77 resultados para Residência Multiprofissional

em Universidade Federal do Rio Grande do Norte(UFRN)


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The Health Multiprofessional Residency Program of the Federal University of Rio Grande do Norte (PRMS/UFRN) adopts as guiding keystones the learning process of in-service teaching, the interdisciplinary multiprofessional work and the compliance with the principles and guidelines of the Brazilian Unified Health System (SUS). Although PRMS/UFRN have been idealized with a focus on hospital care, the training process in the insertion of residents in the Primary Health Care (PHC) has an important role because they need to experience all levels of care, taking into account that the educational process through work proposed by the Residence is based on the comprehensiveness of health care. In light of the foregoing, the present research has sought to elucidate the insertion of these residents in PHC services, through a qualitative approach of case study, where data collection was held in two different moments: firstly, a questionnaire was accomplished, through an semi-structured script, with the residents of PRMS/UFRN, Natal Campus; subsequently, the focus group technique was accomplished with a group of nine residents, and data were analyzed from the categorical thematic content analysis. From the process of empirical categorization, categories and subcategories were raised, among which, the positive aspects and potentialities of insertion of residents in PHC. We detected the articulation of actions for promoting, preventing and recovering health; training in comprehensiveness of health care, multiprofessional activities and activities aimed at doing the integration among teaching-service-community. Regarding the difficulties found in this experience, we dealt with the organization and planning of rotation activities, the preceptorship, the process of work found in the Basic Health Units (BHU), in addition to factors external to educational practice, such as the issue of safety within these communities. Accordingly, with this situational diagnosis, we became able to realize that residents have identified the importance of this rotation for their vocational training, since these are inserted in post-graduate programs in hospital care. As an immediate product of this study, we will present a report that will provide a space for discussion and assessment of this rotation by the coordination bodies of PRMS/UFRN, in order to seek organizational and pedagogical adaptations, besides the proposition of qualification courses for the actors involved with this process, aiming the implementation of improvements in the rotation of PHC toward the qualified training of professionals for SUS.

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A residência médica é uma modalidade de ensino de pós-graduação destinada a médicos, funciona em instituições de saúde, sob a orientação de profissionais médicos de elevada qualificação ética e profissional, sendo considerada o “padrão ouro” para a formação do especialista. A utilização do método de avaliação 360 graus na residência médica visa a avaliação integral dos médicos residentes, preenchendo lacunas que a avaliação cognitiva isolada deixa, quando utilizada como método único. Essa avaliação proporciona uma avaliação mais global do médico residente, já que inclui sua autoavaliação, avaliação pelos pares, pacientes e equipe de saúde. O objetivo deste estudo foi definir instrumentos de avaliação para implementar a avaliação 360 graus no programa de residência médica em cardiologia da UFRN e capacitar os docentes e preceptores do citado programa para avaliação de desempenho clínico do residente. Trata-se de estudo exploratório, prospectivo e descritivo, envolvendo quatro médicos residentes do programa de residência médica de cardiologia e 20 de clínica médica, esses durante o rodízio de cardiologia do programa de residência médica (PRM) em Cardiologia do Hospital Universitário Onofre Lopes (HUOL), além de 13 preceptores/docentes do PRM em Cardiologia do HUOL. Para implementação do novo modelo avaliativo na residência médica foram programadas três etapas, sendo a primeira a elaboração dos instrumentos de avaliação para a avaliação 360 grus; a segunda, o planejamento e a capacitação dos preceptores do PRM em Cardiologia do HUOL; e a terceira, o início das avaliações 360 graus dos residentes do PRM em Cardiologia e Clínica Médica, durante o período de janeiro de 2014 a março de 2015. Foram avaliados, no total, 24 residentes até o momento, sendo quatro residentes da cardiologia (três residentes do primeiro ano e um residente do segundo ano) e vinte residentes da clínica médica (sendo doze residentes do primeiro ano e oito residentes do segundo ano). Foram realizadas autoavaliações por oito residentes, sendo essas consideradas difíceis pela maioria dos residentes. A avaliação por pares foi realizada por 6 residentes, sendo o desempenho dos pares considerado acima do esperado em todos os itens da avaliação. A avaliação pela equipe de preceptores e equipe multiprofissional com feedback ao final das avaliações mostrou que os residentes de clínica médica do primeiro ano apresentam desempenho acima do esperado em relação ao humanismo, ética e profissionalismo, enquanto os do segundo ano apresentaram desempenho abaixo do esperado no item referente ao exame físico. Quanto aos demais domínios da avaliação todos estiveram dentro do esperado. Dez pacientes avaliaram os oito residentes, sendo tais avaliações positivas no sentido da qualidade da assistência prestada e das informações fornecidas pelos residentes. O método de avaliação 360 graus foi implementado na residência de cardiologia do Hospital Universitário Onofre Lopes da UFRN, tendo sido realizada em quatro residentes. A maioria dos preceptores e equipe multiprofissional da residência estão capacitados para utilização do método de avaliação.

