Influência de fatores biopsicossociais sobre a mortalidade de idosos no município de Santa Cruz/RN: um estudo prospectivo

The aging process if characterizes for a complex events network, from multidimensional nature, that encloses biological, social, psychic and functional aspects. The alteration of one or more aspects can speed up the aging process, anticipating limitations and until the death in the aged. For an adjusted confrontation of this question is necessary an interdisciplinary vision, in which the some areas of the knowledge can interact and with this to intervenes of the best possible form. Then, information derived from studies of aspects related to incidence, morbidity-mortality and transition patterns, involved in the health-illness process can more accurately identify risk groups thereby establishing links between social factors, illness, incapacity and death. Thus, this study aimed to identify, by a multidimensional vision, the risk factors of mortality in a coorth of elderly in a city in the interior of the state of Rio Grande do Norte (RN), Brazil. A prospective study carried out in Santa Cruz RN, where 310 elderly were randomly selected to form a baseline. The follow-up was 53 months. The predictive variables were divided into sociodemographic, physical health, neuropsychiatric and functional capacity. The statistical analysis carried out by bivariate analysis, survival analysis, followed by binary logistic regression and Cox regression, in the multivariate analysis, considering significant levels p < 0.05 and confidence interval (CI) of 95%. A total of 60 (19.3%) elderly died during the follow-up, where cardiovascular disease was the main cause. The survival was approximately 24.8 months. The study of general survival showed, at 12, 24, 36, and 48 months of observation, a survival rate of 97%, 54%, 31%, and 5% respectively, with a statistical difference in survival only observed for the variables of cognitive function and Basic Activities of Daily Living. In the logistic regression analysis, the risk factors identified were cognitive deficits (OR = 8.74), poor perception of health (OR = 3.89) and dependence for Basic Activities of Daily Living (OR = 3.96). In the Cox analysis, as well as dependence for Basic Activities of Daily Living (HR = 3.17), cognitive deficit (HR = 4.30) and stroke (CVA) (HR = 3.49) continued as independent risk factors for death. The risk factors found in the study can be interpreted as the primary predictors for death among elderly members of the community. Therefore, improvements in health conditions, with actions towards sustaining an autonomous life with special attention for elderly with cognitive impairment, could mean additional healthy quality of life, resulting in the reduction of premature mortality in this population

Otimização do Uso das Águas da Barragem Santa Cruz-RN

The semiarid potiguar presents a quite discrepant. It is a region with one of the highest rates of artificial lake the world, but the policy of building dams to mitigate the problem of water scarcity does not solve, given that they have not demonstrated the ability to ensure supply human priority during periods of great drought and fail to solve the widespread demand existent in the semiarid. This work aims to present the optimal allocation of water, according to multiple uses and limited availability of water resources in the reservoir, from the simulation of the operation of the same, with the application of techniques to support decision making and performance evaluation alternatives for water use. The reservoir of Santa Cruz, the second largest reservoir of RN with storage capacity of approximately 600 million cubic meters, located about 20 km from the town of Apodi in RN, was conceived as a way to promote economic development in the region as well as the water supply of nearby towns. The techniques used are the simulation model of network flow ACQUANET and also the set of performance indicators. The results showed that the container has the capacity to serve up to 3,83m3/s flow required by existing uses, without any compromising the same. However, it was also observed that all anticipated future demands are implemented it will generate failures in meeting some uses

Síndrome da fragilidade e fatores associados em idosos comunitários do município de Santa Cruz RN

The frailty in the elderly is characterized by decreased physiological reserves, and is associated with increased risk of disability and high vulnerability to morbidity and mortality. This study is part of a multicentric project on Frailty in Elderly Brazilians (REDE FIBRA). Aims: to investigate characteristics, prevalence and associated factors related to frailty. Metodology: We interviewed 391 elderly patients aged 65 years, selected randomly. Data collection was performed using a multidimensional questionnaire containing information about socio-demographic and clinical variables. To characterize the frail elderly, was considered the phenotype proposed by Fried. Data were analyzed using descriptive statistics, bivariate analysis (χ ²) and binary logistic regression. Results: The prevalence of frailty was 17.1%. In the final model of multivariate analysis, was obtained as factors associated with frailty: advanced chronological age (p <0.001), have comorbidity (p <0.035), show dependence on performing basic activities of daily living (p <0.010) and instrumental (p <0.003) and have poor perception of health status (p <0030). Conclusions: The factors associated with frailty suggest a predictive model helping to understand the syndrome, guiding actions that minimize adverse effects on the aging process

