly planned for the implementation of environmental education in schools in a multidisciplinary way, exposes the lack of interest the predominant classes have in such kind of education being made available, as it could be developed based on a critic political view, becoming a political and educational action against dominance. When analyzing the basic principles and fundamental goals in Law 9.795/99 (Brazil, 2009c) the development of a critic environmental education is really possible and concurs with the National Environmental Education Policy, reflecting the social and political mediations established between this public policy and the contexts associated to its legislative production process, which are responsible for approving a regulation which also represents the mind of the people about environmental protection above anything else