Impacto da estratégia saúde da família com equipe de saúde bucal sobre indicadores de saúde bucal: análise em municípios do nordeste com mais de 100 mil habitantes

This study examined in municipalities of Northeast of Brazil with more than one hundred thousand people who incorporation of Oral Health Teams (OHT) into the Family Health Strategy (FHE) the possible impact on oral health indicators. Sought to answer whether implementation OHT brought the best indicators of health problems and coverage, compared to areas without coverage by the FHE through a community trial in parallel, quasi-randomized. In each of the municipalities surveyed were 20 census tracts, 10 were located in areas covered by oral health teams in the ESF and 10 industries in areas not covered. The final sample consisted of 59.221 individuals. We compared oral health indicators related to health problems, access to services and coverage of oral health actions. The analysis strategy was based on the calculation of prevalence ratios and confidence intervals, adjusted for confounding factors through Poisson regression with robust variance. It also has measured the association between an indicator of social inequality for comparison between areas. The best results are associated with indicators of access and coverage of oral health actions at the expense of the indicators of health problems, suggesting a possible maintenance of a traditional model of practice yet. The results also suggest a possible effect of a specific policy in the area of primary care on inequality in access. From the discussions presented throughout this work, we can see that the impact analysis of public policy, obtained by comparing areas with and without the intervention, not only captures the effect on the target population, but other dimensions of organization service and therefore should be understood as one of the analytical possibilities related to the management

Avaliação gerontológica multidimensional das condições de saúde de idosos residentes em instituições de longa permanência

Introdução/objetivos: A avaliação do estado de saúde de idosos institucionalizados é considerada prática essencial à promoção e recuperação da sua saúde, a qual deve incluir a investigação de aspectos multidimensionais e multidisciplinares relacionados ao envelhecimento saudável. O estudo objetivou avaliar as condições de saúde dos idosos residentes em instituições de longa permanência (ILPI) do município de Natal RN. Métodos: Trata-se de um estudo descritivo, longitudinal, envolvendo seis ILPI filantrópicas, com uma população de 243 idosos. A coleta de dados se deu por meio de entrevistas com os idosos nas instituições mediante a aplicação de um questionário com informações sócio demográficas, saúde e institucionalização, além de várias facetas multidisciplinares que envolvem a escala de avaliação cognitiva (Mini Exame do Estado Mental); o índex de KATZ, para avaliação das atividades da vida diária e uma análise do estado nutricional com questões antropométricas (peso, estatura, circunferência abdominal) e Índice de Massa Corpórea. Participaram do estudo todos os idosos com idade igual ou superior a 60 anos, que aceitaram responder a entrevista e assinaram o Termo de Consentimento Livre e Esclarecido e/ou a impressão datiloscópica. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, sob parecer n° 164/2011. Resultados: Os participantes do estudo incluem 243 idosos, sendo a maioria mulheres (172 = 70,7%), com média de idade de 79 ± 9,44 anos. 124 idosos são solteiros (51,0%) e 66 viúvos (27,0%). A prática de atividades físicas não é rotina nas instituições, onde a maioria dos idosos (82,7%; n = 201) não realiza nenhum tipo de atividade. 78% dos idosos (n = 192) chegou a instituição sendo levados por familiares, enquanto que apenas 18% (n = 44 idosos) por vontade própria e 4% (n = 7 idosos) não souberam responder. Quanto aos aspectos cognitivos, identificou-se que 64,2% dos idosos (n = 156) apresentaram alterações significativas dentro da pontuação dos escores com restrições em responder aos demais questionamentos durante a entrevista por apresentarem limitações cognitivas e/ou dificuldades senso perceptivas.Conclusão: O presente estudo evidenciou alterações cognitivas na maioria dos idosos institucionalizados impossibilitando-os a continuidade da realização da avaliação global da saúde. A identificação correta da perda cognitiva em idosos é de suma importância para a equipe de saúde a fim de promover a detecção precoce de alterações cognitivas e a adoção de tratamento adequado, no sentido de contribuir para uma melhor qualidade de vida desta população

A importância da atividade física regular como estratégia complementar na promoção de resiliência de idosas e sua importância para suas vidas

