Avaliação de efetividade do centro de reabilitação de adultos - CRA/NATAL/RN

Public services with an emphasis on rehabilitation treatment of disabled people, as established law, have aimed to ensure quality and equity assistance in a rehabilitation way to the segment highlighted. As for people with physical disabilities, the Unified Health System (hereby SUS) through the directive GM/ MS No. 818 of 2001, requires the creation of hierarchical and regionalized services networks at different levels of complexity to ensure appropriate assistance. This study whose title is Evaluation of effectiveness of the Adult Rehabilitation Center in Rn: elements for a discussion aimed to evaluate the effectiveness of rehabilitation services that institution, reference in the State of Rio Grande do Norte, has directed its patients, more specifically those who have had a stroke and therefore are disabled ones. From the standpoint of methodological conduction, it was prioritized a qualitative and empirical theoretical research which was carried out from the following courses: literature references with authors who are the themes pertaining to rehabilitation, inclusion, public policy evaluation, health policy and disability; documentary research through Regulation of Technical Procedures, files, records, informative booklets that were of great importance to the knowledge of the institution, as well as its functioning and dynamics of field research that was materialized with the managers, rehabilitation staff and Center s users, through the application of semi-structured interviews as a tool for data collection. The information obtained was analyzed from the critical analysis of discourse. As a result, it was identified some technical, administrative and financial difficulties which have obliterated the effectiveness of services provided, such as: lack of many professionals to meet existing demand, poor quality of equipment and the physical structure, limits on autonomy management as a result of dependence along with the SESAP/RN; besides the excessive bureaucratization in the administrative processes compromising Center s problem-solving needs. However, in the narratives of managers, rehabilitation staff of patients, despite the difficulties, treatment made by Centre has effectiveness to the extent that has been contributing even in a limited way to improve their quality of life

Agir, aprender, formar, intervir, agir uma experiência dos consultores internos na gestão do conhecimento da Petrobrás UN-RNCE

This research aims at studying the formation of internal consultants in organizational setting in the joint resolution of problems, around the conversion of knowledge. The objective of research is to understand and explain the meanings attributed by Petrobras internal consultants to their practice and training for the conversion process of tacit knowledge into explicit, around the joint resolution of their problems with their collaborators. It has directed the next question: what the meanings assigned by the consultants of Unidade de Negócios Rio Grande do Norte e Ceara (UN-RNCE) in Knowledge Management (KM), for their interventionist and formative practices in problem solving, as well as conversion of tacit knowledge in explicit? This paper has assumed that there is a dual logic integrated into its daily practices: solving troubles and converting knowledge. The thesis has considered the daily practices of these consultants are characterized as epistemic spaces and permanent education through the conversion of knowledge. It has adopted the principles of multi-referential approach as foundations, regarding the translation of a variety of angles, perspectives and prospects which allow the interpretation and understanding of complex issues that are part of conversion of knowledge. The understanding and explanation of the senses are based on the methodology of the comprehensive interview; taking ownership is the sensitive listening for comprehensive interpretation of oral discourses of ten consultants, in addition to the autoscopy that putting into practice, thus, the stance of the researcher as an intellectual craftsman. Furthermore, it has assessed that the limits and possibilities for training and learning in the conversion of knowledge arise, on one hand from a predominantly driven training culture by the paradigm of technical rationality and one the other hand, from a set of relationship to knowledge and relation to know , revealed in the search for training in other dimensions. There are tensions between the local and global demands located in a situation marked by a systemic organization of knowledge. However, the context is perceived by researchers as impregnated by the discontinuity, unpredictability and uncertainty; mobilizing a number of elements necessary for the mediation in training practices of these consultants. Finally, it has set an instrumental and technological support, restricting the formation and undermining the position of the consultancy as nuclear function in Knowledge Management

Navegando nas ondas dos saberes do ser: uma conversa com a sexualidade à luz da corporeidade.