Saúde física e emocional de cuidadores da cidade de Santa Cruz-RN: perfil epidemiológico e fatores associados

Taking care for an impaired elderly is a hard and costly task that could affect directly the caregiver health. The purpose of this study was to evaluate the physical and mental health of elderly caregivers from the city of Santa Cruz-RN and analyze the potential correlated factors through an observational analytic design of a crosssectional. A multidimensional questionnaire was used to evaluation of the social demographics characteristics and those related to the care activity, as well as the caregivers´ physical and mental health. It was realized a descriptive analyze using frequency distribution and measures of the central tendency and dispersion to description of the caregivers. To verify the magnitude of the association between the variables was used the bivariate analysis through the Pearson and Spearman correlations and qui-square test. To evaluation of the association of the correlated factors to the adverse outcome with the caregivers´ physical and mental health was made a multivariate analysis by logistic binary regression and multiple linear regression models. The final sample was constituted by 304 persons, mostly women with a mean age of 50.3 ±16.8 years. The principal factors related to the physical health were age, stress and life satisfaction. Be a male caregiver, caring for a little while the elderly with cognitive deficit and not been spouse were related to worse mental health. Have worse physical health, high stress, depressive symptomatology, burden and low levels of satisfaction were also related to the mental health. After adjust through multiple linear regression was observed R2 values of R2=0,21 for Stress, R2 =0,17 for Depressive Symptomatology, R2 =0,21 for Burden and R2 =0,16 for Satisfaction. The attainment of the factors associated with caregiver´s health can help in the elaboration of specifics politics witch the goal is the integral attention to the elderly and his caregiver. The inability of continuous taking care could result in adverse outcomes such as institutionalization, impairment and death

Turismo religioso na cidade da santa: a percepção da comunidade sobre a construção do Complexo Turístico e Religioso Alto de Santa Rita, Santa Cruz/RN

The general objective of this study was to analyze the city of Santa Cruz cope with the impacts of the changes caused by the insertion of religious tourism with the construction of the Tourist Complex Religious Alto de Santa Rita, and specific objectives: to identify the economic activities from building the Tourist Complex Religious Alto de Santa Rita with the monument of Santa Rita; describe the research scenario to respect the traditions, rituals and spatial organization of the city and to evaluate the impacts through construction of movement by Religious Tourism Complex human capital and economic development fostered by Religious Tourism. To this end, we used the methods of application of Questionnaires and interviews, as well as the method was conducted participant observation, individual and systematic, having exploratory held through a correlational analysis regarding the impacts by inserting Tourism religious elsewhere. Was performed also discourse analysis of speeches Stakeholder city of Santa Cruz / RN for understanding the local reality. Literature search was performed readings of books, articles, theses and dissertations dealing with the issue, it was necessary to use data from websites. As for the media research field was qualitative. At the end of the study, it was concluded that the city of Santa Cruz suffered socio-economic and cultural, as a result, especially the lack of a previously developed tourism planning

Fatores capazes de influenciar o apoio dos residentes ao desenvolvimento do turismo religioso em Santa Cruz - RN

This study is about the primary stakeholder management - the resident community, given its participation and support for the development of tourism in touristic destinations. It has as a general aim to analyze the factors that are capable to influence the residents‟ support to the development of religious tourism in Santa Cruz, RN, and the existing interrelationships between factors. In order to achieve this objective, it was necessary to use exploratory and descriptive research, followed by a quantitative approach through questionnaires with 422 residents of Santa Cruz -RN. The study was based on the variables relationship model proposed by Nunkoo and Ramkissoon (2012), it was also used the technique of Structural Equation Modeling - SEM, aiming to explain the relationships between the constructs studied. The results found on the survey suggest that the more residents realize the benefits generated by tourism, as well as trust in government actors in charge of tourism development, the more there will be a propensity to support the development of religious tourism. This result is similar to the one found in the study of Nunkoo and Ramkissoon (2012). We conclude that the structural model that best represents the reality of Santa Cruz -RN is composed of the factors: benefits, costs, and confidence in governmental actors, which are able to influence the support of Santa Cruz‟s residents for the development of religious tourism. It is also noteworthy that it was found a highly significant connection between the factors benefits perceived from tourism and confidence in governmental actors and between both of them, the political support for tourism

