Avaliação da estratégia saúde da família na capital potiguar

This research aimed to evaluate the Family Health Strategy (FHS) in Natal, Rio Grande do Norte, through its managers, professionals and users, having as its support the Theory of Belief and the Cognitive-Behavioral Theory. This is a multimethod research and is divided into three sub-studies. In the first study, nine managers answered to a semi-structured interview, to verify the knowledge and beliefs on SUS; the quantitative data were analyzed with descriptive statistics with the aid of SPSS software and the qualitative data were submitted to lexical analysis with support of ALCESTE software. In the second study, we have a descriptive correlational research in which the antecedent variables are related to working conditions in the family health units (FHUs) and to the professionals‟ profile; the corresponding variables refer to the evaluations of the FHS; a stratified probabilistic sample with 475 professionals, who answered to two scales, both consisting of three factors: Physical infrastructure, Material resources, and Treatment effectiveness, and data were analyzed using descriptive, bivariate and multivariate statistics, with the aid of SPSS. The third study is a descriptive correlational research in which the antecedent variables refer to the treatment in the FHUs and to the users‟ profile, and the corresponding variables refer to the evaluations of the FHS, with a stratified non-probabilistic sample with 390 users, who contributed to the construction of a new scale with a factor, effectiveness in treatment, analyzed through descriptive, bivariate and multivariate statistics, with the aid of SPSS. The results showed problems which start from management, under the shape of admission due to political indication and lack of knowledge on SUS and the FHS; they pass through the low tenure of professionals and insufficient professional; and they end up spreading all over the analyzed items: infrastructure of FHUs, material resources, professionals‟ training, accessibility and referral system. One concludes that, despite following an ideal model, the FHS is in need of changes with regard to the barriers to its operational reality

Análise gráfica de estruturas porosas sobre a ótica da estereologia

In this work we developed a computer simulation program for physics porous structures based on programming language C + + using a Geforce 9600 GT with the PhysX chip, originally developed for video games. With this tool, the ability of physical interaction between simulated objects is enlarged, allowing to simulate a porous structure, for example, reservoir rocks and structures with high density. The initial procedure for developing the simulation is the construction of porous cubic structure consisting of spheres with a single size and with varying sizes. In addition, structures can also be simulated with various volume fractions. The results presented are divided into two parts: first, the ball shall be deemed as solid grains, ie the matrix phase represents the porosity, the second, the spheres are considered as pores. In this case the matrix phase represents the solid phase. The simulations in both cases are the same, but the simulated structures are intrinsically different. To validate the results presented by the program, simulations were performed by varying the amount of grain, the grain size distribution and void fraction in the structure. All results showed statistically reliable and consistent with those presented in the literature. The mean values and distributions of stereological parameters measured, such as intercept linear section of perimeter area, sectional area and mean free path are in agreement with the results obtained in the literature for the structures simulated. The results may help the understanding of real structures.

