Qualidade de vida no trabalho: o caso de enfermeiros dos Hospitais Públicos Walfredo Gurgel e Santa Catarina

The theoretical foundation of this study addresses the construct Quality of Worklife involving pro-active reading organizations in face to social developments of the working class, which is a challenge to the people s management. In this sense, as a contribution to the studies of quality of worklife (QOWL), this study addresses the quality of lifework of nurses at Walfredo Gurgel and Santa Catarina public hospitals. The goal is to make a diagnosis about the quality of lifework of these employees taking as a basis dimensions and performance indicators shown in the model by Fernandes (1996). The research is characterized by field, in a descriptive way. This survey comprised 75 nurses, with 49 by Walfredo Gurgel hospital and 26 by Santa Catarina one. The data collection was carried out through structured questionnaire. The questions were processed in the software Statistic 6.0, with factor analysis and multiple regressions, after the systematization of data. As a result, the most nurses in hospitals are dissatisfied with the quality of lifework, with the highest incidence in Santa Catarina hospital. The variable occupational health assessment was more negative in the hospital Santa Catarina one, whereas in Walfredo Gurgel, was family assistance. The variable guarantee of employment was more positive assessment in two hospitals without, though, implying in high importance on QOWL of nurses. The factor structure and decision showed greater sensitivity to explain the QOWL of nurses, joining 17 variables from 40 of the model. The factor working conditions, joining 6 variables, showed the second highest sensitivity. The compensation factor, gathering 5 variables, showed the third highest sensitivity while image and health factors showed minor importance

Visitabilidade-vivenciabilidade em assentamentos informais : um estudo da acessibilidade de percursos urbanos no Conjunto Santa Terezinha em Fortaleza-CE

This research approaches the issue of accessibility in informal settlements, seeking for the challenges and limits defined by informal urban settings, about the application of accessibility parameters. Take the empirical universe as the Conjunto Santa Terezinha, located in Fortaleza- Ce. Initially, the study presents a reflection about the housing issue in Brazil and the informal settlementes in view of the Right to the City. In this sense, the main references are, the works of Suzanne Pasternak (2008), Nabil Bonduki (1998) and Erminia Maricato (1996-97), among others. Follows with the discussion of the concepts and classifications of this type of settlement, making a content analysis of legislation and regulations relating to accessibility and proposed the discussion of the accessible route as the right strategy for the city. In another step, the methodology of 'walking together' created by Dischinger (2000) was applied in a passage previously chosen, which the researcher follows the disabled person during the journey through city making records like photos and video. The comments and perceptions are compared to the spatial analysis of urban morphology, made from the method of Del Rio (1990) and Panerai (2006), and the parameters of NBR 9050. Knowledge of the area is enriched by the methodology of the production of space made by Henri Lefebvre in his book 'The production of space' (1974) with these categories: space conceived, perceived and lived. Another key reference of this author it s the book 'The Right to the City' (991), which allowed in-depth reflections on the social function of town. In conclusion, the study finds that to guarantee a minimum access conditions in informal sittlements it´s necessary to know the specifics of their morphology, their relations and urban practices in view of the visitability- experiencebility, describing it as complementary concepts

Influência de fatores biopsicossociais sobre a mortalidade de idosos no município de Santa Cruz/RN: um estudo prospectivo

The aging process if characterizes for a complex events network, from multidimensional nature, that encloses biological, social, psychic and functional aspects. The alteration of one or more aspects can speed up the aging process, anticipating limitations and until the death in the aged. For an adjusted confrontation of this question is necessary an interdisciplinary vision, in which the some areas of the knowledge can interact and with this to intervenes of the best possible form. Then, information derived from studies of aspects related to incidence, morbidity-mortality and transition patterns, involved in the health-illness process can more accurately identify risk groups thereby establishing links between social factors, illness, incapacity and death. Thus, this study aimed to identify, by a multidimensional vision, the risk factors of mortality in a coorth of elderly in a city in the interior of the state of Rio Grande do Norte (RN), Brazil. A prospective study carried out in Santa Cruz RN, where 310 elderly were randomly selected to form a baseline. The follow-up was 53 months. The predictive variables were divided into sociodemographic, physical health, neuropsychiatric and functional capacity. The statistical analysis carried out by bivariate analysis, survival analysis, followed by binary logistic regression and Cox regression, in the multivariate analysis, considering significant levels p < 0.05 and confidence interval (CI) of 95%. A total of 60 (19.3%) elderly died during the follow-up, where cardiovascular disease was the main cause. The survival was approximately 24.8 months. The study of general survival showed, at 12, 24, 36, and 48 months of observation, a survival rate of 97%, 54%, 31%, and 5% respectively, with a statistical difference in survival only observed for the variables of cognitive function and Basic Activities of Daily Living. In the logistic regression analysis, the risk factors identified were cognitive deficits (OR = 8.74), poor perception of health (OR = 3.89) and dependence for Basic Activities of Daily Living (OR = 3.96). In the Cox analysis, as well as dependence for Basic Activities of Daily Living (HR = 3.17), cognitive deficit (HR = 4.30) and stroke (CVA) (HR = 3.49) continued as independent risk factors for death. The risk factors found in the study can be interpreted as the primary predictors for death among elderly members of the community. Therefore, improvements in health conditions, with actions towards sustaining an autonomous life with special attention for elderly with cognitive impairment, could mean additional healthy quality of life, resulting in the reduction of premature mortality in this population

