Atuação profissional e vivência do cirurgião-dentista na estratégia do programa de saúde da família

The purpose of this research was to analyze the working profile of dentists from the Family Health Program (PSF Programa de Saúde da Família, Brasil) of some Municipal Districts of Rio Grande do Norte (Brazil) in order to understand the way they handle the experience acquired with the work developed in that Program. This discussion evolves a reflection about the perspectives of consolidation of the FHP as well as the possible advancements of the Brazilian Unified Health System (SUS - Sistema Único de Saúde). The target population was composed of dentists from the FHP of Rio Grande do Norte. Thus we performed twenty-one interviews orientated by a semi-structured guidebook with open questions and identification data. We opted for recording the speech of all the professionals in order to ensure the accuracy of the information gathered. The main results found were: predominance in the female gender; the majority of dentists has no post graduation courses; in those few cases of dentists with some post-graduation a lack of correlation with Public or Collective Health was observed; the dentists interviewed present a profile directed to clinical activities; the dentists used to develop basic restorative and periodontic treatment, simple surgeries and educative and preventive activities, even though the last two ones are carried out in an extremely traditional way (lectures and topical application of fluoride). In addition, as biggest difficulties to manage the work dentists pointed out the lack of permanent and consumer material, inadequate infrastructure, no transport to take them to distant places, no integration with the Health Family Team, technical difficulty such to perform educative and preventive activities as to provide adequate service to a repressed lawsuit. The results indicate the existence of a necessity to lead them to reflect and redirect their practices. In order to reach this aim it must be considered as initial measure the investment and encouragement toward to permanent education as well as a close follow-up and evaluation of the actions developed by them

Fatores socioeconômicos contextuais associados à condição bucal de adolescentes no Brasil

Many surveys are conducted comparing oral health conditions with individual variables, such as socioeconomic and demographic factors. However, in the same way that individuals differ among themselves, the groups also have their own characteristics and the effects of this differentiation must be researched. Brazil, despite being one of the major economic powers of the world and shows an improvement in the average value of its health indicators, is also one of the most unequal and remains among the countries with the greatest health inequities. The purpose of this study was to investigate the importance of social determinants on the contextual level oral health among Brazilian adolescents, population not much researched by the literature. The research was made using an ecological approach in order to identify possible inequalities between cities and capitals. Using data from SBBrasil 2010 it was evaluated less common outcomes (loss of first molar, dental care index and T-Health) which provide information on the degree of morbidity of caries and health level of dental tissues, in addition to analyze the related services. The association of these oral health indicators with socioeconomic factors such as income, employment, education and inequality, collected from Census 2010, was analyzed by simple and multiple linear regressions. The study included the 27 state capitals and four clusters representing the municipalities of the country. It was possible to see better access to services in locations with better income distribution. However, the strong association of contextual factors related to poverty, low levels of education and poor housing and jobs with poorer levels of oral health in adolescents seems to overshadow the effects of income inequalities on dental caries in the country. In some locations, particularly within the North and Northeast, whichever one keeps dentistry mutilating, whose effects are already noticeable in its adolescent population. Access to restorative services in Brazil remains limited and unequal. The results of this study highlight the inequities in oral health in the country and show the need of the inclusion of new perspectives on the traditional approach of Preventive Dentistry and education models in Dentistry. Tackling health inequalities in oral health in the country requires the cooperation of various actors involved in the process and the inclusion of oral health in the context of overall health. The social determinants approach, as well as evaluating the distribution of oral diseases in the country and its inclusion in the context of overall health, should guide the implementation of programs and oral health practices in order to contribute to the reduction of inequalities

Estrutura de organizações sociais: adaptação aos projetos sociais ou às pressões institucionais?

