Prática do enfermeiro do Programa Saúde da Família PSF na promoção da saúde do adolescente

Attention to the health of adolescents, based on paradigm flexneriano, needs to be overcome. Since the International Conference of Ottawa (1986), the literature is developing a discussion of the promotion of health, based on the paradigm of social production in health, suggests a design to overcome the health care traditional practices. Program Health of the Family PSF has this purpose to transmute the model of existing assistance, where the nurse is an essential element to the work done in the program. Around this context, it is our purpose to analyze the practice of nurse of the PSF for the promotion of health of adolescents, produced by a search of descriptive quantitative approach with the inclusion of qualitative data. Interviews were conducted with 9 nurses 3 units of health of the family USF, Mossoró-RN and applied questionnaires with 74 teenagers aged between 15 and 19 years old, with some nearby public schools where USF operate these nurses. The quantitative descriptions were transformed on tables, pictures and graphics using the program Excel (Microsoft) and the qualitative were worked through the technique of analyzing the content of Bardin (2004). The review was realized using the reference to promote health brought by the study. The results show that the most common problems that happen with teenagers are the drugs (33,8%), pregnancy (27,0%) and political problems-socio-economic-cultural issues (24,3%). Adolescents are spontaneous demand and rarely seek the USF. The actions presented by the nurses as, lectures and groups, are nothing comparing to the macro-problems presented by adolescents, and verticalized irregular. The nurses know the promotion of health generally, not explaining how operate it from its daily practice. Concluded that the practice of nurse of the PSF has not yet reach the promotion of health of the adolescent, being necessary to scheduling modules on the subject to continuous training of teams, professionals from USF, as well as teachers and other staff of schools, giving space to the participation of academic. The discussions should be socialized with the community to discuss possibilities of confrontation of the problems, which also require socio-structural changes. This research can contribute as work-diagnosis, which experienced the reality of care in nursing PSF to a specific group

Interações físicas e psicossociais em mulheres com fibromialgia

Fibromyalgia (FM) is a non-inflammatory rheumatic syndrome of unknown etiology, with symptoms of diffuse musculoskeletal pain and presence of specific anatomic sites called tender points. The symptoms are often associated with fatigue, sleep disturbances, morning stiffness, alterations in pain perception, anxiety and depression. Fibromyalgia exhibits a correlation between physical and behavioral symptoms, which have a negative influence on the quality of life of patients. Emotional skills are important factors since they are related to subjective well-being, personal productivity, social interaction and interpersonal relationships. We aim to describe the physical and psychosocial interactions in women with FM, showing the association between perceived social support and affect with symptoms of pain, functionality and mood. We will also describe a body representation of pain in women with FM. Data were collected over 3 years and the sample size ranged between studies. This is an exploratory cross-sectional study conducted with a convenience sample of 63 women with FM and 42 healthy women as a control group (CT), aged 20-76 years, recruited through spontaneous demand at Onofre Lopes University Hospital (HUOL) and the Clinical School of Physiotherapy of Universidade Potiguar (UNP). The Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), Social Support Scale (MOS), Hamilton Anxiety Scale and Scale of Positive and Negative Affect Schedule (PANAS), in addition to pressure algometry were used. For data analysis, we used parametric and non-parametric tests and a general linear model with adjustment variables and analysis of variance. A significant difference was found between pain threshold and tolerance, functionality, depression, anxiety, social support, and positive and negative affect between the groups. Affective states and social support were associated with anxiety, depression and functionality. A body was drawn representing pain with higher incidences in trapeze, supraspinatus and second ribs. The reason for studying sensory aspects, affective behavior and social support in FM patients opens perspectives for scientific and clinical research of this syndrome. Women with chronic pain such as FM appear to have altered mood states, less social support and affective dysfunctions, influencing the other symptoms of the syndrome

