Fatores da satisfação, fidelidade e recomendação em serviço de saúde: estudo em setor ambulatorial de hospital

This thesis deals with the factors affecting customer satisfaction, loyalty and recommendation in the health care sector. It is adapted a model proposed by Johnson et al. (2001) of quality and loyalty antecedent factors and it is conducted a survey with a sample of 109 customers of a hospital on the ambulatory in Natal city, a capital of a Northeastern State of Brazil. It is carried descriptive and multiple regression statistical analysis. The main findings related to satisfaction are that quality factors of doctor professionalism, clerical staff efficiency, consultancy room comfort, time to provide the medical consultancy but also hospital localization are the most significant factors affecting satisfaction. Regarding personal full loyalty, satisfaction with the hospital and affective commitment are the main factors yet for partial loyalty image and calculate commitment play the main role. For recommendation satisfaction, image and brand are the main factors. The overall model used fairly explains the satisfaction, loyalty and recommendation outcomes with varying factors regarding each final purpose, e.g. loyalty or recommendation

Um framework de agentes de recomendação para sistemas Web

The World Wide Web has been consolidated over the last years as a standard platform to provide software systems in the Internet. Nowadays, a great variety of user applications are available on the Web, varying from corporate applications to the banking domain, or from electronic commerce to the governmental domain. Given the quantity of information available and the quantity of users dealing with their services, many Web systems have sought to present recommendations of use as part of their functionalities, in order to let the users to have a better usage of the services available, based on their profile, history navigation and system use. In this context, this dissertation proposes the development of an agent-based framework that offers recommendations for users of Web systems. It involves the conception, design and implementation of an object-oriented framework. The framework agents can be plugged or unplugged in a non-invasive way in existing Web applications using aspect-oriented techniques. The framework is evaluated through its instantiation to three different Web systems

A Literatura de Cordel como recurso didático na orientação de usuários em uma biblioteca universitária

A Literatura de Cordel consiste numa forma de conhecimento que produz conteúdos importantes para serem inseridos nos mais diversos contextos educacionais. Através de sua linguagem simples, o cordel versa sobre os mais variados temas, proporcionando uma leitura prazerosa. Assim, o objetivo geral desse trabalho é utilizar-se do cordel, com sua característica lúdica, para educar usuários e funcionários de bibliotecas, promovendo um espaço de formadores de habilidades e competências no uso consciente do acervo. A metodologia constou de abordagem aos alunos durante a visita guiada à Biblioteca Central da Universidade Federal do Rio Grande do Norte, onde são prestadas informações dos serviços oferecidos e da importância do acervo de uma biblioteca na sua vida acadêmica, bem como de sua preservação. Ao final da visita, cada aluno recebe um folheto de cordel contendo informações sobre o uso consciente do acervo, além da recomendação de que após a leitura do cordel, o mesmo seja repassado sucessivamente para outros membros da comunidade, de forma a alcançar uma maior parcela de leitores. Os resultados apontam que o cordel destaca-se como um poderoso instrumento didático-pedagógico e disseminador de informações. Ademais, ele tem a facilidade de alcançar desde os mercados e feiras, que divulgam a ciência e a arte, bem como as tradições populares. Conclui-se que o uso do cordel, numa perspectiva educativa, permite transmitir para os usuários de uma biblioteca, bem como à comunidade em geral, as boas maneiras de utilização dos suportes informacionais.

Interação de microorganismos na solubilização de fósforo e potássio de rochas para produção de biofertilizantes