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Considering that tourism tends to reproduce itself privatizing the areas where it installs, the secondary residence has been an urban element responsible for the private appropriation of the public spaces of coastal of Nísia Floresta. The private appropriation of these accesses, for secondary residences, constitute in an issue-problem of the research. The principal goal is to analyze the relationship of the consumers/users of secondary residences with the public space; and, specifically, identify how the government has been acting and manifesting itself about the occupation of the coastal of Nísia Floresta; as also to verify how the secondary residence has been appropriating privately of the public access of the coastal. On account of the scarce literature about secondary residences and the importance of the public access to beaches for the inhabitant, the present work aims to contribute to the discussion of this theme. The secondary residences in Rio Grande do Norte began in the late nineteenth century, becoming more common in the 90s, when the coast south of Natal is appropriated from local vacationers. In 2000, foreign investment began to be applied in real state and tourism, producing closed developments, served in leisure infrastructure, trade, and hospitality, mainly to external demands. The methodology included a bibliographic survey, data collection and in lócus observation. Applied questionnaires and interviews were performed with consumers/users of the secondary residences, permanent residents and government, respectively. To the legal grounding, taken as a reference the article. 10, of the law 7.661/88 to establish that the beaches are goods of common use . Considering the conclusive analysis of the research, can be said that the right of free access and use of the beach is committed for the benefit of the consumers/users of secondary residences, due to the negligence and omission of the government

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The present study had as goal to evaluate Rio Grande do Norte state’s medical residency programs (MRP) in Cardiology. It’s a descriptive study, including a documental analysis of the program’s accreditation processes (PAP) of cardiology’s medical residency in Rio Grande do Norte state in 2014 and the analysis of the resident’s perception about his professional education as a specialist in Cardiology. Beside the documental analysis of the PAPs, it was applied a semi-structured questionnaire with closed questions Likert style and open questions to all the current and former residents of the MRPs analyzed. Two MRPs in Cardiology were identified in Rio Grande do Norte state, one hosted in a public institution and the other in a private institution. The documental analysis showed a greater amount of preceptors with a good level of ownership on the public institution in comparison with the private one, as well as a bigger number of publications, participation in congresses and in book’s publications. The private institution presents a better Urgency’s infrastructure, with emergency room and cardiologic ICU. It IS clear that the residents are aware of how a good residency must work, as well as the strengths and fragilities of their own residences. Most of Onofre Lopes Universitary Hospital’s residents point out as a strength the organization, participation and quality of the preceptors, practice activities and scientific debates, great amount of patients and the visits and debates with the preceptors on the sickrooms. As the greatest fragilities, they emphasize the lack of a urgency service of their own and a specialized ICU. In Coração Hospital of Natal (HCor), it is listed as weak points the theoretic scheduling and the few ambulatory practices. As positive aspects, they report the preceptors, the agility on the execution of exams, a good number of serious patients and procedures. In both residences, it is seen a certain difficulty in accepting the important and mandatory items imposed by the rules of the Medical Residences’ National Committee, such as: biostatistics, bioethics, medical ethic, epidemiology and research methodology. Besides that, the residents recognize that both hospitals have a good infrastructure and technological support, especially in imaging methods. The evaluation of PRMCs identifies the strengths of each program and the aspects to be improved in both programs. It also allowed the observation of difficulties in accepting some regulations contained in the CNRM resolution by the resident, such as participation in activities such as biostatistics, epidemiology and research methodology as well as the improvement needs of specific technical training, such as in emergency care. Thus, our results make possible to develop strategies for continued improvement of PRMC in RN state. In addition, it enabled the preparation of the resident’s manual in cardiology, containing even a breakdown of resident evaluation system, which could serve as a model for other residency programs.

