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

O direito à saúde: a medida do dever do estado de fornecer Medicamentos de dispensação excepcional à sociedade sob a ótica do desenvolvimento

It is a fact that the fundamental rights of citizens are being recognized and guaranteed by the state over time, regardless of the belief that if these rights has always been part of the heritage of subjective individuals, or whether they will be aggregated during the course of human history. In that, emerged the rights of freedom of men and, subsequently, the rights to create a situation of equality between the humans, the so-called social rights. In turn, as these rights known as social, to be implemented, need a positive action by the state, more precisely by the state power whose function is to manage public money and create policies for implementation of fundamental rights. Given this, pay attention to the right to health, was created the Programa de Medicamentos de Dispensação Excepcional, which aims to provide high-cost medicines to citizens Brazilian carriers of serious diseases, such as Alzheimer's and Mal Hepatitis C. Also on the program, it provides a way which will be mandatory that the drugs will be offered in such situations, and does not include a means of updating the list predicted able to monitor the progress of medicine that have been in the interest of the program. Given that, at present it is necessary to mention the recognition of another fundamental right: the right to development, which is the right of access to positive actions being implemented by the State, which are nothing more than public policy, gender which the Programa de Medicamentos de Dispensação Excepcional is kind. Thus, through the search in legislation and doctrine in relation to the theme, this work has the aim to examine the extent of the state to provide exceptional dispensing of medicines. Specifically, if the State in attention to the right to development and the implementation of the right to health, can really list exhaustively the drugs to be provided by the State, and what are the elements guiding this choice and how to control the same

A medida cautelar na ação direta de inconstitucionalidade: uma abordagem pela perspectiva do princípio do acesso à justiça

The present study deals with the caution measure in the direct action of inconstitutionality. The treatment given to the approach is through the principle of access to justice. For this, a construction of the juridical content in the principle of access to justice is proposed, without losing the focus of its characteristic as a metajuridical principle, which is presented in the constitutional field as a fundamental right, generator of a new universality, destined to guarantee the prevalence of an adequate juridical tutelage. Some challenges of the concretizing hermeutics are still shown to give way to principle of access to justice, dealing with certain limitations and proposals. The direct action of inconstitutionality in face of the dissertation, begins to focus on the presentation of the tutelage of urgency, differentiating it from the other brief tutelage and elevating it to the condition of instrument which is indispensable to the principle of access to justice. In the most specific field of the abstract control of constitutionality, the characteristics of the objective process are defined, their sources, amongst which the regimental norms of the Federal Supreme Court and their role in the new constitutional reality. Finally, the caution measure in the direct action of inconstitutionality is presented by the perspective of principle of access to justice, identifying some points: the interpretations of the principle of the natural judge to adapt him to the aspect of continuous and temporarily adequate juridical account, especially when concerned to emergency; the analysis of facts in the direct action; the bonding objective effects and the erga omnes; the effect over the factual and normative plan; the effect of the caution measure over other processes and over the prescriptional course; the polemic of the possibility of caution measure in direct action of inconstitutionality through omission

Objetiva(ação) da medida e contagem do tempo em práticas socioculturais e educativas

This thesis describes and analyzes various processes established and practiced by both groups about the socio-cultural objective (action) the measurement and timing, mobilized some socio-historical practices as the use of the gnômon of the sundial and reading and interpretation of movements celestial constellations in cultural contexts such as indigenous communities and fishermen in the state of Pará, Brazil. The Purpose of the study was to describe and analyze the mobilization of such practices in the socio-historical development of matrices for teaching concepts and skills related to geometric angles, similar triangles, symmetry and proportionality in the training of mathematics teachers. The record of the entire history of investigation into the socio-historical practice, the formative action was based on epistemological assumptions of education ethnomathematics proposed by Vergani (2000, 2007) and Ubiratan D'Ambrosio (1986, 1993, 1996, 2001, 2004) and Alain Bishop conceptions about mathematics enculturation. At the end of the study I present my views on the practices of contributions called socio-cultural and historical for school mathematics, to give meaning to the concept formation and teaching of students, especially the implications of Education Ethnomatematics proposed by Vergani (2000) for training of future teachers of mathematics

A concepção de ensino sob medida na obra hygiene mental e educação (1927), de Luiz Antônio dos Santos Lima

