Qualidade nutricional dos cardápios em escolas públicas e alcance às metas do programa nacional de alimentação escolar em município do nordeste brasileiro

O Programa Nacional de Alimentação Escolar tem como objetivo atender as necessidades nutricionais dos alunos durante sua permanência em sala de aula, contribuindo para o crescimento, o desenvolvimento, o rendimento escolar e a formação de hábitos alimentares saudáveis. Diante da relevância social e considerando os princípios do direito humano da alimentação adequada e da segurança alimentar, é fundamental o monitoramento da execução e consecução das metas nutricionais estabelecidas pelo programa. Desta forma, este estudo teve como objetivos analisar a qualidade nutricional dos cardápios ofertados em escolas públicas de um município rural do Nordeste brasileiro, quanto à composição nutricional, custo com gêneros alimentícios, nível de adesão dos escolares às refeições oferecidas e atendimento às recomendações nutricionais do Programa Nacional de Alimentação Escolar. Foi desenvolvido estudo transversal, realizado com 473 escolares, em Nísia Floresta, município do Estado do Rio Grande do Norte. A frequência de consumo semanal da alimentação escolar foi analisado segundo o padrão adotado por Sturion et al., que classifica o nível de adesão em: efetiva (quatro a cinco dias), média (dois a três dias) e baixa (um dia). Analisou-se 64 preparações da alimentação escolar, eleitas de forma aleatória por conglomerado, avaliadas quanto à energia, macronutrientes e micronutrientes (vitaminas A e C, ferro, zinco, magnésio e cálcio). Utilizaram-se como parâmetros as recomendações nutricionais estabelecidas pelo programa (2009), para atender 20% das necessidades nutricionais diárias, considerando as faixas etárias de 6 a 10, 11 a 15 e 16 a 18 anos. Calculou-se o custo das preparações servidas com base na licitação realizada no município. A associação entre adesão e extratos etários foi investigada utilizando a análise de correlação. A energia oferecida pelos cardápios foi inferior a recomendação em até 50%. As refeições atingiram, em média, 249,34 kcal (±64,43). Observaram-se preparações com inadequação dos macronutrientes e micronutrientes, exceto para proteínas (102,3%) e lipídios (100,1%), na faixa etária ix de 6 a 10 anos. O custo das preparações foi R$ 0,53 (±0,16), sendo provenientes 56,6% de recursos federais e 43,4% da contrapartida municipal, com essencialidade de recursos municipais no provimento do custo. Quanto à adesão, 93,9% dos escolares informaram consumir os lanches. Para o nível de adesão, obtiveram-se: 67,2% efetiva, 21,8% média e 4,9% baixa. Foi encontrada associação significativa entre as variáveis adesão e idade (χ2 = 89,36; GL=6; P < 0,001), sendo a baixa adesão encontrada, sobretudo, na faixa de 16 aos 18 anos. Os cardápios ofertados não atingem as metas do Programa Nacional de Alimentação Escolar, favorecendo a insegurança alimentar, especialmente aos adolescentes. Portanto, há necessidade de reformulações, planejamento, e implantação de refeições diferenciadas e adequadas às distintas faixas e factíveis de execução

Limites e possibilidades do programa nacional de alimentação escolar enquanto estratégia de promoção da segurança alimentar e nutricional no municipio de Macaíba/RN

This dissertation aims to understand the importance of the National School Feeding as a strategy for ensuring the promotion of food and nutrition security in the municipality of Macaíba / RN, taking into account the implementation of the Law School Feeding, 11,947, 2009. The program was extended to all public basic education, youth and adults, in addition to ensuring that 30% of transfers from FNDE, were intended for the purchase of products from family farms. The survey was conducted with 160 students from public schools and farmers nesting Quilombo dos Palmares II, who produce on their land vegetables, fruits and cereals for their own consumption, for sale in local markets, in addition to providing for PNAE. The reciprocity between neighbors, such as mutual aid and sharing of common goods was noticeable in this group of farmers, since it was necessary to meet weekly deliveries of products to schools. As students, we applied a test of acceptability in two schools located in rural and in urban areas, to learn the opinion of ourselves in relation to school food consumed. It was concluded that to be most effective program in the region, there must be a better match in school menus, so that it can be attractive to students and to ensure greater use of fresh food, the main ingredient of same, practice of nutrition education in schools, to teach students the importance of food to health. In relation to local management, noted the need for adjustments bureaucratic as hiring staff for the departments, in order to be more agile in releasing payments to farmers, in addition to hiring assistants general services for schools, one Since the cooks exert dual role, the cooking while being responsible for cleaning the entire school environment. Government investments in the rural sector would be extremely valuable for farmers, since they need financial resources to purchase inputs, irrigation projects for gardens, availability of land for planting, transportation to facilitate the delivery of its products to schools and technical assistance more frequently