This study aimed to provide a continuing education towards raising teachers for reflection and effective sexual education within the school environment as a possible route of self-education and training of teachers of elementary school. More specifically aim to facilitate through the Continuing Education to discuss the knowledge of the body and knowledge of human sexuality, presenting them as core knowledge in the integral formation of individuals and promote discussion of a Human-centered education Teaching in a vocational training and human .In this sense, we dialogue with the human teaching preconized by Arroyo (2002, 2004) along with the humanization (hominization) of the individuals through education, under Freire´s perspective of the being more (2003) as well as his ideas, Pineau´s (2003) and Josso´s (2004) about the educational practice understanding as a way to build up the autonomy of the individuals who we intend to educate. We defend the inclusion of the body as an essential learning element according to the principles of corporeity presented by Assman (2001), whose comprehension is that every learning experience has a corporal inscription. Furthermore, the knowledge about human sexuality cannot be excluded from this process since the sexuality is inherent of individuals and is constructed and reconstructed during their existence. Our view of the world and of man is supported by the knowledge of the complexity (Morim, 2004) trying to surpass the mechanist view that sees them through the duality view, fragmenting them. For the discussion and construction of knowledge that search for the confluence of these knowledges about the being and the educational practice, aiming at the individual integral formation starting from the process of self-formation/self-knowledge, we´ve directed our research-action-formation having as compass the theoretical-methodological postulate of the research-action (Barbier, 2002; Morin, 2004; Thiollent, 2004) because it makes the participation of all the involved people in the process of resolution or surpassing of problem solving possible. We´ve used the continuing formation as a way of access for data collection, applying a questionnaire with open questions for the ones involved in the research. Based on the findings it´s been possible to infer that for the teaching formation it is necessary the inclusion of the Human sexuality and corporeity theme, so that the teacher can surpass the biological view of sexuality and also the expansion of the mechanist view of the body. To do so, we suggest that the teaching formation happens supported by the teaching capacitation and formation according to Maturana (2004), bringing teaching knowledges (Tardiff, 2002), which contribute effectively for the responsibility to educate people for life.

O projeto politico pedagógico de enfermagem e o sistema único de saúde: a visão de discentes

This research aims to analyze, in the view of students, the pedagogic project of undergraduate nursing course, of UFRN, and its articulation with the SUS, in an attempt to understand the issues that permeate the teaching and learning of nursing. This is a qualitative study that used the focus group technique as a tool to collect empirical data. There were three meetings, where we had the collaboration of 23 graduating students from the eighth period of the semester 2009.1. For the analysis of information, we use a theoretical framework based on curriculum guidelines and basic principles of the SUS, making the analogy of the results with the metaphor of Greek mythology, Ariadne's thread, in dialogue with authors who discuss education as a transformative practice. Thus, the texture of the yarn was built of five thematic fields: joint the pedagogic project with the SUS; the teaching/service and theory/practice relation; interdisciplinarity or transdisciplinarity; didactic/methodological and relational approaches; and co-participation of students in the pedagogic project. According to the discussions, we find many difficulties in the teaching and learning process of undergraduate nursing in UFRN to strengthen the SUS, including: dislocation of educational institutions with services, professionals, managers and community; dichotomy between theory and practice; reality of services as a learning field and working process in health; posture adopted by professionals, teachers and other subjects included in the process of health education; decontextualization and fragmentation of teaching with the practice in health and nursing; excessive use of very illustrative methodologies, but little problem-solving; difficult and precarious situation in the relations between teachers and between teachers/students, regarding the acceptance of differences; absence of participation of students in the evaluation process and conduct of the educational project in progress. In this sense, we understand the need an auto-reflexive act of teaching and conducting collective pedagogical course with a view to achieving the SUS. Thus, it is necessary to support practices motivated by the polyphonic dialogue and the exercise of symbiosis and autopoiesis of subjects/actors jointly responsible for the ongoing process of learning for life.

Reinternações psiquiátricas no Rio Grande do Norte: implicações e impacto das novas estratégias de atenção à saúde mental

