45 resultados para Medicina baseada na evidência
em Universidade Federal do Rio Grande do Norte(UFRN)
Resumo:
The birth models of care are discussed, in the light of classical and contemporary social science theoretical background, emphasizing the humanistic model. The double spiral of the sociology of absences and the sociology of emergences is detailed, being based, on one hand, on the translation of experiences of knowledge, and, on the other, on the translation of experiences of information and communication, by revealing the movement articulated by Brazilian women on blogs that defend and bring into light initiatives aiming to recover natural and humanized birth. A cartography of the thematic ideas in birth literature is produced, resulting in the elaboration of a synthetic map on obstetric models of care in contemporaneity, pointing out the consequences of the obstetric model that has become hegemonic in contemporary societies, and comparing that model to others that work more efficaciously to mothers and babies. A symbolic cartography of the activism for humanizing birth on the Brazilian blogosphere is configured by the elaboration of an analytical map synthetizing the main mottos defended by the movement: Normal humanized birth; Against obstetrical violence; and Planned home birth. The superposition of the obstetric models of care s map and the rebirth of birth s analytical map indicates it is necessary to reinforce three main measures in order to make a paradigmatic turn in contemporary birth models of care possible: pave the way for the humanistic care of assistance in normal birth, by defending and highlighting practices and professionals that act in compliance with evidence based medicine, respecting the physiology of birth; denaturalize obstetric violence, by showing how routine procedures and interventions can be means of aggression, jeopardizing the autonomy, the protagonism and the respect towards women; and motivate initiatives of planned home birth, the best place for the occurrence of holistic experiences of birth. It is concluded that Internet tools have allowed a pioneer mobilization in respecting women s reproductive rights in Brazil and that the potential of the crowd s biopower that resides on the blogosphere can turn blogs into a hegemonic alternative way to reach more democratic forms of social organization. In that condition of being virtually hegemonic in contesting the established power, these blogs can be understood, therefore, as potentially great contra-hegemonic channels for the rebirth of birth and for the reinvention of social emancipation, as their author s articulate and organize themselves to strive against the waste of experience, trying to create reciprocal intelligibility amongst different experiences of world
Resumo:
The 1988 Federal Constitution of Brazil by presenting the catalog of fundamental rights and guarantees (Title II) provides expressly that such rights reach the social, economic and cultural rights (art. 6 of CF/88) as a means not only to ratify the civil and political rights, but also to make them effective and practical in the life of the Brazilian people, particularly in the prediction of immediate application of those rights and guarantees. In this sense, health goes through condition of universal right and duty of the State, which should be guaranteed by social and economic policies aimed at reducing the risk of disease and other hazards, in addition to ensuring universal and equal access to actions and services for its promotion, protection and recovery (Article 196 by CF/88). Achieving the purposes aimed by the constituent to the area of health is the great challenge that requires the Health System and its managers. To this end, several policies have been structured in an attempt to establish actions and services for the promotion, protection and rehabilitation of diseases and disorders to health. In the mid-90s, in order to meet the guidelines and principles established by the SUS, it was established the Política Nacional de Atenção Oncológica PNAO, in an attempt to sketch out a public policy that sought to achieve maximum efficiency and to be able to give answers integral to effective care for patients with cancer, with emphasis on prevention, early detection, diagnosis, treatment, rehabilitation and palliative care. However, many lawsuits have been proposed with applications for anticancer drugs. These actions have become very complex, both in the procedural aspects and in all material ones, especially due to the highcost drugs more requested these demands, as well as need to be buoyed by the scientific evidence of these drugs in relation to proposed treatments. The jurisprudence in this area, although the orientations as outlined by the Parliament of Supreme Court is still in the process of construction, this study is thus placed in the perspective of contributing to the effective and efficient adjudication in these actions, with focus on achieving the fundamental social rights. Given this scenario and using research explanatory literature and documents were examined 108 lawsuits pending in the Federal Court in Rio Grande do Norte, trying to identify the organs of the Judiciary behave in the face of lawsuits that seeking oncology drugs (or antineoplastic), seeking to reconcile the principles and constitutional laws and infra constitutional involving the theme in an attempt to contribute to a rationalization of this judicial practice. Finally, considering the Rational Use of health demands and the idea of belonging to the Brazilian people SUS, it is concluded that the judicial power requires ballast parameters of their decisions on evidence-based medicine, aligning these decisions housing constitutional principles that the right to health and the scientific conclusions of efficacy, effectiveness and efficiency in oncology drugs, when compared to the treatments offered by SUS