This is a study concerning in the structure of non governmental organizations, based on the institutional theory. It aims to understand the relation among structure, social projects and environmental influences, analyzing if there is coherence with project social or expresses adaptation to the institutional pressures of the environment. It introduces as theoretical support for the themes, studies about institutional theory and social structure. The research is descriptive and exploratory; it also applies to a study of case, based on the technical procedures. From the research universe, that was compound by non governmental organizations from Natal, RN, Brasil, it was chosen the Casa Renascer, a non governmental organization that works with the combat to the violence and sexual exploration of children and teenagers. The data collection process employed includes documental research, observations and semi structured research devices, guided by the organizational process proposed by Serva (1996) and by the institutional theory. The collected data were qualitatively treated. The analysis was divided into three parts, following the research matters. The social project characterization demonstrated that the organization went by three main phases. The first one, characterized by focus in women and girls education and health; the second shows the emphasis on girls in social risk situation, with preventive approach; and the last one, characterized by victims assistance of violence and sexual exploration. From the analysis using the institutional theory mechanisms, the results showed that exists coherence between structure and environmental influences, but a weak coherence between structure and social projects. It indicates as main determinant of the structure, an aspect forgotten by the institutional theory, the power. It was observed the presence from normative, coercive and mimetic mechanisms, highlighting normative influences

Atividades educativas aos portadores de periodontite crônica: escuta e troca de saberes no autocuidado em saúde bucal

This research aimed at evaluating oral health education activities for Periodontitis carriers, emphasizing the motivation for self-care and understanding the cultural aspects involved. This was a qualitative and quantitative study. Based on the qualitative referential, 20 interviews were done, in which differences between scientific and popular explicative models of the health-illness process were verified, besides the increased knowledge and motivation in relation to the use of preventive measures and also the fails in the understanding of the chronic character of periodontitis, enhancing frustration and guilty feelings in the patients. Two groups were structured: intervention and control. The intervention group was submitted to clinical attendance and education activities, while the control group undergone the traditional clinical attendance only. The sample consisted of 51 participants of intervention group and 47 of control group. Structured interviews were conducted at the beginning and at the end of the treatment in order to evaluate the knowledge and motivation for self-care in both groups. For comparison between the previous and post moments in both groups, there were applied McNemar tests with a probability of p < 0.05. In intervention group there was an increase in knowledge related to the name, the causes and related factors of the disease (p < 0.05). In control group there wasn t a rise in the understanding of the diseases chronic character, unlike in intervention group. However, in what concerns self-care, a greatest frequency in medium and high scores was observed in both groups. By this study, it is conclude that there is a common sense knowledge about the importance of preventive techniques and poor oral health as causing periodontitis; clinical interventions for bearers of chronic Periodontitis do not add values to the patients, regarding the illness, its causes and its chronic character; popular beliefs stay in their imagination, and the patients have a increased motivational capacity for self-care

EMPRESAS DA CONSTRUÇÃO CIVIL DO MUNICÍPIO DE ARACAJU-SE: Percepções sobre Responsabilidade Social Empresarial

The companies are part of an important segment of the society, besides, it exercises a significant contribution, being also responsible for helping in the improvement of the quality of life of the population. Like this being, to present research looked for to investigate the perception that the entrepreneurs of the building site of Aracaju/SE have concerning the theme Business Social Responsibility (RSE). besides the perceptions, it was part also of the research, to know the entrepreneur's of the building site social construction and the possible practices of Social Responsibility. The research grew in two different moments. The first looked for the theoretical embasamento, trying to study the economical sociology, understanding the effects provoked by the economy, understanding to you reason them that you/they took to the appearance of the perceptions that you/they permeate the historicity among the market, the nascedouro of the associations as company and his/her dynamics in the society. It was also researched, the concept of social responsibility in national and local extent, as well as, the contextualização of the state of Sergipe, detaching the municipal district of Aracaju, and describing how it happened his/her development starting from what is considered urbanization. In the second moment, the accomplishment of interviews in five companies, allowed to notice the entrepreneurs' perception concerning business social responsibility, as well as, actions of different characteristics in four of the samples. In these actions, they are patronage in cultural events, donations of projects for charity institutions, the concern with the preservation of the environment in the use of work materials ecologically correct, preventive health and employees' training. Concluding the research, I introduce the conclusions which it allowed to arrive me, and I point some suggestions for future researches that enlarge the reflection on this theme

