Qualidade da assistência e o conhecimento sobre o direito à saúde das pessoas com úlcera venosa crônica

The study aimed to identify the quality of care and knowledge of health rights of people with chronic venous ulcers (VU) in Brasilian National Health Care System (SUS). It is a cross-sectional study, with quantitative approach, performed at the University Hospital Onofre Lopes (HUOL). The study was approved by the Ethics Committee of HUOL (CAAE nº 0148.0.051.000-10). The sample by accessibility was composed for 30 people with VU treated at the outpatient surgical clinic of HUOL. For data collection we used a structured questionnaire composed of two parts: sociodemographic characteristics and of health, of care and the clinical course of VU; and knowledge of people with VU about the rights of health. The results were processed using SPSS 15.0 and analyzed by descriptive statistics. Given the characterizations sociodemographic and health presented, we identified a clientele of users with VU predominantly female (76,7%), aged from 60 years (66,7%), married/ stable union (60,0%), low education level (83,3%), family income lower than a minimum wage (73,3%), unemployeds and with chronic diseases (53,3%), sleep greater than or equal to 6 hours (76,7%) and were not alcoholics or smokers (93,3%). In relation to clinical conditions, were shown the presence of one or more relapses of VU (73,3%), predominance of granulation tissue/epithelialization in the bed of VU (60,0%), exudate serosanguineous (43,3%), in quantity medium/large (60,0%), with no predominance of presence or absence of odor (50,0%), all patients with tissue loss in grade III / IV, no signs of infection (73,3%) and presence of intense pain (50,0%). In the last 30 days the main venue of achievement of dressing was the HUOL (100,0%), the main compression therapy used was the Unna boot (60,0%) and on inability to perform the dressing on the unit were the own patients who made the exchange at home (40,0%). The majority of respondents listed out more positive factors associated with quality of care (56,7%) were satisfied with the care of SUS (76,7%), claimed to have knowledge about their rights (70,0%), but at the same time did not know the meaning of the acronym SUS (90,0%) and classified their level of information as inappropriate (70,0%). We realize that people with VU identified as good the quality of care and demonstrated inadequate knowledge about their rights to health in the SUS, but showed interest in acquiring more information. The basic rights to entry in the SUS are constitutionally guaranteed and need to be disseminated in order to make them known to the population, so it can be implemented and ensured a greater resolution assistance in treating this type of injury

Desigualdade regional da mortalidade neonatal no Brasil

In Brazil, despite the decline in infant mortality in recent decades it still has high rates going against recommended by WHO. Being the largest percentage of infant mortality rate composed of neonatal deaths. Objective: A study was conducted to analyze the spatial distribution of neonatal mortality and its correlation with the biological, socioeconomic and maternal and child health care in the Brazilian states in the period from 2006 to 2010. Method: The study made thematic maps and correlation (LISA) for verification of spatial dependence and multiple linear regression models. Results: Was found that there is no spatial autocorrelation for neonatal mortality in the Brazilian states (R = 0.002, p = 0.48). Most of variables were correlated (r> 0.3, p <0.05) with neonatal mortality, forming clusters in the North and Northeast, with the highest rates of teenage mothers, low household income per capita, lower prenatal appointments and beds of Neonatal Intensive Care Unit. The number of Neonatal UCI beds remained independent effect after regression analysis. Conclusion: The study concludes that regional inequalities in living conditions and especially the access to maternal and child health services contribute to the unequal distribution of neonatal mortality in Brazil

