Qualidade da assistência e o conhecimento sobre o direito à saúde das pessoas com úlcera venosa crônica

The study aimed to identify the quality of care and knowledge of health rights of people with chronic venous ulcers (VU) in Brasilian National Health Care System (SUS). It is a cross-sectional study, with quantitative approach, performed at the University Hospital Onofre Lopes (HUOL). The study was approved by the Ethics Committee of HUOL (CAAE nº 0148.0.051.000-10). The sample by accessibility was composed for 30 people with VU treated at the outpatient surgical clinic of HUOL. For data collection we used a structured questionnaire composed of two parts: sociodemographic characteristics and of health, of care and the clinical course of VU; and knowledge of people with VU about the rights of health. The results were processed using SPSS 15.0 and analyzed by descriptive statistics. Given the characterizations sociodemographic and health presented, we identified a clientele of users with VU predominantly female (76,7%), aged from 60 years (66,7%), married/ stable union (60,0%), low education level (83,3%), family income lower than a minimum wage (73,3%), unemployeds and with chronic diseases (53,3%), sleep greater than or equal to 6 hours (76,7%) and were not alcoholics or smokers (93,3%). In relation to clinical conditions, were shown the presence of one or more relapses of VU (73,3%), predominance of granulation tissue/epithelialization in the bed of VU (60,0%), exudate serosanguineous (43,3%), in quantity medium/large (60,0%), with no predominance of presence or absence of odor (50,0%), all patients with tissue loss in grade III / IV, no signs of infection (73,3%) and presence of intense pain (50,0%). In the last 30 days the main venue of achievement of dressing was the HUOL (100,0%), the main compression therapy used was the Unna boot (60,0%) and on inability to perform the dressing on the unit were the own patients who made the exchange at home (40,0%). The majority of respondents listed out more positive factors associated with quality of care (56,7%) were satisfied with the care of SUS (76,7%), claimed to have knowledge about their rights (70,0%), but at the same time did not know the meaning of the acronym SUS (90,0%) and classified their level of information as inappropriate (70,0%). We realize that people with VU identified as good the quality of care and demonstrated inadequate knowledge about their rights to health in the SUS, but showed interest in acquiring more information. The basic rights to entry in the SUS are constitutionally guaranteed and need to be disseminated in order to make them known to the population, so it can be implemented and ensured a greater resolution assistance in treating this type of injury

A pessoa idosa com doença crônica não transmissível atendida em serviços de média complexidade na cidade de Natal/RN

The demographic and epidemiological transition process caused by a declining in birth rates and in mortality, also changes occurred in morbidity and mortality is represented by the increasing of the aging population and the raising of chronic diseases. These diseases are characterized by multiple etiologies, risk factors, long latency period, a prolonged evolution, non-infectious origin and it has association with functional impairment and disability. Thus, elderly with chronic non-communicable disease has priority because they belong to a vulnerable group to get affection of comorbidities in aging, with increased demand and spending on health services. This study is aimed to analyse the understanding of elderly people with chronic non comunicable disease in the medium complexity service as a contribution to the improvement of health care in the city of Natal / RN. This is a descriptive and exploratory study with a quantitative approach, carried out at the Specialized Center for Elderly Health Care and at the Pescadores Hospital. The population was composed of 4,180 persons with a sample of 124 elderly aged above 60 years, attended in these medium complexity services. The instrument, a structured form, adapted from a questionnaire for monitoring risk and protective factors for chronic disease of the Ministry of Health. To collect data was was used the interview form containing demographic data, habits, health status and health care services. The results were processed using the Statistical Package for Social Science, version 18.0, analyzed by simple statistics. It was found that most seniors were female, predominantly between 70 and 74 years old, married, with a brown skin tone and Catholic religion, more than half had incomplete basic education, family income between one to two minimum wages and living with their families. Regarding the interviewers lifestyle, 94.4%, of them ate chicken and 97.6%, fruits, it was observed a reduction in smoking, alcoholism habits and physical activity according to the increasing age, 58.1 and 18.5% had insomnia18,5 % used sleeping pills. The elderly (51.6%) reported using services in times of sickness, seeking primary care at first (30.6%), 52% did not receive referral and was looking for free demand (38.7%). The most reported morbidity was hypertension, followed by musculoskeletal disorders. Regarding the difficulties in seeking health services, the delay in treatment and the waiting line were the most cited by the elderly. Almost all of them reported no activities to promote health in these services and those who received individual counseling on chronic diseases. Almost always, the health professionals who care of them, were mostly doctors followed by nurses. Based on the results presented, it is considered that the health services of medium complexity must undergone a more continuous dialogue with other attention level and focus on actions of health promotion and prevention. It is also recommended the necessity for qualified professionals to delivery health care to elderly and the implementation of protocols by a multidisciplinary health team, intending to provide better and continous care for the elderly with chronic diseases. The healthcare professionals who served them, were mostly physicians, followed by nurses. Through the results presented, it is considered that the medium complexity healthcare services need to perform a more continuous dialogue with the other levels of attention focusing attention to the health promotion and prevention actions. It is also recommended the necessity for qualified professionals to delivery healthcare for the elderly, in addition, a protocol implementation for the multidisciplinary health care team, to provide better care, and also the care continuity to elderly with chronic diseases