Aborto em adolesecentes: Ato tão praticado e tão pouco conhecido

O aborto provocado na adolescência como problema de saúde pública, é tema deste estudo que teve como objetivo identificar os motivos que levam adolescentes a provocar o aborto. A multidisciplinariedade do Programa de Pós Graduação em Ciências da Saúde, da Universidade Federal do Rio Grande do Norte, proporcionou o convívio com vários pesquisadores, bem como contribuiu para a coorientação e o crescimento deste estudo e da Pesquisadora com aquisição de conhecimentos diversificados e inovadores. Estudo transversal, quantitativo, analítico, usou questionário semi-estruturado como instrumento que foi aplicado em dez escolas. Trabalhou-se com jovens do sexo feminino, dos 12 aos 19 anos de idade. A amostra representativa foi calculada considerando-se o número de internações por curetagens na cidade de Maceió em 2004. O Banco de Dados foi analisado pelo programa Epi Info versão 3.3.2. Foram usados os testes Quiquadrado, Odds Ratio, Risco Relativo e Regressão Logística. A amostra foi de 2592 jovens, numa distribuição normal, com idade média e mediana de 15 anos, desvio padrão de 1,7. A maioria das jovens era solteira (95,7%), não trabalhava (94,1%), residia com ambos os pais (66,2%) e conhecia algum método contraceptivo (95,5%). Do total das adolescentes estudadas, 52,4% estudava o nível educacional médio. Delas 21,6% tinham vida sexual ativa, 6,4% engravidaram e 5,7 % abortaram. A maioria (95,5%) afirmou conhecer algum método contraceptivo, destas 70,1% tinha mais de 15 anos e os métodos mais citados foram os de barreira/hormonal com 72,4%. Analisando o Risco Relativo observou-se que o risco era significativo e protetor para o começo da vida sexual antes dos 15 anos de idade. Apenas 32,4% delas citaram algum tipo de complicação o aborto. Foi significativa a relação entre a idade e as citações da morte, da esterilidade como a complicação do aborto. A maioria recebeu apoio para abortar (63,8%), amigas foram as que mais apoiaram (32,9%), sendo significativa a relação entre o apoio recebido para abortar e a pratica do ato. O motivo mais citado foi o medo da reação dos pais (57,7%), esteja este motivo apontado como único ou associado a outros. A análise de significância entre as variáveis dicotômicas, forneceu 8 variáveis significativas, 2 protetoras para o abortamento: idade de 12-14 anos e conversar com os pais sobre sexo. As demais variáveis: estado marital com companheiro, vida sexual ativa, gravidez anterior, uso de método contraceptivo, recebimento de apoio para abortar e necessidade de internamento pós-aborto, foram promotoras ao abortamento. Receber apoio para abortar foi a mais significativa para abortar, estado marital com companheiro foi fator de proteção para o ato. Conclui-se que o apoio para abortar foi a variável mais significativa deste estudo reforçando a importância do grupo na adolescência. Sugere-se maior atenção as ações educativas como prevenção para riscos na saúde reprodutiva dos jovens

Sintomatologia depressiva e avaliação de níveis de TNFα IL-2 em indivíduos idosos e com doença pulmonar obstrutiva crônica

The aim of the present study was to assess the presence of depressive symptomatology among elderly residents in long-stay institutions (LSI) and in the community of Recife, Brazil. In total, 81 long-stay elderly patients (mean age of 75.55 ± 9.18 years) and 132 elderly (mean age of 73.14 ± 8.27 years) individuals from the community were evaluated. Depressive symptomatology was assessed by the Geriatric Depression Scale (GDS-15), cognitive status by the Mini Mental State Examination (MMSE) and capacity to perform the activities of daily living (ADL) by the Katz Index. Comorbities and the use of medication were recorded. The LSI elderly exhibited more depressive symptoms (p < 0.001) and more dependency (p< 0.001). We observed no differences in MMSE (p = 0.058). The elderly in the community displayed more comorbidities and the LSI elderly consumed more medication (p < 0.001 and p < 0.001, respectively). According to multivariate analysis (logistic regression), being male, having no spouse and having a low schooling level are risk factors for depressive symptoms. In conclusion, most elderly with depressive symptoms received no medication fordepression.

Evuloção cognitiva e funcional de pacientes pós-acidente vascular cerebral - AVC

PURPOSE: Stroke is a high-incidence cerebrovascular disease with elevated morbidity that results in impairments such as functional disabilities. This study aimed to investigate the functional evolution of individuals in the first six months post-stroke. METHOD: Longitudinal study with 42 stroke patients. The functional independence measure (FIM) and The National Institutes of Health Stroke Scale (NIHSS) were used by multidisciplinary staff 3 times in each participant; the first application was at admission to rehabilitation and the others three and six months later. RESULTS: Sample predominantly female (57%), married (52%), mean age 65.26 ±10.72 years, elementary schooling level (43%), ischemic stroke (91%), and right cerebral hemisphere (74%). Motor FIM scores and NIHSS scale showed improvement in the 3 evaluations, with significant p-value (<0.001). There was a strong relation between motor FIM evolution and NIHSS evolution (r = - 0.69 p-value< 0.001). CONCLUSIONS: It was observed that functional evolution at 6 months post-stroke was significant and the smaller the evolution of clinical impairment in these patients, the larger the evolution of their functional independence. The study is important because it allows a more appropriate therapeutic planning according with functional evolution in stroke rehabilitation

