Desempenho motor de pacientes com acidente vascular cerebral em um jogo baseado em realidade virtual

The Cerebral Vascular Accident (CVA) is the leading cause of motor disability in adults and elderly and that is why it still needs effective interventions that contribute to motor recovery. Objective: This study was aimed to evaluate the performance of stroke patients in chronic stage using a virtual reality game. Method: 20 patients (10 with injury to the left and 10 to the right side), right-handed, average age 50.6 ± 9.2 years, and 20 healthy subjects with average age of 50.9 ± 8.8, also right-handed participated. The patients had a motor (Fugl-Meyer) and muscle tone assessment (Ashworth). All participants made a kinematic evaluation of the drinking water activity and then underwent training with the table tennis game on XBOX 360 Kinect®, 2 sets of 10 attempts for 45 seconds, 15 minutes rest between sets, giving a total of 30 minutes session. After training the subjects underwent another kinematic evaluation. The patients trained with the right and left hemiparect upper limb and the healthy ones with the right and left upper limb. Data were analyzed by ANOVA, t Student test and Pearson correlation. Results: There was significant difference in the number of hits between the patients and healthy groups, in which patients had a lower performance in all the attempts (p = 0.008), this performance was related to a higher level of spasticity (r = - 0.44, p = 0.04) and greater motor impairment (r = 0.59, p = 0.001). After training, patients with left hemiparesis had improved shoulder and elbow angles during the activity of drinking water, approaching the pattern of motion of the left arm of healthy subjects (p < 0.05), especially when returning the glass to the table, and patients with right hemiparesis did not obtain improved pattern of movement (p > 0.05). Conclusion: The stroke patients improved their performance over the game attempts, however, only patients with left hemiparesis were able to increase the angle of the shoulder and elbow during the functional activity execution, better responding to virtual reality game, which should be taken into consideration in motor rehabilitation

Realidade virtual na atividade cerebral: um estudo comparativo entre estados emocionais de adultos jovens e idosos

The association of Virtual Reality (VR) to clinical practice has become common in the recent years, showing to be an additional tool on health care, especially for elderly. Its use has been related to higher therapeutic adhesion levels and well being sensation. Such emotional based aspects are often observed by subjective tools of relative validity. This study analyzed the immediate effects of varied VR contexts balance training over emotional behavior, which was observed under peaks of maximum expression of EEG waves. Methodology: 40 individuals, divided in two groups, both gender, 20 young and 20 elderly, were submitted to a 60 minutes intervention, including balance training under VR. The first 25 minutes referred to initial evaluation, general orientation and cognitive assessment by the use of Mini Mental. The next ten minutes were designated to the avatar creation and tutorial video presentation. Through the following 20 minutes, the individuals from both groups were exposed to the exact same sequence of games under virtual contexts, while submitted to electroencephalography by Emotiv EPOC® focusing Adhesion, Frustration and Meditation states. The virtual interface was provided by the Nintendo® game, Wii Fit Plus, with the scenarios Balance Bubble (1), Penguin (2), Soccer (3), Tight Rope (4) and Table Tilt (5). Finally, a questionnaire of personal impressions was applied on the 5 minutes left. Results: data collected showed 64,7% of individuals from both groups presented higher concentration of adhesion peaks on Balance Bubble game. Both groups also presented similar behavior regarding meditation state, with marks close to 40%, each, on the same game, Table Tilt. There was divergence related to the frustration state, being the maximum concentration for the young group on the Soccer game (29,3%), whilst the elderly group referred highest marks to Tight Rope game (35,2%). Conclusion: Findings suggest virtual contexts can be favorable to adhesion and meditation emotional patterns induction, regardless age and for both sexes, whilst frustration seems to be more related to cognitive motor affordance, likely to be influenced by age. This information is relevant and contributes to the orientation for the best choice of games applied in clinical practice, as for other studies regarding this topic

Saúde psíquica e condições de trabalho dos profissionais de saúde nos hospitais da Universidade Federal do Rio Grande do Norte