O conceito de saúde, na concepção mais abrangente, é uma condição multidimensional de bem-estar físico, psicológico e social e não apenas a inexistência de enfermidades. Os benefícios da atividade física são tão relevantes quanto os benefícios psicológicos, porque ambos contribuem para a saúde. A literatura aponta um conjunto de ligações diretas e indiretas entre a atividade física e a qualidade de vida. Apesar destes benefícios, o processo de envelhecimento é caracterizado por grandes perdas biopsicossociais, que geram várias situações de adversidades que causam preocupação e podem colocar em risco a saúde do idoso. Deste modo, surge a resiliência como um conjunto de processos sociais e intrapsíquicos, que possibilitam o desenvolvimento saudável do idoso, mesmo diante de experiências negativas. Nesta direção, observou-se a necessidade de executar uma pesquisa de conhecimento multidisciplinar conciliando a Educação Física com a Psicologia, a Medicina, a Terapia Ocupacional e a Gerontologia, com o objetivo de investigar o efeito da atividade física sobre os níveis de resiliência em mulheres idosas, bem como conhecer a importância desta atividade para suas vidas. Para tanto, realizou-se um estudo comparativo descritivo, de caráter transversal. Assim sendo, 230 mulheres idosas foram divididas em dois grupos: ativas (n=115; 65,8±5,8 anos de idade), constituído por idosas matriculadas em um programa de atividade física orientada para idosos com período de prática igual ou superior a dois anos, e sedentárias (n=115; 69,2±7,2 anos de idade). Em seguida, foram submetidas à avaliação do nível de resiliência psicológica e da aptidão física (resistência muscular de membros superiores e inferiores, flexibilidade e resistência aeróbia). As idosas ativas apresentaram valores significativamente (p=0,001) maiores do fator 3 da resiliência psicológica quando comparados àqueles do grupo de idosas sedentárias, o qual está relacionado à autoconfiança e à capacidade de adaptação a situações diversas. Não foram observadas diferenças significativas (p>0,05) entre os grupos para os demais fatores (1 e 2). Quando comparados os testes de aptidão física com o nível de resiliência psicológica moderada (n=28) e alta (n=202) do fator 3, observou- se que idosas com nível de resiliência psicológica alta apresentaram maior flexibilidade (p=0,004). E para a avaliação da percepção da importância da atividade física para as idosas foi aplicado um questionário semiestruturado. A partir da Análise de Conteúdo proposto por Bardin (2009) os resultados foram: saúde/prevenção (85%), interação (47%), autonomia (40%), alegria/felicidade (33%), resiliência (33%), lazer (15%). E para avaliar a resiliência utilizou-se a Escala de resiliência de Wagnild e Young (1993). Quanto aos níveis de resiliência os resultados demonstraram que todas idosas apresentaram alto nível. Considerando os achados do presente estudo, sugere-se o emprego da atividade física como método de intervenção para melhora da saúde mental e, por conseguinte, da resiliência psicológica na população em questão, uma vez que os resultados apontam que idosas fisicamente ativas apresentam escores de resiliência psicológica superiores àquelas estratificadas como sedentárias. O resultado desse estudo possibilitou também concluir que a importância da atividade física parece estar relacionada, na sua maioria, às características de saúde/prevenção, interação social, autonomia, resiliência, alegria/felicidade e lazer. Além disso, as mulheres do presente estudo apresentaram um alto nível de resiliência quando comparado à tabela normativa

Um olhar sociológico sobre a criança e o brincar: espaço e tempo de construção, reinvenção e aprendizagem

This research I discuss the play, also talking with the other subjects that make up the universe in which the play is inserted, such as family, school and culture. The fundamental proposition of this dissertation assumes that the absence of play in children's lives affect their physical structure, psychological, biological, cultural, social, historical and theirs development. The initial questions were: What are the spacetimes reserved in the school for play? What is the importance of play in the development of children? Does the school recognize the importance of play in its social space? How the children perceive and use the spacetimes to play at school? Are there spacetimes at school to play? This is a theoretical and empirical research of exploratory study. The research‟s field was the Municipal School Professor Ulysses Góes, located in district of Nova Descoberta, in Natal, Rio Grande do Norte and, as research techniques, I used: participant observation, photography, structured interviews with students and questionnaires with teachers. The results indicate that for most of children, the school allows the play, few disagree with this preposition.Teachers recognize the importance of play in school, but for various reasons do not provide your practice. The dissertation points the possibility of new studies and developments for the theme.

