Metodologia para gerenciamento de projetos em tecnologia da informação baseada no guia PMBOK: um estudo de caso na Secretaria de Estado da Saúde Pública do Rio Grande do Norte

Nowadays the search for growth makes organizations seeking competitive advantages, project management shares this goal, through techniques that assist in the search for an improved management of the various fields of knowledge through a design methodology. The world is driven by projects and the search for ways to better manage activities such as time, cost and term towards the success of a particular project is something constant. A major contribution that IT can make to the health sector is the support for the management area. IT can integrate processes, optimize the interconnection between the various sectors, make hospitals have access to inside information of good quality, as well as support in the healthcare area, sharing pictures, uniting the various aspects of nursing and nursing service. The major challenge faced by the SESAP Information Technology sector at present is in project management in IT , which does not exist makes investments in the area are increasingly difficult due to this deficiency in management develop their own systems without cost additional to the State. This study seeks to build and strengthen the Project Management within the Department of Health through the implementation of a project office that will manage the final result of this work methodology based on PMBOK, and still show the functionality applied to development the state Hospital Management System that will later be installed on all Regional Health Units and proposing measures for the sustainability and development of the sector amid the difficulties of the current public service. Such action will result in a savings of more than R$ 107,000.00 (one hundred seven thousand) regarding spending private software currently used by the assignment of invested by the State of Rio Grande do Norte user licenses, representing more than 5 % of the total budget of the State Department of Public Health of the State

Perfis epidemiológicos de saúde bucal no Brasil e os modelos de vigilância

National surveys are important tools for public health surveillance and thus key elements in monitoring health conditions and system performance. In the field of oral health, such surveys began with the oral health survey in 1986 and later in 1996 and with the SBBrasil Project in 2003. The 2010 edition of SBBrasil is the principal oral health surveillance strategy for the production of primary data. In order to contribute to this discussion, this article proposes: (a) to present and discuss the Brazilian experience with nationwide oral health surveys and (b) to discuss the use of data in health surveillance models. One can conclude that oral health surveys in Brazil have great possibilities as a tool for health services and academia. Such surveys have shown evident potential for verifying trends in the oral health profile, as well as for producing valid indicators for use in health services.

Estética do apocalipse: (re) considerações acerca da (des) arborização urbana de Natal e seu contributo à saúde pública

This study intends to establish a relation between environmental degradation, particularly the devastation of the green canopy, and public health. Utilizing a mapping of the trees included in the researched area, each individual tree was analyzed according to its age, taxonomic listing, architecture, shape and size (determined by aesthetic/convenience reasons or deformed by pruning). Initially investigated were the covert reasons lying underneath the constant aggression against trees (which many times seem to contain elements of hatred and contempt) within the urban environment. In addition to that, the aspects concerning environmental modifications and the consequent impact on public health were also assessed. Two main problems promptly emerged as a result of the removal of trees: a) without a canopy to protect the areas, they became subject to winds directly blown from SW Africa and impregnated with aerosol partic les, which are common causes for respiratory disorders and, b) direct UV solar radiation, which causes some types of skin cancers and eye disorders. To reach such results, we studied the origins and formation of UV radiation induced cancers and searched for the UV radiation spectra of action, e.g., usual intensity and quantity reaching clear and shadowed spaces in a certain area and its consequences. In a second instance, we also searched for pertinent data resources in order to confirm the increase of skin cancer cases due to exposure to UV radiation and the relation between the destruction of the green canopy and the above mentioned problems. We believe that a few significant results have been achieved by this study, namely: the relation between a culture based on medieval beliefs and its consequences on the environment; how this culture exploits and deforms nature in pursuit of financial and psychological interests to a point of transforming the landscape into a copy of something devoid of any relation to latitude and altitude; and above all, the indifference concerning the alarming results carried by these modifications

Prevalência da infecção pelo Papilomavírus humano, Chlamydia Trachomatis e Herpes Simples do tipo 2 em adolescentes atendidas em unidades de saúde pública de Natal