Avaliação da atividade biológica de óleos essenciais sobre candida não albicans de origem clínica

Candidíase é um problema de importância crescente, devido o aumento do número de indivíduos imunocomprometidos e o surgimento de cepas resistentes aos antifúngicos convencionais. É de fundamental importância a busca por novos agentes antifúngicos mais eficazes, menos tóxicos, sendo os óleos essenciais (OEs) excelentes alternativas para esse propósito. Esse estudo investigou a atividade biológica do OE de Mentha spicata L. sobre Candida guilliermondii de origem anal e vaginal. Para tanto foram determinadas a Concentração Inibitória Mínima (CIM), Concentração Fungicida Mínima (CFM), cinética do crescimento das leveduras (Time-Kill), alterações micromorfológicas (técnica do microcultivo em câmara úmida) e investigação do mecanismo de ação antifúngico, utilizando o bioensaio do sorbitol. O OE de M. spicata foi obtido pelo processo de extração por destilação a vapor. Na análise fitoquímica desse óleo foi observada a presença de carvona com 84,32%, seguida pelo limoneno (13,70%) e traços de iso-dihidrocarvona (0,82%). Os resultados da análise da CIM variou entre 32 e 128 μg/mL. A CFM variou entre 64 e 1024 μg/mL. Na avaliação da ação de OE e da nistatina 100UI/mL, o antifúngico padrão apresentou o efeito fungicida a partir de 4 horas e para OE de M. spicata foi observado efeito fungistático na CIM, CIMX2 e CIMX4 frente às cepas avaliadas. O OE de M. spicata apresentou forte atividade antifúngica contra as cepas de C. guilliermondii, promovendo alterações micromorfológicas visíveis por microscopia óptica, nas concentrações testadas (CIM, CIMx2), resultado semelhante ao que se observou com a nistatina (100UI/mL). Na investigação do mecanismo de ação antifúngico foi constatado que houve alteração da CIM na presença de sorbitol, com elevação dos valores quatro vezes maior que a concentração inicial, o que indica que os componentes desse OE apresentam ação direta sobre a parede celular das leveduras. Conclui-se que o OE de Mentha spicata é um potencial agente terapêutico no tratamento de candidíase

Identificação e fatores de virulência de Candida spp isoladas da cavidade bucal de transplantados renais do hospital universitário Onofre Lopes em Natal-RN

Despite Candida species are often human commensals isolated from various oral sites such as: tongue, cheek and palatal mucosa plus subgingival region, there are some properties linked to the organism commonly known as virulence factors which confer them the ability to produce disease. Oral candidiasis is one of the main oral manifestations reported in literature related to kidney transplant patients. The objectives of the present study were to identify and investigate virulence factors of yeasts isolated from the oral cavity of kidney transplant recipients admitted at the Hospital Universitário Onofre Lopes, in Natal RN. Seventy Candida species isolated from 111 kidney transplant recipients were investigated in this study. Identification of the isolates was performed by using the evidence of germ tube formation, hypertonic broth, tolerance to grow at 42°C, micromorphology and biochemical profiles. We observed a high rate of isolation of yeasts from the oral cavity of kidney transplant recipients (63.1%) being C. albicans was the most prevalent species. Oral candidiasis was diagnosed in 14.4% of transplant recipients. We evaluated virulence properties of the isolates regarding to: biofilm formation on polystyrene microplates as well as XTT reduction, adherence to acrylic resin and human buccal epithelial cells and proteinase activity. Most isolates were able to form biofilm by the method of adhesion to polystyrene. All isolates of Candida spp. remained viable during biofilm formation when analyzed by the method of XTT reduction. The number of CFU attached to the acrylic resin suggested high adherence for C. parapsilosis. C. albicans isolates showed higher median adherence to human buccal epithelial cells than non-C. albicans Candida isolates. Nevertheless, this difference was not statistically significant. C. dubliniensis showed low ability to adhere to plastic and epithelial cells and biofilm formation. Proteolytic activity was observed for all the isolates investigated, including the unique isolate of C. dubliniensis. There was a statistically significant association between proteinase production and the presence of oral candidiasis. Studies related to oral candidiasis in renal transplant recipients are limited to clinical and epidemiological data, but investigations concerning Candida spp. virulence factor for this group of individuals are still scarce. We emphasize the importance of studies related to virulence factors of yeasts isolated from this population to contribute to the knowledge of microbiological aspects of oral candidiasis