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This work intends to describe and analyze the parties of forró that happen in Serra da Gameleira, in São Tomé/RN. Serra is a divided social space: groups of different ethnic origins live together in Gameleira de Baixo, Salgadinho (or Gameleira de Cima) and Chaves Belas. They are approximately two hundred families that live exclusively from agriculture. We try to understand how the parties inform about the social organization, the ethnic composition of the families that live there and the past of Serra, through the genealogy offorró players. In the discussion, we identify the festive places: in the total, we have Five houses of forró that function regularly one of them has been described. The private and public spaces inside them are intimate related, with no clear limits between the house of forró and the residence. Each house of forró has an owner, that regularly makes the parties, mobilizing a big part of the inhabitants, and provoking the straitening of the social relations. Observing the festive sociability between different social segments, the forró appears like na element that minimizes social conflicts, providing news ways of association and cooperation in the space of Serra da Gameleira. For the collection of facts, we used the ethnographic method, through the direct observation, interviewing and documentary research. The local history is recounted following the routes of oral memory and historical documents analysis. In the end of the analysis, we concluded that music and party are elements that aggregate the different groups that live in the location and determine forms of expression of what is seen as a traditional culture

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In this work was used a plasma torch of non transferred arc with argon as work gas, using a power supply with maximum DC current of 250 A and voltage of 30 V to activate the plasma and keep it switched on. The flame temperature was characterized by optical emission spectroscopy, through Boltzmann-plot-method. The torch has been used like igniter in the aluminothermic reduction of the mixture tantalum oxide and aluminum, seeking to obtain metallic tantalum. In heating of the reagents only one particle will be considered to study interactions between plasma-particle, seeking to determinate its fusion and residence time. The early powders were characterized by laser granulometry, scanning electron microscopy (SEM) and X-ray diffraction analysis. The final product of this reaction was characterized by SEM and X-ray diffraction. Crystallite size was calculated by the Scherrer equation and microdeformation was determined using Willamsom-Hall graph. With Rietveld method was possible to quantify the percentile in weight of the products obtained in the aluminothermic reaction. Semi-quantitative chemical analysis (EDS) confirmed the presence of metallic tantalum and Al2O3 as products of the reduction. As was waited the particle size of the metallic tantalum produced, presents values in nanometric scale due the short cooling time of those particles during the process

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A self-flotator vibrational prototype electromechanical drive for treatment of oil and water emulsion or like emulsion is presented and evaluated. Oil production and refining to obtain derivatives is carried out under arrangements technically referred to as on-shore and off-shore, ie, on the continent and in the sea. In Brazil 80 % of the petroleum production is taken at sea and area of deployment and it cost scale are worrisome. It is associated, oily water production on a large scale, carrier 95% of the potential pollutant of activity whose final destination is the environment medium, terrestrial or maritime. Although diversified set of techniques and water treatment systems are in use or research, we propose an innovative system that operates in a sustainable way without chemical additives, for the good of the ecosystem. Labyrinth adsor-bent is used in metal spirals, and laboratory scale flow. Equipment and process patents are claimed. Treatments were performed at different flow rates and bands often monitored with control systems, some built, other bought for this purpose. Measurements of the levels of oil and grease (OGC) of efluents treaty remained within the range of legal framework under test conditions. Adsorbents were weighed before and after treatment for obtaining oil impregna-tion, the performance goal of vibratory action and treatment as a whole. Treatment technolo-gies in course are referenced, to compare performance, qualitatively and quantitatively. The vibration energy consumption is faced with and without conventional flotation and self-flotation. There are good prospects for the proposed, especially in reducing the residence time, by capillary action system. The impregnation dimensionless parameter was created and confronted with consecrated dimensionless parameters, on the vibrational version, such as Weber number and Froude number in quadratic form, referred to as vibrational criticality. Re-sults suggest limits to the vibration intensity