O processo de invenção de si: um estudo sobre a construção identitária de pedagogas em formação

This work was developed in the course of Pedagogy, Universidade Federal do Rio Grande do Norte. Aims to understand the process of identity construction of teachers and educators in initial training. We started from the idea that such process was made by a complex and interdependent movement, once it was an inventive phenomenon wrought by individuals who are authors and actors of the story of their "real life" (KAUFMANN). This identity is rooted in the trajectories and social biographical experiences (FERREIRA), relationships with the constructed and accumulated knowledge in this route (CHARLOT) and in the developing of a sense of cultural belonging institutionally constructed (Luckmann, Berger). Then, the training involves relationships with knowledge in several instances, considering the effects, in one hand, the historic-social production and, in another hand, from the positions of subject and their biographical itinerary, existential and formative. We used the methodology of the Comprehensive Interview (KAUFMANN; SILVA), associated with a network of theoretical references, empirical and very analytical and interpretive activity. She researcher also relied on the "sensitive listening" (BARBIER), empathic attitude of "listening / seeing" the subject, and the notion of "intellectual artisan" (MILLS). The individual interviews were supplemented by the Focus Group. The approach was multi-referential (ARDOINO; MACEDO), with the intertwining of different perspectives, allowing a more complex configuration and less reductionist. In the analysis and interpretation we located the starting point, genesis of identity whose dynamics is not rigidly determined, but localized in space-time that precedes entry into the initial training. It is the time of concerns, questions and reflections about what you want to be in the future professional life. In sequence, we saw the route, multifaceted process whose the direction is the increasing involvement of individuals with their training. This training is engendered by the relations with the curricular, extracurricular and discursive knowledge, as simultaneous dynamics of self training and socio training. The self training of the individuals, understanding the critical, ethic and authority reading of their own experiences, is also seen as an exercise of shared responsibility, it assumes that the relationship with others meanings and professor mediation. The socio training refers to the collective subject and turns to the historical production and diversified knowledge, and comprehension of the various training instances. Self training and socio training are both objects of negotiation, because they are provocative of new designs, and cultural and identity maps, mobilizing the senses towards new meanings of themselves and the professional reality. It is in this interdependence between what is historically produced and the experiences of the subjects, who we located the arrival, considering it as a radically incomplete process of the professional identity and the building itself.

PLANFOR: política compensatória para a inclusão na informalidade?

Study about the national politics on the professional education, under responsibility of the brazilian Work Department in 1990 years. Purposes to apprehend the results of the actions of the professional education in a basic level, offered by the National Plan of the worker qualification ( PLANFOR ), as well as the effects on the assisted exits, starting from the experience appreciated on the Plan of Qualification developed in the state of Maranhão between 1996 to 2000. It adopts a theoretical-methodological conception by an ontological nature, if being worth of categories as the one of totality and of mediation that together, makes possible the apprehension of a dialectical movement that happens among the analysis object, the professional education politics in a basic level, performed by PLANFOR and your context, the underdevelop and heterogeneous Brazilian capitalism and the consequent job market generalized precarious and informal, making possible that the reality investigated become to understood rationally. This paper uses the indirect documentation technique, instruments of the bibliographical research and documental research. This study is based on those that aren´t part of PLANFOR, qualified by professional education courses in basic level,they didn't get to be inserts at the formal job market, just occupying precarious occupations in the informal job market. Aims to presents and discusses the productive process and your restructuring globally in progress. It focuses at the impacts on the workers, the precariousness of the work that appears like a new phenomenon calls new informality. Talks about the particularity process of productive restructuring assumed in Brazil highlights, showing that the informality, was always a structural phenomenon in the country. Discusses about the professional qualification in the contemporary capitalism, specifying some of your theses. Shows in a historical view the process of appearance of the employment notions and competence, and the influence that it exercised on the reforms of the basic and professional education, as well as the implications of both in the politics of professional education in the country. Rescues the process of creation of PLANFOR, your official formulations and your organized bases, starting from the second half of the 1990 decade. Shows yet the continuos changes in the job market of Maranhão state, for after, starting from the reports expresses at the Plans of Qualification from the state, elaborated by the Group of Evaluation and Studies of the Poverty and the Politics addressed to the poverty from the Master degree Program in Public Politics, from the Federal University of Maranhão, analyzing the acting of PLANFOR in the State, your probable deficiencies, as results the changes verified in the conditions of occupation and the gains of the exits from the professional education courses in basic level

