Associação entre as narrativas em saúde bucal e condições socioeconômico-culturais: a dentição como reflexo da desigualdade social

This anthropological study investigates the lived-experience of oral diseases in the context of poverty in Northeast Brazil. During six months in 2004???, ethnographic interviews, narratives and participant-observation with 31 residents of the low-income community, Dendê, located in Fortaleza, Ceará were conducted and analyzed utilizing a hermeneutic-dialetic method. It is revealed that precarious life conditions make prioritizing caretaking a difficult task. Despite suffering tooth pain, seeking a dentist's care is perceived as "a luxury" not a citzens' right. Difficulties in accessing services and poor quality restorations, favor tooth extractions as the most effective intervention. The deterioration of one's oral health is lamented by community members who seek help from popular clinics, politicians and traditional healers. The experience of dental disease differs according to social class, leaves oral scars of inequity, harms self-esteem and inhibits social inclusion. In this context, "treating" the Teeth of Inequity demands that we deepen our comprehension of the social determinants of health, reduce injustice in the access to quality care, remove demoralizing stigmas and empower the community to confront structural forces which affect its life

Apitidão funcional e comportamentos relacionados à saúde em mulheres idosas do município de Jequié-BA

The identification of the factors that interfere in the decline of functional conditions is useful in the planning of actions addressing the improvement in the conditions of the lives of elderly people. The purpose of this investigation was to analyze the relationship between social demographics and health aspects of the functional condition in elderly women of low income of the Brazilian northeast. This crosssectional study involved a representative sample of 222 women with an average age of 70 years (± 7.1), belonging to coexisting groups and that were resident in the urban area of the municipal district of Jequié /Bahia. In order to achieve this objective, a battery of physical tests of functional aptitude was carried out previously tested in pilot study, anthropometric measurements collected with a comparison of the measures referred to the reported weight and height as well as the application of an interview with questions containing subjects related to social demographic variables, clinical conditions and health, physical conditions and behaviors. Descriptive statistics Proceedings (frequency, average, standard deviation and percent distribution) were used for statistic analysis, and the calculation of the respective odds ratio by binary logistics regression, for the analysis of factors hierarchically grouped; p<0.05. The prevalence of 56% (n=122) of women considered with moderated or serious type of functional limitations was found, In which from multi-varied hierarchical analysis, significant association was verified with the age group over 80 years (p=0.02), conditions of widowhood (p=0.04), presence of arterial hypertension (p=0.001), and physical inactivity during leisure time (p=0.03). On the other hand for functional incapacities the prevalence was of 46.8% (n=104) being associated to the increase of the age (p=0.01), hospitalization (p=0.02), absence of physical activities along their lives (p=0.001) and the occurrence of alterations in the cognitive function (p=0.001). The normative table for the parameters of physical fitness generated conducive to health professionals in the diagnosis of health conditions and the prescription of physical exercises. The identified characteristics that are associated with the functional limitations / functional incapacities suggest a complex causal net in the determination of the functional condition in elderly women. However, actions addressed to the incentive of the practice of physical activities in the leisure time and the preservation of the cognitive function can contribute to a life with more quality for these people. This research was multidisciplinary approach to involve elements of psychology, nutrition and Physical Education in the elucidation of the object of study related to the functional condition of elderly women

Determinantes socioeconômicos e ambientais do declínio das hospitalizações por diarréias em lactentes no Rio Grande do Norte - 1992 a 2001

There was a significant decline in hospitalizations for acute diarrhea in children younger than 1 year of age in Brazil between 1992 to 2001. The less economically developed state of Rio Grande do Norte is a case example of the national trend. In this work, we show a significant association between improvements in socioeconomic variables as well as increased access to sanitation and the decreased rate of hospitalization. Additionally, we observed a positive, seasonal correlation between rainfall and hospitalizations. Most notably, however, we show that improvements in income and inflation were positively correlated with a decline in hospitalizations. Improvements in public health infrastructure, socioeconomic variables like education and literacy, and increased investment in health services were important in reducing severe early childhood diarrheas. However, the data suggests that increased buying power and reductions in poverty played an equally crucial role in reducing hospitalizations for acute diarrhea in infants in Brazil. The work includes elements of the demography of the period for the age groups involved, children under one year, women in fertile age and fertility rate