Resumo:
In whole world, including in Brazil, there is an absence of professionals who are able to be present at the moment of birth and give to the newborn the cares that they need to because either an absence of opportunity or inappropriate training to those professionals. This master´s thesis describes a construction and application of a neonatal resuscitation course that uses the problem based learning (PBL) methodology. The course has done in two meetings, one for the tutorial session, and another for practice session. The students were divided in groups of eight students each, under supervision of two teachers with experience in PBL methodology. The experience was considered successfully because there were students involvement and motivation. Some course aspects were rebuilt for its upgrading, like the correct use of methodology and building of custom educational material for students learning necessity. It suggests that the course can be used by the medical and nursing schools and perhaps other kind of health courses.
Resumo:
Este estudo teve por objetivo avaliar a eficácia de uma estratégia de ensino sobre diagnósticos de enfermagem, fundamentada na aprendizagem, baseada em problemas no desempenho do raciocínio clínico e julgamento diagnóstico dos discentes de graduação. É estudo experimental, realizado em duas fases: validação de conteúdo dos problemas e aplicação da estratégia educativa. Os resultados mostraram melhora na capacidade de agrupamento dos dados dos discentes do grupo experimental. Conclui-se que houve influência positiva da estratégia implementada
Resumo:
This study has the purpose of investigating the term reader-creator , on the textual aspects of the dramatical works A Morte nos Olhos , A Memória Ferida and Na Outra Margem (2010) by Antonia Pereira Bezerra. In this sense, we propose an analysis of these works based on author‟s life experience as creative matter for a autofictional narrative, highlighting the relations between the autobiographical elements (LEJEUNE, 2008; DOSSE, 2009) and fictional elements in the construction of dramatic narratives. The theoretical analysis pervades the studies fields of Reception Aesthetics (ISER, 1996), memory (RICOUER, 2007) and narrative (RICOEUR, 2010), evidencing the relation between the author and the pursuit of her memories and life experiences, the matter to elaboration of writing. Then we intend thinking a reader-creator of herself, that at the same time she seeks in her memories the biographic aspects to her narrative, she converts this reality with the insertion of fictional elements from the imagination (SARTRE, 2008)
Resumo:
The aim of this study is to understand the perception of medical students at the Federal University of Rio Grande do Norte (UFRN) about humanization in the context of their medical formation, using a qualitative approach. The focus group and participant observation techniques were used, involving a multidisciplinary team composed of professionals from the areas of anthropology and psychology, as well as professors from the medical course, who studied two groups of nine students in their final year. The data were analyzed using the categorical thematic content analysis technique, from which emerged three categories: student/patient relationship, teaching/learning and student/professor relationship. The first allows us to identify that student-patient contact is an essential experience for adopting a more humanized view of the disease process. The second category shows that unqualified professors in the pedagogic practices inherent to the teaching profession and the theory the practical dichotomy hinder the autonomous and holistic formation of knowledge. Similarly, the lack of practices outside the academic environment and the absence of multiprofessional stimulation interfere in the construction of an integral view of the individual. From the third category, the student/professor relationship, emerge two opposing subcategories (professor model and assymetric relationships), which reflect the importance of the professor`s ethical humanist position, as opposed to an authoritarian attitude, to form the professional attitude of the student. The results point important aspects of the medical formation that may open a discussion about humanization, in the context of new national curricular guidelines
Resumo:
An important unsolved problem in medical science concerns the physical origin of the sigmoidal shape of pressure volume curves of healthy (and some unhealthy) lungs. Such difficulties are expected because the lung, which is the most important structure in the respiratory system, is extremely complex. Its rheological properties are unknown and seem to depend on phenomena occurring from the alveolar scale up to the thoracic scale. Conventional wisdom holds that linear response, i.e., Hooke s law, together with alveolar overdistention, play a dominant role in respiration, but such assumptions cannot explainthe crucial empirical sigmoidal shape of the curves. In this doctorate thesis, we propose an alternative theory to solve this problem, based on the alveolar recruitment together with the nonlinear elasticity of the alveoli. This theory suggests that recruitment may be the predominant factor shaping these curves in the entire range of pressures normally employed in experiments. The proposed model correctly predicts the observed sigmoidal pressure volume curves, allowing us to discuss adequately the importance of this result, as well as its implications for medical practice
Resumo:
No Brasil, a despeito das conquistas obtidas a partir da implantação do Sistema Único de Saúde e dos avanços legais e institucionais na atenção a diversos problemas relacionados ao gênero, a incorporação de temas relacionados aos direitos humanos, sexuais e reprodutivos no contexto da formação profissional em saúde permanece deficiente. Este trabalho teve como objetivos avaliar a inserção da temática saúde sexual e reprodutiva no currículo do curso de graduação em Medicina, por meio do emprego de avaliações de conteúdo cognitivo, procedimental e atitudinal. Trata-se de estudo de intervenção educacional envolvendo alunos do internato do curso de Medicina da UFRN. Foram utilizados os seguintes métodos avaliativos: prova escrita, exame clínico objetivo estruturado (OSCE) e Mini-CEX. Como variáveis explicativas foram consideradas o sexo, idade e participação prévia no componente curricular optativo Saúde Reprodutiva . A avaliação do processo constou da aplicação de questionários de satisfação e entrevistas acerca dos métodos avaliativos utilizados. Considerando os três métodos avaliativos empregados, 183 estudantes participaram do estudo, com média de idade de 24,5 ± 2,2 anos, sendo 52,5% do sexo masculino e 47,5% do sexo feminino. No contexto geral, observamos concordância entre os desempenhos dos estudantes nas avaliações de conteúdo cognitivo, procedimental e atitudinal. A participação dos estudantes no componente curricular eletivo Saúde Reprodutiva mostrou-se associada com melhor desempenho em algumas dimensões da avaliação cognitiva e na avaliação com o Mini-CEX, em relação às competências de anamnese, profissionalismo e qualidades humanísticas, relação médico paciente e desempenho global. A análise da fidedignidade entre os avaliadores na avaliação com o método OSCE mostrou-se adequada (alfa de Cronbach superior a 70%) em relação ao desempenho global e aos aspectos técnicos das competências avaliadas, observando-se baixa confiabilidade na avaliação da comunicação médico-paciente. O presente trabalho constitui-se numa experiência educacional inovadora e pioneira no âmbito da educação médica brasileira no que tange à inserção da temática de saúde sexual e reprodutiva na graduação, sugerindo-se um impacto positivo da iniciativa na formação do médico generalista na UFRN. A avaliação de conhecimentos, habilidades e atitudes em saúde sexual e reprodutiva na graduação de Medicina mostrou-se factível, com alta concordância entre os diferentes métodos empregados. Os métodos OSCE e Mini-CEX podem ser aplicados ao contexto da saúde sexual e reprodutiva, possibilitando a avaliação de competências clínicas relevantes para a formação do médico generalista e que habitualmente não são contempladas nas avaliações rotineiramente realizadas na graduação
Resumo:
Epilepsy is a chronic disorder of the central nervous system, most frequently characterized by abnormal electrical impulses in the brain. It is the oldest recorded neurological disease and has been surrounded by myths, mistaken beliefs and preconceptions. Three professionals work with epileptic patients on a daily basis: teachers, physical educators and physicians . This study aimed to analyze and compare the level of knowledge, preconceptions and attitudes of undergraduate students in the courses of Pedagogy, Physical Education and Medicine, future professionals who will deal with epileptic patients. This descriptive observational study was conducted with 286 university undergraduates of both sexes (women 99/34.6% and men 187/65.4%) from the first to fourth year of Pedagogy, Physical Education and Medicine courses at the Universidade Estadual Rio Grande do Norte (UERN), with mean age of 23 years. A validated and adapted 17-question questionnaire, divided into nine knowledge-based questions, five related to preconceptions and three on attitudes, was applied. Results allowed elaboration of a manuscript entitled Comparative Analysis of Knowledge, Attitude and Preconceptions in University Undergraduates of Pedagogy, Physical Education and Medicine Courses in Relation to