This study assessed the level of knowledge, attitude and practice of Pap smear and human papillomavirus (HPV), in addition to analyzing the prevalence of genital HPV infection, Herpes Simplex Type 2 (HSV-2) and Chlamydia trachomatis in teenagers. The study consisted of two approaches, one based only on interviews conducted with adolescents enrolled in public schools or in public health facilities in the city of Natal. The other approach involved only a group of 132 adolescents enrolled among those admitted to two health units in Natal-RN. This second group of participants two specimens were collected for laboratory analysis: one was directed to prepare the blade for the Pap test, and other processed for DNA extraction for molecular analysis, focusing on the detection of HPV, HSV-2 and C . trachomatis. The presence of DNA of the three pathogens was investigated by the technique of polymerase chain reaction (PCR). The presence of each of the three pathogens was analyzed in terms of socio-demographic characteristics, as well as sexual and reproductive activity to identify risk factors for infection and development of lesions of the uterine cervix. The results show that the adolescents in this study had levels of knowledge and attitude very low, both in relation to cytology to HPV as though they have made a reasonable percentage of adequate practice exam and prevention of HPV infection. The overall prevalence of HPV infection was 54.5% and 48.2% in adolescents with normal cytology and 86.4% in those with abnormal cytology. We observed a higher proportion of cases of infection in the age group of 18 to 21. The prevalence of HPV infection was slightly higher among pregnant teenagers. The overall prevalence of HSV-2 infection was 13.6% and 11.8% in women with normal cytology and 22.7% in those with abnormal cytology. A higher proportion of cases of infection was found in the age group from 14 to 17, with a slightly higher prevalence among pregnant women. The C. trachomatis was found with an overall prevalence of 19.7% and 21.8% in adolescents with normal cytology and 9.1% in those with abnormal cytology. The prevailing rate was highest in the age group 18 to 21 years and in nonpregnant

A eficiência do gasto e da qualidade da saúde pública: uma análise nos municípios do estado do Rio Grande do Norte (2004 e 2008)

The overall objective of this study is to analyze the efficiency in the use of resources and the quality of public health in the municipalities of Rio Grande do Norte, from 2004 to 2008. It also seeks to identify the determinants of municipal inefficiency and measure the productivity of public spending on health. To this end, three methods of analysis are used: the DEA, the Malmquist index and the Tobit regression model. Among other findings, it appears that municipalities considered more inefficient in the measurement of expenditure on health make the largest expense in this function. On the other hand, from 2004 to 2008, only 13 municipalities showed an increase in the productivity of public spending. It is also noted that municipalities considered efficient in quality of health, although having more physical and human resources, offer fewer health services to the population. In all, the major determinants of health spending inefficiencies are the variables: age of the mayor, coalition, population density, literacy race and budget revenues. Regarding the inefficiency of the health quality, variables such as: coalition, literacy race have strong influence on this behavior. Thereby, the hypotheses proposed by the study have been fully accepted. In other words, for the efficiency of the quality and health spending it is needed more than resources, i.e., the expenditure shows itself as essential, but not enough, for political and economic aspects also interfere with the performance of spent and in the quality of health care offered to the population

Gestão ambiental na saúde pública: um estudo sobre a percepção ambiental de gerenciamento de resíduos sólidos de serviços de saúde, dos servidores do Hospital Universitário Onofre Lopes do Rio Grande do Norte

This research has aimed at studying the perception of University Hospital Onofre Lopes (HUOL) s workers on the environmental management plan of RSSS. They have been interviewed 250 workers: doctors, nurses, nursing assistants, and cleaners. It was used an exploratory and descriptive research of the type Survey, which aims at obtaining of data or information on characteristics, actions or opinions of any group of people. The questions of the questionnaire were of the kind objective", formulated in a model "scale", analyzed in according to the positioning of the interviewee. The wastes of health service have high potential for environmental impact in the activities from HUOL. Actions or environmental protective policy can improve the image of HUOL. They have been detected divergences on the rigor in application of law of ANVISA. The HUOL s workers unaware of the law of ANVISA and they have little or no knowledge about the practices of environmental control, public health and, they do not know the Environmental Management System ISO 14001. They have divergent views on the degree of importance of ISO 14001. There is not a Waste Management Plan for Health Service and / or is not disclosed for most of HUOL workers. It has not carried out audits or defined the goals and objectives. Besides, it has not been identified legal requirements, and there has not been communication about the service is performed or has been made a critical analysis and no control of documents the environmental management plan. The HUOL have not had a committee of environmental management. The direction of HUOL has not been organized courses, training and recycling of waste on environmental control of the health service. On a scale from 01 to 05, the level of aware level concerning to the waste management from health services of the workers, so is at the threshold between 01 and 02. For the reversal of this situation, the first and urgent step is the creation and institutionalization the environmental management committee of the University Hospital Onofre Lopes

Gestão ambiental na saúde pública: um estudo sobre a percepção ambiental em laboratórios de análises clínicas