Níveis de homocisteína e desempenho cognitivo em uma amostra populacional de idosos da cidade do Natal-RN

The imprecision of the frontier that separates those cognitive deficits inherent to the human physiological aging process from those which represent the early signs of nervous system degenerative pathologies ,very prevalent among the elderly, has brought attention to the need of studies aiming to establish clinical and/or laboratorial criteria to allow this differentiation. Elderly people living in poor and developing countries are frequently exposed to precarious socioeconomic conditions which facilitate the development of an array of pathologies which have metabolic and nutritional dysfunctions as the established or proposed etiological agents. The levels of certain micronutrients, such as the vitamins B12 and B9 (folic acid), and of some intermediary metabolites, such as homocysteine are being thought of as etiological factors and/or as biological markers of a group of alterations which affect the normal functioning of the nervous system with important reflexes upon cognitive performance. This study aims to investigate the influence of homocysteine, B12 vitamin and folic acid levels on the cognitive performance of the low income elderly population. This transversal study took place in Natal, Rio Grande do Norte State, Brazil, and involved 205 dwelling elderly people, users of the Programa de Saúde da Família, a public healthcare program, maintained by the city s health authorities. A multidimensional questionnaire was used to assess the socio-demographic aspects and the overall health and nutrition conditions. The cognitive performance was measured by the use of the Portuguese version of the Mini Mental State Exam (MMSE). The serum levels of homocysteine, B12 vitamin and folic acid were determined by chemiluminescence. The association between the socio-demographic and serum levels of Hcy, B12 vitamin and folic acid was determined by multiple linear regression. Serum levels higher than 13.5 μmol/l, indicative of hyperhomocysteinemia (HHcy), were found on 25.4% of the sample, being more prevalent in men (p<0.05). Deficitary levels of folic acid (<5ng/mol) and of B12 vitamin (<193 pg/ml) were found on 3.9% and 10.2% of the sample respectively. A negative correlation was found between cognitive performance with both age and HHcy and a positive correlation was found between cognitive performance and schooling. The isolated HHcy R2 values were an explanation to only 4% of the variance of the MMSE scores. However, when associated with schooling and age, this model explains about 25% of this association

Síndrome metabólica e risco cardiovascular na pós- menopausa: avaliação por diferentes critérios diagnósticos e influência de fatores sócio-econômicos

The metabolic syndrome (MetS) involves a group of risk factors and is associated with a significantly higher risk of developing cardiovascular diseases (CVD) and type 2 diabetes. Recent studies have shown the importance of preventing CVD through early diagnosis and treatment of patients with MetS. The objective of our study was to determine the prevalence of MetS by different diagnostic criteria in postmenopausal women and analyze the influence of socioeconomic factors on cardiovascular risk in this sample of the population. A cross-sectional study involving 127 postmenopausal women (45 to 64 years) from Natal and Mossoró, Brazil. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte. The experimental protocol consisted of applying structured interview, clinical examination and implementation of dosages blood. The diagnosis of MetS was based on NCEP-ATP III (National Cholesterol Education Program-Adult Treatment Panel III) and IDF (International Diabetes Federation) criteria. The research was accomplished with the participation of an interdisciplinary team in their several phases. The result of the sample studied had mean age of 53.9 ± 4.6 years and per capita income of 54.5 dollars. The prevalence of MetS, according to NCEP-ATP III and IDF criteria, was 52.8% and 61.4$, respectively. The agreement rate between NCEP-ATP III and IDF criteria was 81.9%, with a kappa value of 0.63 (CI 95%, 0.49-0.76), indicating good agreement between the two definitions. The most prevalent cardiovascular risk factor was HDL < 50 mg/dl, observed in 96.1% of the women analyzed, followed by increased waist circumference (≥ 80 cm) in 78.0%, elevated blood pressure in 51.2%, triglycerides ≥ 150 mg/dl in 40.9% and glycemia ≥ 100 mg/dl in 37.0% of the women. The occurrence of MetS was significantly associated with schooling and body mass index (BMI). High blood pressure was significantly associated with low family income, low schooling and weight gain. There was no significant association between the intensity of climacteric symptomatology and the occurrence of MetS. The conclusions of the research were that MetS and its individual components show a high prevalence in postmenopausal Brazilian women, and significant associations with weight gain and low socioeconomic indicators. The data point to the need for an interdisciplinary approach at the basic health care level, directed toward the early identification of risk factors and the promotion of cardiovascular health of climacteric women.