This dissertation examines the concept of the personalized teaching proposed by the physician and educator from Rio Grande do Norte Luiz Antonio dos Santos Lima, in his doctoral thesis "Mental Hygiene and Education," published in 1927. To do so, we start from the assumption that this thinker appropriated part of the educational theory formulated by Èdouard Claparède - specifically, in the case of the teaching concepts of the personalized teaching and comprehensive education designed by the Swiss intellectual - and, considering the Brazilian social reality of early twentieth century, reframed these concepts, adapting them to the country context. To implement the proposed idea, the bibliographical study was the option chosen, and so was done through a theoretical research which had as a reference authors whose studies referred to the Brazilian historical moment in the late nineteenth and early twentieth century, our examined time frame. As for the understanding and the methodological analysis of discourse, seen as socially constructed, the Foucault postulations were studied under an analytical approach, in which the disciplinary society is analyzed from the relations of power and knowledge that exist in it. The main source of this research was the work of "Mental Hygiene and Education," published as a requirement to the obtainment of Luiz Antonio s medical degree by the Rio de Janeiro Medicine School. Thus, it was found that the conception of personalized learning to the comprehensive education of students, as proposed in the doctoral thesis of Luiz Antonio dos Santos Lima, was related to abnormalities of mental character that children could present. School education was thought in a way by the potiguar thinker that it could be applied as deep as the moral, intellectual and behavioral deviations of the individual were, making use of hygiene practices of the minds through a normalizing process towards a civilized and developed future of the Brazilian nation which would manage, watch and fix the thoughts of the school students

Corpo e saúde: reflexões sobre o quadro "Medida Certa"

The present scenario is permeated by different comprehensions about the body and health. These are the result of a historical process experienced by men in different times and social contexts through which were being built. Faced this scenario, we emphasize the media as a powerful means of information and training ideas regarding the body and health of theses. The media also as a means of mediating information we present characteristics of the social scenario where is inserted. In our research we bring reflects about the comprehensions, knowledge and practices propagated by the way the body and health under "Medida Certa" of the program Fantastico the broadcaster Globo Telecommunications, in order to identify how Physical Education, has contributed the construction of knowledge disseminated. Therefore, we focus our analysis to the table "Medida Certa" exhibited by Fantastico in the months of April, May and June of 2011.The data for analysis were collected through the videos shown live in Fantastic and the information provided in the blog that table. Thus, we had 14 videos shown live, 16 videos posted on the blog, 97 posts in blog. As technique of analysis of the datas used of content analysis of the Bardin (2011). About body obtained as analytical categories: body as operating system; biological body; fragmented body exterior to the subject; body trailer quantified to patterns; subject body. How to health we analyze the categories of health existential: health existential based in biological indices of normality; health existential associated with weight loss and aesthetic patterns; health existential associated with physical activity and nutritional control; and finally we propose a comprehension of health existential. Therefore, from the analysis of the data evidenced a predominance of comprehensions, knowledge and practices about the body and health guided the biological constituents of the body, quantification and classification in medium and normal patterns on pervasive forms of care, in the linear association among physical activity and nutritional control with health, evidenced that Physical Education has contributed to these constructions, through some of his discourses with emphasis on biological aspects. Thus, in our study we advocate an understanding of not only the body as object, but also as a subject clipped by organic, cultural, historical and social elements, a living body, feeling, desire and above all expresses itself, and health viewed as something body, interlaced through the biological, cultural, historical and emotional aspects of this body that coexist in this society

Qualidade de vida medida pelo "WHOQOL-bref": estudo comparativo de pacientes em hemodiálise e pós-transplante renal