he present model of agriculture is based on intensive use of industrial inputs, due to its rapid response, but it brings harmful consequences to the environment, and it is necessary the use of modern inputs. And an alternative is the use of rock biofertilizers in agriculture, a product easy to use, with higher residual effect and does not harm the environment. The objective of study was to evaluate the inoculation and co-inoculation of different microorganisms in the solubilization of rock phosphate and potash ground microbial evaluating the best performance in the production of biofertilizers comparing with rocks pure in soil chemical properties and, verify effect of inoculation of the bacterium Paenibacillus polymyxa in the absorption of minerals dissolved in the development of cowpea (Vigna unguiculata [L.] Walp.). The first bioassay was conducted in Laboratory (UFRN) for 72 days in Petri dishes, where the rock powder was increased by 10% and sulfur co-inoculated and inoculated with bacterial suspension of Paenibacillus polymyxa grown in medium tryptone soy broth, Ralstonia solanacearum in medium Kelman, Cromobacterium violaceum in medium Luria-Bertani and Acidithiobacillus thiooxidans in medium Tuovinen and Kelly,and fungi Trichoderma humatum and Penicillium fellutanum in malt extract. Every 12 days, samples were removed in order to build up the release curve of minerals. The second bioassay was conducted in a greenhouse of the Agricultural Research Corporation of Rio Grande do Norte in experimental delineation in randomized block designs, was used 10 kg of an Yellow Argissolo Dystrophic per pot with the addition of treatments super phosphate simple (SS), potassium chloride (KCl), pure rock, biofertilizers in doses 40, 70, 100 and 200% of the recommendation for SS and KCl, and a control, or not inoculated with bacteria P. polymyxa. Were used seeds of cowpea BRS Potiguar and co-inoculated with the bacterial suspension of Bradyrhizobium japonicum and P. polymyxa. The first crop was harvested 45 days after planting, were evaluated in the dry matter (ADM), macronutrients (N, P, K, Ca, Mg) and micronutrients (Zn, Fe, Mn) in ADM. And the second at 75 days assessing levels of macro end micronutrients in plants and soil, and the maximum adsorption capacity of P in soil. The results showed synergism in co-inoculations with P. polymyxa+R. solanacearum and, P. polymyxa+C. violaceum solubilizations providing higher P and K, respectively, and better solubilization time at 36 days. The pH was lower in biofertilizers higher doses, but there was better with their addition to P at the highest dose. Significant reduction of maximum adsorption capacity of phosphorus with increasing dose of biofertilizer. For K and Ca was better with SS+KCl, and Mg to pure rock. There was an effect of fertilization on the absorption, with better results for P, K and ADM with SS+KCL, and N, Ca and Mg for biofertilizers. Generally, the P. polymyxa not influence the absorption of the elements in the plant. In treatments with the uninoculated P. polymyxa chemical fertilizer had an average significantly higher for weight and number of grains. And in the presence of the bacteria, biofertilizers and chemical fertilizers had positive values in relation to rock and control. The data show that the rocks and biofertilizers could meet the need of nutrients the plants revealed as potential for sustainable agriculture

Prescrição de exercício físico para mulheres com síndrome dos ovários policísticos: impacto sobre a aptidão cardiorrespiratória e resposta afetiva

analisar o efeito do treinamento aeróbio periodizado sobre a aptidão cardiorrespiratória e respostas afetivas em mulheres com síndrome dos ovários policísticos (SOP) e II) investigar se o exercício aeróbio realizado na zona de prazer para essa população atende a recomendação do American College of Sports Medicine (ACSM) no que se refere à intensidade para melhoria da saúde. Metodologia: foram incluídas mulheres na faixa etária entre 18 e 34 anos, com diagnóstico de SOP de acordo com o Consenso de Rotterdam. Para o subestudo I, oito pacientes sedentárias participaram de 16 semanas de treinamento aeróbio com incrementos mensais de intensidade: fase 1 = 60-70% da frequência cardíaca máxima (FCmax); fase 2 = 70-75% da FCmax; fase 3 = 75-80% da FCmax; fase 4 = 80-85% da FCmax. A intervenção foi realizada três vezes por semana, 40 minutos por sessão. Em todas as sessões foram registradas as respostas afetivas (Feeling Scale -5/+5) e a percepção subjetiva do esforço (escala de Borg CR 6-20). Antes e após a intervenção, as voluntárias realizaram teste ergoespirométrico. Para o subestudo II, 11 pacientes realizaram duas sessões de exercício aeróbio na zona de prazer, sendo registrados parâmetros relativos à demanda física através de receptor de GPS (Global Positioning System) de pulso com cardiofrequencímetro acoplado. As pacientes foram instruídas a realizar 40 minutos de exercício guiadas pelas âncoras verbais bom e muito bom (+3 e +5 na Feeling Scale). Resultados: no subestudo I, após 16 semanas de treinamento, houve aumento da aptidão cardiorrespiratória máxima (17,3%) e submáxima (21,5%). As respostas afetivas variaram entre bom (+3,1 ± 0,8) e razoavelmente bom xi (1,0 ± 0,9) e a percepção subjetiva do esforço entre muito leve a leve (10,2 ± 0,7) e um pouco difícil (12,7 ± 0,6) durante a intervenção. No subestudo II, as pacientes exercitaram-se a ~72,5 ± 6% da FC máxima, ~78,5 ± 6% da FC no limiar anaeróbio e passaram > 95% do tempo em intensidade moderada (~82%) e vigorosa (~16%) durante as sessões experimentais. Em média, as voluntárias reportaram as sessões como fácil (percepção subjetiva do esforço da sessão ~2,2 ± 0,7). Conclusões: o programa de treinamento aeróbio periodizado aumentou a aptidão cardiorrespiratória das pacientes analisadas e foi percebido como uma intervenção prazerosa. Adicionalmente, exercício aeróbio realizado de forma prazerosa atende a recomendação do ACSM no que se refere à intensidade para melhoria da saúde