Eficácia do cimento de ionômero de vidro como selante oclusal sobre a paralisação de lesões cariosas em dentina

Dental caries consists in a multifactorial and dynamic process. The knowledge of the ionic interactions among dental tissues and dental biofilm make possible its understanding as a process that can be stopped. Recently, the use of sealants have lost its function as preventive agent and passed to be argued as a possible therapeutical agent. This happens by hindering the substratum flow to the lesion inner and, therefore, controls the advance of the process. This study aimed to evaluate glass ionomer cement as a not invasive technique of treatment in occlusal caries without clinical cavitation, but with dentinal involvement. The research was accomplished using a controlled clinical trial with two groups (experimental and control) in 38 subjects (8-18 years) with 51 molars. The teeth of the experimental group were sealed with glass ionomer cement (Vidrion-R, S.S.White, Juiz de Fora, Brazil) and the molars control did not suffer intervention. The experimental group was followed by a year and the control by 8 months due the progression of the carious injury. Both groups were reevaluated to each 4 months with the use of clinical, radiographic and laser fluorescence (DIAGNOdent®) examination. The analysis of the clinical evaluation did not observe a significant difference between experimental and control groups. However, analysis with radiographic and laser fluorescence (DIAGNOdent®) examination observed a significant difference (p> 0,05) between groups, demonstrating a wors condition to the group without intervention. The results suggest that glass ionomer cement as sealant can be efficient to paralyze dentinal caries without clinical cavitation

Estudo das percepções ambientais e de ações educativas promotoras da biodiversidade em unidade de conservação no Rio Grande do Norte

Important issues involving the awakening to the need for conservation of biodiversity and the importance of establishing protected areas as a strategy in pursuit of environmental protection, are increasingly being developed in biological and social investigative fields. In this sense, this research aimed to emphasize the use of environmental perception of social agents are significant elements for the understanding of the man / nature, and develop educational activities aimed at raising awareness and changing attitudes towards environmental issues thus promoting reflections on Environmental Education (EE) as a critical and transformative tool for conservation of rich biological diversity. This research covers as a place of study, schools located in the Environmental Protection Area Jenipabu (APAJ), Rio Grande do Norte. Methodology in general, we highlight the use of questionnaires and mind maps as generators of the contents of empirical research, and execution of content analysis for the treatment of data collected. This dissertation has two chapters in the form of scientific articles, where the first is entitled: "Study of the perceptions and evaluation of interactions concerning environmental education in schools in a conservation area of Rio Grande do Norte - Brazil", obtaining thus a primary diagnosis for analysis about the visions that students and teachers from two schools located in APAJ have on the environment. The second article, entitled: "Effective and analysis of educational activities that promote biodiversity in a coastal area of Environmental Protection Northeast - Brazil" provides an analysis of the educational use of biodiversity as a way to raise awareness of the need for environmental conservation. It appears from research that there is a lack of training in EA by teachers, but there is a need for greater involvement of students in conservation areas, however, from the analysis of educational activities, we observed that the effectiveness of such actions acts to promote awareness and change in actors involved. Thus, environmental education needs to take into account the different perceptions found in each individual, and it can not be based solely on transmission of knowledge, so that we reach a model of conservation.