Alterações dos parâmetros climáticos no município de Apodi-RN, antes e após a construção da barragem Santa Cruz do Apodi, e formação do lago

Este trabalho teve como objetivo principal analisar as mudanças ocorridas no clima local onde o município de Apodi/RN está inserido, em virtude da construção da Barragem Santa Cruz do Apodi. Foram utilizadas para o tratamento dos dados climáticos precipitação pluviométrica, umidade relativa do ar e temperatura técnicas estatísticas como Desvio Padrão, Teste T, Coeficiente de Variação e Média aritmética, além do modelo matemático. Para o balanço hídrico foi aplicado o método de Thornthwait (1948), considerando dois períodos em análise: o anterior e posterior a construção da Barragem Santa Cruz do Apodi, respectivamente 1995 e 2005. os resultados obtidos permitiram inferir que a hipótese inicial levantada se confirma, ou seja, a construção da Barragem Santa Cruz do Apodi, está influenciando diretamente numa alteração no que concerne à condição atmosférica local, especialmente no parâmetro umidade relativa do ar. Quanto ao balanço hídrico, observou-se a predominância do déficit hídrico especialmente entre os meses de junho a janeiro, período de estiagem; um excedente ocorrente entre os meses de maio e junho, conseqüente do período chuvoso; e uma reposição hídrica antecedendo e sucedendo este período, chuvoso, ou seja, compreendendo os meses de fevereiro a junho. Todas as considerações e análises poderão contribuir para o planejamento de abastecimento d´água, a irrigação, auxílio na previsão de enchentes e estiagens, bem como o manejo do uso da água subterrânea

Ilha de Santana e Alto de Santa Rita: a produção do espaço a partir do turismo em Caicó e Santa Cruz - RN

Tourism is an activity that uses the spatial objects and also produces and because it creates an economic activity areas for leisure. So for this to occur itdoes need a space reorganized, with infrastructure to receive visitors. And in the process of construction / reconstruction of tourist destination the state comes as a precursor, creating public policies that tourism can develop. Thus, this paper examines the transformation process by which the spaces are aiming to become tourist, and what changes occur in socio-spatial dynamic of the city in which this activity is inserted. The spatial area of study refers to the Alto de Santa Rita, Santa Cruz and the Isla de Santana Tourist Complex in Caicó both in Rio Grande do Norte. The reconstruction of the Island de Santana did not occur randomly, in order that the spatial changes were performed to meet the demand for which Caicó had to perform his greatest social and religious event, the Feast of Santana, which occurs since its colonization in year 1748 and also the Carnival these two events being considered as a strong tourist attraction of the city. And the Santa Rita High was built in order to enter the city of Santa Cruz in the script of religious tourism of the state through the devotion of the patron. The Dissertation isstructured in five parts, the first refers to the introduction of the work, while the second examines how tourism wound to the Rio Grande do Norte and internalizesthe third part deals with the spaces for tourism in these cities, the the fourthidentifies as the symbolism of these spaces influence the transformation and the latter reveals how these spaces affect the socio-economic structure of cities across the events

(Santa) Rita de Cássia na boca do povo de Santa Cruz/RN: identidades culturais em construção

The purpose of this study is to investigate the cultural identities of Santa Rita de Cassia constructed from the representations contained in the speech of Santa Cruz urban area residents, which is located in a harsh part of the State of Rio Grande do Norte. These residents make the story of the Saint full of meaning for themselves, in their daily lives, as well as to the society. This is observed in the narration of Rita de Cassia’s story which has been told in the city over the past one hundred and eighty years, the number of women's names and commercial establishments named “Santa Rita”. In 2010, with the inauguration of the Alto de Santa Rita – a space for worshiping the saint –, the amount of visitors increased in the city, due to the construction and inauguration of a colossal monument representing the image of Rita de Cassia. Then, new social, cultural, religious and political aspects became part of the local reality of the city of Santa Cruz, what made residents have something in common to talk about. According to the interdisciplinary approach of Applied Linguistics, our theoretical background is based on the socio-historical language concept, which understands language as discursive practice. Still theoretically speaking, this study establishes an interface with cultural studies, taking into account the concept of cultural identity in post-modernity society. Discourse analysis proved plural, with a multiplicity of cultural identities ranging from very obedient daughter to wife who suffered because of the husband, from very religious woman to the widow who entered the convent, on to the Saint of the miracles and healings interceding in the lives of the ones who seek for help. It was also observed in the above mentioned investigative path that these identities can be constructed and reconstructed if immersed in a different set of social practices historically determined