Ocupação de área e interações de golfinhos-rotadores (Stenella longirostris) com o turismo náutico no Arquipélago de Noronha/PE, Brasil

Several works characterize the presence of spinner dolphins at Fernando de Noronha Archipelago in the Dolphins Bay. Though, the dolphins abidance inside this cove has decreased and a new area has been occupied by the animals to achieve the same behaviors, that are resting, breeding and nursing. This area comprises the Inside Sea northeast border of Fernando s de Noronha Island, including the opposing Middle and Dog shore area, the San Antonio Bay and the Between Islands region. The aim was to characterize the dolphins occupation and describe their interactions with the tourism in this area. Data were collected in 2008 and 2009 through a fixed point observation. The study area was divided into seven sub-areas, recording: presence/absence of dolphins, days abidance endurance, abidance length in each area, estimated number of individuals, dolphins direction and speed of displacement, boats presence, interaction period, monitoring, boats attitude and velocity. The dolphins abidance time displayed the same pattern during both years of study, with the higher occupancy in the Between Islands region. Groups with farther than 200 individuals were more frequent both 2008 (46.2%) and 2009 (42.3%). Thus the displacement s slow speed as the preferred direction towards Rat Island also showed the same pattern in both years. The Between Islands region also presented the boats major abidance near the dolphins groups. Boats moved farther in slow speed (95%) than at high speed (5%). The legislation s compliance for the cetaceans protection occurred in 89.7% of 2.839 interactions between boats and spinners, in which this variable was recorded. Whenever boats moved at a slow speed during the meetings with spinner dolphins groups, animals also moved at a slow speed (n = 337), significantly more than the fast displacements (n = 128) ix or "porpoise" (n = 4) (X2 = 318.543, p = -0.001). When boats quickly passed by groups, a significant difference between the dolphins displacement speeds was observed (X2 = 18.264, p =- 0.001), however, the slow (47%) and fast (47% ) displacements frequency was equal, noted the difference with the porpoise displacements (6%), which had the lowest frequency. Data indicate the establishment of a new occupation pattern of the spinner dolphins at Fernando de Noronha, with the Between Islands area being of great importance to the dolphins habits and currently the main area of the boats meeting with the dolphins, showing the need of new conservation measures in this area

Critérios comportamentais utilizados por técnicos na avaliação do desempenho esportivo de futebolista das categorias de base