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

Avaliação do status de zinco e da expressão gênica de metalotioneínas em pacientes com aterosclerose tratados com rosuvastatina

The study had as objective to evaluate the zinc status by means of dietary intake, zinc in plasma and in erythrocytes and the metallothionein gene expression in patients with atherosclerosis in use of rosuvastatin. The research involved 27 adult and elderly patients of both genders with atherosclerosis that were treated with rosuvastatin (10mg/day) during 4 months. We performed the dosage of lipids, glucose, AST and ALT, ultrasensitive C-reactive protein (hsCRP), plasmatic and erythrocyte zinc and 1 and 2 metallothionein gene expression. The assessment of body mass index (BMI) and abdominal circumference (AC) was performed, besides the analysis of dietary intake of patients. The majority of the evaluated patients presented overweight, before and after the treatment, with no significant difference between the times of the study. It was identified that the AC was significantly reduced in the group (p<0.05) after the intervention. The majority of the patients had intake below the recommendation of calories and fibers and above recommendation of proteins. The mono and polyunsaturated fats were adequate for the majority of the patients, however, the saturated fat and cholesterol were consumed in excess by a great part of the individuals. The intake of zinc was inadequate, being noticed an inadequacy of 100% in the male gender and of 84% in the female. After the treatment with rosuvastatin there was a significant reduction in the total cholesterol (TC) and LDL-c (p<0.01) and no alterations were observed in the HDL-c and triacylglycerols. It was also verified that the reduction of glycemia (p<0.05) and of hsCRP (p<0.01). The analysis did not demonstrate significant differences in the plasmatic and erythrocyte zinc concentration after the treatment. There was, after the treatment, reduction of the MT1F gene (p<0.05) without, however, occurring significant alterations in the MT2A gene. The treatment with rosuvastatin was effective in the reduction of TC and LDL-c, and promoted the reduction of inflammatory marker hsCRP. The zinc in the plasma and erythrocyte was not altered by the use of the medication and there was a reduction in the MT1F gene, possibly due to the reduction of inflammation. The majority of patients presented inadequate intake of zinc and this inadequacy did not have relation with the mineral parameters in plasma and erythrocytes or with the metallothionein gene expression

Aspectos linguístico-ergonômicos em rótulos: avaliação da linguagem verbo-visual de rótulos de embalagens para alimentos achocolatados

We have been living in a world of packed products. The package and the labels support the companies to communicate with the customers in addition to give protection, storage and convenience in proportion to the products that move in the price list. The labels mainly add up a value which helps the companies differ their products and increase the value of the brands among the final customers. However, the information given in the label are not clear sometimes. It displays a verbal-visual defective language resulted from a poor visibility, legibleness and comprehensibleness of the verbal and visual marks. The aim of this research is to verify, according to the costumers‟ view, the level of the clarity in the informative texts, harmony and ergonomic conformity of the package labels in the chocolate powder of the Claralate brand, considering the linguistic aspects presented on the labels. The criteria to evaluate the chocolate package selected were based on the linguistic field: the organization and the structure of the text derided from the classification of the textual genre; the clarity and the comprehension of the language utilized on those labels. From the ergonomic view, the informative and ergonomic conformity, based on the following requirements: legibility, symbols, characters, reading fields and intermission of the written lines. Therefore, the research done july 2007 and added july 2011 had a structured questionnaire in the interview put to the 118 customers of the chocolate package that go shopping in one of the two supermarkets in Floriano, Piauí São Jorge and/or Super Quaresma. The main results of the investigation show that the linguistic aspects in the informative texts of the labels provide the customers‟ expectancy partially, while the consideration of the informative ergonomic analyzed can contribute to the improvement of the information and consequent visual progress of those, on the labels of chocolate package investigated. As recommendation towards the maker of the product, the outcome of the research indicates: harmonize the proportion of the letters and numbers; enlarge the letters size; make the visual information more comprehensive determined by the reading field; put the expiry date in a better visual place