The Brazilian Psychiatric Reform based on the desinstitucionalization of the assistance, translated to the emphasis on community/territorial treatment and in the social inclusion of the mental suffering, promoted advances in the psychiatric restructuring. In the Rio Grande do Norte (RN), we can enumerate as advances of the Brazilian Psychiatric Reform the expansion of the mental health care chain and the implementation of some strategies that, together, aims to further the psychosocial attention of the individual with psych suffering and to reduce the indices of psychiatrics readmissions in the state. In the current Brazilian‟s mental health situation we were interesting in answered the following question: what the impact of the substitutes services‟ extension in the revolving door phenomenon? This search aims to analyze the revolving door phenomenon occurrences based on the news strategies of mental health care in the Rio Grande do Norte. This is a descriptive-exploratory study with a qualitative approach, oriented by the theoretical framework of critical-dialectical approach about the Brazilian Psychiatric Reform and using the thematic oral history as method of information collects. The search was realized on the Hospital João Machado (HJM), estate reference in psychiatric treatment, and the participants was 20 professionals that work on it. The collection of information had started after the approval of the UFRN Research Ethics Committee with the opinion number 216/2011 and CAAE number 0021.0.051.000-11 and was realized using the direct observation and semi-structured interview. The study‟s results were categorized in two categories and five subcategories of analysis. CATEGORY 1) Current situation of the mental health care chain in the RN, with the subcategories: 1.1 Impact of the new services of mental health care in the revolving door phenomenon in the RN; 1.2 Implications of the new services of mental health care in assisting user to the HJM; 1.3 Issues the permeate the mental health care chain in the RN. CATEORY 2) Main causes of the revolving door phenomenon in HJM, with the categories: 2.1 Family problems; 2.2 Lack of assistance after discharge from psychiatric hospital. In summary, we conclude that the extension of the mental health care chain contributed for the reduction of the psychiatrics re-hospitalization‟s indices in RN. However, we realized that territorial services of mental health care are not the only responsible for the revolving door phenomenon. Factors as family problems and the disarticulation of the assistance after the discharge from hospital influence on the perpetuation of hospitalizations and re-hospitalizations in the local scenario. To study the revolving door phenomenon that occur in the psychiatrics‟ assistance considering the news strategies of mental health care allowed us to approach the advances and challenges brought by the RPb and by the desinstitucionatization in the state, indicating the need for further discussions and problem-solving strategies of psychosocial care.

Ensino do processo de enfermagem: visão dos discentes de graduação de Natal/RN

The nursing process (NP) it s the systematized way of offering humanized care with the objective of reaching the expected results. The concern of the health and education institutions of elaborating implementation strategies of it is growing. The objective of this research was to know the vision of the senior students of the nursing graduation courses from Natal/RN, about the teaching of the NP. It s about a descriptive and exploratory study of the qualitative and quantitative type, done in five teaching institutions of the undergraduate nursing course of the municipality of Natal- RN in 2011. The research was composed by 48 students of the last 2 years of the nursing course. The gathering of the data was done through an online survey with open and closed questions via SurveyMonkey. For the quantitative data it was used the descriptive statistics from Microsoft Office Excel and for the qualitative data the Content Analysis of Bardin. The results pointed a predominance of female students (81,25%) with an age between 21- 39 years old (75,00%) and in the last year of the course (62,50%). As the opinion of the students about the NP two categories emerged: 1) Nursing Process as grounded method in scientific knowledge and established in two stages; 2) Nursing Assistance Quality, with two subcategories: Nursing Process as Nursing Practice and Nursing Process as instrument of improvement of the aid quality and promotion of well-being. In relation to the tuition of the NP the students (45,83%) said that the knowledge on the subject of the instructor was good; 81,25% reported that the professors use a traditional teaching methodology with the problem solving components and 45,83% answered that is addressed in specific disciplines in an isolated way starting from the professional line. The phase of NP that the nursing students have more difficulties of learning and implementing, being mentioned 22 times (29,70%). In relation to the student s difficulties, in the fields of supervised internships, in applying the NP it was stated for 83,50% that the barriers were related to the non implementation of the practice, overwork and the lack of trust of the nurse in the NP. The teaching-care strategies described as the internship fields were: the training of nurses to be able to contribute with the University in the implementation of the service and teaching; and the need of the universities to focus, continuously throughout the course, the NP with the involvement and incentive of the instructors in this process. These results show that the NP for the nursing students is a work methodology of the profession that needs to be implemented effectively in the practical reality for its teaching to turn effective and for the future professionals to be able to bring real contributions in the achievement of systematized actions trying to improve the assistance quality and the nursing actions. It is expected that this study could help bringing some strategies to facilitate the merging between theory and practice in teaching the NP and stimulate a discussion about the topic at the Nursing Schools where the research was held together with the coordinators, instructors and students