Cultura e consumo: o fluxo dos bens

It is an ethnographic work that has an objective of verifying devices throngh the residents of a low income suburban area, and the way they deal with their social relations through sonsumerism (and the aspiration connected to it), the symbolic character acquired through consumer goods, understood as one of the fundamental components for the comprehension of the web as relations that established, Though consumerism, individuais will reveal ways of communication, of the status, of creating new forms of action and identification. Using the principal that believes in a web of symbolic significance where own individuais develop their impressions, as a resource to look at their own bodies, a social order (yet unstable), and the process of inclusion in a broader society. In conclusion, the act of consuming is more than a perspective that establishes statistics on consumer goods, with their ways of production, circulation and economic functioning: it is also a way of perceiving a collection mapped by consumers individually and socially, and by those means organizing, classifying and identifyring the social world

Quem tem direito à moradia? :uma análise da política nacional de habitação e dos programas de habitação de interesse social (2003-2005)

This dissertation analyses the Brazilian housing policy of today s, focusing on the programmes in the socalled Social Interest Housing Subsystem in order to discuss to what extent the government has been able to grant housing constitutional rights in the country. The discussion is about housing policy and the principles in the country s Constitution regarding the role of housing as a social right, a right that must be granted by the state. This refers to land rent theory to understand the relationship between capital and property and the reasons why, under capitalism, housing becomes a commodity in the market. Then, it discusses the national housing policy, which emphasizes land ownership through financing, that is, via market, a process that excludes all low income population. In the conclusion, it is clear that, although government programmes cover extensively at least potentially the national territory as well as social group, subsidized housing programmes cannot be implemented in the city due to land prices because subsidy is too low. In this way, the law that grants housing rights to all Brazilian citizens is violated

Representações sociais de discentes sobre universidade: um estudo psicossocial entre ingressantes do vestibular e da seleção ProUni

Demand for access to higher education to put in test the education Brazilian system in view of the surplus of selective processes of public universities, people without option to pay their studies at this education level. In this context, it has arisen the University for All(Universidade para Todos)Program, the ProUni, from Ministry of Education - MEC, created by the Federal Government in 2004, and that it aims the granting of full and partial scholarships in private higher education institutions, graduate courses in sequential specific training, low-income Brazilians students who do not have higher-level degree. Created by the Provisional Measure No 213/2004 and institutionalized by Law No. 11096 of January 13, 2005, the ProUni offers, however, the exemption of some taxes to those institutions that join the program. This is one of the privileged time for the study of Social Representations by offering the researcher, a living laboratory, natural environment, the confrontation between the established and new. In time like this people are challenged to incorporate the new system to the pre-existing one, aiming it through a strangeness of what was so familiar. It is through this game of social forces that we developed the present study with 196 entering higher education, of these are 116 of selective vestibular system and 80 of the ProUni selective system. We opt by the procedures for data collection in order to have access to the circulating senses, in addition to the streamlined responses. With foundation in Abric, we perform the test the Free Association of Words, then analysed by the software and by EVOC Content of the type theme as Bardin. Besides, we require of the subjects, a writing on the study object university later analysed by the software ALCESTE. The results point out to a representation strongly rooted in social factors such as more traditional socio-cultural elements: the beliefs, values, the symbols. It is unique in both groups of subjects: among those entering by the selective ProUni system, there was a stronger anchor in that it does not make inquiries about the program. At the same time, there is a stronger presence of objectivation, entering the selective vestibular system in order that they explained with a value judgement on the programme. It is suggested further studies considering the embryonic state of social representation, as recent as the social purpose that triggered. It would be relevant even the replication of the same research with other people in order to strengthen the power of the theorising of empiria available

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Da negatividade a positividade: possível trânsito de saberes, práticas e representações sociais sobre o estigma da hanseníase