Currently one of the major concerns in sports is to identify, select, discover and reveal talents in soccer. As principal reasons is perceived the search direct or indirect for resources for players, clubs, media, sports brands and their sponsors. However, high salaries are an exception and not a rule, because the majority of professional players in Brazil receives 1 minimum salary per month. It is also known that on professional clubs, daily, arriving several players to try to be a professional soccer player, however, the majority of clubs - almost all does not present methodological, systematic and analytical aspects to select promising players. The selective processes ("sieves" or "big sieves") developed by technical observers ( olheiros") summarized in the observation of the sportive performance of a big group of players in a period of few minutes given to each player. In this period the target behavior is the ability with the ball. If promising players are identified on that selection, they are referred to the club for a new observation, which will be conducted by the responsible coach of base category in question. It is understood by base categories, the amateur categories (not professional), to serve as a "base" for the formation of the cast of professional clubs. What are sub-13 (under 13 years), sub-15 (under 15 years), sub-17 (under 17 years) and sub-20 (under 20 years). The absence of common criterias and performance indicators of these professionals may hamper the evaluation of promising players, and be a costly activity for the club. This study proposes to identify, characterize and categorize the criterias and methods of behavioral evaluation, used by coaches of base categories of Rio Grande do Norte (RN) to evaluate the sportive performance of young soccer players, with the purpose of to compare the criterias of evaluation of sportive performance of young soccer players, used by coaches with different time of experience in function. The proposal had 2 pilot studies, the first (June and July, 2007) were interviewed 29 coaches, 17 of category sub-13 and 12 of category sub-17. The data were tabulated and organized into spreadsheets in order to describe, and developed a set of descriptors of behavior. And the second (May and June, 2008), with revisions made based on observations, analysis and descriptions found in the first, were interviewed 14 technical of category sub-15. After the results found in pilots, it was possible to outline the study in question, which had 46 coaches base categories of the RN. And from the results show that the characteristic of greatest importance, according to the interviewees was the behavior, the 2nd most important characteristic considered was the motivation, the 3rd was the ability and the 4th was the physical condition and the last was the affiliation. And by analyzing the results to the methods of evaluation of sportive performance used by coaches, it was noted clearly that most uses only the observation to select young soccer players. Therefore, needs a systematization to the selection of soccer players, since there is complexity in the verification of characteristics and aspects involved with purpose to avoid wrong evaluations and selections and the results negligible

Estudos de validade da escala de dependência alcoólica do millon clinical multiaxial inventory iii para o Brasil

This study has as main objectives to translate and to adapt the MCMI-III to brazilian Portuguese, as well as investigate and analyze the involved modifications in the Alcohol Dependence Scale concerning to the results obtained on the validity and on the process of adaptation to Brazil. The inventory was translated and, posteriorly, applied on people with different reading levels to certify that the items are understandable to public in general, from diverse places of the country, divided into clinical and non-clinical groups. Were evaluated 2855 subjects between the ages of 18 and 85 years old, male and female, resident and dwellers of Brazilian cities. The application methods were face-to-face and computerized. Results showed that the clinical group presented significant differences between the means in comparison to the non-clinical group. Through the application of the General Health Questionnaire were developed studies related to the achievement of convergent validity and its results pointed to the relation between the instrument scores and the MCMI-III. The Alcohol Dependence Scale analysis indicated that people who reported abusive use of alcohol had highest scores, indicating adequacy of the instrument on identifying manifestation of disorders and syndromes. Nevertheless, further studies are necessary to the establishment of normative patterns to the Brazilian sample

Entendendo as interações entre povos pesqueiros, manguezal e área protegida: RDS estadual Ponta do Tubarão (RN, Brasil)

The mangrove ecosystem has a great importance to maintaining marine biodiversity, and to the livelihoods of communities living around it. Despite its importance, many mangrove areas have been extensively cleared and converted to other uses. There are few places where communities can retain their traditional uses of mangrove. A good example of conservation of traditional costumes are the fishing communities of the Sustainable Development Reserve (Reserva de Desenvolvimento Sustentável RDS) Ponta do Tubarão. The creation of the reserve came from the own population, and the devastation of a mangrove area, which would be destined for activity shrimp, was one of the reasons that led the population to ask authorities the establishment of a legally protected area. Thus, this study aimed to investigate the environmental perception of the fishing communities of RDS Ponta do Tubarão with respect to the mangroves in a biological, ecological and social perspective as well as evaluate the influence of the reserve in the mangrove conservation and quality of life. To meet objectives of this study was required the appropriation of some method and approaches of ethnosciences and environmental perception. Data were collected through direct observation, and semi-structured interviews. Through content analysis found that the population has a strong dependence on the mangrove ecosystem, as well as provides a good ecological knowledge of ecosystem functions. It was also found that the reservation has a good performance in the conservation of the mangroves; however, need to outline strategies to conciliate both the biological and cultural conservation.