Aspectos de patogenicidade e relacionamento genético de isolados clínicos vaginas e anais de Candida albicans oriundos de pacientes com candidíase vulvovaginal

Vulvovaginal candidiasis (VVC) is one of the most common causes of vaginitis and affects about 75% of women of reproductive age. The majority of cases (80 to 90%) are due to C. albicans, the most virulent species of the genus Candida. Virulence attributes are scarcely investigated and the source of infection remains uncertain. Objective: This study aimed to evaluate the virulence factors and genotypes of clinical isolates of C. albicans sequentially obtained from the anus and vagina of patients with sporadic and recurrent VVC. Materials and methods: We analyzed 62 clinical isolates of C. albicans (36 vaginal and 26 anal strains). Direct examination of vaginal and anal samples and colony forming units (CFU) counts were performed. Yeasts were identified using the chromogenic media CHROMagar Candida® and by classical methodology, and phenotypically characterized regarding to virulence factors, including the ability to adhere to epithelial cells, proteinase activity, morphogenesis and biofilm formation. The genotypes of the strains were investigated with ABC genotyping, microsatellite genotyping with primer M13 and RAPD. Results: We found 100% agreement between direct examination and culture of vaginal samples. Filamentous forms were present in most of the samples of vaginal secretion, which presented CFU counts significantly higher than the samples of anal secretion. There was no statistically significant difference between virulence factors of infecting vaginal isolates and those presented by colonizing anal isolates; as well as for the comparison of the vaginal isolates from patients with different clinical conditions (sporadic or recurrent VVC). There was a decrease in the ability to adhere to HBEC, morphogenesis and biofilm formation of the vaginal isolates during the progress of infection. There was an association between the ability to express different virulence factors and the clinical manifestations presented by the patients. Genotype A was the most prevalent (93.6%), followed by genotype C (6.4%). We found maintenance of the same ABC genotype and greater prevalence of microevolution for the vaginal strains of C. albicans sequentially obtained. Vaginal and anal isolates of C. albicans obtained simultaneously from the same patient presented the same ABC genotype and high genetic relatedness. Conclusion: It is noteworthy that the proliferation of yeast and bud-to-hypha transition are important for the establishment of CVV. The expression of virulence factors is important for the pathogenesis of VVC, although it does not seem to be determinant in the transition from colonization to infection or to the installation of recurrent condition. Genotype A seems to be dominant over the others in both vaginal and anal isolates of patients with VVC. The most common scenario was microevolution of the strains of C. albicans in the vaginal environment. It is suggested that the anal reservoir constituted a possible source of vaginal infection, in most cases assessed

Características genotípicas e fenotípicas de Candida Albicans isoladas da cavidade bucal de pacientes transplantados renais com ênfase na ação do extrato bruto de Eugenia uniflora em fatores de virulência

Candida albicans is a diploid yeast that in some circumstances may cause oral or oropharyngeal infections. The investigation of natural products is mandatory for the discovery of new targets for antifungal drugs development. This study aimed to determine the genotypes of 48 clinical isolates of C. albicans obtained from the oral cavity of kidney transplant patients from two distinct geographic regions of Brazil. In addition, we investigated three virulence factors in vitro: phospholipase activity, morphogenesis and the ability to evade from polymorphonuclear neutrophils. The expression of these virulence factors in vitro was also investigated in the presence of the crude extract of Eugenia uniflora. The genotype A was the most prevalent (30 isolates; 62.5%), followed by genotype C (15 isolates; 31.5%) and genotype B (3 isolates; 6.25%). When microsatellite technique with primer M13 was applied, 80% of the isolates from the South were placed within the same cluster. All Genotype C strains were grouped together within two different clusters. Genotype C was considered more resistant to PMNs attack than genotypes A and B. Strains isolated from the South of Brazil showed higher ability to combat PMNs phagocytosis. We found a high rate of genotype C strains isolated from the oral cavity of this group of patients. The crude extract of E. uniflora inhibited proper hypha formation and phagocytosis by PMNs, but had no significant effect on phospholipase activity. This study characterized oral C. albicans strains isolated from kidney transplant recipients and will contribute for the better understanding of the pathogenesis and alternative therapeutics for oral candidiasis