Brincar, atividade humana e ferramenta pedagógica no contexto escolar da região metropolitana de natal

This thesis talks about the use of guided educational tools in play and playful in public schools in the Metropolitan Region of Natal (MRN), contributing to the teaching and students learning of basic education in the contents of portuguese and mathematics. We assume that the play is an activity / human need and therefore implies the proper development of children in physical, psychological, biological, cultural, social and historical aspects. We consider the mediation exercised by the teacher in the classroom, and the affection existing between teacher and student, sine qua non terms, so that the truth and fact of the process of teaching and learning occur. Thus, theoretically collaborated Paulo Freire, with his dialogical vision; Lev S. Vygotsky says that we learn and why we develop; Lev S. Vygotsky that states that we learn and for that we develop ourselves; Pierre Bourdieu and the concept of habitus, as something embedded and therefore procedural, and the cultural capital that needs to be fed and (re)meaning at school; Luiz Pereira, Bernard Lahire, Gilles Brougère and others brought their theoretical contributions. The empirical field of research was composed by the Municipal School Professor Ulysses de Góis, located in the neighborhood of Nova Descoberta in Natal, and the Municipal School José Horacio de Góis, located in the community of Guanduba, in São Gonçalo do Amarante, municipalities of the Metropolitan Region of Natal (MRN). We used as methodology the collaborative-action-research as a possible of effective participation of the research subjects, imputing them a voice and performance in the process, and not considering them just observers. The results indicate the effectiveness of the pedagogical tools in play and playful to the learning of students, but that alone is not able to solve all the problems of the school, other referrals need to be secured, as the planning of the actions to be developed in the school and in the classroom, systematized pedagogical orienttion for faculty, family participation/involvement in the school life of students, among other actions that need to be weighted so that education fulfills its role and promote the emancipation of the subject, because in the freireana liberating perspective, "the reading of the world preced the lecture of the word"

Apelação no código de processo civil: uma análise sob o prisma do princípio da efetividade

The present dissertation, elaborated is based on the deductive method, through the use of the General Theory of Resources concepts, by the main types of judgments existing in the Code of Civil Procedure, the interlocutory judgment and sentence, as well as the features and effects that challenge these decisions, we sought to identify on this theme one of the greatest evils facing the justice system in the world, which is the processing delays. This slowness in adjudication affects seriously the principle of effectiveness, one of the postulates of procedural law and society as a whole. Thus, the use of tort serves to fight the interlocutory decision and appeal which challenges the judge`s ruling. It is a resource for excellence in appellate system as it meets with the most awaited decision of the process. In weighing the importance of the appeal that seeks to oppose the court decision today by the numerous reforms that the procedural system has been through, it has ended up to transform the process ineffective or inconsistent, for it is much easier to have efficacy in a interlocutory decision for preliminary injunction than by judgment on the merits of the judge. This is due to the prevision of the resources and their effect to those decisions. That is, the interlocutory decision involves interlocutory appeal only in the devolved effect, allowing its provisional execution, and the sentence has as recourse to appeal the double effect, remanding and suspension, which necessarily prevents its provisional execution. But it undeniably shows a paradox, because as to give effect to a measure that is based on a mere probability by a summary cognition, partial and superficial, and stop it on a decision by a court that is closer to the truth and sure, for a full and depleting cognition? It is seriously affect the principle of effectiveness. Therefore, starting from this ineffectiveness, sought to defend the solution of this problem with the approval of the bill n. º 3.605/2004 or the new Code of Civil Procedure project that modifies the general rule the effects of appeal. That is, remanding and suspensive, as to merely remanding effect to and thereby enable the provisional execution of the judgment of the court of the first degree of jurisdiction, giving effectiveness and enhancing the decision of the magistrate, making a fair distribution of time in the process and better guaranteed principle of access to justice

Mediação como instrumento de desjudicialização das questões familiares: constitucionalização do Direito de Família