A estratégia didática de resolução de problemas na formação de professores de química

In this work it is presented a research developed in the initial training of teachers of the chemistry graduation course at the Universidade Federal do Rio Grande do Norte (UFRN). The intervention was realized in two classes in the context of a discipline in the curricular structure with nineteen undergraduate students of chemistry. The study utilizes characteristics of the qualitative approach and uses observation, questionnaires, interviews and examination papers. The experiment involved a sequence of activities fundamented on the Problem Solving (PS) teaching strategy to approach chemical concepts. The proposal was planned and organized according to the theoretical presupposition of the work developed by the authors of the Science Education in PS, of teaching experience and from the initial hypotheses of the research. The goal was that the future teachers could experience the strategy and advance to the new meanings. The themes addressed in the activities were the difference between exercises and problems, exercises turning into problems, the steps of problem solving and some implications of the teaching strategy for the work of the teacher. The results showed evidence that through a process of collective reflection, and from the difficulties experienced in the strategy practice, the undergraduates are introduced to new perspectives of reflection and action of teaching practice, and understanding some benefits of innovative proposals for the teaching of chemistry. It also showed that, although this theme is approached, in some moments of the graduation, the future teachers don‟t know when or how to realize activities in this perspective. From the aspects that rose in research we highlighted the difficulties in the problem solving steps, the use of the strategy in school and the knowledge and skills of the teacher for planning activities in Problem Solving

Investigação da influência do cochilo na aprendizagem escolar

There is a known positive effect of nocturnal sleep for brain plasticity and the consolidation of declarative and procedural memories, as well as for the facilitation of insight in problem solving. However, a possible pro-mnemonic effect of daytime naps after learning is yet to be properly characterized. The goal of this project was to evaluate the influence of daytime naps on learning among elementary and middleschool students, measuring the one-day (acute), and semester-long (chronic) effects of post-learning naps on performance. In the Acute Day-Nap condition, the elementary students were exposed to a class and then randomly divided into three groups: Nap (N), Game-based English Class (GBEC) and Traditional English Class (TEC). There were 2 multiple-choice follow-up tests to evaluate students performance in the short and long runs. In the short run, the N group outperformed the other two groups; and such tendency was maintained in the long run. In the chronic condition, the middle-school students were randomly separated into two groups: Nap (N) and Class (C) and were observed during one academic term. The N group had increased school performance in relation to the C group. In the statistical analyses, independent t-tests were applied considering the scores significant when p<0,05, expressed in terms of average ± average standard error. Results can be interpreted as an indication that a single daytime nap opportunity is not enough to ensure learning benefits. Therefore, more research is needed in order to advocate in favor of a daytime nap as a pedagogical means of promoting enhanced school performance

Estilos de aprendizagem sob a ótica da Psicologia Evolucionista

Among a variety of learning conceptions, David Kolb´s Experiential Learning Theory proposes four different learning styles: diverging, characterized by orientation towards people and multi-perspective vision; assimilating, concerned with ideas and abstract concepts as well as theory formulation; converging, expert in dealing with technical tasks and problem solving; and accommodating, risk taker and good at getting things done. Interesting correlations have been pointed out between Kolb s learning styles, professional careers and genders. With respect to behaviors, specific cognitive skills and interests, sex differences are widely known, and explained by Evolutionary Psychology as the result of distinct selective pressures acting on each gender. The aim of this research was to assess adolescents learning styles and their relation with interests on school and career choices, analyzing possible gender differences. We distributed questionnaires to 221 senior high school students to research their preferences for school disciplines, professional activities and career choices. The Learning Style Inventory specified the learning style of each individual. Our results showed a high frequency of reflective styles, with predominance of females as diverging and males as assimilating. Concerning school and professional interests, there were correlations between styles oriented towards the abstract and technical interests. Moreover, females preferred disciplines related to languages and interpersonal activities while males preferred disciplines related to science and technical activities. There were more males in exact science and engineering careers, and more females in social science and applied social science. Correlations found between learning styles, school and professional interests corroborate Kolb´s propositions, and the findings about gender differences are supported by Evolutionary Psychology theories

Prospecção e formação no domínio das competências e habilidades em tecnologia da informação: o caso do projeto metrópole digital em Natal/RN

