Satisfação do paciente com a fisioterapia :tradução, adequação cultura e validação de um instrumento de medida

The measurement of patient satisfaction can provide information about the success of the care provider in reaching the values and meeting the expectations of the patient. The purpose of this study was to translate into the Portuguese language and to culturally customize to the Brazilian population the instrument to measure patient satisfaction with physical therapy elaborated by Goldstein et al. The study sample was made up of 279 patients who were undergoing physical therapy treatment at 39 different private clinics in a middle-sized town in northeastern Brazil. For the translation of the survey instrument, the back-translation technique was employed, in association with the bilingual method. The reliability and validity of the Brazilian version of the instrument were both assessed. Reliability analysis, carried out with the computation of Cronbach alpha coefficients, showed that the measures obtained with the instrument have a high degree of internal consistency. The aspects dealing with the patient therapist relationship are the most important predictors of satisfaction, followed by those dealing with courtesy, privacy, and practical aspects such as efficiency of the facility in the patient admissions process, setting up of appointments, and waiting time in waiting room. Items dealing with aspects such as location of the facility and availability of parking facilities may underestimate the reliability of the instrument. This study translated, culturally customized, and validated an instrument to measure patient satisfaction with physical therapy originally developed in English. By so doing, this study has made this instrument available to the Brazilian society, and it has rendered it a useful parameter that can be utilized in our country in the field of physical therapy

Democracia brasileira: fortalecimento da participação popular

A democracia tem representado ao longo da História o mais perfeito mecanismo político de convivência social, encontrando na soberania popular seu fundamento e legitimidade. De berço grego, instituiu-se sob princípios que radicavam o poder político no povo, exercido diretamente na ágora ateniense. O iluminismo dos séculos XVII e XVIII reacendeu o ideal democrático, encontrando no positivismo sua base teórica. O poder passou a ser exercido por via de representantes eleitos periodicamente. O locus da atividade política era o parlamento, ambiente fechado e refratário à participação popular, cingida, à época, ao voto do cidadão nos períodos eleitorais. O distanciamento entre governantes e governados gerou déficit de legitimidade no modelo liberal clássico, levando o constitucionalismo do século XX a abandonar o rigor formal positivista, para adotar uma nova hermenêutica, de base axiológica e centrada na participação direta do povo nas instâncias do poder. A Constituição Federal de 1988 compendiou a democracia participativa em seu texto, declarando no parágrafo único, de seu artigo 1º, que todo o poder emana do povo. Consagrou como base da soberania popular o sufrágio universal, o voto direto, secreto e de igual valor, além do plebiscito, do referendo e da iniciativa popular de leis. Garantiu ainda a ação popular como ferramenta de cidadania. A participação popular foi restringida com o advento da Lei nº 9.907/98, que impôs bloqueios processuais para seu exercício, gerando déficit de legitimidade no sistema representativo brasileiro. O propósito desse trabalho é demonstrar a necessidade de se estabelecer um novo espaço público na ordem constitucional do Brasil, de textura aberta e dialógica e de perspectiva emancipatória, que customize a participação do povo nas instâncias do poder, a partir da desburocratização dos instrumentos de soberania popular já existentes e da adoção de outros institutos democráticos semidireto, notadamente a iniciativa popular de emenda à Constituição, a revogação de mandato eletivo e o veto popular

Adaptação eletrônica de um leitor mecânico de coto, investigação e desenvolvimento de interface CAD

Due to advances in the manufacturing process of orthopedic prostheses, the need for better quality shape reading techniques (i.e. with less uncertainty) of the residual limb of amputees became a challenge. To overcome these problems means to be able in obtaining accurate geometry information of the limb and, consequently, better manufacturing processes of both transfemural and transtibial prosthetic sockets. The key point for this task is to customize these readings trying to be as faithful as possible to the real profile of each patient. Within this context, firstly two prototype versions (α and β) of a 3D mechanical scanner for reading residual limbs shape based on reverse engineering techniques were designed. Prototype β is an improved version of prototype α, despite remaining working in analogical mode. Both prototypes are capable of producing a CAD representation of the limb via appropriated graphical sheets and were conceived to work purely by mechanical means. The first results were encouraging as they were able to achieve a great decrease concerning the degree of uncertainty of measurements when compared to traditional methods that are very inaccurate and outdated. For instance, it's not unusual to see these archaic methods in action by making use of ordinary home kind measure-tapes for exploring the limb's shape. Although prototype β improved the readings, it still required someone to input the plotted points (i.e. those marked in disk shape graphical sheets) to an academic CAD software called OrtoCAD. This task is performed by manual typing which is time consuming and carries very limited reliability. Furthermore, the number of coordinates obtained from the purely mechanical system is limited to sub-divisions of the graphical sheet (it records a point every 10 degrees with a resolution of one millimeter). These drawbacks were overcome by designing the second release of prototype β in which it was developed an electronic variation of the reading table components now capable of performing an automatic reading (i.e. no human intervention in digital mode). An interface software (i.e. drive) was built to facilitate data transfer. Much better results were obtained meaning less degree of uncertainty (it records a point every 2 degrees with a resolution of 1/10 mm). Additionally, it was proposed an algorithm to convert the CAD geometry, used by OrtoCAD, to an appropriate format and enabling the use of rapid prototyping equipment aiming future automation of the manufacturing process of prosthetic sockets.

A experiência da criança com a droga :características do uso e circunstâncias familiares

The study is a reflexion of the use of drugs among children, pointing that as one of the most serious social problem nowadays. Customize the abuse of drugs reflecting on the childhood and the family s influence of the problem of the children that use drugs, is the main objective of this thesis. Choosing the qualitative method of research, the investigation starts with the reports of the children and mothers assisted at Centro de Referência e Apoio à Criança e ao Adolescente Usuários de Drogas, program of specialized assistance of 1ª Vara da Infância e da Juventude de Natal/RN. The research was done through semi-structured interviews, in a total of six subjects: three children and their respective mothers. Through the reports of the subjects, it is brought theorical reflexions that illustrates their perceptions and conceptions about topics like the usage of drugs, the circumstances the usage of drugs was started, the family s structure and dynamic, the situation on the streets, and other factors that affect the development of a child in her/his environment. It is proved that the usage of drugs in Brazil, problem that has been increasing the number of children affected by, is a multi faceted and complex phenomenon but some factors of social and family risks deserve to be pointed out like the manner of support future actions in the prevention area