Exploratory descriptive study, prospective with quantitative approach, performed in the nefrology outpatient service from the Onofre Lopes University Hospital (HUOL), Natal/RN, aiming to identify aspects that concern Quality of Life (QOL) on transplanted and hemodialysis patients, as measured by WHOQOL-bref and describe the aspects that differentiate QL between the two groups as measured by the same instrument. The population was of 62 renal patients in hemodialysis and 58 transplantd, with data collected from february to march 2006. The instrument used was WHOQOL-bref, translated to and validated for Portuguese by the multicentric group of the World Health Organization (WHO) in Brazil. The results show predominance of the masculine gender both in the post-transplant group (55,17%), as well as in the hemodialysis group (51,61%); the age strip of 28 to 43 prevailed, among which were 53,45% transplanted and 48,99% hemodialysis patients; 79,93% of the hemodialysis patients and 62,07% of the transplanted were provenient from ouside the capital of the state; from the hemodialysis population, 59,68% were married, while among the transplanted 48,28% were single; 58,06% of the hemodialisys patients had 1 to 3 children, while the majority of the transplanted, 44,83%, had no children; regarding scholarity level on both groups, there was a predominance of incomplete fundamental school, representing 62,9% of the hemodialysis patients and 46,6% of the transplanted; regarding work status, 98,39% of those in hemodialysis informed not to be working, and the same applied to the transplanted, with 75,86%; regarding treatment time, most patients of both populations were in the 1- to 4-year interval, of which were 62,9% of the hemodialisys patients and 53,45% of the transplanted. The analysis of WHOQOL-bref reliability through Crobach s Alpha coefficient had a value of 0,8816, demonstrating good internal consistency for the instrument. Regarding description of QOL tests, the average scores of the post-transplant were (Q-1) 18,14 e (Q-2) 18,69, and 12,3 (Q-1) and 11,29 (Q-2) for the group in hemodialisys. Regarding the aspects that differentiate QOL on the two groups observed through average scores from the Domains: Physical, 15,91 for the post-transplant group and 12,71 for the hemodialisys group; Psychological, 16,75 for the post-transplant group and 14,84 for the hemodialisys group; Social Relations, 17,79 on the post-transplant group and 16,58 on the hemodialisys group; Environment, 14,16 on the post-transplant group and 12,38 on the hemodialisys group. On every evaluated item, the post-transplant group achieved higher scores when compared to the hemodialisys group. The diference in QOL for both populations was significant on all items evaluated with a p<0,005

Validação de instrumentos para avaliação da habilidade e do conhecimento acerca da medida da pressão arterial

This study aimed to validate tools for evaluating the ability and knowledge about blood pressure (BP) among nursing students. It is a cross-sectional, descriptive, quantitative and methodological study accomplished at the Universidade Federal do Rio Grande do Norte (UFRN), Universidade do Estado do Rio Grande do Norte (UERN) and a private university of the state. The sample consisted of 27 judges of research selected from the inclusion criteria: nursing, teachers of the semiology and/or semiotics discipline, with at least 1 year of experience, being from UFRN, EEN, UERN and private university of the state and and agree to participate voluntarily with the signing of the consent form. The research was development in three stages: construction of two instruments based on the scientific literature, resulting in a structured checklist consists of 28 items and a knowledge questionnaire with 12 questions; submission of the instruments to the judges, in the period from June to September 2012, which should evaluate each item in appropriate , appropriate with changes and inappropriate , addition to making an overall assessment of each instrument based on 10 requirements; validation and verification to the level of agreement among the judges, through the application of Kappa and Content Validity Index (CVI). Was used the consensus level greater than 0.61 (good) to the Kappa index and greater than 0.75 for CVI. Was approved by the Ethics in Research / HUOL. After being coded and tabulated, the data were analyzed using descriptive statistics. Of the 27 judges who evaluated the instrument, 77.8% are female, with a mean age of 36.6 (± 9.0) years, 63.0% worked in UFRN, 74.1% had academic master and 63.0% worked exclusively on teaching. Average length of teaching experience was 7.9 (± 8.0) years and in the semiology and/or semiotics discipline of 5.5 (± 6.7) years. In the judgment of structured checklist and questionnaire of knowledge about blood pressure mensurement any item/question was considered inappropriate since all obtained level of agreement within the indices established (CVI> 0,75 E Kappa> 0.61). In relation to structured checklist, of those 28 items present, 9 showed perfect concordance index (CVI = 1.00, Kappa = 1.00) and another 19 were considered appropriate with changes, especially with regard to clarity and vocabulary. In the questionnaire of knowledge, among the 12 questions that comprised, 7 had perfect concordance index and the others were considered appropriate with changes as requirements as clarity, vocabulary, and feasible sequence of instructional topics. In terms of a overall evaluating of instruments, the structured checklist got CVI of 0.94 and Kappa of 0.89 and the knowledge questionnaire, CVI of 0.97 and a kappa of 0.94. Both instruments proved to be valid as to their content, configuring it as clear and objective tools of assessment of knowledge and ability on blood pressure, being of nursing students as well as others students and health professionals, since the use of valid measures seeking to reduce the risk of distorting the results