Ação da β-1,3 glucana no sistema imune de camundongos com sepse por Candida albicans

The frequency of disseminated candidiasis caused by yeast has enhancing in intensive care unit. Despite the availability of new antifungal drugs, C. albicans sepsis mortality causes can be as high as 30-40%. So, it has been needed to looking for a new therapeutic medicament that helps in treatment and prevention of this infection. Previous data that demonstrated that particulated β-glucan stimulates the immune system and experiments of this work were conducted to investigating if β-glucan extracted from Saccharomices cerevisiae, could modified the evolution of mouse model C. albicans systemic infection. Balb/c mice with sepsis and β-1,3 glucan treated or not were analyzed the influence of β-1,3 glucan in survival of the animals, in the fungal burdens in kidney, in the production of urea and TNF even in the histopathology of kidney. The experiments shown that the infected animals a nd glucan treated had great survival (p<0,05), less unit form colony in kidney and normal levels of urea. In the kidney histopathology of not glucan treated animals it has seen more lesions when compared with treated animals. So we conclude that β-1,3 glucan could stimulate the immune system against disseminated C. albicans

Retratos do cotidiano: as mulheres do assentamento rural Santa Vitória

The present work shows trajectories of life of seated women agricultural, with the objective to apprehend on aspects to the experience of its sexuality. The daily one of the seated woman is constructed in a new space, called agricultural nesting whose formation if presents with proper singularity to a social and economic context and politician of the Great River of the North. Its passages of life are permeaty by different violences suffered in its daily one and its sexuality is weaveeed by a set of rules that the naturalization of the subordination of the woman in relation to the man keeps. The societies use the systems of the relations between men and women and transform the biological characteristic into activities human beings

Otimização do Uso das Águas da Barragem Santa Cruz-RN

The semiarid potiguar presents a quite discrepant. It is a region with one of the highest rates of artificial lake the world, but the policy of building dams to mitigate the problem of water scarcity does not solve, given that they have not demonstrated the ability to ensure supply human priority during periods of great drought and fail to solve the widespread demand existent in the semiarid. This work aims to present the optimal allocation of water, according to multiple uses and limited availability of water resources in the reservoir, from the simulation of the operation of the same, with the application of techniques to support decision making and performance evaluation alternatives for water use. The reservoir of Santa Cruz, the second largest reservoir of RN with storage capacity of approximately 600 million cubic meters, located about 20 km from the town of Apodi in RN, was conceived as a way to promote economic development in the region as well as the water supply of nearby towns. The techniques used are the simulation model of network flow ACQUANET and also the set of performance indicators. The results showed that the container has the capacity to serve up to 3,83m3/s flow required by existing uses, without any compromising the same. However, it was also observed that all anticipated future demands are implemented it will generate failures in meeting some uses

Síndrome da fragilidade e fatores associados em idosos comunitários do município de Santa Cruz RN

The frailty in the elderly is characterized by decreased physiological reserves, and is associated with increased risk of disability and high vulnerability to morbidity and mortality. This study is part of a multicentric project on Frailty in Elderly Brazilians (REDE FIBRA). Aims: to investigate characteristics, prevalence and associated factors related to frailty. Metodology: We interviewed 391 elderly patients aged 65 years, selected randomly. Data collection was performed using a multidimensional questionnaire containing information about socio-demographic and clinical variables. To characterize the frail elderly, was considered the phenotype proposed by Fried. Data were analyzed using descriptive statistics, bivariate analysis (χ ²) and binary logistic regression. Results: The prevalence of frailty was 17.1%. In the final model of multivariate analysis, was obtained as factors associated with frailty: advanced chronological age (p <0.001), have comorbidity (p <0.035), show dependence on performing basic activities of daily living (p <0.010) and instrumental (p <0.003) and have poor perception of health status (p <0030). Conclusions: The factors associated with frailty suggest a predictive model helping to understand the syndrome, guiding actions that minimize adverse effects on the aging process

Saúde física e emocional de cuidadores da cidade de Santa Cruz-RN: perfil epidemiológico e fatores associados