The Liberal Constitutionalism emerged from the late eighteenth century, a period of major revolutions (French and American), fruit of the struggle for libertarian rights. Although the time of the first written constitutions, these were linked to mere political letters, did not provide for fundamental human rights, as it is, so only on the state organization, structure of powers, division of powers of the state and some relations between state and individuals. There was a clear division between the civil codes and constitutions, those governing private relations and acted as barriers to non-state intervention. After the Second World War, the constitutions are no longer Letters political order to establish how the human person, in order to enshrine the fundamental rights, the primacy of constitutional principles and take their normative function against ordinary legislator. Constitutional evolution gave the name of contemporary constitutionalism, based on repersonalization or despatrimonialização of Private Law, ceasing the separation of legislative civil codes and constitutions, in favor of the protection of fundamental rights of the human person. And this tendency to the Brazilian Federal Constitution of 1988 brought higher ground the dignity of the human person, the epicenter axiological legal to govern private relations, including family law. The constitutionalization of family law motivates the adoption of desjudicialização family issues, so as to respect the direio intimacy, privacy, private autonomy and access to justice. Conflictual family relationships require special treatment, given the diversity and dynamism of their new compositions. The break in the family relationship is guided in varied feelings among its members in order to hinder an end harmonic. Thus, the judiciary, through performances impositive, not to honor the power of decision of the parties, as also on the structural problems faced to operate on these cases, the environment is not the most appropriate to offer answers to the end of family quarrels. Situation that causes future demands on the dissatisfaction of the parties with the result. Before the development of the Family Law comes the need to adopt legal institutions, which monitor the socio-cultural, and that promote an effective assistance to people involved in this kind of conflict. In obedience to the private autonomy, before manifestations of volunteers involved in family mediation, among autocompositivos instruments of conflict resolution, is indicated as the most shaped the treatment of family quarrels. Remaining, then the state a minimal intervention to prevent excessive intrusion into private life and personal privacy

Arranjos produtivos globalizados: o caso do APL da fruticultura de melão de Mossoró - Baraúna-RN

This study discuss the issue on Clusters Global, the productive arrangement of fruits melon Mossoró/Baraúna in Rio Grande do Norte, located in the Potiguar semi-arid RN, is entered in the arket international level, the job serch, from the benchmark neo-schumpeterian, strongly condensed and absorbed in Brazil by focusing on Local Productive Arrangements set out by the Reseatch Netwoark on Sistemas Produtivos e Inovativos Locais (REDESIST), understanding the extent to which innovation efforts, and as interactions between the main actors that make up this APL in particular, account for its global insertion. The methodology includes the application of questions to the producers of melon arrangement as well as interviews with the main responsible for the support, promotion and financing. In conclusion, there is a significant interaction between producres and actors of the arrangement, a fact that contributes to the integration into the international market together with the implementation of relevant innovations. Finally, it is pointed out the need for public policies directed to the production of melon because of its relevance to the exports of Rio Grande do Norte

Robótica e educação: uma possibilidade de inserção sócio-digital

This paper presents a reflection on the use of robotics in education technology and the fostering of social and digital inclusion, unveiling a new field that has been outlined today. Robotics constitutes a tool still little known and not regulated at national level in education, there is little experience involving the tool in the Northeast. This research aims to reveal one of the first experiments with educational level robotics in Rio Grande do Norte. We present a field research conducted in a public school chancellor for a major institute of science and technology education of the state from seeking review of the robotics course, understand how they work and show their use in school and shows that contributions were generated for digital inclusion category students, based on speeches by teachers, engineers, management and students. As part of gathering information, we used the focus group technique, applied in two stages, one with groups of students, teachers and other school administration, as well as comments directed to the times when the robotics course was being finalized. As a result, we found that the school, through the robotics course is a provider of social and digital inclusion, since it awakens in the sample of students in this research knowledge enabler of social change. And that despite the student category do not understand the depth of meaning of inclusion, the same report in daily actions that integrate technology into their social context in harmony, enjoying its cultural citizenship in full

Evidências de validação de um protocolo para assistência às pessoas com úlceras venosas em serviços de alta complexidade

Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs . After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa ≥ 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity

Conhecimentos e habilidades de acadêmicos sobre procedimentos em semiologia e semiotécnica da enfermagem

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Validação de instrumentos para avaliação do conhecimento e da habilidade acerca da punção venosa periférica com cateter agulhado

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Análise da adesão ao tratamento e da qualidade de vida de pessoas com úlcera venosa

