Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária

People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconized in the scientific literature, interfering with wound healing and quality of life of affected. In this sense, the construction of a assistance protocol specific to people with venous ulcers (VU) can help professionals of the Family Health Strategy both in patient assessment as and in establishment of quality assistance. Thus, this study aimed to analyse the validity of a multiprofessional assistance protocol for people with venous ulcers in primary care by health professionals using Delphi technique. This is a quantitative study, the methodological type conducted in two steps: first step related to integrative literature review to subsidize the development of the protocol, then these aspects were organized and proposed to the judges of the study through the Delphi technique. The study was initiated after approval by the Research Ethics Committee. The first step was performed between August and September 2012, in the virtual library of health, in the page of the Coordination of Improvement of Higher Education Personnel, of Municipal Health Secretariat and international guidelines of associations and in the subsequent step carried out between September 2012 to January 2013, was performed search by Lattes platform of the National Council of Technological and Scientific Development, in order to identify health professionals in Brazil who act as judges of the instrument and then, via online, the form was submitted to them.The sample for the second step was 51 judges in the first round and 35 for the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach Kappa and CVI established were: request / realization / test results, demographic data, medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion location/ edema and pain treatment. After removal of items which have not obtained Kappa or CVI index established, it was found achieving optimal levels of these index for the categories. In the next step was the ressubmissão of protocol to judges through the Delphi technique in it was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2 phase and the other three categories remained the same Kappa and IVC of the previous phase. As for the average of evaluation requirements of the protocol was found that the scores assigned by the judges were higher in the second phase in nine of the 10 items, remaining the same in only one of the items indicating validity of the instrument before the consensus of the judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The formulation of this assistance protocol valid and reproducible will enable a reorganization and redesign of assistance, with standardization of actions and continuity of care for persons with venous ulcers in primary health care

São Vicente (RN) nos primeiros anos da TV: Memória, sociabilidade e cotidiano

The present work aims to reflect on the everyday and its Vincentian practices of sociability in the early years of the presence of television in the city of São Vicente (RN), from the memories of the protagonists who witnessed the first insertion of TV set sin the beginning sof 1970s.Thus, the research was guided by some questions deemed relevant to the study in order to understand the most significant changes in the daily Vincentian boosted by the arrival of television in some private houses, which soon became a meeting place, recreation and sociability. At that time, filled the role of TV unites and brings people together. These houses, reinvented in spaces of sociability, were sanctioned by the various actors who gathered daily to include television programming. This popularity of television was measured by the joint efforts of people who moved their homes to homes that had this technical device. Each home with their uniqueness sand peculiarity, which attracted the population frequency f these spaces were frequent. Of course people still sit on the sidewalks, to be held the night rides in the streets and square, but soon came to the program schedule Preferred came into leaving their homes or to homes that had TV, watch them in the design of audiovisual programs. We use the oral memory as the principal methodology in order to interpret the memories recounted by people who lived in that time period studied. For this purpose we constructed a narrative that highlights the categories memory, media, social practices, everyday life and thus has the theoretical and methodological contributions of authors of humanities and social sciences its main foundation. In field research in the use of in-depth interviews, since the narratives of our research is interviewed. The importance of a study of such order, is not only in understanding the TV as an essential mediator for the interaction of individuals in society, from 1970 in São Vicente (RN), but also for the unveiling of his relationship with the daily routines of the Vincentians, founded in environments and symbols that regulated the conduct and reordered the social practices and sociability of these subjects. In this sense, the making of a work on the presence of TV in the city of São Vicente (RN) is also of paramount importance for the history of this media at the national level, since this is nothing more than a set of multiple stories