This objective of this work was to investigate the enviromental perception of technician of clinical laboratories, in the city of the Natal/RN, focusing the generated environmental aspects and impacts in the activities, the strategical importance of the environmental management for the activity, as well as the knowledge about environmental norms and resolutions applied to the sector. A type survey exploratory and descriptive was carried through, using a questionnaire applied in 82 clinical laboratory, getting a return tax of 53,65%, or either, 44 laboratories. The results of the descriptive analyses point with respect to environmental conscience of the interviewed, therefore the majority (75%) described the activities of clinical analyses as great imapact on the environment. Although the interviewed present certain knowledge on the advantages of practical of envivonmental protection and the risks that the activities of clinical analyses offer, some important practical of environmental protection arer not develped by the majority of the iterviewed. The carried through statistical analyses had allowed to investigate the level of environmental knowledge of the professionals of the sector, being consisted themselves that they present little knowledge on practical ISO 14001 and of environmental protection in the health public sector. It can be conclude that, a program of environmental qualification for the sector becomes necessary, in order to improve the knowledge of the professionals of the area, and that the majority of the professionals would have a good recptivity therefore recognize the benefits of the practicadl of environmental protection for the competitiveness of the clinical analyses laboratories

Abordagem de temas em saúde pública por meio de atividades lúdicas com professoras da educação infantil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

A educação em saúde pública na práqtica cotidiana: atuação dos cirurgiões-dentistas do PSF de Natal-RN

Considering education a support to health promotion, care integration and citizenship formation,the purpose of this research was to analyze the perception of the oral surgeons from the Family Health Program of Natal-RN over education in health as well as their performance as educators based on their activities on the program. A qualitative study was accomplished by a semi-structured interview and a Free Association of Words Test with 80 oral surgeons from the Family Health Program of Natal-RN. The instruments were analyzed through the meaning analysis and the Central Nucleus of Vergès Theory. The results showed a lack of planning in health actions so there is no standardization on the educative practices done by the oral surgeons which mostly are focused on scholars. There was an agreement among the group according to the oral surgeons´ perception about education in health that education is related to its function of recall prevention ideas to the population. Most part of the context units analyzed by the professionals´ speech show the knowledge of education in health as an inadequate behavior change instrument of the individuals. An interesting point was a quotation cited by some professionals that included actual themes such as citizenship, motivation and life quality, put inside the speech of education in health. To the oral surgeons the biggest difficulties on the development of the educative actions are due to the lack of incentive by the Municipal Health Bureau and to the detachment and lack of valorization of the themes by the population. The oral surgeons consider themselves co-responsible for the formation of a population which is able to request its health. They also mention the knowledge about the need of the community participation on the planning of the Family Health Program actions. Finally, it is notable the need for more encouragement so the oral surgeons can be more capable and have more interest in applying education in health on the perspective of a new model in health, because once capable and stimulated they can awake the population to education importance as a great transformation instrument for people searching for a fair, equalitarian and citizeness society

Estética do apocalipse: (re) considerações acerca da (des) arborização urbana de Natal e seu contributo à saúde pública

This study intends to establish a relation between environmental degradation, particularly the devastation of the green canopy, and public health. Utilizing a mapping of the trees included in the researched area, each individual tree was analyzed according to its age, taxonomic listing, architecture, shape and size (determined by aesthetic/convenience reasons or deformed by pruning). Initially investigated were the covert reasons lying underneath the constant aggression against trees (which many times seem to contain elements of hatred and contempt) within the urban environment. In addition to that, the aspects concerning environmental modifications and the consequent impact on public health were also assessed. Two main problems promptly emerged as a result of the removal of trees: a) without a canopy to protect the areas, they became subject to winds directly blown from SW Africa and impregnated with aerosol partic les, which are common causes for respiratory disorders and, b) direct UV solar radiation, which causes some types of skin cancers and eye disorders. To reach such results, we studied the origins and formation of UV radiation induced cancers and searched for the UV radiation spectra of action, e.g., usual intensity and quantity reaching clear and shadowed spaces in a certain area and its consequences. In a second instance, we also searched for pertinent data resources in order to confirm the increase of skin cancer cases due to exposure to UV radiation and the relation between the destruction of the green canopy and the above mentioned problems. We believe that a few significant results have been achieved by this study, namely: the relation between a culture based on medieval beliefs and its consequences on the environment; how this culture exploits and deforms nature in pursuit of financial and psychological interests to a point of transforming the landscape into a copy of something devoid of any relation to latitude and altitude; and above all, the indifference concerning the alarming results carried by these modifications

Paradigms that guide the models of attention to the health in Brazil: an analytic essay

SILVA, Flávio César Bezerra da ; COSTA, Francisca Marta de Lima; ANDRADE, Hamilton Leandro Pinto de; FREIRE, Lúcia de Fátima; MACIEL, Patrícia Suerda de Oliveira; ENDERS, Bertha Cruz ; MENEZES, Rejane Maria Paiva de. Paradigms that guide the models of attention to the health in Brazil: an analytic essay. Revista de Enfermagem UFPE On Line., Recife, v.3,n.4, p.460-65. out/dez. 2009. Disponível em < http://www.ufpe.br/revistaenfermagem/index.php/revista/search/results >.