Entre rios e ruas: água, açude e tragédia em uma cidade do agreste potiguar (Santa Cruz, 1º de abril de 1981)

On the evening of April 1, 1981, the city of Santa Cruz was taken by a flood that destroyed the spillway weir Santa Cruz and much of the city, causing the population of the lower areas to abandon their homes. Residences and closest to the dam, the river and the creek Trairi Sin streets were totally affected, and many of the houses and public buildings completely destroyed. Located in the state of Rio Grande do Norte, the city of Santa Cruz is marked by a very hot climate and semi-arid. With an average normal rainfall of 498.7 mm per year, the city is affected by drought since the beginning of its foundation, around the year 1831. For its development had continued, it was necessary that the population actualize various environmental interventions Nature, especially as regards the storage and distribution of water. Considering the process of occupying the space in question, as well as the relationships that human groups have with the natural environment, we aim to analyze how human interventions affect the environment around them, modifying it to meet their needs and interests. Thus, we intend to understand how media coverage enabled the construction of a framework of tragedy. We intend to observe how the occupation of Santa Cruz led to the modification of their surroundings, trying to discuss the effects of human intervention on natural disasters. Among the research sources include newspapers A República, Diário de Natal, Tribuna do Norte, O Poti and Folha de São Paulo, as well as interviews with the then mayor of Santa Cruz, Hildebrando Teixeira de Souza, and with the couple José Henrique de Pontes and Severina Aguida de Pontes, whose house was hit by the flood. We will also take messages from the state government, the minutes of the city council of Santa Cruz and reports produced by DNOCS on the construction of the weir and its survey after the flood.

A atuação do enfermeiro no combate à dengue e a febre chikungunya: estudo comparativo nos municípios de Parnamirim e Santa Cruz/RN

The research aimed to analyze the role of nurses in the Family Health Strategy (FHS) in the control of Dengue and Chikungunya fever in the cities of Parnamirim and Santa Cruz. It is exploratory and descriptive nature of research, with a qualitative approach, which was developed with nurses of the Family Health Strategy in the municipalities of Parnamirim and Santa Cruz. All research process followed the ethical standards laid out research in Resolution No. 466/2012 of the National Health Council about research involving human beings. Data collection was performed using a semi-structured questionnaire with open and closed questions, organized into three parts: the profile of respondents, knowledge of the disease (transmission, prevention, control) and description of practices. The actions performed by nurses are punctual performed when there is growing disease of the number of cases in order to try to reduce the number of cases. The principal methodology used for them is to talk and guidelines resulting from campaigns and home visits, using leaflets and social networks. Regarding knowledge of nurses in the city of Santa Cruz on Dengue Fever and Chikungunya, is clearly some gaps. Nursing professionals know recognize a suspected case of dengue, but get confused when trying to explain to the Chikungunya fever, exhibiting the same symptoms of dengue. Although everybody had participated in a training on Chikungunya Fever and Dengue, a very limited knowledge of nurses regarding the clinical management. It is suggested that further studies are developed on the ground a few nurses have accepted to participate in the study, so that we can identify strategies, interventions, activities and nursing actions that are consistent with the reality of working in favor of coping Aedes epidemics aegypti that have positive impact on reducing the infestation rates and may be suitable and applied in other regions.