Eficácia do bochecho de quitosana a 0,4% sobre o biofilme e bactérias orais

The purpose of this study was evaluate the effectiveness of the chitosan at 0.4 with high molecular weight and high deacetylation degree mouthrinse over the total decrease of the streptococci, Streptococcus mutans, lactobaci/li and over the perceptible bacterial film and gingival bleeding indices. For that, a total of 68 healthy students between 11 and 13 years old, not allergic to crustacean and not users of antibiotics or antimicrobial agent for the last three months or during the treatment, was selected. From those, thirty two individuaIs used the mouthrinse test, and thirty six, the control one. The participants rinsed 10 mL of the solutions twice a day, one during the moming (which was supervised), and another one during the aftemoon (which was not supervised), for fifteen days. The saliva collect for the microbiological analysis, as well as the perceptible bacterial film and gingival bleeding indices check, were made before the use ofthe mouthrinses (base line), immediately after the last mouthrinse on the day (zero time) and fifteen days after (fifteen time). These data were collected at school and the saliva was carried inside the ice to the laboratory. The samples were diluted, and 0.1 mL ofthe 10 -1 dilution was seeded in Rogosa SL agar, for further analysis of the total of lactobaci/lus~ 0.1 mL of the 10-4 dilution in Mitis Salivarius with bacitracin, for S. mutans analysis; and 0.1 mL of the 10-6 dilution in Mitis Salivarius for the analysis ofthe total of streptococcus. The Rogosa SL agar plates were incubated in aerobic at 37°C for 72 hours and the MSB and the MS were incubated in anaerobic in Gaspak@ jars at 37°C for 48 hours for further count ofColonies Former Units (CFUs). The assay was made in duplicate for each bacterial group analyzed. The number of CFUs transformed in LOGlO was analyzed according to the following tests: ANOV A, t of Paired and Not Paired Student, Friedman, Man-Whitney and square-qui test. On the base line, alI the variables analyzed were similar on both tested groups. On both groups, for the total of streptococcus there was no significant difference along the time and for S. mutans there was a statistic significant increase of the CFUs from the base line to the zero time. For the total of lactobaccilus there was no significant difference on the test group along the time, and on the control there was a significant increase ofthe CFUs ITom the base line to the zero time. For both groups, there was significant decrease ofthe perceptible bacterial film index along the time, and that can be explained by the mechanic effect of the mouthrinse over the bacterial film and by the participation of the students on the research which could have motivated him to a better toothbrushing (Hawthome effect). The gingival bleeding index also showed a decrease along the time, even though it was not significant. Therefore, the conclusion of this study was that the chitosan at 0.4 % mouthrinse was not effective on the CFUs reduction of the three bacterial groups analyzed, as well as on the reduction of the perceptible bacterial film and gingival bleeding indices

Comércio internacional e meio ambiente: estímulo à produção sustentável ou mero protecionismo comercial a posição do Brasil em dois casos de litígio

The World Trade Organization (WTO) was established in 1994 as a result of the Uruguay Round, and has as its principal aim advocate for the maintenance of free trade between nations. The preamble of its Constitutive Agreement specifically cites as an institution the goal of achieving sustainable development and the pursuit of protecting and preserving the environment, bringing into the sphere of world trade the idea that concern for the environmental cause is not restricted only the group of environmentalists, but rather has entered the economic landscape in a way not only ideological, but also pragmatic. The General Agreement on Tariffs and Trade (GATT) 1947, part of the GATT 1994, contains a device that allows the adoption of trade restrictive measures, provided that such measures aimed at protecting the environment - Article XX. The Settlement Body (DSB) is part of the WTO and acts in dissolving disputes between the countries motivated by trade. It examines two cases where countries have imposed restrictive trade measures with environmental justification. The first case was closed in 1996, with award of damages given to Brazil, on the breakdown of U.S. environmental legislation imposed on imported gasoline from Brazil - and the second, begun in 2005 and closed in 2007, coming out victorious again Brazil is on the import ban on retreaded tires to Brazil. The objective is to answer the question: how the environment is treated in the midst of trade discussions - which is aimed at its protection or its use with economic objectives in disguise? For the preparation of this work, extensive documentary research was undertaken with the virtual site of the WTO to review the entire production of legal cases and subsequent analysis of the key issue for the work, and literature of authors who have studied the tense relationship between trade international environment. The first case, it could be seen that the political movement performed by the U.S. with the aim of achieving acceptable standards of air quality was an institutional effort to ensure the quality of air, and thus would be inappropriate to say that the regulation of gasoline was merely a disguised trade barrier.However, a careful analysis of the implementation and operation of gasoline regulation may reveal intentions disguised trade and U.S. environmental argument did not hold. The weight of this environment was relegated, since there were clearly outside interests to the environmental cause. The second case, it was realized that, despite clear attempts by the EC to promote ecological dumping, send when brought to Brazil, supposedly a country with weaker environmental structure on surveillance, a residue that, pursuant to internal policies, as could not be sent to their own landfills, the Brazilian discourse remained focused on the environmental cause, and this sort there was the existence of disguised trade barriers, but of importance, at least a priori, the discussion of foreign forces on the environment environment because there is no way to legally justify the reversal of the total understanding of the first judging body, the sight of all the arguments presented by Brazil and the nonsubmission of new facts upon appeal. Still, quite heartening to reflect on the role of trade liberalization on the environment in general, because, while they do not reach a definitive conclusion will reveal positions in both directions, both for and against, the that only adds to the discussions and makes this a very fertile topic for future research

Efeitos de Confinamento de Vórtice Magnético em Nanodiscos de Fe e Py

We report two theoretical works, based in numerical simulations. The first study consists in the investigation of equilibrium phases and vortex formation in Ferro and Permalloy circular and square nanoelements.The another have the aim to investigate the magnetostatic interaction between pairs of nanodisks of Ferro and Permalloy and it`s impact in the vortex structure