ENTENDENDO AS INTERAÇÕES ENTRE POVOS PESQUEIROS, MANGUEZAL E ÁREA PROTEGIDA: RDS ESTADUAL PONTA DO TUBARÃO (RN, BRASIL)

The mangrove ecosystem has a great importance to maintaining marine biodiversity, and to the livelihoods of communities living around it. Despite its importance, many mangrove areas have been extensively cleared and converted to other uses. There are few places where communities can retain their traditional uses of mangrove. A good example of conservation of traditional costumes are the fishing communities of the Sustainable Development Reserve (Reserva de Desenvolvimento Sustentável RDS) Ponta do Tubarão. The creation of the reserve came from the own population, and the devastation of a mangrove area, which would be destined for activity shrimp, was one of the reasons that led the population to ask authorities the establishment of a legally protected area. Thus, this study aimed to investigate the environmental perception of the fishing communities of RDS Ponta do Tubarão with respect to the mangroves in a biological, ecological and social perspective as well as evaluate the influence of the reserve in the mangrove conservation and quality of life. To meet objectives of this study was required the appropriation of some method and approaches of ethnosciences and environmental perception. Data were collected through direct observation, and semi-structured interviews. Through content analysis found that the population has a strong dependence on the mangrove ecosystem, as well as provides a good ecological knowledge of ecosystem functions. It was also found that the reservation has a good performance in the conservation of the mangroves; however, need to outline strategies to conciliate both the biological and cultural conservation.

Avaliação de impacto ambiental e gestão dos recursos natuarias no estuário Apodi Mossoró, nordeste do Brasil

The aim of this study is to investigate the eco-environmental vulnerability, its changes, and its causes to develop a management system for application of eco-environmental vulnerability and risk assessment in the Apodi-Mossory estuary, Northeast Brazil. This analysis is focused on the interference of the landscape conditions, and its changes, due to the following factors: the oil and natural gas industry, tropical fruits industry, shrimp farms, marine salt industry, occupation of the sensitive areas; demand for land, vegetation degradation, siltation in rivers, severe flooding, sea level rise (SLR), coastal dynamics, low and flat topography, high ecological value and tourism in the region and the rapid growth of urbanization. Conventional and remote sensing data were analyzed using modeling techniques based on ArcGIS, ER-Mapper, ERDAS Imagine and ENVI software. Digital images were initially processed by Principal Component Analysis and transformation of the maximum fraction of noise, and then all bands were normalized to reduce errors caused by bands of different sizes. They were integrated in a Geographic Information System analysis to detect changes, to generate digital elevation models, geomorphic indices and other variables of the study area. A three band color combination of multispectral bands was used to monitor changes of land and vegetation cover from 1986 to 2009. This task also included the analysis of various secondary data, such as field data, socioeconomic data, environmental data and prospects growth. The main objective of this study was to improve our understanding of eco-environmental vulnerability and risk assessment; it´s causes basically show the intensity, its distribution and human-environment effect on the ecosystem, and identify the high and low sensitive areas and area of inundation due to future SLR, and the loss of land due to coastal erosion in the Apodi-Mossoró estuary in order to establish a strategy for sustainable land use. The developed model includes some basic factors such as geology, geomorphology, soils, land use / land cover, vegetation cover, slope, topography and hydrology. The numerical results indicate that 9.86% of total study area was under very high vulnerability, 29.12% high vulnerability, 52.90% moderate vulnerability and 2.23% were in the category of very low vulnerability. The analysis indicates that 216.1 km² and 362.8 km² area flooded on 1m and 10m in sea levels respectively. The sectors most affected were residential, industrial and recreational areas, agricultural land, and ecosystems of high environmental sensitivity. The results showed that changes in eco-environmental vulnerability have a significant impact on the sustainable development of the RN state, since the indicator is a function of sensitivity, exposure and status in relation to a level of damage. The model were presented as a tool to assist in indexing vulnerability in order to optimize actions and assess the implications of decisions makers and policies regarding the management of coastal and estuarine areas. In this context aspects such as population growth, degradation of vegetation, land use / land cover, amount and type of industrialization, SLR and government policies for environmental protection were considered the main factors that affect the eco-environmental changes over the last three decades in the Apodi-Mossoró estuary.