O controle da tuberculose no contexto da atenção primária à saúde no Brasil

O Brasil é um dos países que concentram 80% da carga de tuberculose no mundo. No contexto da atenção primária brasileira, fatores interferem para que as equipes de saúde da família possam incorporar as atividades de controle da doença no processo de trabalho. O controle da doença depende da forma como os serviços de saúde estão organizados para garantir o acesso ao diagnóstico precoce e ao tratamento. Esse estudo tem como objetivo geral analisar o controle da tuberculose no contexto da atenção primária à saúde no Brasil. Os objetivos específicos são comparar o tratamento diretamente observado com o regime autoadministrado em pessoas com tuberculose; Verificar se o Programa Nacional de Controle da Tuberculose é avaliável e elaborar um modelo teórico e lógico para avaliação deste programa; avaliar a relação entre porte populacional dos municípios e as características de estrutura e processo de cuidado a pacientes de tuberculose na atenção primária no Brasil. Realizou-se uma revisão sistemática, seguida de um estudo de avaliabilidade e de um estudo transversal. Os achados da revisão sistemática revelam que não houve diferença significativa entre os grupos de tratamento (observado e não observado) para cura (OR 1,06. IC95% 0,75 - 1,50) e para conclusão do tratamento (OR 1,64, IC 95% 0,79 - 3,42). Menor abandono no grupo com tratamento supervisionado e não houve diferença estatisticamente significativa entre os grupos (OR 0,73, CI 95% 0,58-0,92). O risco de morte foi maior no regime de tratamento autoadministrado (OR 1,49 IC 95% 1,03 - 2,45). A hetorogeinadade entre os estudos analisados não permite afirmar que nao há diferença estatisticamente significativa para cura e tratamento concluído. A pré-avaliação do Programa de Controle de Tuberculose possibilitou a descrição do Programa, elaboração e pactuação do modelo lógico e a matriz de relevância dos indicadores. Caracterizou-se os seus elementos estruturantes, definição de indicadores de estrutura e processo, além das perguntas avaliativas. Uma avaliação somativa com enfoque na análise dos efeitos da intervenção de controle da tuberculose é recomendada. A avaliação das características de estrutura e processo de cuidado à pessoa com tuberculose revelou melhor desempenho para as equipes de atenção básica de municípios classificados como metrópole no acesso, coordenação do cuidado e qualidade técnica da atenção. Em relação ao acesso: 98,5% acolhimento a demanda espontânea; 95,8% programação de consultas. Na coordenação do cuidado, 93,2% existência de protocolo para tuberculose. Quanto a qualidade técnica da atenção à tuberculose verifica-se que 93,4% acompanhamento de tratamento diretamente observado, 95,8% com busca ativa de faltosos ao tratamento, 64,0% oferta de ações educativas, 91,3% busca ativa de sintomáticos respiratórios. Cabe destacar que metrópoles apresentaram maior tempo médio de espera para escuta/acolhimento (24,41 minutos); para consulta previamente agendada (23,52 dias); para consulta em pneumologia (87,12 dias). Percebem-se fragilidades na estrutura e processo da atenção à tuberculose, principalmente no controle especializado da doença e na qualidade técnica entre os municípios. Recomenda-se reforço, particularmente na qualidade técnica para aumentar a cobertura de acompanhamento do tratamento, busca de sintomáticos respiratórios e das ações educativas.

A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em saúde bucal coletiva

RONCALLI, Angelo Giuseppe. A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em Saúde Bucal Coletiva. raçatuba, 2000. 238p. Tese (Doutorado em Odontologia Preventiva e Social). Faculdade de Odontologia, Universidade Estadual Paulista “Júlio de Mesquita Filho”

Perfuração espontânea de colédoco em adolescente

Spontaneous perforation of the common bile duct is rare. It happens predominantly in children and it is related to obstructive disease of the biliary tract. We present a case of an 18 year-old male patient, with ulcerative rectocolitis associated with malignant tumor of the head of pancreas. The patient developed an acute abdomen syndrome and laparotomy, a spontaneous perforation of common bile duct was evidenced. The authors make a revision of the clinical aspects of that pathology

Demanda química de oxigênio, clorofila a e comunidade fitoplanctônica como indicadores da qualidade da água no Canal do Pataxó/RN

The current study examined spatial-temporal modifications and water quality through chemical and biotic indicators during both dry (January, February and November 2006) and wet seasons (March to June 2006). This study was carried out in Armando Ribeiro Gonçalves Reservoir, RN, Canal do Pataxó and after the water station treatment (WST). The physical-chemical parameters were measured in situ and inorganic nutrients, chlorophyll a and Free Oxygen Demand (FOD) were analyzed in laboratory conditions. Quali quantitative analyses of phytoplankton were carried out utilizing Sedgwick-Rafter camera. Results indicate that DQO concentrations were low. FOD concentrations in the reservoir were comparatively higher in the dry season (5.21 mgL-1; 5.64 mgL-1 e 6.05 mgL-1) in relation to the wet season (4.52 mgL-1; 4.12 mgL-1 e 4.92 mgL-1), in surface, intermediate and bottom waters, respectively. FOD values were inferior to 1.0mgL-1in both Canal do Pataxó and after WST, which is considered adequate for public use reservoirs. Although FOD concentrations were low, Armando Ribeiro Gonçalves Reservoir, Canal do Pataxó and WST were classified as euthophizied, mesotrophic ad oligotrophic, respectively, considering the Index of Trophic State Criteria. Chlorophyll a concentrations in the study reservoir were higher in the surface (199.2 µgL-1) during the wet season, whereas in Canal do Pataxó concentrations decreased from 1.56 µgL-1 to 0.028 µgL-1, and after WST values were low (0.059 µgL-1). Dominance of cianobacterias, such as Planktotrhix agardhii (dry season) and Microcystis sp (wet season) was registered in all three areas. In the reservoir and Canal do Pataxó, density of cianobacterias, such as P. agardhii and Microcistys sp., was superior to the values allowed by the Health ministry (HM). However, after WST, density values of cianobacteria were inferior to values established by the HM

Estimação da demanda de instalações elétricas de edificações com múltiplas unidades de consumo