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Sandflies stand out as important vectors of leishmaniasis. The females need to ingest blood meals, enabling them to transmit protozoa of the genus Leishmania, which may give rise to visceral leishmaniasis (VL) or American tegumentary leishmaniasis (ATL), in addition to transmitting other parasites. Leishmaniasis are important infirmities, distributed worldwide, whose infection results from the interaction of reservoir animals, the vector insect, parasitic protozoa and the healthy host. In the state of Rio Grande do Norte (RN), Brazil, these insects are important transmitters of VL, which usually presents in the most serious form. It occurs mainly in metropolitan areas, with the dog as its main reservoir and Lutzomyia longipalpis as the vector. ATL is most present in the highland areas of the state. In addition to hematophagia, engaged in by the females, both sexes need to ingest carbohydrates, which are essential to the sand flies energy requirements and may interfere in the development of Leishmania. The aim of this study was to determine the occurrence and abundance of sand flies in different environments on the farm belonging to the Empresa de Pesquisas Agropecuárias do RN (Institute of Agricultural Research of RN), in the municipality of Parnamirim, in order to relate this occurrence with climatological and biological references and eating habits. Three consecutive monthly collections were carried out with CDC traps in a fragment of the Atlantic Forest, in a residence, on a goat breeding farm and on cashew, dwarf and giant coconut, mango, banana, eucalyptus, acacia and bean plantations. A total of 1241 sandflies from eight species (Lutzomyia evandroi, Lutzomyia longipalpis, Lutzomyia shannoni, Lutzomyia sordellii Lutzomyia walkeri, Lutzomyia wellcomei, Lutzomyia whitmani, and Lutzomyia intermedia) were collected, most in the forest environment. L. longipalpis, the main VL transmitter, was confirmed as a species adapted to anthropic environments, whereas others such as L. wellcomei, the vector of ATL, occurred predominantly in forests. Carbohydrate characterization of the sand flies and plants of the region demonstrated that a number of exotic plants such as hay and eucalyptus may play some role in the adaptation of these species to modified environments. Breeding in laboratory showed a mean biological cycle of 53.5 days from egg to adulthood for L. shannoni and the possibility of diapause behavior in L. wellcomei. This study serves as a source of information that may contribute to the epidemiological vigilance of tegumentary and visceral leishmaniasis in the state, given that it analyzes the bioecology of transmitting species, as well as their potential to adapt to new environments

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The sand fly Lutzomyia longipalpis (Diptera: Psychodidae) is currently appointed as the main vector of visceral leishmaniasis in the Americas. The growth of cities in areas originally endemics to American Visceral Leishmaniasis (AVL) resulted in the spread of the disease at the same time that observed the adaptation of this species to the urban environment.Changes in behavior of L.longipalpis that enabled the adapt to increasing losings of biodiversity, as well as the frequent exposure of the vector to insecticides evident in urban areas, could justify the increasing population of the species and consequently the spread of disease for these environments .Thus, we selected sixty houses spread among three areas with increasing stages of occupation of an area endemic for AVL in Teresina-PI. We evaluated the correlation between the density of L.longipalpis captured and different aspects, such as population density of animals, vegetation cover and socio-economic aspects in each house. In addition to the correlations, the feeding preference of the vector between the predominant plant species in the neighborhoods, as well as the presence of metabolic mechanisms of resistance among the captured insects were tested. The results showed that over the growing occupations, represented by three areas, L.longipalpis demonstrate its adaptive nature through an apparent opportunistic behavior in relation to sources of carbohydrates and blood. On the evolutionary point of view, this behavior may have favored its vector competence in urban areas among the limited presence of food sources, as well as in various environments encountered.

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Investigate intrahospital and neonatal determinants associated to the weaning of very low birth weight (VLBW) infants. Methods: 119 VLBW (<1500g) infants 81 were monitored from July 2005 through August 2006, from birth to the first ambulatory visit after maternity discharge. This maternity unit uses the Kangaroo Method and the Baby Friendly Hospital Initiative. Results: Out of 119 VLBW infants monitored until discharge, 88 (75%) returned to the facility, 22 (25%) were on exclusive breastfeeding (EB) and 66 (75%) were weaned (partial breastfeeding or formula feeding). Univariate analysis found an association between weaning and lower birth weight, longer stays in the NICU and longer hospitalization times, in addition to more prolonged enteral feeding and birth weight recovery period. Logistic regression showed length of NICU stay as being the main determinant of weaning. Conclusion: The negative repercussion on EB of an extended stay in the NICU is a significant challenge for health professionals to provide more adequate nutrition to VLBW infants