As repercussões dos serviços hospitalares em diferentes contextos: uma análise de profissionais de saúde

This study has as general object: to verify as the health professionals that work in different hospitals evaluate the hospital services; and specific objectives: identify how health professionals evaluate the work conditions in different hospitals and verify the central nucleus and the peripheral elements of the social representations elaborated by these professionals about these institution. This is a descriptive study realized in Natal, capital of Rio Grande do Norte. Were collected 213 questionnaires. Concerning the evaluation of the health services, high averages had been verified in the philanthropic hospital, for example, quality of the customer service. At the state hospital was observed lowest ones: respect to the privacy of the patients. Similar results were found about work conditions. It was observed as central nucleus the categories Overcrowded and Humanized care, in the state and philanthropic hospital respectively, and as peripheral elements Low wages and Overcrowded. Being thus the conflicts in this scene are inevitable because of the poor structure of some public hospitals, however, these problems can be foresee and solvable if the hospital has a free expression channel accessible to all agents. The evaluation has to become integrant part of the culture of the organization, a time that this will guide the steps in direction to the best quality in the hospital assistance

Tradução, adaptação cultural e análise das propriedades psicométricas do activities of daily living questionnaire - ADLQ - para avaliação funcional de pacientes com a doença de alzheimer

O Activities daily living questionnaire - ADLQ foi elaborado para avaliar atividades básicas e instrumentais em pacientes com a doença de Alzheimer. O objetivo principal deste estudo consistiu em realizar a tradução do ADLQ para a língua portuguesa, adaptação transcultural e análise das suas propriedades psicométricas. A amostra foi composta por 60 pacientes e os respectivos 60 cuidadores. O estudo iniciou-se com a tradução do instrumento pela técnica de retrotradução associada ao método bilíngüe. A versão traduzida foi respondida pelo cuidador e o Mini Exame do Estado Mental (MEEM) aplicado ao paciente. A análise psicométrica foi realizada através da validade das medidas do instrumento. Os resultados verificaram uma correlação inversamente significativa (r=-0,793;p<0,05) entre os instrumentos avaliados, com uma explicação da variância total de 62%. A coerência interna do instrumento foi realizada através da correlação com os resultados do MEEM sugerindo uma versão condensada do ADLQ. Avaliando-se através do teste t para amostras correlacionadas, as médias do ADLQ-versão traduzida e versão condensada não apresentaram diferenças significativas, demonstrado assim que a simplificação do instrumento não alterou os valores do nível de dependência funcional observados. A análise fatorial realizada através da rotação Varimax indicou seis dimensões. Atividades como; comer, vestir-se, banho, necessidades fisiológicas, tomar comprimidos, participação em grupos, administrar finanças, manusear dinheiro, locomover pela vizinhança, usar telefone, compreensão, dentre outras, são os mais importantes preditores da capacidade funcional, no grupo estudado. Atividades com desempenho pouco comum a ambos os sexos, e no desempenho de papéis sociais enquanto gênero na sociedade brasileira (afazeres domésticos, consertos e manutenção em casa), na amostra estudada, não demonstraram ter importância na determinação da capacidade funcional com o paciente com a Doença de Alzheimer. O presente estudo disponibiliza uma nova ferramenta de avaliação funcional, visando contribuir para a mensuração mais cuidadosa do estado funcional do paciente por todos os profissionais da área da saúde