Uso urbano não potável de água de lagoas do sistema de drenagem de Natal

The detention and infiltration ponds of urban drainage system has function to protect the population from undesirable effects of floods. In general these ponds are not completly used and it potential is wasted. As it are disseminated at different places at cities it can reduce costs with water transport and permit water preservation of best quality. Some it utilities includes use in green areas irrigation, industrial among than cooling towers and boiler, soil compaction, cleaning urban road, pisciculture and fire fighting system. The quality these water is influenced by anauthorized sewage in the drainage system. This study was performed in six detention and infiltration ponds at drainage system of Natal, which aim was to verify the non-portable use these ponds on urban environment. As indirect aim would to incentive the water utilization these ponds as a water source to another uses in urban environment. These ponds represents the characteristics of detention and infiltration of Natal city and consequently of Brazil. As the water quality, the ponds presents following characteristics: three has apparently good quality, other showed intermediate condition and two had water polluted. Were performed twenty sample in each ponds and the following parameters assessed: pH, temperature, dissolved oxygen, turbidity, electrical conductivity, coliform thermotolerant, ammonia, organic nitrogen, TKN, nitrate, total phosphorus and alkalinity, bicarbonate, chloride, total hardness, calcium and magnesium hardness, total solids, TSS, TDS, COD and SAR°. To utilization on pisciculture we recommend use in ponds which presents the best quality. Only one pond presented higher pollutants and it not being appropriated for use in cooling tower. The content of solids suspension restricted the water use in all ponds in boilers. As water use in soil compaction, cleaning urban road and fire fighting system the water from these ponds are not appropriated. However, the recommended limits from literature are to domestic sewage, due to this, the parameters are restrictive to diminish the sanitary risk that could be offered with it utilization. The infiltration velocity of water these assessed ponds restrict a moderato use, however the effects are potentiated only in soil less sandy, which not occur in Natal. It is recommend the unrestricted irrigation utilization in ponds with best quality of water, and a restricted irrigation to ponds with worst quality of water. As load of pollutants, it is recommended a complementary treatment in those ponds whit higher load to diminish sanitary risks. In only one pond was found one helminth eggs and due to the convention formula of results, it was found for all ponds less than 1 helminth/liter eggs.

Desempenho de analistas sell-side no mercado de ações brasileiro

The purpose of this study was to analyze the behavior of Sell-Side analysts and analysts propose a classification, considering the performance of the price forecasts and recom- mendations (sell-hold-buy) in the Brazilian stock market. For this, the first step was to analyze the consensus of analysts to understand the importance of this collective interven- tion in the market; the second was to analyze the analysts individually to understand how improve their analysis in time. Third was to understand how are the main methods of ranking used in markets. Finally, propose a form of classification that reflects the previous aspects discussed. To investigate the hypotheses proposed in the study were used linear models for panel to capture elements in time. The data of price forecasts and analyst recommendations individually and consensus, in the period 2005-2013 were obtained from Bloomberg R ○ . The main results were: (i) superior performance of consensus recommen- dations, compared with the individual analyzes; (ii) associating the number of analysts issuing recommendations with improved accuracy allows supposing that this number may be associated with increased consensus strength and hence accuracy; (iii) the anchoring effect of the analysts consensus revisions makes his predictions are biased, overvaluating the assets; (iv) analysts need to have greater caution in times of economic turbulence, noting also foreign markets such as the USA. For these may result changes in bias between optimism and pessimism; (v) effects due to changes in bias, as increased pessimism can cause excessive increase in purchase recommendations number. In this case, analysts can should be more cautious in analysis, mainly for consistency between recommendation and the expected price; (vi) the experience of the analyst with the asset economic sector and the asset contributes to the improvement of forecasts, however, the overall experience showed opposite evidence; (vii) the optimism associated with the overall experience, over time, shows a similar behavior to an excess of confidence, which could cause reduction of accuracy; (viii) the conflicting effect of general experience between the accuracy and the observed return shows evidence that, over time, the analyst has effects similar to the endowment bias on assets, which would result in a conflict analysis of recommendations and forecasts ; (ix) despite the focus on fewer sectors contribute to the quality of accuracy, the same does not occur with the focus on assets. So it is possible that analysts may have economies of scale when cover more assets within the same industry; and finally, (x) was possible to develop a proposal for classification analysts to consider both returns and the consistency of these predictions, called Analysis coefficient. This ranking resulted better results, considering the return / standard deviation.