A tese se propôs a avaliar a relação entre saúde psíquica e condições de trabalho em dois hospitais da Universidade Federal do Rio Grande do Norte, a saber: Hospital Universitário Onofre Lopes e Hospital Universitário Ana Bezerra. Adotou como ponto de partida epistemológico a abordagem psicossociológica, considerando que a compreensão sócio-histórica do contexto é indispensável para entender os fenômenos em análise. As condições de trabalho e a saúde psíquica foram abordadas interdisciplinarmente, fundamentando a construção de um modelo compreensivo de saúde psíquica que orientou a investigação. O caminho metodológico utilizado foi a pesquisação. Essa foi desenvolvida, utilizando técnicas como análise documental, observação participante, entrevistas não estruturadas, grupo focal e aplicação de um protocolo de pesquisa composto pelo questionário de condições de trabalho, pelo Questionário de Saúde Geral (QSG-60), pela Escala de Bem-Estar Afetivo no Trabalho (JAWS-12) e por questões sociodemográficas. A análise dos resultados mostrou que os escores sintomáticos de saúde psíquica variam por hospitais e que a saúde psíquica sofre influência das condições de trabalho, sobretudo em aspectos referentes a três dimensões: condições físicas e materiais; processos e características do trabalho e o ambiente sociogerencial. Em referência à primeira dessas dimensões, destacaram-se a exposição aos riscos psicobiológicos e de acidentes, bem como as exigências de esforço físico. Na segunda dimensão, a complexidade das atividades e a responsabilidade implicada nas mesmas. E, na última, os fatores de organização da atividade, violência e ambiente conflitivo. Como a relação do indivíduo com seu contexto é dialética, os resultados encontrados corroboraram que quanto mais as condições de trabalho são desfavoráveis, maior a afetação da saúde psíquica e dos afetos com relação ao trabalho, repercutindo novamente no ambiente de trabalho. Portanto, ações de melhoria das condições de trabalho precisam ser estabelecidas para resultar, no efeito inverso, proporcionando o aumento dos afetos positivos e a redução dos sintomas psíquicos

A assistência técnica e extensão rural no assentamento modelo: proposição e realidade

This discourse analyzes the technical assistance concerning the rural settlement, which is seen as a demand of the social movement that claims for agrarian reformation, and is a goal of II PNRA, launched in may 2004, as a essential national public politics on process of building and consolidation of settlement and familiar agriculture, proposing the return of technical assistance service and rural extension in Brazil, which were started in the and of 1940 s. We analyze, in particular, the technical assistance program, social and environmental agrarian reformation, on model settlement, a program created, especially, to the rural settlements, coordinated by INCRA. Based on the documental analyze and local study, it is noticed that the experience of technical assistance implemented on model settlement shows the non continuation and fragility on technical assistance actions to rural workers. This context goes against the lately technical assistance governmental apparatus, which ensures to make settlements stronger, to support and to get important the familiar agriculture system. This way, technical assistance execution, trough the tertiary service, follows the neoliberal strategy and, the State, besides decreases the estimate to public politics, takes its actions control from the State to the shared control through partnership and transferring of responsibility, expressing its historic lack of attention to the worker class demands. In spite of workers resistance, expectative and hope, the lack of these services, as well as the other politics deficiencies, which are necessary to the settlements, are endangering its activities and threatening its survival in the settlement

O programa de saúde da família e os princípios básicos do Sistema Único de Saúde na realidade de Santana do Matos RN

This work shows the professional staff of the Family Health Program (PSF) in Santana do Matos City perceive the Unified Health System (SUS). Their discourse and recognition of the advances of SUS, as well as their participation on the implementation of the system, are analyzed. The Brazilian Ministry of Health instituted it in 1994 in order to rebuild the health politics on a new basis, substituting the traditional model. The city-centered implementation of SUS was instituted on May 27, 1992 by the act nº 631/92 and today it experiences a Full Management of Basic Attention. In July 2001 the PSF program was started in the city with 5 teams: 2 in the urban zone and 3 in the rural one. The methodology was developed with the combination of qualitative and quantitative research with the employment of a questionnaire with both open and closed inquiries to 31 members of the program. The study appointed that, no matter how positive and enlarged be the staff s concept of health and SUS, they dont s have on understanding of the total chain of the system on its integrality, hierarchy and regionality what hinders the system performance close to the users. The PSF incorporates and reaffirms the basic principles of the SUS; however, on its everyday employment it has not yet abandoned totally the curative model, which is reinforced by the hospital-centered and physiscian-centerend culture