This study deals with cognitive competences and abilities that are relevant to selection and education regarding Information Technology (IT). These competences relate to problem solving, decision making, and practical intelligence that regard scholar and extracurricular knowledge mobilization. The research aimed to contribute for the improvement of a selection instrument, consisting of five arrays of skills (dealing with objectives and prospection), as well as the development and comprehension of those skills that are involved in IT education. This is done by means of an analysis on the selection instrument used in the first selective process that occurred at Metropole Digital an Institute at the Federal University of Rio Grande do Norte in Brazil. This was evaluated aiming to acknowledge IT education (with basic training and emphasis on Web programming and electronics). The methodology used was of quantitative method involving performance scores relating education delivery. An Anova analysis of variance was done along with descriptive analysis involving socioeconomic data that was not observed in the meaningful relations between parental instruction and student performance in the graduate course. These analyses were able to point out the importance and need of the policies for vacancy reservation on behalf of public school students. A Spearman correlation analysis was done considering the instrument selection performance in the training course. The instrument is presented as a predictor that is significantly moderate and presents a good performance in the course as a whole. A Cluster and Regression analysis was also realized in the process. The first analysis allowed finding performance groups (Clusters) that ranged from medium and inferior. The regression analysis was able to point out association amongst criterion variables and the (average performance in basic and advanced modules) and explanatory (five matrixes). Regression analysis indicated that matrix 1 and matrix 3 were pointed out as being the strongest ones. In all the above analysis, the correlation between the instrument and the course was considered moderate. Thus this can be related in some of the aspects present in the course such as emphasis on evaluation itself as well as in technical contents and practical skills (educational ones) and competences and selection skills. It is known that the mediation of technological artifact in cultural context can foster the development of skills and abilities relevant to IT training. This study provides subsidies to reflect on the adoption of selection instrument and IT training in the Institute. Thus the research offers means to achieve a interdisciplinary discussion and enriching of areas such as Psychology and Information Technology; all of which regarding competencies and skills relevant in IT training

Ações educativas com portadores de diabetes Mellitus através da educação popular em saúde

Popular Health Education in its emancipatory dimension refers to individuals and groups to exchange knowledge and experiences, allowing them to associate health to the outcomes of their living conditions. Under this view, health workers and health users are subjects of the educative process. Thus, this study aims to identify the key clinical and socio sanitary attributes and promote educational activities with patients with Diabetes Mellitus (DM) in a Family Health Care Unit of the Western Sanitary District, in the city of Natal / RN. It is an action research which uses the references of the Theory of Liberating Education, which is based on a problem-solving pedagogy and that values dialogue in the process of understanding oneself and the world. Thirty-six diabetics, who are residents of the area covered by the health care unit, and thirty health workers participated in the survey. Each group had an average of twelve participants, and the meetings took place at the Unit´s hall, using conversation wheels, group dynamics, life narratives, experiences telling, movie exhibition and discussions, music, knowledge telling, desires, limitations, beliefs and values socially constructed. Data collection took place during the second half of two thousand and thirteen through Free Word Association Technique (FWAT), recordings of conversation wheels, participative observation, group dynamics, testimonies, questionnaires, life narratives and photographs. The empirical material was organized and subjected to three analyzes: thematic content (Bardin), textual statistics analysis by software IRAMUTEQ (Ratinaud), and photographic analysis (Edmund Feldman). The data analyses originated words, expressions, categories, themes and creative situations showing that popular health education is in process of construction, but still very incipient in primary care. The National Policy on Popular Health Education shows us the necessary ways for the transformation of health practices and the build of a more shared and solidary society. The meetings could be place to reverse that normative logic that has been happening over the years in primary care, but that by itself is not enough. It is possible to conclude that the use of active practices, increasing of listening and training on Popular Health Education will enable changes in the scenario where users and health workers deal with diabetes mellitus. Thus we see the popular health education is being timidly incorporated to the educational process of the subjects involved in this study, and far away from the principles of participation, organization of political work, increase opportunities for dialogue, respect, solidarity and tolerance among different actors involved in addressing the health problems that are fundamental to the improvement in building healthy practices of primary care