Percepção de riscos ambientais de populações vulneráveis a inundações e deslizamentos de dunas em Natal-RN

In urban, flooding and landslides are among the troubles that most bring human and material loss. Therefore, this study objected to perform an analysis on the risk perception on the population living in social environmental vulnerable places in order to understand what is the way this population realize the risks they are exposed to and what are the outbrave strategies the develop. The first analyzed area was Complexo Passo da Pátria for the flooding risk problematic and then the Cidade Nova neighborhood threatened by the dunes slides. The areas locate, respectively, in the West and East zones of Natal-RN. Using an interview screenplay adapted from risk perception researches from different brazilian cities, it was collected primarily data on the variables: perception, evaluation and choice, safety threshold, adjustment, decision and participation. Due to the studied areas characteristics the qualitative approach adjusted itself to the difficulties for accessing the areas. The studied places characterize for its insecure situation like selling/using drugs, robbery and murder among others. Due to this situation the interviewed individuals were the ones that could be found more accessibly and available in the moment and the interviews were made in the community leader presence of each area. Through the discourse of the respondents analysis it was able to conclude that the interviewed population is exposed to a high vulnerability grade and risks. However it was identified substantial differences between the perception and risks of Complexo Passo da Pátria and bairro Cidade Nova, because in the first area the intervied ones can recognize the high risk they are exposed to in a more emphatic way to the interviewed ones for the Cidade Nova neighborhood. Furthermore, there is a heavy dissatisfaction for the population of the two places about the city hall positions relating to the present problems in the studied areas. It was also identified the strategy development of acquaintanceship with the risk in the research places beyond a feeling of belonging and affection between the dwellers and the places, yet it was more evident for Complexo Passo da Pátria. Though this analysis it was possible to understand and perceptions and the behavior of the individuals or social groups facing the risks as acceptance and rejection of determined risks beyond adaptation measures of living together with the persistence presence of risks. Therefore, qualitative nature researches emphasizing the perception approach are in the fundamental importance in the studies about risks making it possible to offer aids to the urban planning and management in the implement of effective preventive measures and compatible with the population aims

Modelagem e desenvolvimento de um banco de dados geográficos : aplicação à elaboração de mapas de sensibilidade ambiental ao derramamento de óleo na área costeira entre galinhos e São Bento do Norte-RN

The area between Galinhos and São Bento do Norte beaches, located in the northern coast of the Rio Grande do Norte State is submitted to intense and constant processes of littoral and aeolian transport, causing erosion, alterations in the sediments balance and modifications in the shoreline. Beyond these natural factors, the human interference is huge in the surroundings due to the Guamaré Petroliferous Pole nearby, the greater terrestrial oil producing in Brazil. Before all these characteristics had been organized MAMBMARE and MARPETRO projects with the main objective to execute the geo-environmental monitoring of coastal areas on the northern portion of RN. There is a bulky amount of database from the study area such as geologic and geophysical multitemporal data, hydrodynamic measurements, remote sensing multitemporal images, thematic maps, among others; it is of extreme importance to elaborate a Geographic Database (GD), one of the main components of a Geographic Information System (GIS), to store this amount of information, allowing the access to researchers and users. The first part of this work consisted to elaborate a GD to store the data of the area between Galinhos and São Bento do Norte cities. The main goal was to use the potentiality of the GIS as a tool to support decisions in the environmental monitoring of this region, a valuable target for oil exploration, salt companies and shrimp farms. The collected data was stored as a virtual library to assist men decisions from the results presented as digital thematic maps, tables and reports, useful as source of data in the preventive planning and as guidelines to the future research themes both on regional and local context. The second stage of this work consisted on elaborate the Oil-Spill Environmental Sensitivity Maps. These maps based on the Environmental Sensitivity Index Maps to Oil Spill developed by the Ministry of Environment are cartographic products that supply full information to the decision making, contingency planning and assessment in case of an oil spilling incident in any area. They represent the sensitivity of the areas related to oil spilling, through basic data such as geology, geomorphology, oceanographic, social-economic and biology. Some parameters, as hydrodynamic data, sampling data, coastal type, declivity of the beach face, types of resources in risk (biologic, economic, human or cultural) and the land use of the area are some of the essential information used on the environmental sensitivity maps elaboration. Thus using the available data were possible to develop sensitivity maps of the study area on different dates (June/2000 and December/2000) and to perceive that there was a difference on the sensitivity index generated. The area on December presented more sensible to the oil than the June one because hydrodynamic data (wave and tide energy) allowed a faster natural cleaning on June. The use of the GIS on sensitivity maps showed to be a powerful tool, since it was possible to manipulate geographic data with correctness and to elaborate more accurate maps with a higher level of detail to the study area. This presented an medium index (3 to 4) to the long shore and a high index (10) to the mangrove areas highly vulnerable to oil spill