Epilepsy. The findings of this article show that knowledge of epilepsy in the three groups is very satisfactory. The low level of preconception indicates that educational or clarifying information is being transmitted, albeit by television, a layman s information vehicle, which has undoubtedly contributed to reducing the stigma of epilepsy through educational information. Results also suggest a lack of knowledge on how to act during a seizure, especially in education professionals. Although there are limitations in our sample, the relevance and contribution of this study is to call attention to the importance and need for these future professionals to be informed and learn correct attitudes with respect to epilepsy during their academic formation. This is essential at a time when the disease is being brought out of the shadows. This research was supported by the Office of the Dean of Teaching, and Deans of Pedagogy, Physical Education and Medicine at UERN. The research was made possible by the multidisciplinary interaction among a physical educator, child neurologist and statistician, all contributing to achieving the aims set out here
Resumo:
The apparent virtuosity that if could wait of the globalization and the neoliberalism has given signals of deterioration in the contractual relations, especially in contracts of mass consumption, generating innumerable offensive situations to the basic rights and the goods constitutionally protected of the contractors. In the world of today, still that it does not reveal any desire, the individual practically is compelled to contract, for force of necessities and customs completely imposed, mainly in face of the essentiality of the services or agreed to goods. Ahead of as much and unexpected changes in the civil liames and of consumption, dictated for the globalization, it comes to surface the reflection if the private law e, more specifically, the civil law, meet prepared adequately to deal with these new parameters of the economy. The present dissertation has the intention to investigate if the globalization and the consequent neoliberalism, in this beginning of third millennium, will imply to revive of the principles and the basics paradigms of the contracts that consolidated and had kept, for more than two centuries, the liberal State. One notices that the study of this phenomenon it gains importance to the measure where if it aggravates the decline of the social State (Welfare State), with the embrittlement and the loss of the autonomy of the state authority, over all in countries of delayed modernity, as it is the case of Brazil, that presents deep deficiencies to give or to promote, with a minimum of quality and efficiency, essential considered public services to the collective and that if they find consecrated in the Federal Constitution, as basic rights or as goods constitutionally protecting, the example of the health, the education, the housing, the security, the providence, the insurance, the protection the maternity, the infancy and of aged and deficient. To the end, the incidence of constant basic rights of the man in the Constitution is concluded that, in the process of interpretation of the right contractual conflicts that have as object rights or goods constitutionally proteges, in the universe of the globalized perhaps economy and of the neoliberalismo, it consists in one of the few ways - unless the only one - that still they remain to over all deal with more adequately the contractual relations, exactly that if considers the presence of clauses generalities in the scope of the legislation infraconstitutional civil and of consumption, front the private detainers of social-economic power. To be able that it matters necessarily in disequilibrium between the parts, whose realignment depends on the effect and the graduation that if it intends to confer to the basic right in game in the private relation. The Constitution, when allowing the entailing of the basic rights in the privates relations, would be assuming contours of a statute basic of all the collective, giving protection to the man against the power, if public or independently private
Resumo:
A modeling of criterias and alternatives is through and applied a questionnaire based on method AHP to proprietors of gas stations. The considered alternatives had been the maintenance of the current state with electric energy of the deliverer and the generation in small scale based on the natural gas. The used criteria had been Cost of the Investment, Final Cost of the Energy, Operational cost, Ambient Benefits, Risk and Variation of Costs. The study it was carried through in the city of Natal, RN in ranks that make use of the natural as for resale, where the generation alternative on the basis of the available gas is present. The main results evidence in a dimension the viability of use of method AHP with questionnaire by means of validation of the judgments with analysis of variance beyond proper the normal mechanisms of analysis of consistency to the method. The main results of the analysis help to show that in this in case that the profile of models of criteria and judgments of the actors is similar, with the final evidence of that it has a dominance of the maintenance of the energy of the deliverer. The main criterion to influence this decision was the risk