Leprosy is a chronic infectious-contagious disease, caused by Mycobacterium leprae, manifested by dermatological and neurological signs and symptoms and has great disabling power. It was marked by a strong stigma throughout its history, since its bearers represented a threat, target of fear and social contempt. Currently, leprosy has treatment and cure, and the need to separate the diseased from family and social environment is no more necessary. However, patients still suffer prejudice and discrimination. This study aimed to understand the social representations of leprosy that interfere modifying mental health of the patient with leprosy in relation to stigma and prejudice. This is a descriptive and exploratory study, with qualitative approach, which involved 22 users of the Special Care Clinic in Infectious Diseases at the Hospital Giselda Trigueiro, located in Natal / RN. They were in use of multidrug therapy in the period of data collection, were of both sexes, aged between 16 and 80 years of age and classified as paucibacillary or multibacillary. The study was approved by the UFRN Ethics in Research Committee. Data collection was performed by filling the questionnaire identification and then for conducting the semi-structured interview, which was recorded. After the end of data collection, there was the construction of tables and graphs, using the Microsoft Excel Start 2010 for proper characterization of the research subjects; and for the treatment of the data obtained from the interviews, was used the Content Analysis and based on the Theory of Social Representations. The subjects studied were mostly male (64%), married or in a stable relationship (68%), concentrated in the age group 50-60 years (36%) and 28-38 years (23%), had at most elementary education (65%) and were low-income (59%). Of the total respondents, 64% were classified as multibacillary, with predominantly dimorfous form, and 50% had disability grade I or II, with different periods of diagnosis. The reports originate two categories: 1. The negative meanings of illness and leprosy; and 2. The positive meanings of illness in leprosy, which were subsequently subdivided into subcategories. Thus, it was found that in the group studied, the social representation of leprosy experiences a moment of transition, as regards the understanding of the disease and its way of experiencing the disease process. Such representation is anchored in the quality of information on the disease of its bearers and aimed at an attempt to face the illness of leprosy as a "normal process". It was found in this study that the transition is due to the work of combating stigma and consequences of leprosy, which is able to gradually transform reality, both regarding the team work of reference, and in relation to a broader character, of actions of health education, which favors overcoming of psychosocial disabilities

Projeto, construção e análise de desempenho de coletores solares alternativos utilizando garrafas pet

A solar alternative system for water heating is presented. It work on a thermosiphon, consisting of one or two alternative collectors and a water storage tank also alternative, whose main purpose is to socialize the use of energy mainly to be used by people of low income. The collectors were built from the use of pets bottles, cans of beer and soft drinks and tubes of PVC, ½ " and the thermal reservoirs from a drum of polyethylene used for storage of water and garbage placed inside cylinder of fiber glass and EPS ground between the two surfaces. Such collectors are formed by three elements: pet bottles, cans and tubes absorbers. The heating units, which form the collector contains inside the cans that can be closed, in original form or in the form of plate. The collectors have an absorber grid formed by eight absorbers PVC tube, connected through connections at T of the same material and diameter. It will be presented data of the thermal parameters which demonstrate the efficiency of the heating system proposed. Relative aspects will be boarded also the susceptibility the thermal degradation and for UV for the PVC tubes. It will be demonstrated that this alternative heating system, which has as its main feature low cost, presents thermal, economic and materials viabilities

Estudo da Potencialidade da produção de tijolos de adobe misturado com outros materiais: uma alternativa de baixo custo para a construção civil

The production of the red pottery brick, made traditionally with clay, is a technique that is already stabled. However, in spite of the little complexity that involves the conventional process of these bricks production, it are exposed to many problems that begin in the fase of exploration of the mines, the problems get worse because of the lack of the clay's characterization, and they continue through the steps of the dough preparation, conformation of the products, the drying and the burning process. The wastefulness is shown and so is the low quality of the material produced. Among other factors, the high use of energy in the burning makes the cost of this material inaccessible to the low income consumer. Besides this, the destruction of the environment around the mines and the use of native vegetation to produce wood - the most used fuel in the pottery industry - make serious environmental damage. The production technique of a new type of simple brick (adobe), that has low cost and no environmental damage, can be the viable altemative to lower the cost of this part of the civil construction, and, consequently, in the building of cheaper houses. In this paper, the results of the mechanical resistance of the adobe brick are shown, using in its composition, clay, natural vegetable fibers, cement and plaster in a process that is completely handcrafted and manual. It is intented to make clear that are possible alternatives to be put in practice, with the simple process, using "raw earth" that has been used in the construction of houses in thousands of years, trying to solve these severe problems. Analysis and tests were performed to find results that could prove the possibility of the utilization of this kind of material. Other studies are in progress, and the new researches are necessary to enrich this work, but it stays the certainty that there is potential to produce bricks from adobe, as an alternative that has low cost to civil construction