Poluentes atmosféricos: monóxido e dióxido de carbono no nordeste do Brasil

The interference of man in the middle atmosphere can be evidenced by the presence of carbon monoxide, gas associated with burning fossil fuels and carbon dioxide content, essential for respiration of plants and thermal balance of the Earth. In this thesis we initially evaluated the intensity of the spatial distribution of carbon monoxide in the Northeast of Brazil, and subsequently the behavior of temporal variations of the pollutants carbon monoxide and carbon dioxide in the atmospheric boundary layer Maxaranguape / RN. Research has shown that, driven by speculation and promoting the occupation of land for agriculture, cattle ranching and tourism in the Northeast of Brazil, the changes established by the man in the middle geomorphological affect the lower troposphere on a large scale, with a predominance of concentrations in central Pernambuco, Paraiba's south-central and central-west of Alagoas. However, the study of Maxaranguape / RN results showed little variation in carbon monoxide and carbon dioxide, with the speed of the wind persisting with values greater than 7.8 m / s, showing dispersion and diffusion of pollutants which resulted in faster renewal of local atmospheric air

Socioeconomic and demographic profile of leprosy carriers attended in nursing consultations

A hanseníase é doença infecto-contagiosa para a qual, além das condições individuais, outros fatores relacionados aos níveis de endemia e às condições socioeconômicas desfavoráveis influem no risco de adoecer. Objetivou-se reconhecer o perfil socioeconômico e demográfico e o grau de incapacidade instalado dos portadores de hanseníase, atendidos no Centro de Saúde Escola de Botucatu, São Paulo, Brasil. Fizeram parte do estudo 37 pacientes. Os dados foram obtidos por meio do instrumento de consulta de enfermagem. Os resultados mostraram predominância de indivíduos com união estável (78%), brancos (92%), com idade entre 30 e 49 anos (51%), com baixo nível de escolaridade e com renda familiar per capita menor que um salário mínimo. Mais de um terço dos pacientes investigados (35%) apresentavam algum grau de incapacidade física. A associação do baixo perfil socioeconômico com a presença de incapacidades físicas imprime maior vulnerabilidade a essa população, podendo impactar negativamente a sua qualidade de vida.

Petrologia do plúton Serra da Macambira, neoproterozóico da faixa seridó, província Borborema (NE do Brasil)

The final stage of Brasiliano/Pan-African orogeny in the Borborema Province is marked by widespread plutonic magmatism. The Serra da Macambira Pluton is an example of such plutonism in Seridó Belt, northeastern Borborema Province, and it is here subject of geological, petrographic, textural, geochemical and petrogenetic studies. The pluton is located in the State of Rio Grande do Norte, intrusive into Paleoproterozoic orthogneisses of the Caicó Complex and Neoproterozoic metassupracrustal rocks of the Seridó Group. Based upon intrusion/inclusion field relationships, mineralogy and texture, the rocks are classified as follows: intermediate enclaves (quartz-bearing monzonite and biotite-bearing tonalite), porphyritic monzogranite, equigranular syenogranite to monzogranite, and late granite and pegmatite dykes. Porphyritic granites and quartz-bearing monzonites represent mingling formed by the injection of an intermediate magma into a granitic one, which had already started crystallization. Both rocks are slightly older than the equigranular granites. Quartz-bearing monzonite has K-feldspar, plagioclase, biotite, hornblende and few quartz, meanwhile biotite-bearing tonalite are rich in quartz, poor in K-feldspar and hornblende is absent. Porphyritic and equigranular granites display mainly biotite and rare hornblende, myrmekite and pertitic textures, and zoned plagioclase pointing out to the relevance of fractional crystallization during magma evolution. Such granites have Rare Earth Elements (REE) pattern with negative Eu anomaly and light REE enrichment when compared to heavy REE. They are slight metaluminous to slight peraluminous, following a high-K calc-alkaline path. Petrogenesis started with 27,5% partial melting of Paleoproterozoic continental crust, generating an acid hydrous liquid, leaving a granulitic residue with orthopyroxene, plagioclase (An40-50), K-feldspar, quartz, epidote, magnetite, ilmenite, apatite and zircon. The liquid evolved mainly by fractional crystallization (10-25%) of plagioclase (An20), biotite and hornblende during the first stages of magmatic evolution. Granitic dykes are hololeucocratic with granophyric texture, indicating hypabissal crystallization and REE patterns similar to A-Type granites. Preserved igneous textures, absence or weak imprint of ductile tectonics, association with mafic to intermediate enclaves and alignment of samples according to monzonitic (high-K calcalkaline) series all indicate post-collisional to post-orogenic complexes as described in the literature. Such interpretation is supported by trace element discrimination diagrams that place the Serra da Macambira pluton as late-orogenic, probably reflecting the vanishing stages of the exhumation and collapse of the Brasiliano/Pan-African orogen.