Resumo:
According to great concern between the developed industrial activities and resultant impacts over the environment, an association of several factors have occurred, procedures to the efficient management of the rotation between economical development and the environment have been improved. A research in field have been realized inside building sites of companies in order to provide knowledge about the implemented and accomplish actions according to the resolution from CONAMA nº307. Trough the interview among the representations of the companies and photographic survey in loco, such as, what makes the companies implement this management, reutilization and recycling, transport and disposition. The present study had as objective: analyze the insertion of the used tools to residuals management, proposing improvements, in a way that it can be easily identified during the procedures execution in the building sites of the building companies of the city of Natal/RN. To reach the goal, in the first place a revision of the pertinent literature was performed; there for, it can be seen the relation between residues management and environment sustainability, once it happens in a continued way it may prevent the waste and reduces the risk that the activities way bring to the employees, community and environment; once found the great difficult faced with regard to labors, material, equipment, project, planning, costumer s interference, furnisher. And still, it could be verified wich materials generate greater indexes of residues in the works and the main occurrences of waste and loss. However a greater transparency is needed coming from the high administration in the commitment with the continued actions, to make it so, there must be a cultural change inside the company. There for there will be a greater productivity and quality of the under taking such as costumer s satisfaction
Resumo:
The industrial automation is directly linked to the development of information tecnology. Better hardware solutions, as well as improvements in software development methodologies make possible the rapid growth of the productive process control. In this thesis, we propose an architecture that will allow the joining of two technologies in hardware (industrial network) and software field (multiagent systems). The objective of this proposal is to join those technologies in a multiagent architecture to allow control strategies implementations in to field devices. With this, we intend develop an agents architecture to detect and solve problems which may occur in the industrial network environment. Our work ally machine learning with industrial context, become proposed multiagent architecture adaptable to unfamiliar or unexpected production environment. We used neural networks and presented an allocation strategies of these networks in industrial network field devices. With this we intend to improve decision support at plant level and allow operations human intervention independent
Resumo:
In this work, we present the GATE, an approach based on middleware for interperceptive applications. Through the services offered by the GATE, we extension we extend the concept of Interperception for integration with several devices, including set-top box, mobile devices (cell phones), among others. Through this extension ensures the implementation of virtual environments in these devices. Thus, users who access the version of the computer environment may interact with those who access the same environment by other devices. This extension is just a part of the services provided by the GATE, that remerges as a new proposal for multi-user virtual environments creation.
Resumo:
Furthered mainly by new technologies, the expansion of distance education has created a demand for tools and methodologies to enhance teaching techniques based on proven pedagogical theories. Such methodologies must also be applied in the so-called Virtual Learning Environments. The aim of this work is to present a planning methodology based on known pedagogical theories which contributes to the incorporation of assessment in the process of teaching and learning. With this in mind, the pertinent literature was reviewed in order to identify the key pedagogical concepts needed to the definition of this methodology and a descriptive approach was used to establish current relations between this conceptual framework and distance education. As a result of this procedure, the Contents Map and the Dependence Map were specified and implemented, two teaching tools that promote the planning of a course by taking into account assessment still in this early stage. Inserted on Moodle, the developed tools were tested in a course of distance learning for practical observation of the involved concepts. It could be verified that the methodology proposed by the above-mentioned tools is in fact helpful in course planning and in strengthening educational assessment, placing the student as central element in the process of teaching and learning