A experiência do usuário idoso no design de jogo digital para a reabilitação neural de pacientes com quadro de acidente vascular cerebral (AVC)

Stroke is nowadays one of the main causes of death in Brazil and worldwide. During the rehabilitation process, patients undergo physioterapic exercises based on repetition, which may cause them to feel little progress is being made. Focusing on themes from the areas of Human-Computer Interaction and Motor Imagery, the present work describes the development of a digital game concept aimed at motor rehabilitation to the neural rehabilitation of patients who have suffered a stroke in a playful and engaging way. The research hypothesizes that an interactive digital game based on Motor Imagery contributes to patients' raised commitment in the stroke sequel rehabilitation process. The research process entailed the investigation of 10 subjects who live with sequels caused by stroke - it was further established that subjects were over 60 years old. Using as foundation an initial survey regarding target-users' specificities, where an investigation on subjectrelated aspects was carried out through Focus Group (n=9) and Contextual Analysis (n=3), having as subjects elderly individuals, a list with the necessary requirements for the conceptualization of a digital game was fleshed out. The initial survey also enabled the establishment of preliminary interactions for the formulation of game prototypes. At first, low-resolution prototypes were used, with two distinct interaction models for the game - one with a direct approach to the Motor Imagery concept, and another using a narrative with characters and scene settings. The goal was to verify participants' receptivity regarding the addition of playful activities into game dynamics. Prototypes were analyzed while being used by five patients, through the Cooperative Evaluation technique. The tests indicated a preference for option with elements in a playful narrative. Based on these results high fidelity prototypes were created, where concepts close to the game's final version were elaborated. The High Fidelity prototype was also evaluated with four patients through the Cooperative Evaluation technique. It was concluded that elderly individuals and patients were receptive to the idea of a digital game for the rehabilitation from sequels caused by stroke; that, for the success of devices aimed at these cohorts, their contexts, needs and expectations must be respected above all; and that user-centered design is an essential approach in that regard.

A influência do conforto luminoso na satisfação dos profissionais que atuam no ginásio do Centro de Reabilitação Infantil, Natal-RN

This study addresses the environmental quality in therapeutic spaces for children's rehabilitation. The assumption that space is active and interfere in interpersonal relationships, highlights the importance of natural light to the hospital architecture, to foster the creation of environments that encourage and assist in the recovery of patients in the rehabilitation process. Therefore, interferes with health humanization through positive actions in the physiological and emotional effects of natural light, as facilitators of the health recovery process. In Brazil hospital openings systems projects are built exclusively to follow requirements of the local construction code which do not consider the landscape, but only ventilation and heat stroke; and the luminance levels are treated just as recommendations for artificial lighting. The National Policy for Healthcare Humanization presents the environmental comfort as a priority. However, it does not guidelines for achieving it. In this context this research aims to evaluate the lighting comfort in infant therapeutic areas from the professional satisfaction, in order to identify human preferences on the variables: technical and constructive aspects, relationship with the exterior, internal visual interface and quality elements. With this purpose it was adopted as research strategy the Post-Occupancy Evaluation (Technical Functional) through a multi method approach, which included a case study in the rehabilitation gym of Children Rehabilitation Center, at Natal, Rio Grande do Norte, and a reference study at SARAH Rehabilitation Center, Fortaleza Unit at Ceará, both in Brazil northeast. The results indicate that the definition of openings systems should consider external and internal factors to the building, as the natural landscape, the immediate surroundings and activities to be performed. The POE found out the preference of the professional visual privacy in detriment to other analyzed aspects. Thus, it is expected that this study can contribute to the discussion of luminous quality and generate inputs for future projects or renovations in the Children's Rehabilitation Centers, which should not be projected as hospitals