Humanização do atendimento à criança na atenção básica: visão dos profissionais

Objetivou-se compreender a humanização do atendimento à criança na Atenção Básica na visão dos profissionais. Estudo qualitativo, realizado em uma Unidade de Saúde da Família de Natal-RN, Brasil. Dezesseis profissionais responderam a um formulário contendo questões referentes ao atendimento à criança, à humanização e às práticas realizadas para humanizar o atendimento. Os dados foram categorizados por temas e analisados a partir dos princípios da Política Nacional de Humanização. Para os profissionais, humanizar o atendimento envolve acolher, escutar, aconselhar sobre o que está sendo realizado com a criança, valorizar a família, e tornar o sujeito ativo no atendimento, mesmo que de forma incipiente. A maioria dos profissionais descreveu atendimento que valorizava parte dos princípios da política de humanização, mesmo com dificuldades para implementá-los na rotina. Requer, portanto, estímulos e atualização dos profissionais para uma postura autocrítica sobre o atendimento

Terrenos de marinha: terras públicas com função social? um estudo da orla marítima de natal

This work has as its theme the social function of terrenos de marinha. Theresearch universe is the terrenos de marinha of Natal coastline, focusing on thefulfillment of its social function. Prescribed by law since the colonial period with thepurpose of protecting the coast and free movement of people and goods, theywere swathes of land not available to private use by individuals. With the transitionfrom the allotments system to the purchase and sale, regard to land access,crystallized with the creation of the Land Law in the nineteenth century, the land isheld as merchandise and terrenos de marinha, following this logic, also acquireexchange value and become capable of enjoyment by private individuals, with thecondition of tax payments to the state. This is seen until the twentieth century,when in 1988, primarily because of the Federal Constitution promulgation, begins anew cycle when is possible to use on terrenos de marinha the principle of thesocial function of property. From this perspective this study aims to identify thesocial function of terrenos de marinha in Natal, focusing on the public destinationand the use value of the city coastline. To this end, it was made a data collection inthe on-line information system of the Federal Heritage Department of Rio Grandedo Norte (SPU / RN) and in the terrenos de marinha areas, in order to find out ifthey had public or private use, or if they were empty lots, as well as if thepopulation access to the shore exist. Interviews with managers of the SPU weremade. The empirical study showed that the social function of terrenos de marinhain the city of Natal still didn´t happen, considering the constant existence of vacantlots in their areas, the lack of access in significant portions of the coastline and thereduced areas directed to common use along the coastline, minimizing its potentialof enjoyment by the population. It concludes by pointing to the existence of a newtransition phase on the terrenos de marinha, in witch, gradually, come up lawprovisions in the legal system and public policies to expand the purely taxcollection function attributed to this land for two centuries. In this direction, thesocial function of terrenos de marinha is embodied in concomitant adjustment ofthe tax collection function and the rescue of coastline use value, national heritageand a place for sociability and social relations development

Política de atenção à saúde do idoso em Mossoró/RN: potencialidades e possibilidades para promoção do envelhecimento saudável no estado do Rio Grande do Norte

It discusses the Health Care of the Elderly in the town of Mossoró, traversing the paths that discussed the history of health care, which has been altered by the new (con) formation and required adjustments of society which led the development and implementation of the National Health Care for the Elderly with the backdrop of the guiding principles of the Health System - SUS. The goals outlined were: To map the implementation of the policy of health care for the elderly in Mossoró considering whether this is based on the principles and guidelines of the NHS and National Health Policy of the Elderly; Check if health promotion is seen as a strategy that favors the elderly mossoroenses the possibility of healthy aging; identify the discourse of the elderly about the aging process and the strategies you use to take care of your needs. Applies as a methodological strategy BOAS, complemented by interviews with twenty (20) elderly residents of Mossoró with a view to understand the objective elements, and the political and subjective traits that express a regularity which marks the area of health care mossoroense elderly. The data were tabulated and the BOAS divided into nine sections for analysis. The speeches were transcribed seized and subjected to a thorough reading that allowed the visualization of issues that have been examined with theoretical and methodological support to the model proposed by Boaventura de Souza Santos (2006) designated this cosmopolitan reason being supported by three meta-sociological procedures, namely, the sociology of absences, the sociology of translation work and emergencies. It appears as a result the exclusion and discrimination of the elderly in different social settings, a condition that prevents them from being aware of their importance as citizens deserving of decent treatment and respect for the family, society and the government, when addressing health the elderly said the need to propose alternative models of care that has the paradigm of health promotion. We conclude that in these areas, meetings are held, to draw lines that were heterogeneous because they were built by the dissimilarities that engender incessantly and show that although we have advanced regarding the attention of the elderly in Mossoró there is still a long way to go in order to meet the needs revealed by the elderly. It is suggested that the practice of trial-creation-differentiation, while highlighting the historical and procedural dimension, deconstructions and negotiations with collective effects. A democratic paradigm and analytical creeps: the constitution are moments of Health Care for the Elderly shaping a new landscape in the town of Mossoró.