A relação entre transtorno da insônia e funções executivas em adultos

The insomnia disorder is defined as a difficulty initiating or maintaining sleep or waking up earlier than expected unable to return to sleep, followed by a feeling of nonrestorative and poor quality sleep, present for at least three months, with consequences on daytime functioning. Studies have shown that insomnia affects cognitive function, especially executive functions. However, researches that sought to investigate the relationship between primary insomnia and executive functioning were quite inconsistent from a methodological point of view, especially in regard to the variability of the used methods, the heterogeneity of diagnostic criteria for insomnia and the control of sleep altering drugs. In this sense, the present study aimed to investigate the relationship between insomnia and executive functions in adults. The participants were 29 people, from both genders, aged 20-55 years old. Participants were divided into three groups, one composed of 10 people with primary insomnia who used sleep medication (GIM), nine people with primary insomnia who did not use medication (GInM) and 10 healthy people who composed the control group (CG). The research was conducted in two stages. The first one involved a diagnostic evaluation for insomnia disorder through a clinical interview and the application of the following protocols: the Athens Insomnia Scale, the Insomnia Severity Index, Sleep Journal (for 14 days), Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Test, depression and anxiety Beck inventories, and Lipp’s Iventory of stress symptoms for adults. After this stage, the evaluation of executive functions was performed by applying a battery of neuropsychological tests composed by the following tests: Wisconsin, Stoop Test, Colored trails Test, the Tower of London Test, Iowa Gambling Task (IGT) and WAIS III subtest digit span, which measured selective attention, inhibitory control, cognitive flexibility, planning, problem solving, decision making and working memory, respectively. The results showed that insomniacs (GIM and GInM) showed higher sleep latency, shorter sleep duration and lower sleep efficiency compared to the CG. In regard to the performance in executive functions, no statistically significant difference between groups was observed in the evaluated modalities. However, the data show evidence that, compared to GInM and GC, the performance of GIM was lower on tasks that required quick responses and changes in attention focus. On the other hand, GInM, when compared to GIM and GC, showed a better performance on tasks involving cognitive flexibility. Furthermore, impaired sleep measures were correlated with the worst performance of insomniacs in all components evaluated. In conclusion, people with the insomnia disorder showed a performance similar to healthy people’s in components of the executive functioning. Thus, one can infer that there is a relationship between primary insomnia and executive functions in adults.

Mobilização de competências na atividade informal do vendedor ambulante em praia de Natal (RN)

The central issue of this dissertation is to investigate the labor activity of beach hawker, in order to identify the main professional competencies mobilized in this activity, traversed by both the precariousness of the means of labor exercise, as for complex and structured routines. In the town of Natal (RN) the beaches serve as workplace for thousands of informal workers, who use various professional skills, translated into the ability to mobilize and articulate knowledge, skills and behaviors to solve problems in concrete work situations. This research therefore had as main objective to investigate the work of beach hawkers, trying to identify the core competencies mobilized for facing demands and obstacles in such a context. The beach of Ponta Negra (Natal-RN) was chosen as field of observation, in which a group of hawkers took part as voluntary subjects. Methodologically, quantitative and qualitative methods of production and analysis of data were combined in three stages. In the quantitative phase an occupational questionnaire was applied to a sample of 60 subjects, generating a set of data analyzed with quantitative univariate and multidimensional descriptive statistical tools, complemented by inferential statistical analysis. The results of this phase indicate a predominance of men sellers with salary varying in a range from one to two minimum wage Brazilian salary, age and education quite heterogeneous, extended working hours and the choice of only this activity and this beach throughout the year. Concurrently with this step of analysis, unsystematic observations of the activity of vendors were held and then driven to the technique of Instruction Impersonator with four chosen subjects. This phase had a clinicalinterpretive analysis, rooted in historical-cultural Vygotskian psychological perspective and in the french approach of skills and abilities. The main results point to several strategies for overcoming obstacles, use of technics anchored in everyday work experience and practical knowledge, building rules of conduct and collective mobilization of diverse professional skills similar to those found in formal work, such as business and time management, use of communicative tools, flexibility in problem solving, creativity and teamwork competence. We conclude that informality investigated in context can not be seen exclusively as a synonym of precariousness. It also covers skills and knowledge in a complex culture that situates informal labor in a complementary way with respect to formal work. This conclusion, therefore, contributes to overcome the notion of antinomy between formal and informal labor activity, since they both can be considered as a way to achieve job satisfaction, and even a personal representation of well done job, which is an important psychological generator of identity and social place.