Concentração da posse da terra e o programa nacional de crédito fundiário - uma análise para o estado do Rio Grande do Norte, 2006 - 2012

O objetivo do trabalho é propor um estudo sobre a relação do Programa Nacional de Crédito Fundiário - PNCF, no estado do Rio Grande do Norte, e sua concentração fundiária. Ou seja, se o PNCF está sendo direcionado, para as microrregiões que apresentam maior índice de concentração, de acordo com o índice de Gini, e se as áreas adquiridas através do crédito fundiário estão emergindo nestas microrregiões. Para isto, o estudo levantou a hipótese de que o PNCF no estado do Rio Grande do Norte não está sendo conduzida, de modo a reduzir a concentração fundiária, dentre as microrregiões do estado. Ou seja, não existe correlação entre o índice de Gini, da concentração fundiária, e as áreas adquiridas através do programa. Além disso, o trabalho buscou realizar uma discussão da literatura sobre os programas de reforma agrária assistida pelo mercado. Apresentando os autores que são exaltadores do modelo e das suas potencialidades, atrelando as causas dos problemas levantados como sendo de ordem técnica e operacional, onde os principais autores desta linha são: Van Zyl, Kirsten & Binswanger, (1996), Deininger & Binswanger, (1999). Têm-se também a apresentação da posição dos autores adeptos as políticas fundiárias pautadas na dinâmica e liberação dos mercados de terras, mas que visam contribuir com estudos que permitam uma redução para o custo elevado e a sua incapacidade de abarcar a esfera social, em decorrência do pagamento á vista e a preço de mercado aos donos das terras, são eles: De Janvry & Sadoulet (2002), Gordillo (2002), Banerjee (1999), Jaramillo (1998) e Burki & Perry (1997). Todavia, apresentou-se a corrente de autores que ressalta a natureza socialmente agressiva da Reforma Agrária Assistida pelo Mercado (RAAM), sendo os seus principais contribuidores: El-Ghonemy (2001); Barros, Schwartzman & Sauer (2003); Borras Jr. (2006, 2003 e 2003a); Garoz et al. (2005); Sauer & Pereira (2006); Pereira (2005, 2006 e 2010); Sauer (2010); Lahiff, Borras Jr. & Kay (2007). Em sequência, o trabalho apresentou a transição e características dos programas de acesso à terra, no Brasil, a partir da década de 1990, bem como, alguns indicadores do PNCF, no Brasil e o estado do Rio Grande do Norte. Apresentou-se também os indicadores da concentração fundiária, no Brasil e no estado. Através dos dados do Censo Agropecuário de 2006 foi possível calcular o índice de Gini da distribuição fundiária nas microrregiões no estado do Rio Grande do Norte. Com os dados fornecidos pela Secretaria de Estado de Assuntos Fundiários e de Apoio à Reforma Agrária - SEARA mostrou-se a distribuição das linhas de crédito do PNCF e as áreas adquiridas, entre os anos de 2006 e 2012. Por fim, o valor do coeficiente de correlação simples (r) igual a (0,2865), que com base no teste bilateral da distribuição de t de Student chegou-se no resultado para T calculado no valor de (1,2333), que ao ser comparado com o valor de T crítico igual a (2,898), com 17 graus de liberdade, a um nível de significância de 1%, pode aceitar a hipótese de partida, ou seja, que o PNCF não estava sendo direcionado para diminuir a concentração fundiária no estado

Valorização do servidor no Programa Nacional de Humanização: estudo em um hospital universitário