Gasto com a internação de idosos em unidades de terapia intensiva

Introduction: Population aging in Brazil underscores the need to discuss the proper management of the budget allocated in health field, especially in the sectors of high complexity, where coexist costly procedures, limited resources and the need for cost containment. In the other hand, demand is growing in a way directly proportional to the increase in the number of elderly in country. Objective: In this way, this research had as main objective to analyze the costs resulting from the admission of elderly in intensive care units (ICU) and its associated factors. Methods: This is a cross-sectional study with a quantitative approach and featured as a descriptive and exploratory research. Data were collected from medical records of elderly hospitalized in ICU from a brazilian city called Natal-RN, between november first, 2013 and january, 31 of 2014. The variables collected relate to the socio demographic profile, morbidity framework and characterization of hospitalization. The dependent variable was categorized by quartile 75 in high and low expense of hospitalization and submitted to chi-square test with the independent variables of the survey. Associations with p value <0.20 in the bivariate analysis were submitted to the technique of multiple logistic regression. We opted for the construction of three regression models from the above algorithm: general regression model, composed by all 493 hospitalizations in the study, other made with 181 individuals admitted in health public system (SUS) and a third one related to 312 cases from private service in health area. Results: In the general regression model, the variables respiratory diseases, hospitalizations in the private system, disoriented patient and previous stroke were associated with greater probability of high spending in the ICU. In the other hand, in SUS kind of hospitalizations, this probability was associated with disoriented patient, 80 years old or more, sepsis and admission for clinical reason. In the cases from the private network health, the high expenditure was associated with respiratory disease, mechanical ventilation, hospitalization for clinical reason and disoriented patients. Conclusion: The increased expenditure on hospitalization of elderly in intensive care depends on the clinical conditions of individuals. This highlights the importance of avoiding hospitalizations due to diseases sensitive to primary care by health preventive actions and providing comprehensive care to the elderly. In addition, obtaining different explanatory models, according to kind hospital funding, demonstrates the importance of the organization in health services related to composition of costs of hospitalization among the elderly. Another question founded was the need that to improve the funding, we must use rationally the available resources by avoiding unnecessary hospitalizations of elderly people in the extremes of severity. On this kind of precarious funding, ICU hospitalization of elderly non-critical or in a terminal state can compromise the quality of services provided to those who really need intensive care.

Estrutura de organizações sociais: adaptação aos projetos sociais ou às pressões institucionais?

This is a study concerning in the structure of non governmental organizations, based on the institutional theory. It aims to understand the relation among structure, social projects and environmental influences, analyzing if there is coherence with project social or expresses adaptation to the institutional pressures of the environment. It introduces as theoretical support for the themes, studies about institutional theory and social structure. The research is descriptive and exploratory; it also applies to a study of case, based on the technical procedures. From the research universe, that was compound by non governmental organizations from Natal, RN, Brasil, it was chosen the Casa Renascer, a non governmental organization that works with the combat to the violence and sexual exploration of children and teenagers. The data collection process employed includes documental research, observations and semi structured research devices, guided by the organizational process proposed by Serva (1996) and by the institutional theory. The collected data were qualitatively treated. The analysis was divided into three parts, following the research matters. The social project characterization demonstrated that the organization went by three main phases. The first one, characterized by focus in women and girls education and health; the second shows the emphasis on girls in social risk situation, with preventive approach; and the last one, characterized by victims assistance of violence and sexual exploration. From the analysis using the institutional theory mechanisms, the results showed that exists coherence between structure and environmental influences, but a weak coherence between structure and social projects. It indicates as main determinant of the structure, an aspect forgotten by the institutional theory, the power. It was observed the presence from normative, coercive and mimetic mechanisms, highlighting normative influences