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The aim of this study is to understand the perception of medical students at the Federal University of Rio Grande do Norte (UFRN) about humanization in the context of their medical formation, using a qualitative approach. The focus group and participant observation techniques were used, involving a multidisciplinary team composed of professionals from the areas of anthropology and psychology, as well as professors from the medical course, who studied two groups of nine students in their final year. The data were analyzed using the categorical thematic content analysis technique, from which emerged three categories: student/patient relationship, teaching/learning and student/professor relationship. The first allows us to identify that student-patient contact is an essential experience for adopting a more humanized view of the disease process. The second category shows that unqualified professors in the pedagogic practices inherent to the teaching profession and the theory the practical dichotomy hinder the autonomous and holistic formation of knowledge. Similarly, the lack of practices outside the academic environment and the absence of multiprofessional stimulation interfere in the construction of an integral view of the individual. From the third category, the student/professor relationship, emerge two opposing subcategories (professor model and assymetric relationships), which reflect the importance of the professor`s ethical humanist position, as opposed to an authoritarian attitude, to form the professional attitude of the student. The results point important aspects of the medical formation that may open a discussion about humanization, in the context of new national curricular guidelines

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Visceral leishmaniasis hás adapted in the past 20 years to periurban and urban areas, and in Natal, Rio Grande do Norte, it became endemic. Thid study aimed to evaluate the environmental and social aspectsof Leishmania chagasi infection and its epidemiologic transmission chain in an urban, periurban and rural area of Parnamirim-RN. A study with three sections was conducted: Section 1: Sectional study of the human and canine infection by L. chagasi and its environmental and social determinants. Section 2: Observational longitudinal cohort to evaluate the dynamics of the canine infection. Section 3: Longitudinal study to evaluate the behavior of Lu. Longipalpis vector and the seasonal factors related to its dynamics. To include in the study the hauses were randomly selected and georreferenciated. Montenegro skin test was done in the human population and blood samples were collected for anti-Leishmania antibody detection. The canine population was examinated for L. chagasi infection by RIFI, ELISA and ELISA for rK39. An entomologic surveillance was monthly done with CDC light trapsin 10 houses of each locality. Quantitative and qualitative analyses was done using STATISC 6.0. Probality and prediction maps were done using ArcGis 9.0 model. In the human population L. chagasi infection was associated with the area of the hause, age, sex, population densyti, vegetation, kind of the floor of thr hause, water and resides destiny. In the canine population L. chagasi infection was associated with the breed, size, time of living in the hause, presence of dogs in the neighborhood, presence of horses and donkeys in the neighborhood, vegetation, kind of the floor and walls of the hause. The human infection was associated with canine infction only when analyzed taking into account the locality. In the prospective study, serum conversion and antibody lost observed in 30,8% and 22% of the animals examined, respectively. The human infection rate by L. chagasi was 24,6%, by the presence of anti-Leishmania antibody and 38,6% by the Montenegro skin test. The canine infection rate 32,5% by the presence of anti-Leishmania antibody. The vector Lu longipalpis showed an atypical behavior. These results indicate that environmental and social factors are important variables associated with L. chagasi infection in humans and canines, with punctual association of thr last two. Control measures of the infection on the studied points are necessary, in the aim to reduce the endemic focus of the disease in the study area. This research was carried out in a multidisciplinary involving the categories of: doctor, biologist, veterinarian, statistical, pharmaceutical and biochemical