It is at the work environment where value of the health professional is realized, according to the National Humanization Policy (PNH) from a Pediatric Hospital connected to an institution of higher education. Among the guiding principles of PNH it is highlighted the commitment to the democratization of labor relations and enhancement of health professionals, stimulating the continuing education process. For this research, a qualitative approach was chosen, using a semistructured interview as a tool to collect data. In a perspective of identifying the appreciation and humanization into interpersonal relations between workers, information from the theory of communicative action of Habermas was analyzed, considering cultural values goes beyond the practice in action, where the prospects of moral arguments in the universal truisms of life pervade original cultural moral, cognitive and expressive, imbued on ethics. This reasearch had the collaboration 29 employees with a regular contract labor to a teaching hospital in Natal, Brazil. The data was obtained through interviews which all participants signed a consent term. After data analysis the results shows the existance of a satisfaction of all workers on performing duties. The workers perceive its role valorization through kudos received as a consequence of a work done, others believe that it occurs when the institution or the group itself is concerned to enhance the work. Thus, in general, they feel valued. Regarding the interpersonal relationship, the most highlighted point was the fact that in the employees versus general directors item, respondents indicated the existence of a distance between these two categories, which can affect a participatory management. Therefore, the results of this study showed the necessity to develop actions that provide a healthy work environment. The joint guidelines of the PNH and the Employee Health Care Policy, represent some directions with some similarities in their purpose to the theory of communicative action, where there is a mutual respect, tolerance and coexistence of differences, considering the constructive conflict among health workers within the perspective of communication and interaction among individuals

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.

Proposta para uma abordagem do conceito de oxirredução no Programa Nacional de Integração da Educação Profissional com a Educação Básica na modalidade de Educação de Jovens e Adultos Educação Profissional Técnica de Nível Médio (PROEJA)

The National Program of Professional Education Integration with Basic Education for Youngsters and Adults (PROEJA) Technical Professional Education Ensino Médio has opened a new chapter in the history of education in Brazil, making possible the integration of basic education and professional education. This new form of education, which is still in its early implementation, presents a series of challenges to be overcome. Specifically about the teaching of Chemistry, didactic material to match PROEJA s specific needs is practically inexistent. Thus, this work has the purpose of developing didactic material for the teaching of Chemistry for Professional and Technological Education of Youngsters and Adults in the courses of Electronics, Technical Electronics and Maintenance and Support for Computing at Instituto Federal de Educação,Ciência e Tecnologia do Rio Grande do Norte. This material aims at working chemical concepts of oxi-reduction reactions through a theme approach following Freire s conceptions for the teaching of Youngsters and Adults

A institucionalização do programa nacional de Educação Fiscal nos estados brasileiros e Distrito Federal

The research seeks to comprehend the development of the promoting and structuring Fiscal Education actions in the states and in the federal district, attending to the guideline and the administrative requirements established by the Escola de Administração Fazendária (ESAF) to implement the Programa Nacional de Educação Fiscal (PNEF). The study has an exploratory content with a qualitative approach. The informations were collect with a questionnaire applied through the Google-docs by the managers of the program in any federated unit. Were founded several results, as the fragility of the program in the budgeting and financial area, the low frequency of the Grupo de Educação Estadual (GEFE) in regular meetings, the absence to monitor undertaken actions and the absence of interlocution between the GEFE and the forums of national discussions, especially the Conselho Nacional de Política Fazendária (CONFAZ). Despite the fragilities, the work shows the occurrence of some actions to disseminate Fiscal Education in schools and universities, the establishment of partnerships and the participation of the GEFE‟s in the national meetings. With the study, it was possible to conclude that in spite of the weaknesses found in its structure, the PNEF s institutionalized in the states and in the federal district, observing the differences between the federal units in relation to the ripening of the program. Despite the difficulties evidenced, it appears that they are capable of resolution, as far as it recognizes the importance of the Program for the promotion of a culture of active citizenship in the society and it will gives better conditions of implementation

Programa Nacional de Incentivo à Leitura - PROLER: avaliação da implementação pelo Comitê Potiguar