Evuloção cognitiva e funcional de pacientes pós-acidente vascular cerebral - AVC

PURPOSE: Stroke is a high-incidence cerebrovascular disease with elevated morbidity that results in impairments such as functional disabilities. This study aimed to investigate the functional evolution of individuals in the first six months post-stroke. METHOD: Longitudinal study with 42 stroke patients. The functional independence measure (FIM) and The National Institutes of Health Stroke Scale (NIHSS) were used by multidisciplinary staff 3 times in each participant; the first application was at admission to rehabilitation and the others three and six months later. RESULTS: Sample predominantly female (57%), married (52%), mean age 65.26 ±10.72 years, elementary schooling level (43%), ischemic stroke (91%), and right cerebral hemisphere (74%). Motor FIM scores and NIHSS scale showed improvement in the 3 evaluations, with significant p-value (<0.001). There was a strong relation between motor FIM evolution and NIHSS evolution (r = - 0.69 p-value< 0.001). CONCLUSIONS: It was observed that functional evolution at 6 months post-stroke was significant and the smaller the evolution of clinical impairment in these patients, the larger the evolution of their functional independence. The study is important because it allows a more appropriate therapeutic planning according with functional evolution in stroke rehabilitation

Estratégias de intervenção utilizadas por enfermeiros da ESF do município de Natal/RN no controle do câncer do colo de útero

Cancer of the cervix (cervical cancer) is the second most prevalent cancer among Brazilian women. The high rates of cervical cancer in Brazil justify the implementation of effective strategies to control this, which include actions to promote health, primary prevention, early detection, screening, treatment and palliative care. Despite the existence of the National Programme for Control of the CCU there was no reduction in the incidence and mortality of this disease in Brazil. The Family Health Strategy (FHS) has the potential to facilitate such control and, in this context, one should consider that nurses play a central role. The study aimed to know the general intervention strategies used by nurses FHS of Natal / RN in CCU control, and how specific: analyzing the knowledge of these nurses on the CCU, the actions developed in the ESF for the control of CCU and identify the difficulties faced by them to perform it. This is a descriptive exploratory quantitative developed through a structured interview guide with 106 nurses who have experience in controlling the CCU in FHS teams of Natal / RN. Data analysis was performed using descriptive statistic s. The results pointed to actions taken in the FHS to control the CCU, collection of cervical cancer screening, health education activities, nursing consultation, referral of suspected cases for medical monitoring and active women with abnormal test result . The actions that were not mentioned by the nurses included: forming groups of prevention and health promotion; expand coverage of exams and office hours of consultations, establishment of alternatives to end the pent-up demand in the health units, participation in treatment or rehabilitation process users with the CCU; interventions for pain management, alliances and partnerships with schools, in dustry and the use of protocols. This study can be seen that the practice nurses partially shares to the CCU in Natal / RN. The participants of this study, when asked about the CCU, specifically for signs and symptoms of disease and risk factors in general showed important gaps. Difficulties such as lack of materials for collection of Pap smear; inadequate physical space in the Health Units; pent-up demand in the service, delay in arrival of the test results; obstacles in the actions of referral and counter-referral and cultural factors make the CCU control is compromised. It is believed in this research contributed to a reflection on the importance of the role of nurses in the development of the ESF control actions CCU, pointing out the factors that affect these. It is important to involve all nurses who comprise the ESF as knowledgeable of the risk factors, signs and symptoms, and existing tools for the early detection of cervical cancer in the pursuit of quality improvement actions to promote women`s health, contributing in planning future interventions that may reduce mortality from this disease in Natal / RN.