Estudo térmico e de materiais na construção de casas populares com blocos confeccionados a partir de um composto a base de cimento, gesso, eps e raspa de pneu

We built an experimental house on an UFRN´s land using blocks made by a composite consisting of cement, plaster, EPS, crushed rubber and sand. Several blocks were made from various compositions and we made preliminary tests of mechanical and thermal resistance, choosing the most appropriate proportion. PET bottles were used inside the block to provide thermal resistance. In this work, a second function was given to the bottles: to serve as a docking between the blocks, because the ends of the cylinders came out of each block on top as well as at the bottom, with the bottom cut, allowing to fit of the extremities of the upper cylinder of a block in the lower holes of the other one, which were formed by the cutting already mentioned. Minimum compression tests were performed according to ABNT standards for walls closing blocks (fence). With that house built, we did studies of thermal performance in order to ascertain conditions of comfort, checking external and internal temperatures in the walls and in the ambient, among other variables, such as wind speed and relative humidity. The resulting blocks provided adequate thermal insulation to the environment, where the walls presented differences up to 11.7 ºC between the outer and inner faces, getting the maximum temperature inside the house around 31 °C, within the so-called thermal comfort zone for warm climates. At the end of the experiments it was evident the effectiveness of that construction in order to provide thermal comfort in the internal environment of the house, as well as we could confirm the viability of building houses from recyclable materials, reducing the constructive costs, becoming a suitable alternative for low- incoming families. Moreover, besides the low cost, the proposal represents an alternative use of various recyclable materials, therefore considered an ecological solution

Análise de desempenho de um fogão solar construído a partir de sucatas de antena de tv

Given the growing environmental crisis caused by degradation, mainly due to the use of polluting energy sources, increasing the growing use of renewable energies worldwide, with emphasis on solar energy, an abundant supply and available to everyone, which can be harnessed in several ways: electricity generation; dehydration of food; heating, disinfection and distillation and cooking. The latter has as its primary feature the viability of clean, renewable energy for society, combating ecological damage caused by large-scale use of firewood for cooking foods, use in tropical countries with high solar radiation, and has funding NGOs throughout the world with the goal of achieving low-income population. The proposed project consists of a solar cooker for concentration, working from the reflection of sunlight by a hub that they converge to a focal point at the bottom of the pot, getting lots of heat. The solar cooker under study consists of two elliptical reflecting parabolas made from the recycling of scrap TV antenna, having 0.29 m² of surface area for each antenna, which were covered by multiple mirrors of 2 mm thick and mounted on a metal structure, with correction for the mobility of the apparent movement of the sun. This structure was built with the recycling of scrap metal, possessing a relatively low cost compared with other solar cookers, around US$ 50.00. This cost becomes negligible, since that will involve a great benefit to not have fuel costs for each meal, unlike the use of gas or firewood for cooking food. The tests show that the cooker has reached the maximum temperature of 740 ° C, for boiling water in an average time of 28 minutes, cooking various types of foods such as potatoes, rice and pasta in an average time of 45 minutes and still going as a solar oven, making pizza baking and meat. These cooking times do not differ much from the cooking times on a gas stove, it becomes the solar cooker as a good consumer acceptance, and furthermore not to deliver the same gases that can poison the food as with the wood stove. Proves the viability of using the stove to cook or bake in two daily meals for a family, still presenting a position to improve his performance with the addition of new materials, equipment and techniques

Compósito para fabricação de blocos para construção de casas: estudos térmico e de materiais

We present two models of blocks made of composite material obtained from the use of cement, plaster, EPS crushed, shredded tire, mud, sand and water, for the construction of popular housing. Were made metal molds for the manufacture of blocks to be used in the construction of a residence for low-income families. Performed tests of compressive strength of the composite for various formulations that met the specific standard for blocks used in construction. To study the thermal conductivity of the composite for further study of thermal comfort generated in a residence built with the proposed composite. We also determined the mass-specific and water absorption for each formulation studied. Using a home already built with another composite material, made up the closing of a window with the building blocks and found the thermal insulation, measuring external and internal temperatures of the blocks. The blocks had made good thermal insulation of the environment, resulting in differences of up to 12.6°C between the outer and inner faces. It will be shown the feasibility of using composite for the end proposed and chosen the most appropriate wording