A atuação do enfermeiro no combate à dengue e a febre chikungunya: estudo comparativo nos municípios de Parnamirim e Santa Cruz/RN

The research aimed to analyze the role of nurses in the Family Health Strategy (FHS) in the control of Dengue and Chikungunya fever in the cities of Parnamirim and Santa Cruz. It is exploratory and descriptive nature of research, with a qualitative approach, which was developed with nurses of the Family Health Strategy in the municipalities of Parnamirim and Santa Cruz. All research process followed the ethical standards laid out research in Resolution No. 466/2012 of the National Health Council about research involving human beings. Data collection was performed using a semi-structured questionnaire with open and closed questions, organized into three parts: the profile of respondents, knowledge of the disease (transmission, prevention, control) and description of practices. The actions performed by nurses are punctual performed when there is growing disease of the number of cases in order to try to reduce the number of cases. The principal methodology used for them is to talk and guidelines resulting from campaigns and home visits, using leaflets and social networks. Regarding knowledge of nurses in the city of Santa Cruz on Dengue Fever and Chikungunya, is clearly some gaps. Nursing professionals know recognize a suspected case of dengue, but get confused when trying to explain to the Chikungunya fever, exhibiting the same symptoms of dengue. Although everybody had participated in a training on Chikungunya Fever and Dengue, a very limited knowledge of nurses regarding the clinical management. It is suggested that further studies are developed on the ground a few nurses have accepted to participate in the study, so that we can identify strategies, interventions, activities and nursing actions that are consistent with the reality of working in favor of coping Aedes epidemics aegypti that have positive impact on reducing the infestation rates and may be suitable and applied in other regions.

Desenpenho funcional, carga alostática e biomarcadores do estresse em idosos residentes na comunidade

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Avaliação do programa saúde da família no Rio Grande do Norte

The Family Health Program implemented in Brazilian municipalities from 1994 represents today the most promising proposal to promote important changes in municipality`s health systems, to allow universal access to health care, comprehensiveness, equity and to promote social control, achievements provided by the health reform process and incorporated to the Unified Health System principles. However, many are the challenges imposed to the Family Health Program so that it can cause these advances. In this study, we aimed to answer the following research question: what are the results of the Family Health Program in relation to beneficiaries at small, medium and large municipalities? The hypothesis that guided this work was that the variation in levels of achievement/results (strict, impacts and effects) of the Family Health Program is related to the size of the municipalities. Therefore, our general aim was to evaluate the results of the Family Health Program in municipalities at Rio Grande do Norte, Brazil. And as specific objectives, to measure strict results, effects and impacts of the Program, from the criteria of efficiency and effectiveness on the beneficiated population, and to measure the Program`s impact on the organization of municipality`s health system. This is an impact assessment research, developed from multiple case studies with quanti-qualitative approach. The study included small municipalities (Acari and Taipu), midsize (Canguaretama and Santa Cruz) and large (Natal and Mossoró). The individuals chosen to the research were users/beneficiaries of the Program and health professionals. Data analysis was performed using descriptive statistics and content analysis compared from the Program`s logical /theoretical model. The results obtained in relation to the principles evaluated (universality, comprehensiveness and community participation) presented that municipalities show different results, although not directly related to the size, but related with characteristics of the Program`s implementation form in each municipality and the arrangements made for its operationalization. The positive effect that generated significant change in people`s lives has been linked to the increase of access and to the decrease of geographic barriers. However, to the municipal health system, regarding the changes desired by the Program, it was not observed a positive impact, but a negative impact related to the increase of barriers for the user to access other levels of the health system

A formação do enfermeiro na reflexividade

The study proposes an understanding of nurses training in reflexivity and the overcome the limits of biomedical formation model, from the thought of John Dewey, inserted in the panorama of the reflective practitioner introduced by Donald Schön and dialoguing with the perspective of the transforming action of Paulo Freire. We used a qualitative approach to collect empirical data through focus groups conducted with nursing students from 3rd to 5th year in the Faculty of Health Sciences, Trairi / UFRN in the year 2012. Data analysis occurred through the technique of thematic content analysis constituted of three stages: pre-analysis, exploration of the material, treatment of results, inference and interpretation of the material. Thus, the categories formulated by organizing, classifying and aggregating the the content of the speeches to groups who shared opinions approximations of thought generating a set of categories of analysis designed from the contents. The results present the experiences of nursing students and their reflections, demonstrating that the process of reflection permeates the journey of life. It is inferred that the knowledge acquired in these experiences do not always participate in this dialogue in this formative process, reducing previous experiences in the field of exemplification of everyday situations. We conclude that it is necessary to consolidate innovative pedagogical proposals that allow the continuous dialogue with reality, breaking with the decontextualized teaching process from reality insertion of the university. Rethinking of the structures is recommended, reinforcing the break with the biomedical model and the integration of knowledge dynamically