The National Reading Incentive Program (PROLER) is a national initiative to promote and encourage reading throughout the country, linked to the National Library Foundation (FBN) of the Ministry of Culture (MinC). This research aims to assess the PROLER’s implementation process in the state of Rio Grande do Norte, from the actions of their local committee. The framework is based on contextualize the policies that seek to encourage the book and reading, as well as the processes of implementation and evaluation of public policies. The research is understood as a qualitative descriptive-exploratory study, comprising a single case study. Makes use of semi-structured interview as a tool for data collection, which was attended by 8 members of Potiguar Committee as respondents. The techniques of bibliographical and documentary analysis were used for the analysis and discussion of data obtained from surveys and documents on PROLER; as to the content of the interviews, the technique used was the analysis of conversations. As for the results, the existence of four barriers to program implementation in the state that are worth mentioning is observed: a) the political-administrative discontinuity; b) the limited resources and few partnerships; c) the management of school libraries and absence from the post of librarian in the state and; d) the absence of a process or assessment tool able to evaluate the results or the impacts of actions taken by the Potiguar Committee. It was noticed that these limiting four come PROLER making the implementation of the Rio Grande do Norte a process that, although complying with the national regulations of teacher training and follow school libraries and their needs, not flawed to develop assessments that can measure program impacts, making the feedback process of ineffective policy. Another observation of this study is seen in the fact that the Committee did not get enough to supply their shares resources, as well as not being able to articulate new partnerships, thus contributing negatively to the scope of the program form and, consequently, for the effectiveness of their actions. Has even mentioning the fact that the Committee do nothing regarding the mismanagement of the libraries that are in their care, ie, do not use the power of coercion as guaranteed by the National Policy on Reading and federal laws that treat the school library, and is therefore ineffective in relation to compliance with the program guidelines

O Programa Nacional Biblioteca da Escola - PNBE: da gestão ao leitor na educação infantil de Natal-RN

This study aims to investigate the process of implementation of Programa Nacional Biblioteca da Escola, PNBE, and the reader's training on Childhood Education level in Natal. The promotion of literary reading is the opportunity of inclusion in a world that is connected to citizenship, to human rights and social justice, because the reading is the way which gives meaning to the life and, therefore, it is a right for everybody. The study is characterized as a qualitative research with evaluative approach. The methodological procedure that constitutes this corpus took place in three stages: the first one was about the analysis of laws and documents of national public policies for the reading promotion; questionnaires were applied by Managing Committee - Natal/RN to CMEIs and the available websites from MEC that provide distribution of the acquis; in the second stage, we adopted the semi-structured interview as a methodological procedure elaborated with open questions that focus on the program management and to the acquis of PNBE; and in the third step we visited the 21 centers of childhood education in Natal for interviewing and to do the exploratory observation in places of reading. The Informant actors in this research are: the advisors of SME - Natal and FNDE, managers and teachers in Municipal Childhood Education Centers who totalize 30 informants. This theoretical and methodological framework follows the studies of Amarilha (1993; 1994; 2002; 2006; 2010; 2012), Bardin (2001), Bogdan; Biklen (1994), Castro (2007; 2008; 2012), Demo (2000; 2006; 2008), Fischer (2006), Moreira; Caleffe (2008), Paiva (2008; 2012), Secchi (2010; 2012), Soares (2003; 2008) and Zilberman (2001; 2003; 2008). The analysis indicates that decentralization strategy which is adopted in public management model will transfer responsibilities and assumption of the PNBE, exempting the actors to planning actions ensuring the efficiency and efficacy implementation on reading policy to national and municipal levels. The qualified acquis that is distributed by MEC reaches every Childhood Education center and does not depend on teacher's desire or it action, only a few of them know about it and they do not have information about the PNBE, neither receive specific training in order to articulate it to the practice of reading with children from Childhood Education. The reading project implemented by private education system in Natal overlaps the PNBE, making it invisible. The reading places that are available for that schooling stage are summarized to the reading corners. In some CMEI, books remain stored in boxes or they are locked in the closet, out of use to the teachers and students. Thus, care for the acquisition, selecting acquis, and a preoccupation to the supply of the reading and books for this education level are lost into volumes of closed boxes, teachers are jettisoned to this process and children do not have any enchantment to the reading or books. In this context, this paper draws attention to how much we should still investigate in order to understanding the perspectives, stresses and challenges from public policies for the reading promotion in our country. We hope that the research will help to improve the management model of the PNBE, ensuring the reading democratization and therefore the reader's training in early Childhood Education.