Saúde da família: uma estratégia de mudança no processo de produção dos serviços de saúde

The purpose of this study is to analyze, from the point of view of nurses, changes that took place in the process of providing health services after the introduction of the Family Health Program (FHP). It is na investigation of qualitative nature that uses semi-structured interviews as a main empirical approach tool. Six nurses from the city of Caicó, Rio Grande do Norte, who were working with basic care before the introduction of the FHP, within basic care, were: adscription and ties with the community; hospitality and the humanizacion of care-giving; decrease in cases of inpatient treatment; strengthening of the prevention of injuries and health promotion; improvemente of health indicatiors, finally, actions that point towads meeting the principles of wholeness, equity and universality as a declaration of the Brazilian National Health Care System (SUS). Nevertheless, in spite of all recognizable positive aspects, the FHP has some weaknesses, such as: the difficulty posed by colletive work; the mismatch between professional education and the demands of the current health standard; a poor physical infrastructure of the Basic Health Units; a high heath staff turnover and precarious work conditions. In addition to this, some strategies that can be used to help improve the process of providing health services have been pointed out, such as, coordination between sectors, continuous education, making work conditions less precarious and improving the means whereby heathy service management is conveyed,Tthus, finally, we understand that the FHP does bring forward meaningful changes to the process of provinding health services to strengthen the Brasilian National Health Care System (SUS), in spite of the fact that it lies within a scenario of adversities that can be overcome through the collective endeavor of the several social actors

Práticas populares de cuidado à criança: o saber/fazer de cuidadoras

Popular practices correspond to the resources used by households, lay people and popular therapists, whose perception of knowledge is constructed in the everyday. In this context, the sick child can become vulnerable to be dependent on a family caregiver, who often decide to employ popular practices. Thus, the child care should be shared between carer and health professional. However, they know little about the resources that the family uses to detect a grievance in infant. Therefore, the present research aimed to analyse the use of popular practices by caregivers of children with zero to five years old. We conducted an exploratory and descriptive study with a qualitative approach, together with 15 caregivers of children who were treated at the Joint Unit Felipe Shrimp, located in Natal, Rio Grande do Norte, Brazil. To select the participants, they should be age and above 18 years; be caregivers of children up to five years of age; and reside in the area ascribed the Joint Unit Felipe Shrimp. The data collection took place between September and October 2013, through in depth interview. This step was preceded by the approval of the Health Department of the city of Natal; the direction of the Joint Unit Felipe Shrimp; as well as, the Committee on Ethics in Research from the Federal University of Rio Grande do Norte with Certificate of Presentation and Consideration Ethics, No 15467013.8.0000.5537. Furthermore, the interviewees formally authorized their participation in the research by signing the consent form. The data were treated according to the technique of content analysis in the form of thematic analysis according to Bardin. This process, four categories emerged: "Types of popular practices used in the care of the child"; "Source of information of popular practices"; "Results obtained with popular practices"; "Factors that hinder the adoption of common practices." The results showed the use of popular practices by caregivers in the case of illness to children such as the homemade preparations with medicinal plants and folk healers. The family environment was referenced as the main learning space and spread of popular practices, which are influenced by cultural relations present in this context. As to the results obtained with popular features, the caregivers said to be satisfactory, and this triggers a feeling of confidence and acceptability of such measures. It is concluded that the use of popular practices in child care persists in everyday most of the participants, despite the hegemony of allopathic therapy. The caregivers stated that such practices are effective and easy to obtain, being secured in context by popular culture. In addition, health professionals, especially nurses, were seldom mentioned by the caregivers as to the information concerning popular resources used by them, which suggests the weakness in dialogic process of negotiating practices between both of them