This work aims to predict the total maximum demand of a transformer that will be used in power systems to attend a Multiple Unit Consumption (MUC) in design. In 1987, COSERN noted that calculation of maximum total demand for a building should be different from that which defines the scaling of the input protection extension in order to not overestimate the power of the transformer. Since then there have been many changes, both in consumption habits of the population, as in electrical appliances, so that this work will endeavor to improve the estimation of peak demand. For the survey, data were collected for identification and electrical projects in different MUCs located in Natal. In some of them, measurements were made of demand for 7 consecutive days and adjusted for an integration interval of 30 minutes. The estimation of the maximum demand was made through mathematical models that calculate the desired response from a set of information previously known of MUCs. The models tested were simple linear regressions, multiple linear regressions and artificial neural networks. The various calculated results over the study were compared, and ultimately, the best answer found was put into comparison with the previously proposed model

Extração e Representação de Conhecimento de Séries Temporais de Demanda de Energia Elétrica Usando TSKR

The opening of the Brazilian market of electricity and competitiveness between companies in the energy sector make the search for useful information and tools that will assist in decision making activities, increase by the concessionaires. An important source of knowledge for these utilities is the time series of energy demand. The identification of behavior patterns and description of events become important for the planning execution, seeking improvements in service quality and financial benefits. This dissertation presents a methodology based on mining and representation tools of time series, in order to extract knowledge that relate series of electricity demand in various substations connected of a electric utility. The method exploits the relationship of duration, coincidence and partial order of events in multi-dimensionals time series. To represent the knowledge is used the language proposed by Mörchen (2005) called Time Series Knowledge Representation (TSKR). We conducted a case study using time series of energy demand of 8 substations interconnected by a ring system, which feeds the metropolitan area of Goiânia-GO, provided by CELG (Companhia Energética de Goiás), responsible for the service of power distribution in the state of Goiás (Brazil). Using the proposed methodology were extracted three levels of knowledge that describe the behavior of the system studied, representing clearly the system dynamics, becoming a tool to assist planning activities

Avaliação da disponibilidade hídrica e da demanda hídrica no trecho do Rio Piranhas-Açu entre os açudes Coremas-mãe D´água e Armando Ribeiro Gonçalves

Piranhas-Açu basin is a Federal watershed with a drainage area of 43.681,5 km2, sited at Brazilian northeast semi arid, with 60% of your area in Paraiba State and 40% in Rio Grande do Norte State. The main river, Piranhas-Açu, has strategic importance for development of these states, because it s an essential source for many socio-economics activities developed along watercourse. The river s reach between Coremas-Mãe D`água Dam and Armando Ribeiro Gonçalves Dam has many irrigation projects, and supply many riverside cities. All this activities practiced in this river s reach consumes high water volumes. Due the importance of this stream and the necessity of an adequate management, this work aims for an impartial and detailed evaluation of real water supply conditions in this river s reach, by the application of hydrological modeling, including the arrangement of main dams in tributaries, and storage reservoir water balance. The rainfall-discharge model s applied in each sub-basins it was selected the model MODHISA- Hydrological Model of Semi Arid, that is a concentrated model with easy application. The simulation produced 50 years of inflows into the reservoirs, for which, were constructed the guaranties curves; and produced 50 years of synthetic discharge data in relevant points on the river and on its affluents; so it was constructed the permanence curves. Confronting the available discharge with the current and futures volumes of raw water captured in this river s reach, it was verified that de demands have high guaranties. This work concluded that the MODHISA Model is suitable to reproduce the hydrologic characteristics of Piranhas-Açu sub-basins, and showing good results

Processo de difusão com agregação e reorganização espontânea em uma rede 2D

Difusive processes are extremely common in Nature. Many complex systems, such as microbial colonies, colloidal aggregates, difusion of fluids, and migration of populations, involve a large number of similar units that form fractal structures. A new model of difusive agregation was proposed recently by Filoche and Sapoval [68]. Based on their work, we develop a model called Difusion with Aggregation and Spontaneous Reorganization . This model consists of a set of particles with excluded volume interactions, which perform random walks on a square lattice. Initially, the lattice is occupied with a density p = N/L2 of particles occupying distinct, randomly chosen positions. One of the particles is selected at random as the active particle. This particle executes a random walk until it visits a site occupied by another particle, j. When this happens, the active particle is rejected back to its previous position (neighboring particle j), and a new active particle is selected at random from the set of N particles. Following an initial transient, the system attains a stationary regime. In this work we study the stationary regime, focusing on scaling properties of the particle distribution, as characterized by the pair correlation function ø(r). The latter is calculated by averaging over a long sequence of configurations generated in the stationary regime, using systems of size 50, 75, 100, 150, . . . , 700. The pair correlation function exhibits distinct behaviors in three diferent density ranges, which we term subcritical, critical, and supercritical. We show that in the subcritical regime, the particle distribution is characterized by a fractal dimension. We also analyze the decay of temporal correlations