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A venous ulcer is the most serious clinical manifestation of chronic venous failure, and the most frequent in lower limbs, accounting for 70% of all ulcers. Patients may suffer from this infirmity for several years without healing of the lesion if treatment is inadequate. The aim of this investigation was to verify the effectiveness of decongestive physical therapy in the healing of venous ulcers. This is a quasi-experimental, interventionist study, with paired, non-probabilistic sampling, composed of 50 patients divided into two groups: control and intervention, each composed of 25 patients. Both groups were identically treated for six months with daily dressings and the latter also underwent complex physical therapy consisting of a combination of the following techniques: manual lymphatic drainage, compression bandaging, lower limb elevation, myolymphokinetic exercises and skin care. The study was approved (Protocol no. 59/2007) by the Ethics Committee of the State University of Southeast Bahia. The Mann-Whitney and Chi-square tests were applied for data analysis. After statistical analysis the patients who underwent therapy showed a statistically significant difference with respect to wound contraction starting in the second month of treatment. Compared to the control, the intervention group showed a greater reduction in both pain and edema starting in the third and fourth month of therapy, respectively. To reinforce these findings, the mean percentage of tissue present at the base of the ulcer (granulation/fibrin ratio) was calculated. The intervention group showed greater granulation at the base of the ulcer compared to the control, significant from the second month of treatment on. It was observed in this study that lymphotherapy, when compared between the intervention and control groups, accelerated the healing process, and reduced pain and edema in the affected limbs. It is expected, therefore, that these results widen scientific knowledge and we suggest that this therapy be used 78 not only to reduce lymphedema, but also as a treatment option for venous ulcers, given its easy application and low cost. The data, therefore, demonstrated the importance of basic care on the part of a multiprofessional and transdisciplinary health team involved in the healing process of these infirmities, thereby contributing to better quality of life in these individuals

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Conselho Nacional de Desenvolvimento Científico e Tecnológico

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Introdução: A criação de programas de equipe multiprofissional de saúde desponta como uma alternativa eficiente para controlar a evolução dos pacientes portadores de diabetes, e a inserção do farmacêutico em tais programas tem contribuído para melhorar o acompanhamento desses pacientes. Objetivo: Avaliar o impacto da intervenção do farmacêutico no acompanhamento dos pacientes diabéticos tipo 2, em farmácias comunitárias. Métodos: Ensaio clínico randomizado, uni-cego envolvendo 100 pacientes diabéticos tipo 2 de ambos os gêneros, usuários de farmácia comunitária, com idade igual ou superior a 30 anos, em uso de hipoglicemiantes orais com adição ou não de insulina e foram acompanhados por 6 meses. Os pacientes do grupo controle receberam o tratamento habitual existente em qualquer farmácia, e os de intervenção receberam o acompanhamento do farmacêutico incluindo intervenções aos problemas relacionados aos medicamentos. Os desfechos primários avaliados foram os valores da hemoglobina glicada (HbA1c), glicose basal e um questionário de qualidade de vida validado denominado de Diabetes Quality of Life Measure (DQOL) - Brasil; e como desfechos secundários as dosagens dos triglicérides, colesterol total, (HDL) colesterol, (LDL) colesterol, tensão arterial e a satisfação do usuário com o serviço prestado. Essa pesquisa contou com a colaboração de vários profissionais das diferentes áreas do conhecimento a seguir nominados: médico, farmacêutico bioquímico, enfermeiro, nutricionista e estatístico. Resultados: Finalizaram o estudo 89 pacientes. Durante o acompanhamento 95,7% (45/47) dos pacientes no grupo intervenção apresentaram problemas relacionados aos medicamentos (PRM), perfazendo um total de 141, com uma média de 3 eventos por paciente, ocorrendo uma resolutividade de 61,7% (87/141). A categoria que mais apresentou PRM foi a de efetividade com 34,1% (48/141) e a classe farmacológica mais utilizada foi a dos hipoglicemiantes orais com 35% (49/141). As variáveis de desfechos primários como hemoglobina glicada (HbA1c) e a glicose basal não apresentaram valores estatisticamente significantes quando comparadas o final com o inicial do acompanhamento nos grupos intervenção e controle considerando um p<0,05, mas o questionário de qualidade de vida DQOL Brasil apresentou resultados estatisticamente significante com um p=0,000. Os desfechos secundários, com exceção da satisfação do usuário, não apresentaram valores xi estatisticamente significantes quando comparados o final com o início do acompanhamento nos grupos de intervenção e controle. Conclusão: Os resultados indicam que as modificações das variáveis clínicas não apresentaram valores significativos no controle da enfermidade e comorbidades, enquanto que na avaliação da qualidade de vida os pacientes afirmaram que melhoraram; portanto, pode-se postular que a intervenção farmacêutica é uma atividade necessária, mas que a prática do Pharmaceutical Care trará benefícios com sustentabilidade para os pacientes se houver uma efetiva integração do farmacêutico numa equipe multiprofissional de saúde, o que está indisponível nas Farmácias Comunitárias