Caracterização sócio-demográfica, ocupacional e de formação profissional de manipuladores de alimentos e bebidas em uma capital da região nordeste do Brasil

Universidade Federal do Rio Grande do Norte

Tempo livre de lazer e composição corporal de escolares do meio-oeste catarinense

The aim of this study was to investigate the relationship between free time for leisure and body composition of students in the crucial ninth year. (N = 228) of towns in the Midwest catarinense. We used the Adolescent Behavior Questionnaire of Santa Catarina (COMPAC) to assess lifestyle, considering that Active schoolchildren during the week, accumulated 300 or more minutes of moderate or vigorous physical activity (MVPA). Were used the time to 2 hours or more / day to determine the time of excessive use of TV and computer video game. To analyze body composition were used two criteria: the Body Mass Index (BMI) and sum of skinfolds (EDC). It was observed a proportion of 67.3% of girls and 68.7% of boys assets and more than 98% of students were using excessive TV time, computer and video game. In the classification by EDC, most of the boys showed great or low levels of body composition, while more than half of girls were classified at higher levels. As for BMI, most boys and girls had not overweight. Significant difference in the comparison of total minutes per week of MVPA reported between the groups, the second criterion of EDC and BMI for girls but not for BMI in boys. It is concluded that students with higher accumulation in minutes of MVPA showed better body composition indicators, but no significant difference was found when compared active groups with inactive, according to criteria used.

Aptidão física e psicológica relacionada à saúde de policiais militares da cidade de Natal

condições de saúde são questões que precisam ser investigadas na nossa sociedade. Diante da inexistência de estudos que abordem os aspectos psicológicos e físicos desses profissionais, tornou-se necessário e relevante esta investigação para a área de segurança pública num contexto multidisciplinar. O estudo objetivou verificar as características da aptidão física e psicológica relacionada à saúde de policiais militares do Batalhão de Atividades Policiais Especiais (BOPE), da Polícia Militar do Rio Grande do Norte. A amostra selecionada de forma aleatória foi composta de 64 militares de diferentes graduações, do sexo masculino com idade média de 26,2±2,6 anos. Foram utilizados como instrumentos de medida o Questionário de Saúde Geral de Goldberg para avaliar a saúde geral; uma balança digital da marca Techline®, e estadiômetro portátil da marca Sanny® para avaliar a massa corporal e a estatura; fita antropométrica metálica Sanny® para avaliar a perimetria (circunferência do braço contraído, circunferência da panturrilha); paquímetro Sanny® para avaliar os diâmetros ósseos (bi-epicondilar umeral e bi-epicodilar femural); adipômetro Harpender® para avaliar a espessura das dobras cutâneas; dinamômetro manual Jamar para avaliar a força de preensão manual; flexímetro Sanny®, fotocélulas CEFISE modelo Speed Test Fit e o YoYo Intermitent Recovery Test para avaliar o desempenho físico ( flexibilidade, agilidade, velocidade e endurance anaeróbica). Os participantes apresentaram valores elevados para risco de distúrbio ou mesmo a presença de distúrbio, no que se refere à saúde geral; o grupo estudado é classificado como mesoendomorfico, predominando características de endurance aeróbico e anaeróbico e força que foram relacionadas com os aspectos psicológicos. O perfil somatotípico meso-endomorfo parece interferir nos elevados riscos de distúrbios psicológicos advindos da atividade laboral exigida, apesar dos mesmos apresentarem um bom desempenho físico

Análise da contribuição de estagiários remunerados na força de trabalho em enfermagem