Interpretação sísmica e análise de atributos - área do levantamento sísmico 3D de siririzinho (Bacia Sergipe-Alagoas, NE do Brasil)

The main objective of the present thesis was the seismic interpretation and seismic attribute analysis of the 3D seismic data from the Siririzinho high, located in the Sergipe Sub-basin (southern portion of Sergipe-Alagoas Basin). This study has enabled a better understanding of the stratigraphy and structure that the Siririzinho high experienced during its development. In a first analysis, we used two types of filters: the dip-steered median filter, was used to remove random noise and increase the lateral continuity of reflections, and fault-enhancement filter was applied to enhance the reflection discontinuities. After this filtering step similarity and curvature attributes were applied in order to identify and enhance the distribution of faults and fractures. The use of attributes and filtering greatly contributed to the identification and enhancement of continuity of faults. Besides the application of typical attributes (similarity and curvature) neural network and fingerprint techniques were also used, which generate meta-attributes, also aiming to highlight the faults; however, the results were not satisfactory. In a subsequent step, well log and seismic data analysis were performed, which allowed the understanding of the distribution and arrangement of sequences that occur in the Siririzinho high, as well as an understanding of how these units are affected by main structures in the region. The Siririzinho high comprises an elongated structure elongated in the NS direction, capped by four seismo-sequences (informally named, from bottom to top, the sequences I to IV, plus the top of the basement). It was possible to recognize the main NS-oriented faults, which especially affect the sequences I and II, and faults oriented NE-SW, that reach the younger sequences, III and IV. Finally, with the interpretation of seismic horizons corresponding to each of these sequences, it was possible to define a better understanding of geometry, deposition and structural relations in the area.

Caracterização multi-escalar de bandas de deformação nas tectonossequências paleozóica, pré- e sin-rifte da Bacia do Araripe, Nordeste do Brasil

Deformation bands are structures, developed in porous sandstones, that has small offsets and they are not shown on seismic section. The deformation bands of the pre and synrift sandstones of Araripe Basin were studied in outcrop, macroscopic and microscopic scales. The hierarchical, cinematic and spatial-geometric characteristics, and also the deformational mechanisms acting during its structural evolution were established too. In general, the mesoscopic scale observation allowed to discriminate deformation bands as singles or clusters in three main sets: NNE-SSW dextral; NE-SW normal (sometimes with strike-slip offset); and E-W sinistral; further a bed-parallel deformation bands as a local set. The microscopic characterization allowed to recognize the shearing and cataclastic character of such structures. Through the multi-scale study done in this work we verified that deformation bands analyzed were preferentially developed when sandstones under advanced stage of lithification. We also infer that the geometrical-spatial complexity of these bands, together with the presence of cataclastic matrix, can difficult the migration of fluids in reservoir rocks, resulting on their compartmentalization. Therefore, the study of deformation bands can aid researches about the structural evolution of sedimentary basin, as well as collaborate to understand the hydrodynamic behavior of reservoirs compartmented by these deformational structures

Fatores associados à realização dos exames de rastreamento para o câncer de próstata: um estudo de base populacional

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

De artista a designer: Alexandre Wollner e o pensamento concreto na construção do design visual no Brasil

Pós-graduação em Artes - IA