O Programa Nacional Biblioteca da Escola - PNBE: da gestão ao leitor na educação infantil de Natal-RN

This study aims to investigate the process of implementation of Programa Nacional Biblioteca da Escola, PNBE, and the reader's training on Childhood Education level in Natal. The promotion of literary reading is the opportunity of inclusion in a world that is connected to citizenship, to human rights and social justice, because the reading is the way which gives meaning to the life and, therefore, it is a right for everybody. The study is characterized as a qualitative research with evaluative approach. The methodological procedure that constitutes this corpus took place in three stages: the first one was about the analysis of laws and documents of national public policies for the reading promotion; questionnaires were applied by Managing Committee - Natal/RN to CMEIs and the available websites from MEC that provide distribution of the acquis; in the second stage, we adopted the semi-structured interview as a methodological procedure elaborated with open questions that focus on the program management and to the acquis of PNBE; and in the third step we visited the 21 centers of childhood education in Natal for interviewing and to do the exploratory observation in places of reading. The Informant actors in this research are: the advisors of SME - Natal and FNDE, managers and teachers in Municipal Childhood Education Centers who totalize 30 informants. This theoretical and methodological framework follows the studies of Amarilha (1993; 1994; 2002; 2006; 2010; 2012), Bardin (2001), Bogdan; Biklen (1994), Castro (2007; 2008; 2012), Demo (2000; 2006; 2008), Fischer (2006), Moreira; Caleffe (2008), Paiva (2008; 2012), Secchi (2010; 2012), Soares (2003; 2008) and Zilberman (2001; 2003; 2008). The analysis indicates that decentralization strategy which is adopted in public management model will transfer responsibilities and assumption of the PNBE, exempting the actors to planning actions ensuring the efficiency and efficacy implementation on reading policy to national and municipal levels. The qualified acquis that is distributed by MEC reaches every Childhood Education center and does not depend on teacher's desire or it action, only a few of them know about it and they do not have information about the PNBE, neither receive specific training in order to articulate it to the practice of reading with children from Childhood Education. The reading project implemented by private education system in Natal overlaps the PNBE, making it invisible. The reading places that are available for that schooling stage are summarized to the reading corners. In some CMEI, books remain stored in boxes or they are locked in the closet, out of use to the teachers and students. Thus, care for the acquisition, selecting acquis, and a preoccupation to the supply of the reading and books for this education level are lost into volumes of closed boxes, teachers are jettisoned to this process and children do not have any enchantment to the reading or books. In this context, this paper draws attention to how much we should still investigate in order to understanding the perspectives, stresses and challenges from public policies for the reading promotion in our country. We hope that the research will help to improve the management model of the PNBE, ensuring the reading democratization and therefore the reader's training in early Childhood Education.

A educação profissional em debate: uma avaliação política da formação para o trabalho ofertada pelo SENAC/RN através do Programa Nacional de Acesso ao Ensino Técnico e Emprego

In this study, we present a political evaluation of how SENAC/RN perceives PRONATEC, emphasizing all ideological principles, aims and theories that this institution reproduces and reinforces while playing this professional qualification program. We intended to reveal ideological aspects that inspire SENAC’s perception of PRONATEC, pointing the actual interests hidden by those aspects. Our starting question is: What ideologies, objectives and theories that are explicitly or implicitly reinforced by Senac in implementing PRONATEC? In the research, we consider the hypothesis that transferring the responsibility about PRONATEC from public to private institutions is something that impoverishes the professional formation process, once the program ends up subordinated to private institution’s ideological, political and economic interests. The methodological approach chosen was the single case study. As data source, we used broad literature survey, official files of PRONATEC and SENAC, official information about the program and personal interviews. At the end of the research, we present elements that show some “flexibility” on PRONATEC due to SENAC’s interests, offering a superficial professional formation, commonly dissociated from a propaedeutic education, focusing on the need of adaptation e consensus of works around a society project. In this regard, despite PRONATEC is payed by public resources, it’s been used by SENAC as a fortifier of this institution on professional education market, in an hegemonic and neoliberal construction of a model of society.