The present study analyses non obligatory and remunerated traineeships in nursing, as a contribution to work process in health and learning of students at nursing technician courses. It objectives to examine the contribution of medium level nursing students on scholarships at a teaching hospital s work force, at Natal/RN. It s a quantitative/qualitative, that uses descriptive statistics and analysis fulfilled with categories that emerged from research, through a dialog between the studied authors in the theoretical reference of nowadays work process, work force, non obligatory and remunerated traineeships, and night shifts. The collaborators of this research were 105 (73,43%) nursing technicians, medium level students on scholarships that fulfill remunerated traineeships at the hospital. The feminine gender was a major part of the collaborators, with 90 (85,70%), in which medium age was 29,71 years, 62 (59,00%) single, 57 (54,30%) don t have kids, 100 (95,23%) students on scholarships with complete medium level, 78,10% with professional experience before their insertion at the remunerated traineeships, 73 (69,50%) referred to enjoy the area, reason for the nursing technician course choice. About the technician course conclusion, 83 (79,00%) affirmed that happened between 2005 and 2008, and about traineeships time in the institution, 38 (36,20%) have between one and six months. About learning, 74 (70,50%) referred to learn with the nursing technicians and all fulfilled specialized courses, or grade up to bond with the school and be able to be trainees. These courses were considered low quality ones, what justifies the number of 54 (51,40%) students with scholarships that said their performance in studies is good and 75 (71,40%) are able to join it with the traineeships without problems. About remuneration as scholarship, 71 (67,60%) referred that helped to keep up with the studies, because this amount has specially this purpose, paying studies. About nonobligatory traineeships, the ABEn-RN affirmed that there s no following process to this traineeship mode, as long as there was never this concern, because obrigatory traineeships demand a lot of the efforts in the meetings. And COREN-RN doesn t supervise this way of contract. The present research observed that there is, in fact, a contribution of medium level nursing students on scholarships work force on the researched institution. Resigned to work circumstances established by the institution, representing the lack of human resources, materials, work conditions, and work insertion in night shifts, it s possible to affirm that the situation is irregular about the students on scholarships, besides the determinant risk factor to their lives and health. In addition to it, the students on scholarships, in order to maintain the quality of trainee in the institution, are obligated to fulfill courses to grade up, or specialized courses in nursing technician, at schools referred as bad quality ones

Otimização de forma aplicando B-splines sob critério integral de tensões

This work proposes a computational methodology to solve problems of optimization in structural design. The application develops, implements and integrates methods for structural analysis, geometric modeling, design sensitivity analysis and optimization. So, the optimum design problem is particularized for plane stress case, with the objective to minimize the structural mass subject to a stress criterion. Notice that, these constraints must be evaluated at a series of discrete points, whose distribution should be dense enough in order to minimize the chance of any significant constraint violation between specified points. Therefore, the local stress constraints are transformed into a global stress measure reducing the computational cost in deriving the optimal shape design. The problem is approximated by Finite Element Method using Lagrangian triangular elements with six nodes, and use a automatic mesh generation with a mesh quality criterion of geometric element. The geometric modeling, i.e., the contour is defined by parametric curves of type B-splines, these curves hold suitable characteristics to implement the Shape Optimization Method, that uses the key points like design variables to determine the solution of minimum problem. A reliable tool for design sensitivity analysis is a prerequisite for performing interactive structural design, synthesis and optimization. General expressions for design sensitivity analysis are derived with respect to key points of B-splines. The method of design sensitivity analysis used is the adjoin approach and the analytical method. The formulation of the optimization problem applies the Augmented Lagrangian Method, which convert an optimization problem constrained problem in an unconstrained. The solution of the Augmented Lagrangian function is achieved by determining the analysis of sensitivity. Therefore, the optimization problem reduces to the solution of a sequence of problems with lateral limits constraints, which is solved by the Memoryless Quasi-Newton Method It is demonstrated by several examples that this new approach of analytical design sensitivity analysis of integrated shape design optimization with a global stress criterion purpose is computationally efficient

Desenvolvimento de um sistema para análise de integridade estrutural de equipamentos estáticos baseado em cad vps micro cracks e ultrassom