Novas abordagens para configurações automáticas dos parâmetros de controle em comitês de classificadores

Significant advances have emerged in research related to the topic of Classifier Committees. The models that receive the most attention in the literature are those of the static nature, also known as ensembles. The algorithms that are part of this class, we highlight the methods that using techniques of resampling of the training data: Bagging, Boosting and Multiboosting. The choice of the architecture and base components to be recruited is not a trivial task and has motivated new proposals in an attempt to build such models automatically, and many of them are based on optimization methods. Many of these contributions have not shown satisfactory results when applied to more complex problems with different nature. In contrast, the thesis presented here, proposes three new hybrid approaches for automatic construction for ensembles: Increment of Diversity, Adaptive-fitness Function and Meta-learning for the development of systems for automatic configuration of parameters for models of ensemble. In the first one approach, we propose a solution that combines different diversity techniques in a single conceptual framework, in attempt to achieve higher levels of diversity in ensembles, and with it, the better the performance of such systems. In the second one approach, using a genetic algorithm for automatic design of ensembles. The contribution is to combine the techniques of filter and wrapper adaptively to evolve a better distribution of the feature space to be presented for the components of ensemble. Finally, the last one approach, which proposes new techniques for recommendation of architecture and based components on ensemble, by techniques of traditional meta-learning and multi-label meta-learning. In general, the results are encouraging and corroborate with the thesis that hybrid tools are a powerful solution in building effective ensembles for pattern classification problems.

Mudanças na relação entre estado e mercado na produção de habitação de interesse social em Parnamirim-RN

The formulation of public policies, particularly those relating to social housing – SH -, follow a dialectical process of construction, which are involved in the figures of the State and tha Market.The combination of the State and Market remains in constant tension and struggle for power, which provides beyond products (policies, programs and projects), periods of crises and disruptions that can give rise to new institutional arrangements. It is possible to verify a change in the relationship between the State and the Market in the formulation of public policies of SH financing, justified by the context of the Brazilian economy growth, especially after 2003, year that began the first Lula Federal Government , and through the international financial crisis (in 2008). Thus, the State and the Real Estate Market has been undergoing a process of redefinition of their interrelations, articulating new arrangements, new scales of action and new logics of financial valorization of urban space. This peculiarity demanded the rapid thinning of speech and the proposals in the reformulation of housing policies, with the primary result within the pre-existing Growth Acceleration Program – PAC -, the release of My House , My Life – PMCMV -, established by Law 1.977 of the year 2009. Given the above, this research has as study object the relationship between financing public policies of SH, promoted by the State, and behavior of Formal Housing Market. It is believed that the established roles for each agent in the new housing finance model introduced with the PMCMV, have been adapted according to the needs of each location to make this a workable policy. It remains to identify the nature of these adaptations, in other words, what has changed in the performance of each agent involved in this process. Knowing that private capital remains where there is more chance of profit, we tend to believe that most of the adjustments were made on scale of State action. The recommendation of easing urban legislation taken by PMCMV points to how the State has been making these changes in activity to implement the production of social housing by this program. We conclude that in the change for PMCMV, the direct relationship for construction and housing projects financing began to be made between the Caixa Econômica Federal bank and the builders. The city was liberated from the direct interlocutor role between all actors involved in the production of SH and could concentrate on negotiating with the parties, focused on the effectiveness of SH public policies proposed by PMCMV. This ability and willingness for dialogue and negotiation of municipal government (represented by their managers), undoubtedly, represents a key factor for rapprochement between State and Real Estate Market in the City of Parnamirim.