A infecção por Leishmania infantum chagasi altera o metabolismo lipídico do hospedeiro

American visceral leishmaniasis (AVL), caused by Leishmania infantum chagasi (L.i.chagasi), stands as a public health problem in Brazil, with human and canine cases related in all states..Lipid metabolism can be modified in several status of infection. For example, experimental studies show that the cholesterol is necessary to internalization and replication of L.i.chagasi in macrophages through caveolar domains. Patients with AVL present low levels of cholesterol and a visible triglycerides increase. This work aimed to evaluate the lipid metabolism in several post-infection status by L.i.chagasi, including individuals with symptomatic infection (AVL), and asymptomatic. The levels of cholesterol, triglycerides, HDL and reactive C protein, were measured. Individuals with AVL were compared with individuals with assymptomatic infection and presented low levels of total cholesterol (128 ± 6.180 mg/dL vs. 158 ±5.733 mg/dL, p=0.0001), HDL (29 ± 1.746 mg/dL vs. 37 ± 1.647 mg/dL, p=0.0001), increased levels of triglycerides (149.5 mg/dL ± 12.72 vs. 78.00 ± 10.43 mg/dL, p=0.0095) and higher levels of reactive C protein (1.750± 0.4939 mg/dL vs. 0.40 ± 0.1707 mg/dL; p=0.0001). The expression of genes related to lipid metabolism, such as LXR-a, LXR-b, PPAR-a, PPAR-d, PPAR-g and APOE was evaluated by real time PCR. A reduction in the expression of those genes was found in the group of AVL patients corroborating the serum levels of the metabolites earlier quantified. Our findings suggest a modulation of metabolism of lipids, in the chronic phase of AVL, this could facilitate the survival of leishmania, due to the known reduction on the ability of macrophages in presenting antigens efficiently to the T cells due to the reduction in the cholesterol available, it results in a subversion of the host immunity.

Alterações nas concentrações das SRAT, conteúdo de GSH e atividade da CAT em pacientes com esquistossomose aguda

Schistosomiasis is an ancient disease caused by helminth Schistosoma mansoni and is a public health problem in Brazil. The granulomatous lesion, typical of the disease, associates itself with increase in the oxidative damage through the generation of free radicals. The aim of this work was to evaluate the occurrence of changes in parameters oxidant / antioxidant that are part of the human defense system, and observe whether they would cause oxidative stress in subjects with schistosomiasis. Moreover, correlating with some biochemical and hematological parameters. Two groups were selected for study, consisting of individuals of both sexes, aged between 16 and 30 years. A control group, formed by individuals without schistosomiasis (n = 30) and a test group, formed by individuals with schistosomiasis (n = 30). The evaluation of lipid peroxidation in plasma was performed by determination of malondialdehyde and antioxidant defense by the quantification of reduced glutathione and catalase activity. For the parameters that assess oxidative stress, the results showed a decrease in the content of reduced glutathione and no change in the activity of catalase, with an increase in the value of malondialdehyde. Therefore, the data found suggest the occurrence of oxidative stress in subjects with schistosomiasis. Of the parameters that assess hepatic function, only levels of aspartate aminotransferase have been high, while there was a decrease of bilirubine. There was a significant change in the lipid profile (p <0.5), however with regard to the renal function of patients, there was a decrease in creatinine. The assessment hematological, made through hemogram and the quantification of hemoglobin, shows increase of eosinophils individuals in the group test, which can be related to the presence of the parasite. The amendments suggest the involvement of oxidative stress in the pathophysiology of this disease

Aborto: um fenômeno sem lugar – uma experiência de plantão psicológico a mulheres em situação de abortamento