A educação profissional em debate: uma avaliação política da formação para o trabalho ofertada pelo SENAC/RN através do Programa Nacional de Acesso ao Ensino Técnico e Emprego

In this study, we present a political evaluation of how SENAC/RN perceives PRONATEC, emphasizing all ideological principles, aims and theories that this institution reproduces and reinforces while playing this professional qualification program. We intended to reveal ideological aspects that inspire SENAC’s perception of PRONATEC, pointing the actual interests hidden by those aspects. Our starting question is: What ideologies, objectives and theories that are explicitly or implicitly reinforced by Senac in implementing PRONATEC? In the research, we consider the hypothesis that transferring the responsibility about PRONATEC from public to private institutions is something that impoverishes the professional formation process, once the program ends up subordinated to private institution’s ideological, political and economic interests. The methodological approach chosen was the single case study. As data source, we used broad literature survey, official files of PRONATEC and SENAC, official information about the program and personal interviews. At the end of the research, we present elements that show some “flexibility” on PRONATEC due to SENAC’s interests, offering a superficial professional formation, commonly dissociated from a propaedeutic education, focusing on the need of adaptation e consensus of works around a society project. In this regard, despite PRONATEC is payed by public resources, it’s been used by SENAC as a fortifier of this institution on professional education market, in an hegemonic and neoliberal construction of a model of society.

O controle da tuberculose no contexto da atenção primária à saúde no Brasil

O Brasil é um dos países que concentram 80% da carga de tuberculose no mundo. No contexto da atenção primária brasileira, fatores interferem para que as equipes de saúde da família possam incorporar as atividades de controle da doença no processo de trabalho. O controle da doença depende da forma como os serviços de saúde estão organizados para garantir o acesso ao diagnóstico precoce e ao tratamento. Esse estudo tem como objetivo geral analisar o controle da tuberculose no contexto da atenção primária à saúde no Brasil. Os objetivos específicos são comparar o tratamento diretamente observado com o regime autoadministrado em pessoas com tuberculose; Verificar se o Programa Nacional de Controle da Tuberculose é avaliável e elaborar um modelo teórico e lógico para avaliação deste programa; avaliar a relação entre porte populacional dos municípios e as características de estrutura e processo de cuidado a pacientes de tuberculose na atenção primária no Brasil. Realizou-se uma revisão sistemática, seguida de um estudo de avaliabilidade e de um estudo transversal. Os achados da revisão sistemática revelam que não houve diferença significativa entre os grupos de tratamento (observado e não observado) para cura (OR 1,06. IC95% 0,75 - 1,50) e para conclusão do tratamento (OR 1,64, IC 95% 0,79 - 3,42). Menor abandono no grupo com tratamento supervisionado e não houve diferença estatisticamente significativa entre os grupos (OR 0,73, CI 95% 0,58-0,92). O risco de morte foi maior no regime de tratamento autoadministrado (OR 1,49 IC 95% 1,03 - 2,45). A hetorogeinadade entre os estudos analisados não permite afirmar que nao há diferença estatisticamente significativa para cura e tratamento concluído. A pré-avaliação do Programa de Controle de Tuberculose possibilitou a descrição do Programa, elaboração e pactuação do modelo lógico e a matriz de relevância dos indicadores. Caracterizou-se os seus elementos estruturantes, definição de indicadores de estrutura e processo, além das perguntas avaliativas. Uma avaliação somativa com enfoque na análise dos efeitos da intervenção de controle da tuberculose é recomendada. A avaliação das características de estrutura e processo de cuidado à pessoa com tuberculose revelou melhor desempenho para as equipes de atenção básica de municípios classificados como metrópole no acesso, coordenação do cuidado e qualidade técnica da atenção. Em relação ao acesso: 98,5% acolhimento a demanda espontânea; 95,8% programação de consultas. Na coordenação do cuidado, 93,2% existência de protocolo para tuberculose. Quanto a qualidade técnica da atenção à tuberculose verifica-se que 93,4% acompanhamento de tratamento diretamente observado, 95,8% com busca ativa de faltosos ao tratamento, 64,0% oferta de ações educativas, 91,3% busca ativa de sintomáticos respiratórios. Cabe destacar que metrópoles apresentaram maior tempo médio de espera para escuta/acolhimento (24,41 minutos); para consulta previamente agendada (23,52 dias); para consulta em pneumologia (87,12 dias). Percebem-se fragilidades na estrutura e processo da atenção à tuberculose, principalmente no controle especializado da doença e na qualidade técnica entre os municípios. Recomenda-se reforço, particularmente na qualidade técnica para aumentar a cobertura de acompanhamento do tratamento, busca de sintomáticos respiratórios e das ações educativas.

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.