In general, the designs of equipment takes into account the effects and processes of deterioration it will undergo and arrives at an approximate useful life. However, changes in operational processes and parameters, the action of external agents, the kind of maintenance conducted, the means of monitoring, and natural and accidental occurrences completely modify the desired performance of the equipment. The discontinuities that occur in anisotropic materials often and due to different factors evolve from being subcritical to critical acquiring the status of defect and compromising the physical integrity of the equipment. Increasingly sophisticated technological means of detection, monitoring and assessment of these discontinuities are required to respond ever more rapidly to the requirements of industry. This paper therefore presents a VPS (Virtual Pipe System) computational tool which uses the results of ultrasonic tests on equipment, plotting the discontinuities found in models created in the CAD and CAE systems, and then simulates the behavior of these defects in the structure to give an instantaneous view of the final behavior. This paper also presents an alternative method of conventional ultrasonic testing which correlates the integrity of an overlay (carbon steel and stainless steel attached by welding) and the reflection of ultrasonic waves coming from the interface between the two metals, thus making it possible to identify cracks in the casing and a shift of the overlay

Análise de desempenho de um refrigerador de pequeno porte com drop in de refrigerantes hidrocarbonetos

From what was stated in the Montreal Protocol, the researchers and refrigeration industry seek substitutes for synthetic refrigerants -chlorofluorocarbons (CFCs) and HCFCs (HCFC) - that contribute to the depletion of the ozone layer. The phase-out of these substances was started using as one of the replacement alternatives the synthetic fluids based on hydro fluorocarbons (HFCs) that have zero potential depletion of the ozone layer. However, contribute to the process of global warming. HFC refrigerants are greenhouse gases and are part of the group of gases whose emissions must be reduced as the Kyoto Protocol says. The hydrocarbons (HC's), for not contribute to the depletion of the ozone layer, because they have very low global warming potential, and are found abundantly in nature, has been presented as an alternative, and therefore, are being used in new home refrigeration equipment in several countries. In Brazil, due to incipient production of domestic refrigerators using HC's, the transition refrigerants remain on the scene for some years. This dissertation deals with an experimental evaluation of the conduct of a drinking fountain designed to work with HFC (R-134a), operating with a mixture of HC's or isobutane (R-600a) without any modification to the system or the lubricating oil. In the refrigeration laboratory of Federal University of Rio Grande do Norte were installed, in a drinking fountain, temperature and pressure sensors at strategic points in the refrigeration cycle, connected to an acquisition system of computerized data, to enable the mapping and thermodynamics analysis of the device operating with R-134a or with a mixture of HC's or with R-600a. The refrigerator-test operating with the natural fluids (mixture of HC's or R-600a) had a coefficient of performance (COP) lower than the R-134a

Otimização topológica de estruturas termoelásticas tridimensionais

This work presents an optimization technique based on structural topology optimization methods, TOM, designed to solve problems of thermoelasticity 3D. The presented approach is based on the adjoint method of sensitivity analysis unified design and is intended to loosely coupled thermomechanical problems. The technique makes use of analytical expressions of sensitivities, enabling a reduction in the computational cost through the use of a coupled field adjoint equation, defined in terms the of temperature and displacement fields. The TOM used is based on the material aproach. Thus, to make the domain is composed of a continuous distribution of material, enabling the use of classical models in nonlinear programming optimization problem, the microstructure is considered as a porous medium and its constitutive equation is a function only of the homogenized relative density of the material. In this approach, the actual properties of materials with intermediate densities are penalized based on an artificial microstructure model based on the SIMP (Solid Isotropic Material with Penalty). To circumvent problems chessboard and reduce dependence on layout in relation to the final optimal initial mesh, caused by problems of numerical instability, restrictions on components of the gradient of relative densities were applied. The optimization problem is solved by applying the augmented Lagrangian method, the solution being obtained by applying the finite element method of Galerkin, the process of approximation using the finite element Tetra4. This element has the ability to interpolate both the relative density and the displacement components and temperature. As for the definition of the problem, the heat load is assumed in steady state, i.e., the effects of conduction and convection of heat does not vary with time. The mechanical load is assumed static and distributed