The therapeutic adherence is still a big problem among people with venous ulcers (VU) because the treatment is long, expensive and demand changes in lifestyle. In this context, this study aims to examine treatment adherence and quality of life (QOL) of people with VU assisted at primary health care. This is an analytical, cross-sectional study with a quantitative approach to treatment and data analysis. The study had the scenario 13 Family Health Units and 02 Units Mixed of Natal. The target population consisted of 44 persons with UV indicated by the teams of the Family Health Strategy between February and April 2014. Three instruments were used: an instrument to characterize the sociodemographic, health and care aspects, the Multidimensional Scale of Adherence Therapy composed of the dimensions: healthy lifestyle, compressive therapy and neurovascular monitoring and the Charing Cross Venous Ulcer Questionnaire (CCVUQ) that evaluates QOL in persons with VU composed by the domains: Total Score, Social Interaction, Domestic Activities, Aesthetics and Emotional State. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, CAAE: 07556312.0.0000.5537. The data concerning the sociodemographic characteristics showed that there was a predominance of females (65.9%), age range as of 60 years (59.1%) and income of up to 1 minimum wage (81.8%). With the characterization of health, it was evident that most people reported chronic diseases (63.6%), sleep more than 6 hours (81.8%), present pain (81.8%), denying alcoholism (86 4%) and smoking (77.3%) and showed a number greater than or equal to 1 (77.3%) recurrences. Concerning the therapeutic adherence was found that in the dimension compressive therapy there poor adherence. No associations between the domains of adherence and sociodemographic and health variables were found. Was observed, however, better adherence among individuals without pain and with higher schooling. When analyzed the averages of the dimensions of therapeutic adherence with the care characteristics there was statistical significance between: adherence to compression therapy and guidance for use of compressive therapy (p = 0.002) and guidance for regular exercise (p = 0.026). Considering the mean of total score of CCVUQ (mean 51.47, SD 18.33) it is observed that the overall QOL of respondents has approximate value of the median of the scale (50). The mean of the domain Social Interaction (mean 44.23, SD 21.38) and Domestic Activities (mean 45.70, SD 23.21) were those who reported better QOL. There were weak correlations but significant between adherence to healthy lifestyle and Domains Total Score (p = 0.012), social interaction (p-value = 0.048), Aesthetics (p-value = 0.025) and Emotional State (0.017) of CCVUQ. From the data analysis it is concluded that among people with UV, there poor adherence to compressive therapy. Furthermore, we found no statistically significant association between treatment adherence and sociodemographic and health characteristics. It is added that there was a correlation between the healthy lifestyle dimension and domains CCVUQ

Atuação e o conhecimento dos profissionais de enfermagem quanto a morte encefálica e manutenção do potencial doador de órgãos e tecidos para transplantes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Modelo matemático para otimização dos custos de um sistema híbrido eólico-solar : aplicação no bombeamento de petróleo

This work purposes the application of a methodology to optimize the implantation cost of an wind-solar hybrid system for oil pumping. The developed model is estimated the implantation cost of system through Multiple Linear Regression technique, on the basis of the previous knowledge of variables: necessary capacity of storage, total daily energy demand, wind power, module power and module number. These variables are gotten by means of sizing. The considered model not only can be applied to the oil pumping, but also for any other purposes of electric energy generation for conversion of solar, wind or solar-wind energy, that demand short powers. Parametric statistical T-student tests had been used to detect the significant difference in the average of total cost to being considered the diameter of the wind, F by Snedecor in the variance analysis to test if the coefficients of the considered model are significantly different of zero and test not-parametric statistical by Friedman, toverify if there is difference in the system cost, by being considered the photovoltaic module powers. In decision of hypothesis tests was considered a 5%-significant level. The configurations module powers showed significant differences in total cost of investment by considering an electrical motor of 3 HP. The configurations module powers showed significant differences in total cost of investment by considering an electrical motor of 5 HP only to wind speed of 4m/s and 6 m/s in wind of 3 m, 4m and 5 m of diameter. There was not significant difference in costs to diameters of winds of 3 m and 4m. The mathematical model and the computational program may be used to others applications which require electrical between 2.250 W and 3.750 W. A computational program was developed to assist the study of several configurations that optimizes the implantation cost of an wind-solar system through considered mathematical model