The present paper discusses the experience of a psychological emergency attendance in Maternidade Escola Januário Cicco (MEJC) in Natal and has as main objective to investigate the limits and possibilities of this practice in offering psychological care to women in abortion situation. The Ministry of Health considers the abortion a serious medical problem in Brazil and acknowledge the repercussions it causes in personal life and between the women’s family, most of all among the younger ones, in fully productive and reproductive age, that if not supported may suffer deep psychological and physical wounds. This research inserts itself in the field of psychological practices in institutions, by many ways, and aim to offer, by different approaches, among then the psychological emergency attendance, a psychological attention at the institutions. This attention refers to a care during the suffering at the time of crisis and in the many ways that the problem is present. The results were analyzed at a heideggerian hermeneutics optics, which search a determined aspect of reality that intends to know/understand, accompanied by the man’s own movement in existence. The cartography and the logbook were chosen in narrative form as a resource to allow the approximation of daily experience. The emergency psychological attendance was realized on curettage setor of MEJC between march of 2013 and february 2014 at tuesdays and Thursdays from 9h to 12h. The existential plot unveiled at this experience showed some possibilities and limits of emergency psychological attendance as studied. Among the possibilities, the emergency attendance helped the women that suffered an abortion to find new meanings, as: realize the need to self-care; see in the attendance a way to cope with the lost or other issues in their life’s; to enlarge the possibilities of her choice; to rethink her sex e reproductive life, and rethink her relationships and life projects. The attendance has proven itself as a health care mechanism showing the women the need to search for the necessary condition to self-care and to question what in that environment was saw as natural. The attendance showed itself as a suitable practice to the health care demand by creating/inventing ways of meet the woman needs. The attendance promoted an opening at the technical horizons of women’s, what was realized when the complaints moved past the physical health. As refered to the limits, some needs was beyond the emergency attendance service and demanded forwarding to regular psychological care or others specialized services. The service was not able to attend all of the demands of the sector. The attendance did not touched the medical staff to its need or made a change in posture to act beyond the technicality. The attendance, although has not made change in this context, was able to show the main difficulties, like the lack on prepare of the medical staff to deal with the abortion past beyond the technical procedure and the precariousness of the infrastructure of the services offered. At last, the attendance represented a shelter to the women in abortion situation, allowing the suffering to have a place.

Magnitude da morbidade relacionada ao trabalho no Rio Grande do Norte

Diseases and disorders related to work sets up an important public health problem in Brazil and worldwide. However, the reality of these diseases still constitutes a gap with regard to its characterization and epidemiological situation, especially in Brazil. In this context, this study aims to analyze the magnitude of morbidity related to work from the injuries and illnesses reported by Health the Diseases Notifiable of Health of the State Public River Health Department worker Reference Center Information System services Grande do Norte from 2007 to 2014. It is ecological study, quantitative cross-sectional study in which the analysis unit of the municipalities of Rio Grande do Norte. Data were collected from the state base of Diseases Notifiable Information System Centre of the Secretariat of State Workers' Health Reference Public Health of Rio Grande do Norte, between March and June 2015, after the approval of the Committee of Ethics in Research of the Federal University of Rio Grande do Norte, Opinion 014/2014. The population was represented by the universe of cases of diseases and disorders related to work that were reported and shut down the system from 2007 to 2014. Data were analyzed using descriptive and inferential statistics, presented in tables, graphs, charts and figures. For this, we used the Microsoft Excel 2007 and SPSS version 20.0. To check the significance level we opted for the application of the chi-square or Fisher tests. We adopted the significance level of p <0.05. Of the 10,161 cases of diseases related to the reported work, the biological work accidents had the highest percentage (52.84%) followed by serious occupational accidents (37.49%). For diseases, the highlights were musculoskeletal (4.82%), mental disorders (2.19%) and exogenous intoxication (1.97%). Among men, there was a predominance of major accidents (91.80%), mental disorders (70.00%) and exogenous poisoning (52.84%). Women were most affected by biological accidents (77.50%) and musculoskeletal diseases (64.10%). Among workers who have suffered injuries predominated mulatto (%), mean age of 35.86 years, low education (%) and workers in the formal sector (%). Among the accidents, biological (n = 5,369) accounted for 52.84% of cases occurred predominantly among nursing professionals (48.31%). The percutaneous exposure was the most frequent (73.05%) and the occurrence of circumstances was improper disposal of sharps (45.28%), the needle the most common agent (66.62%) and the organic material was blood (72.99%). Most injured workers were vaccinated against hepatitis B (68.13%), but no information as to the assessment of the vaccine response. In the course of the disease predominated ignored the situation with loss of monitoring of clinical follow-up (55.62%). There was also an increase in the notification of serious industrial accidents predominantly male (91.80%) workers aged 25-44 years (54.3%) and typical accidents (76.3%). The temporary disability was the most common outcome (55.53%) and hand the most affected part (33.00%); the mining and construction industry had the highest number of cases (25.1%) in registered employee (34.2%). The findings of this study show a positive result in relation to increased mandatory reporting of injuries and illnesses related to work together to health services that meet victimized workers, towards the occurrence of knowledge of these accidents for decision making in public plans and policies of health. However, the information system still needs improvement in both the coverage and the quality of the data to demonstrate with greater reliability the magnitude of events to support the planning of workers' health into shares in the state.