Separação cega de fontes lineares e não lineares usando algoritmo genético, redes neurais artificiais RBF e negentropia de Rényi como medida de independência

Conventional methods to solve the problem of blind source separation nonlinear, in general, using series of restrictions to obtain the solution, often leading to an imperfect separation of the original sources and high computational cost. In this paper, we propose an alternative measure of independence based on information theory and uses the tools of artificial intelligence to solve problems of blind source separation linear and nonlinear later. In the linear model applies genetic algorithms and Rényi of negentropy as a measure of independence to find a separation matrix from linear mixtures of signals using linear form of waves, audio and images. A comparison with two types of algorithms for Independent Component Analysis widespread in the literature. Subsequently, we use the same measure of independence, as the cost function in the genetic algorithm to recover source signals were mixed by nonlinear functions from an artificial neural network of radial base type. Genetic algorithms are powerful tools for global search, and therefore well suited for use in problems of blind source separation. Tests and analysis are through computer simulations

Um modelo de unidade de medida inercial utilizando três acelerômetros triaxiais

No espaço tridimensional, um corpo rígido qualquer pode efetuar translações e ou rotações em relação a cada um de seus eixos. Identificar com precisão o deslocamento realizado por um corpo é fundamental para alguns tipos de sistemas em engenharia. Em sistemas de navegação inercial tradicionais, utilizam-se acelerômetros para reconhecer a aceleração linear e giroscópios para reconhecer a velocidade angular registrada durante o deslocamento. O giroscópio, entretanto, é um dispositivo de custo mais elevado e com alto consumo de energia quando comparado a um acelerômetro. Essa desvantagem deu origem a pesquisas a respeito de sistemas e unidades de medidas inerciais que não utilizam giroscópios. A ideia de utilizar apenas acelerômetros para calcular o movimento linear e angular surgiu no início da década de 60 e vem se desenvolvendo através de modelos que variam no número de sensores, na maneira como estes são organizados e no modelo matemático que é utilizado para derivar o movimento do corpo. Esse trabalho propõe um esquema de configuração para construção de uma unidade de medida inercial que utiliza três acelerômetros triaxiais. Para identificar o deslocamento de um corpo rígido a partir deste esquema, foi utilizado um modelo matemático que utiliza apenas os nove sinais de aceleração extraídos dos três sensores. A proposta sugere que os sensores sejam montados e distribuídos em formato de L . Essa disposição permite a utilização de um único plano do sistema de coordenadas, facilitando assim a instalação e configuração destes dispositivos e possibilitando a implantação dos sensores em uma única placa de circuito integrado. Os resultados encontrados a partir das simulações iniciais demonstram a viabilidade da utilização do esquema de configuração proposto

Medida indireta de temperatura de corpos imersos em plasma

O gradiente térmico da superfície para o interior do sólido depende da taxa de colisões das partículas e da condutividade térmica do material utilizado. Quando um sólido é imerso em plasma, a transferência de energia ocorre por radiação e colisões das partículas sobre a superfície do material. Dependendo da taxa de colisões das particulas e da condutividade térmica do sólido existirão gradientes térmicos da superfície para o interior das amostras, ocorrendo picos térmicos na superficie, ou seja, o aquecimento pontual nas regiões de colisões. A fim de estudar esse efeito, amostras de aço rápido AISI M35 cujos valores de dureza são fortemente sensíveis à temperatura de revenimento, foram utilizadas como micro sensores térmicos. Amostras foram temperadas em forno resistivo e, em seguida, parte das mesmas foram revenidas em forno resistivo e a outra parte em plasma. A partir do gráfico da dureza (Hv) em função da temperatura (T) das amostras revenidas em forno resistivo foi possível obter uma função Hv(T) para determinação indireta do perfil térmico das amostras tratadas em plasma. As amostras foram revenidas em plasma utilizando temperatura de referência igual a 550 oC. Em seguida foi obtido o perfil de dureza dessas amostras ao longo da seção transversal e, subsequentemente, o perfil de temperatura. Verificou-se que amostras tratadas em plasma, ao contrário daquelas tratadas em forno resistivo, apresentaram gradiente de temperatura da superfície para o núcleo. Além disso, verificou-se que as amostras tratadas em configuração planar apresentaram gradientes térmicos inferiores àquelas tratadas em configuração cátodo oco, variando de 20 a 120 °C, respectivamente