Avaliação da concentração de vitamina A materna e de neonatos prematuros e a termo

Vitamin A is an essential nutrient for many physiological processes such as growth and development, so that their adequate nutritional state is essential during pregnancy and lactation. Lactating women and children in breastfeeding are considered risk groups for vitamin A deficiency and some factors may increase the risk of vitamin A deficiency, such as prematurity. The aim of this work was to evaluate the vitamin A concentration in preterm and term lactating women and newborns by determination of retinol in maternal serum, umbilical cord serum and breast milk collected until 72 hours postpartum. 182 mothers were recruited and divided into preterm group (GPT; n = 118) and term group (GT, n = 64). In preterm group were also analyzed transition milk (7th-15th day; n = 68) and mature milk (30th-55th day; n = 46) samples. Retinol was analyzed by high-performance liquid chromatography (HPLC). Maternal retinol concentration in serum was 48.6 ± 12.3 µg/dL in GPT and 42.8 ± 16.3 µg/dL in the GT (p <0.01). Cord serum retinol was 20.4 ± 7.4 µg/dL in GPT and 23.2 ± 7.6 µg/dL in GT (p> 0.05). Among newborns, 43% of premature and 36% of term had low levels of serum retinol in umbilical cord (<20 µg/dL). In colostrum, the retinol in preterm and term groups had an average of 100.8 ± 49.0 µg/dL and 127.5 ± 65.1 µg/dL, respectively (p <0.05). The retinol average in preterm milk increased to 112.5 ± 49.7 µg/dL in transition phase and decreased to 57.2 ± 23.4 µg/dL in mature milk, differing significantly in all stages (p <0.05). When comparing with the recommendation of vitamin A intake (400 µg/day) GT colostrum reached the recommendation for infants, but in GPT the recommendation was not achieved at any stage. Mothers of premature infants had higher serum retinol than mothers at term; however, this was not reflected in serum retinol of umbilical cord, since premature had lower concentration of retinol. Such condition can be explained due to lower maternal physiological hemodilution and placental transfer of retinol to the fetus during preterm gestation. Comparison of retinol in colostrum showed lower concentrations in GPT; however the transition phase there was a significant increase of retinol content released by the mammary gland of preterm mothers. This situation highlights a specific physiological adaptation of prematurity, likely to more contribute to formation of hepatic reserves of retinol in premature infants.

Levantamentos epidemiológicos em saúde bucal: análise da metodologia proposta pela Organização Mundial da Saúde

Epidemiological surveys are important for obtaining information on the prevalence and etiology of mouth diseases, since the data collected permit health actions to be planned, performed, and assessed. Methodological uniformity is necessary, however, to maintain reproductibility, validity, and reliability, and to allow national and international comparisons. The initiative of the World Health Organization (WHO) as an advisor in ongoing surveys has been extremely useful, stimulating standardization in all countries. In 1991, a Portuguese version of the 1987 third edition of Oral Health Surveys - basic methods, an instruction manual for performing epidemiological surveys, was published and became a reference for many parts of Brazil and the World. The present analysis found conflicting points in relation to the sample size, calibration of the examiners, and criteria for evaluating oral health and treatment needs. In conclusion, due to the dynamic characteristics of scientific knowledge and, considering the regional differences in relation to the development of oral diseases, we recommend that proposals for standardizing surveys be checked periodically. Other important issues may have not been detected in this analysis, urging a thorough discussion within the dentistry community as a whole.

Levantamentos epidemiológicos em saúde bucal: análise da metodologia proposta pela Organização Mundial da Saúde

Epidemiological surveys are important for obtaining information on the prevalence and etiology of mouth diseases, since the data collected permit health actions to be planned, performed, and assessed. Methodological uniformity is necessary, however, to maintain reproductibility, validity, and reliability, and to allow national and international comparisons. The initiative of the World Health Organization (WHO) as an advisor in ongoing surveys has been extremely useful, stimulating standardization in all countries. In 1991, a Portuguese version of the 1987 third edition of Oral Health Surveys - basic methods, an instruction manual for performing epidemiological surveys, was published and became a reference for many parts of Brazil and the World. The present analysis found conflicting points in relation to the sample size, calibration of the examiners, and criteria for evaluating oral health and treatment needs. In conclusion, due to the dynamic characteristics of scientific knowledge and, considering the regional differences in relation to the development of oral diseases, we recommend that proposals for standardizing surveys be checked periodically. Other important issues may have not been detected in this analysis, urging a thorough discussion within the dentistry community as a whole.