Taking care for an impaired elderly is a hard and costly task that could affect directly the caregiver health. The purpose of this study was to evaluate the physical and mental health of elderly caregivers from the city of Santa Cruz-RN and analyze the potential correlated factors through an observational analytic design of a crosssectional. A multidimensional questionnaire was used to evaluation of the social demographics characteristics and those related to the care activity, as well as the caregivers´ physical and mental health. It was realized a descriptive analyze using frequency distribution and measures of the central tendency and dispersion to description of the caregivers. To verify the magnitude of the association between the variables was used the bivariate analysis through the Pearson and Spearman correlations and qui-square test. To evaluation of the association of the correlated factors to the adverse outcome with the caregivers´ physical and mental health was made a multivariate analysis by logistic binary regression and multiple linear regression models. The final sample was constituted by 304 persons, mostly women with a mean age of 50.3 ±16.8 years. The principal factors related to the physical health were age, stress and life satisfaction. Be a male caregiver, caring for a little while the elderly with cognitive deficit and not been spouse were related to worse mental health. Have worse physical health, high stress, depressive symptomatology, burden and low levels of satisfaction were also related to the mental health. After adjust through multiple linear regression was observed R2 values of R2=0,21 for Stress, R2 =0,17 for Depressive Symptomatology, R2 =0,21 for Burden and R2 =0,16 for Satisfaction. The attainment of the factors associated with caregiver´s health can help in the elaboration of specifics politics witch the goal is the integral attention to the elderly and his caregiver. The inability of continuous taking care could result in adverse outcomes such as institutionalization, impairment and death

Ruínas sobre a Serra do Sincorá: a patrimonialização de Mucugê e do Cemitério Santa Isabel (Bahia, 1970-2012)

Esta investigación tienes como objetivo comprender como el Cementerio Santa Isabel, mientras que inserta en el paisaje urbano de Mucugê (Bahia), se construyó como un símbolo de la memoria local. Este proceso de valoración se inició con la preservación del cementerio - que fue construido a mediados del siglo XIX - por el Instituto del Patrimonio Histórico y Artístico Nacional (IPHAN), con el sitio urbano, en 1980. En este sentido, el Cementerio Santa Isabel, conocida en la región y en Mucugê como "Cementerio Bizantino", además de ser un espacio funcional y simbólico desde su construcción, se han consolidado después de su preservación como un objeto histórico y paisaje símbolo de la ciudad diamantina

Turismo religioso na cidade da santa: a percepção da comunidade sobre a construção do Complexo Turístico e Religioso Alto de Santa Rita, Santa Cruz/RN

The general objective of this study was to analyze the city of Santa Cruz cope with the impacts of the changes caused by the insertion of religious tourism with the construction of the Tourist Complex Religious Alto de Santa Rita, and specific objectives: to identify the economic activities from building the Tourist Complex Religious Alto de Santa Rita with the monument of Santa Rita; describe the research scenario to respect the traditions, rituals and spatial organization of the city and to evaluate the impacts through construction of movement by Religious Tourism Complex human capital and economic development fostered by Religious Tourism. To this end, we used the methods of application of Questionnaires and interviews, as well as the method was conducted participant observation, individual and systematic, having exploratory held through a correlational analysis regarding the impacts by inserting Tourism religious elsewhere. Was performed also discourse analysis of speeches Stakeholder city of Santa Cruz / RN for understanding the local reality. Literature search was performed readings of books, articles, theses and dissertations dealing with the issue, it was necessary to use data from websites. As for the media research field was qualitative. At the end of the study, it was concluded that the city of Santa Cruz suffered socio-economic and cultural, as a result, especially the lack of a previously developed tourism planning

Fatores capazes de influenciar o apoio dos residentes ao desenvolvimento do turismo religioso em Santa Cruz - RN

This study is about the primary stakeholder management - the resident community, given its participation and support for the development of tourism in touristic destinations. It has as a general aim to analyze the factors that are capable to influence the residents‟ support to the development of religious tourism in Santa Cruz, RN, and the existing interrelationships between factors. In order to achieve this objective, it was necessary to use exploratory and descriptive research, followed by a quantitative approach through questionnaires with 422 residents of Santa Cruz -RN. The study was based on the variables relationship model proposed by Nunkoo and Ramkissoon (2012), it was also used the technique of Structural Equation Modeling - SEM, aiming to explain the relationships between the constructs studied. The results found on the survey suggest that the more residents realize the benefits generated by tourism, as well as trust in government actors in charge of tourism development, the more there will be a propensity to support the development of religious tourism. This result is similar to the one found in the study of Nunkoo and Ramkissoon (2012). We conclude that the structural model that best represents the reality of Santa Cruz -RN is composed of the factors: benefits, costs, and confidence in governmental actors, which are able to influence the support of Santa Cruz‟s residents for the development of religious tourism. It is also noteworthy that it was found a highly significant connection between the factors benefits perceived from tourism and confidence in governmental actors and between both of them, the political support for tourism