Modelos de sobrevivência com fração de cura e erro de medida nas covariáveis

In this work, we study the survival cure rate model proposed by Yakovlev et al. (1993), based on a competing risks structure concurring to cause the event of interest, and the approach proposed by Chen et al. (1999), where covariates are introduced to model the risk amount. We focus the measurement error covariates topics, considering the use of corrected score method in order to obtain consistent estimators. A simulation study is done to evaluate the behavior of the estimators obtained by this method for finite samples. The simulation aims to identify not only the impact on the regression coefficients of the covariates measured with error (Mizoi et al. 2007) but also on the coefficients of covariates measured without error. We also verify the adequacy of the piecewise exponential distribution to the cure rate model with measurement error. At the end, model applications involving real data are made

Amor como medida de satisfação marital

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Medida da preditividade de instrumentos psicológicos nas avaliações psicológicas de condutores

The object of this study was to identify the possibility of predicting the involvement in traffic infractions from the results of the psychological tests carried out by psychologists specialized in the process of driver licensing in the state of Rio Grande do Norte (RN). The proposal consisted in identifying the penalty points recorded in national driving licenses (CNH) and identifying the corresponding tests and scores obtained, verifying if the average scores in the tests of drivers with and without an infraction record were significantly different and if there is any relation between the test scores and the frequency of the infractions. The results of the psychological instruments were collected in two moments the first being in the act of acquisition of the CNH and the second being during license renewal at the only certified clinic and at the DETRAN-RN. A population of 839 drivers of 14 municipalities were identified. 127 protocols of psychological tests were identified in the records of the DETRAN-RN (2002) and 76 at the clinic (2007), pointing out failures in the process of safekeeping of the psychological material, as well as in its retrieval from the record files. The sample was thus reduced to 68 drivers, all male, with age range between 18 and 41 years old, mean of 21,72 years old (DP = 5,24). 54 drivers were identified without a record of infraction, and 14 with a record. The latter committed 29 infractions. The penalty points recorded in their CNH ranged from 0 to 35 and the typical value of points (median) was zero. In the group with a record of infractions the number of points ranged between 3 and 35, mean of 10,79 (DP = 7,73). Differences were observed in the composition of the battery of tests in the two moments with the same subjects. The use of different tests to assess the same construct of the subject, first and second moment of assessment, did not allow for some analyzes with more efficient statistical proof. It was pointed out that five tests were not carried out and 118 were not corrected/analyzed. Significant differences between the groups were not identified with the psychological instruments used. In another attempt to establish differences between the means, the application of the independent t-Test evidenced a significant difference in the scores of the instruments of concentrated attention in 2002 (t = 2,21, gl = 25, p = 0.037) and of diffuse attention in 2002 (t = 2,37, gl = 24, p = 0.026). The results also did not evidence significant correlation between the scores of the tests and the penalty points of the infractions. Based on this study, it cannot be concluded with precision that the high or low scores are good criteria to determine that a driver will commit more or less traffic infractions, nor that the drivers with higher scores in the tests commit less infractions and vice-versa. Furthermore, the problems to find the instruments and the most basic data require a stronger monitoring on the part of the certified clinic and of the DETRAN-RN.

Adolescência e violência: um estudo da medida socioeducativa de prestação de serviço a comunidade no município do Natal

This Project was built to reflect about juvenile violence and the socio-educational´s range of community services provision. It is known that the juvenile violence is a phenomenon inserted on the capitalism system, backed on neo liberal project. Though, it is essential a historical analysis, showing the economical, political, social and cultural mechanisms which determine the juvenile violence personality. On this way, it is seek understand the elements that leads on work world changes, on the State and public politics sphere, that deepens social dissimilarities. On this propose, it is known that there is a relation among the violence, while one of many manifestations of social question on society and the macroestructuals´determinant that lead the teenager to a social rick situation. This research focused on a inquiry quail-quantitative, using the theoric-metodological procedures of observation, interview and documental quest techniques. The universe had been defined by the intentional sample of 22 interviewed on total, during August and October 2008, covering adolescents and their relatives, technical and the coordinator, which subsidized the Socio educational program of community services provision from Natal analysis of limits and their range. The results of this investigation indicate the necessity of development, with the teenagers authors of infringement acts, a care system that is grounded on a professional formation, respect on human rights and citizenship conquest, regarding that children and teenagers are designed as people on development, that have theirs rights and integral protection, being the State, society and family responsibility assure the integral development of them