SISOnt: sistema de informação em saúde baseado em ontologias

The sharing of knowledge and integration of data is one of the biggest challenges in health and essential contribution to improve the quality of health care. Since the same person receives care in various health facilities throughout his/her live, that information is distributed in different information systems which run on platforms of heterogeneous hardware and software. This paper proposes a System of Health Information Based on Ontologies (SISOnt) for knowledge sharing and integration of data on health, which allows to infer new information from the heterogeneous databases and knowledge base. For this purpose it was created three ontologies represented by the patterns and concepts proposed by the Semantic Web. The first ontology provides a representation of the concepts of diseases Secretariat of Health Surveillance (SVS) and the others are related to the representation of the concepts of databases of Health Information Systems (SIS), specifically the Information System of Notification of Diseases (SINAN) and the Information System on Mortality (SIM)

Estimativa populacional e uso do hábitat do boto-cinza (Sotalia guianensis) no litoral sul do Rio Grande do Norte

Four areas are known as of frequent usage by Guiana dolphins (Sotalia guianensis) in the south coast of Rio Grande do Norte state, northeast Brazil: Tabatinga, Pipa, Lagoa de Guaraíras and Baia Formosa. This extension of 40 km of shoreline is under increasing anthropogenic impacts due to continuous development of the coastal areas and vessel traffic. The objective of this study was to investigate aspects of population biology and habitat use of the population of Sotalia guianensis in the south coast of Rio Grande do Norte. It was applied the photo-identification technique and posterior methods of capture-recapture for population estimation (POPAN extension in MARK). The distribution, movement and site fidelity of the dolphins were analyzed trough the geographic information system (GIS) and group characteristics and behavior trough non-parametric statistics. Field work was conducted on board a 10m motor vessel from March 2008 to March 2009. Photo-identification effort was 329h with 113h of direct observation of the dolphins. The population estimatives for each area: Tabatinga: 75 (63-92); Pipa 105 (88-129); Lagoa de Guaraíras: 27 (18-54) e Baia Formosa: 112 (89-129) individuals. Total population estimative was: 223 (192 a 297). High site fidelity was detected for only part of the population (<15%) as low site fidelity and transients individuals were also detected (>20%). It was observed frequent movements between Tabatinga, Lagoa de Guaraíras and Pipa, but not Baía Formosa. This suggests a division in two communities along this shore extension: one in Pipa and other in Baía Formosa. Group size was small, most groups with up to 10 dolphins. The areas were use intensively, only in Lagoa de Guaraíras dolphins were not seen in all field trips. Lagoa de Guaraíras is an area used by small groups exclusively for foraging. In Tabatinga and Pipa dolphins concentrated close to the shore, in the inner sector of the area and the main activity is also foraging. Significant larger groups were seen in socializing behavior but there was no difference in group size between the inner and external sectors of the area. The presence of calves and juveniles were significant greater in the inner areas of Tabatinga and Pipa, confirming the hypothesis that these beaches are also used for parental care. In Baia Formosa dolphins concentrated in the outer sector and foraging was also predominant. Significant larger groups were seen in the outer sector, mainly engaged in mixed behaviors of travel/foraging, possibly in some kind of group foraging. Calves and juveniles were significant more present in the outer sector where group size was also larger. In general there was no difference in area usage and period of the day. Sotalia guianensis has characteristics that make the species vulnerable to human activities such as small population concentrated in patches of suitable habitats restrict to coastal areas. We hope that this study bring new information for the species and help for the adequate management of the area in order to assure the presence of the dolphins as well as its behavior pattern and gene flow betweencommunities.