O centro de Fortaleza como lugar de moradia

The present study has the objective of analyzing how the ways of dwelling influences the uses and the functional and symbolic appropriations of the urban space in Fortaleza city center, through the perspective of the residents and their relation with the living place. Scenarios of development and degradation of its urban space have marked the city center of Fortaleza. The intensification of the commercial and services occupation promoted through the years, paradoxically, the valorization of the land price and the devalorization of the residential use. Thus, the residential occupation was consolidated in a discontinuous way, being concentrated mainly in the external limits of the historical core of the neighborhood. The research is structured over the delimitation of an area and the selection of multifamily residential buildings, built since the 1960s, close to the central core of the neighborhood. The spatial configuration analysis of the selected residential buildings, and their relations with the urban surroundings and the land uses, reveals different aspects related to the urban vitality, producing impacts over the ways of dwelling constituted by the daily life of the residents. The study of the ways of dwelling involves the comprehension that the dwelling is beyond the private residential boundaries and the functional occupation. The conceptual base of this research is developed over the perspective that the dwelling represents a fundamental aspect of the human condition, allowing the person to relate with the space in an essential way (HEIDEGGER, 2012). In this perspective of the dwelling, the space reunites the mental and the cultural, the social and the historical, being marked by simultaneous logics of the conceived, the perceived and the lived space (LEFEVBRE, 2006). The development of this study, over the point of view of the neighborhood residents, is inserted in the perspective of the lived space, related to the concept of place, understood as a qualitative phenomenon, giving essence and identity to the space. The place of dwelling, marked by coexistences, is one of the structural elements of the urban land use, and potential for the rehabilitation of the central areas in big cities. Therefore, the study starts from the hypothesis that the location, the nearby land uses and the spatial configuration of the residential buildings affect the ways of dwelling, in other words the residents dissolve the boundaries of the shelter and experience the urban space, from the dwelling place. The requalification of the dwelling is opposed to the residential space based in functionality, in hierarchy, in self sufficiency, in standardization and in the reproduction of the urban space, materialized in the dense contemporary residential buildings, that are unrelated to the city. The stages of the research involved the spatial configuration analysis of the selected residential buildings and their surrounding, the land use mapping and interviews with the residents. The collected data allowed verifying that the buildings are located in areas presenting heterogeneous land uses, with a great number of residents and users. However, these aspects are not sufficient to promote the vitality of the public spaces in the neighborhood, since the people movement in the streets is controlled by the opening hours of the predominant commercial use in the area. The word of the residents, collected in interviews, indicate that the conservation conditions of the public spaces and the insecurity influences their everyday relations with the place of dwelling, affecting fundamental aspects for the dwelling requalification in the central area of Fortaleza.

O centro de Fortaleza como lugar de moradia

The present study has the objective of analyzing how the ways of dwelling influences the uses and the functional and symbolic appropriations of the urban space in Fortaleza city center, through the perspective of the residents and their relation with the living place. Scenarios of development and degradation of its urban space have marked the city center of Fortaleza. The intensification of the commercial and services occupation promoted through the years, paradoxically, the valorization of the land price and the devalorization of the residential use. Thus, the residential occupation was consolidated in a discontinuous way, being concentrated mainly in the external limits of the historical core of the neighborhood. The research is structured over the delimitation of an area and the selection of multifamily residential buildings, built since the 1960s, close to the central core of the neighborhood. The spatial configuration analysis of the selected residential buildings, and their relations with the urban surroundings and the land uses, reveals different aspects related to the urban vitality, producing impacts over the ways of dwelling constituted by the daily life of the residents. The study of the ways of dwelling involves the comprehension that the dwelling is beyond the private residential boundaries and the functional occupation. The conceptual base of this research is developed over the perspective that the dwelling represents a fundamental aspect of the human condition, allowing the person to relate with the space in an essential way (HEIDEGGER, 2012). In this perspective of the dwelling, the space reunites the mental and the cultural, the social and the historical, being marked by simultaneous logics of the conceived, the perceived and the lived space (LEFEVBRE, 2006). The development of this study, over the point of view of the neighborhood residents, is inserted in the perspective of the lived space, related to the concept of place, understood as a qualitative phenomenon, giving essence and identity to the space. The place of dwelling, marked by coexistences, is one of the structural elements of the urban land use, and potential for the rehabilitation of the central areas in big cities. Therefore, the study starts from the hypothesis that the location, the nearby land uses and the spatial configuration of the residential buildings affect the ways of dwelling, in other words the residents dissolve the boundaries of the shelter and experience the urban space, from the dwelling place. The requalification of the dwelling is opposed to the residential space based in functionality, in hierarchy, in self sufficiency, in standardization and in the reproduction of the urban space, materialized in the dense contemporary residential buildings, that are unrelated to the city. The stages of the research involved the spatial configuration analysis of the selected residential buildings and their surrounding, the land use mapping and interviews with the residents. The collected data allowed verifying that the buildings are located in areas presenting heterogeneous land uses, with a great number of residents and users. However, these aspects are not sufficient to promote the vitality of the public spaces in the neighborhood, since the people movement in the streets is controlled by the opening hours of the predominant commercial use in the area. The word of the residents, collected in interviews, indicate that the conservation conditions of the public spaces and the insecurity influences their everyday relations with the place of dwelling, affecting fundamental aspects for the dwelling requalification in the central area of Fortaleza.