Preferência e competição alimentar em um grupo de Sapajus flavius em fragmento de Mata Atlântica em Caaporã – Paraíba – Brasil

Feeding is the primary selective pressure in all forms of animals. Nutritional ecological models predict consequences of preferred and non-preferred food consumption on behavioural, physiological and morphological adaptations. At same time, socioecological models infer socio-organizarion patterns based on feeding competition faced by animals. A list of preferred foods, and inferences regarding the intensity of feeding competition and its behavioural consequences are information of much importance for management of populations in fragments. In this work we observed the feeding behavior and spatial positioning of a group of more than 100 blond capuchin monkeys (Sapajus flavius) that inhabit a fragment of Atlantic forest, surrounded by sugarcane plantation. We compared the consumption of different food items with their monthly availability in the area to define the preferred and fallback food items. We recorded the vocalizations of aggression and the inter-individual distance (area of Minimum Convex Polygon/n individuals) to infer the type of food competition experienced by animals. In the year studied the fruit feeding time correlated with top consumed fruit productivity, indicating preference for fruits. Our data indicate that the species Elaeis sp., Cecropia palmata, Inga spp. and Simarouba amara are the preferred food items in the diet. Available all year round and uniformly distributed, sugarcane was a regular item in the diet and its was characterized as a staple fallback food for this group. Although fruits are preferential food items, direct competition rate did not correlate to fruit productivity in the area, maintaining the high rates throughout the year (2.45 events/ hour). The inter-individual distance index positively correlated with rain fall indicating scramble food competition. The number of neighbours of females carrying infants was smaller when fruit productivity is low, indicating that females carrying infants are suffering increased indirect competition. Our data indicates that blond capuchins in this fragment make use of sugar cane as a staple fallback food, which evidence the importance of sugar cane landscape for the survival of this critically endangered capuchin species in fragmented habitats in Northeast Brazil. A preliminary list of preferred and important foods is offered, and can assist in the choice of trees for reforestation, better fragments to be preserved and areas of release and translocation of animals. We did not observe an increase of contest competition while using preferred foods, but when using staple FBF. This may be due the altered environment, which results in high competition food throughout the year. Both the food preference as the social and behavioral consequences of high food competition experienced by animals in this fragment must be accompanied over the years to ensure the survival of this population.

Preferência e competição alimentar em um grupo de Sapajus flavius em fragmento de Mata Atlântica em Caaporã – Paraíba – Brasil

Feeding is the primary selective pressure in all forms of animals. Nutritional ecological models predict consequences of preferred and non-preferred food consumption on behavioural, physiological and morphological adaptations. At same time, socioecological models infer socio-organizarion patterns based on feeding competition faced by animals. A list of preferred foods, and inferences regarding the intensity of feeding competition and its behavioural consequences are information of much importance for management of populations in fragments. In this work we observed the feeding behavior and spatial positioning of a group of more than 100 blond capuchin monkeys (Sapajus flavius) that inhabit a fragment of Atlantic forest, surrounded by sugarcane plantation. We compared the consumption of different food items with their monthly availability in the area to define the preferred and fallback food items. We recorded the vocalizations of aggression and the inter-individual distance (area of Minimum Convex Polygon/n individuals) to infer the type of food competition experienced by animals. In the year studied the fruit feeding time correlated with top consumed fruit productivity, indicating preference for fruits. Our data indicate that the species Elaeis sp., Cecropia palmata, Inga spp. and Simarouba amara are the preferred food items in the diet. Available all year round and uniformly distributed, sugarcane was a regular item in the diet and its was characterized as a staple fallback food for this group. Although fruits are preferential food items, direct competition rate did not correlate to fruit productivity in the area, maintaining the high rates throughout the year (2.45 events/ hour). The inter-individual distance index positively correlated with rain fall indicating scramble food competition. The number of neighbours of females carrying infants was smaller when fruit productivity is low, indicating that females carrying infants are suffering increased indirect competition. Our data indicates that blond capuchins in this fragment make use of sugar cane as a staple fallback food, which evidence the importance of sugar cane landscape for the survival of this critically endangered capuchin species in fragmented habitats in Northeast Brazil. A preliminary list of preferred and important foods is offered, and can assist in the choice of trees for reforestation, better fragments to be preserved and areas of release and translocation of animals. We did not observe an increase of contest competition while using preferred foods, but when using staple FBF. This may be due the altered environment, which results in high competition food throughout the year. Both the food preference as the social and behavioral consequences of high food competition experienced by animals in this fragment must be accompanied over the years to ensure the survival of this population.