Avaliação da atenção humanizada ao abortamento em maternidade-escola, em Natal, Rio Grande do Norte

Unplanned pregnancy is experienced by millions of women worldwide. Such fact increases the risk of abortion-related morbimortality, which represents a serious public health problem. This study aims to evaluate the advances and challenges of the implementation of Humanized Abortion Care at the Maternity-School in Natal, state of Rio Grande do Norte. The research was evaluative, was preceded by an Evaluative Study, and resulted in a Case Study. The intentional sample totaled 102 subjects (60 users, 39 professionals and 3 managers). The collection techniques included documental analysis, semi-structured interview and observation with a field diary. The documental analysis was descriptive, while the Content Analysis by Bardin was used for semi-structured interviews and field diary. The Evaluative Study observed that Humanized Abortion Care is an evaluative program with preparation and pact of the logical model, of the matrix of indicators and evaluative questions. The Case Study showed that users were satisfied with the problem-solving capacity and access to the service; however, is also showed that they pointed out inadequacy in terms of environment, qualified hearing and reproductive planning. Professionals reported that the inefficiency of service consists of infrastructure and environment, which are considered inefficient and inadequate to humanized care, especially regarding patient accommodation, the lack of hospital beds, the reduced number of rooms in the surgical center and the lack of laboratory inside the maternity. Moreover, reproductive planning does not consist of an institutionalized practice in the service, and integrality with other services or partnership with the community is not in place. The Maternity Board emphasizes that the excessive demand of patients is one of the reasons that hinders the appropriate implementation of the technical standard. We then conclude that although satisfied regarding problem-solving capacity in terms of service and ease of access, there is room for improvement in qualified hearing systems, in the creation of a system to promote team work, implementation of ombudsman and satisfaction surveys. The right of shared choice did not prevail among users and health professionals with regard to the option of uterine evacuation procedure. Environment was the most mentioned category as that requiring more changes, seeing as a limited factor for the development of humanized and welcoming practices. Health professionals do not establish a periodic routine of planning practices, and such practices are not aligned with the Technical Standard. Incorporation of guidelines and availability of a plurality of methods and possibilities of choices for family planning are required. There is no institutionalization of reference and counter-reference, or partnerships with the community, which makes integrality of care not viable. The Standard needs to be included in the action plans of managers as one of the priorities in the construction of care strategies for women's health, in order to enable, allied to other initiatives, the real integration among safe conduct service, primary care network and social organizations. As a result, respect for human rights and adequate humanized care, as a way of attention and prevention of abortion, can be secured.

Efeitos de um programa de treino cognitivo e das técnicas de higiene do sono para as funções executivas e para a qualidade de sono em idosos saudáveis

The aging process causes changes in the elderly’s sleep/awake standard impairing their cognitive abilities, particularly executive functioning, which already suffers loss by aging. The literature suggests that executive function and preserved sleep quality are key to maintaining good quality of life and independence of older people, requiring interventions to minimize the impact of losses incurred by the aging process. This study evaluated the effect of a cognitive training program and sleep hygiene techniques for executive functions and sleep quality in healthy older people. The participants were 41 healthy older adults, of both sexes, who were randomly divided into four groups: control group [GC], cognitive training group [GTC], sleep hygiene group [GHS] and training group + hygiene [GTH]. The research was developed in three stages: 1st - initial assessment of cognition and sleep; 2nd - specific intervention to each group; 3rd - post-intervention revaluation. The results showed that GTC had significant improvements in cognitive tasks flexibility, planning, verbal fluency and some aspects of episodic memory, besides gains in sleep quality and decrease on daytime hypersomnolence. The GHS improved sleep quality and daytime sleepiness as well and had significant improvements in insights capacity, planning, attention and in all evaluated aspects of episodic memory. The GTH had significant gains in cognitive flexibility, problem solving, verbal fluency, attention and episodic memory. The CG showed significant worsening in excessive daytime sleepiness in capacity planning. Thus, we conclude that cognitive training interventions and sleep hygiene strategies are useful in improving cognitive performance and quality of healthy elderly sleep.