Mulher como sujeito da criminalidade: um estudo sobre a realidade de presidiárias do complexo Penal Dr. João Chaves Natal/ RN

This work presents itself as a result of the research: Women as the subject of crime: a study on the complex reality of the criminal inmates Dr. John Keys - Natal / RN, done with women incarcerated in the Women's Pavilion Complex Criminal Dr. John Keys. Aimed to investigate the key determinants that lead women to enter the institution to be subject of crime. To better understand the object of our study, we start to understand and analyze the social reality, economic and cultural these women, as well as seizure of their family relationships and emotional, within a gender perspective and consider the analysis of major crimes committed and their determinations. In our study, it appears from successive approximations and procedures theoretical and methodological quality and quantity, we were privileged to documentary research, observation and semi-structured, beyond the theoretical foundation on the subject - that the question of increase in recent years, women in the criminal occurs as a result of socioeconomic reality experienced by those. At the same time, the study has also believe that poverty and crime are not phenomena of cause and effect, however, it is undeniable that the large number of prisoners (as) are poor and live situation of denial of rights. The main focus of the research points to the socio-emotional relationships, both marital and family as the main determinant for inclusion of women in crime, breaking with the myth that the woman is "fragile sex." And, more, points out that the woman in the process of emancipation and achievement of public spaces to commit a crime seek equal to the male. Moreover, the research also denounced in a prison system collapsed, and totally abandoned by the public. That denies all rights provided to prisoners (as), both inside and outside the "walls". It is a system that criminalizes and no one wants to fulfill its role, which is the functional rehabilitation and resocialization of (the) inmates (those). It is hoped that this work could contribute to the unveiling of the reality of women in the criminal - no pretension of exhausting it - and can also contribute to further studies on the subject

Assentamento Hipólito: realidade e perspectivas dos jovens assentados

Analisa a inserção da população jovem em assentamentos rurais, tomando como referência o Assentamento Hipólito, no município de Mossoró, no Estado do Rio Grande do Norte (RN). O contato com alguns jovens assentados levou à inquietação frente à problemática situação por eles descrita, em relação aos seus cotidianos e às suas perspectivas, o que aponta para o entendimento de que faltam políticas públicas, ou estas não estão sendo adequadas para a população em estudo. As políticas de juventude são, além de recentes, ainda muito escassas; sobretudo, quando se trata da juventude rural. Nessa perspectiva, procura rastrear a trajetória dos jovens no referido Assentamento, visando a uma melhor percepção da inserção social destes na condição de assentados, com a atenção voltada para as suas relações com o seu meio, e com o poder público (local, estadual e federal), as condições de vida, as perspectivas de futuro e as ações governamentais, frente às suas demandas. Os resultados dessa análise apontaram para a ausência de políticas públicas condizentes com a realidade dessa parcela da população, reforçando, mediante a precariedade das condições de vida em que se encontra, o argumento de que a luta pela terra não se encerra com a conquista desta. Pois a consolidação dessa posse vai depender da luta posterior em prol de melhores condições econômicas e sociais. Reforça ainda a necessidade de reconhecer a capacidade potencial dos sujeitos coletivos, na avaliação de seus problemas e necessidades, e fomentar a participação social e política dos trabalhadores, na conquista de seus direitos e na construção de sua cidadania. E ainda que a participação efetiva da juventude é fundamental a qualquer processo de transformação social. Portanto, os jovens rurais são atores inegavelmente importantes quando se pretende entender a dinâmica dos assentamentos rurais no seu contexto maior

O turismo de base local como um possível indutor de desenvolvimento rural: uma análise da realidade e das potencialidades no distrito de dondo-moçambique

The current debate on rural development focuses on the territorial approach, recognizing the multifunctional character of rural areas. Emphasize the use of endogenous forces, the need of implement policies which valorize local specificities, the participation of social actors in revitalization of rural areas. In this context tourism enters as a means to induce a new dynamic to rural areas, since the activity is regarded as a channel for the upgrading of the natural and cultural resources and the rural way of life. This study focuses on local-based tourism as a promoter of rural development, giving an analysis of the social reality and potential for this tourism in the district of Dondo. In it, is proposed to analyze the potential for development of local-based tourism in the district of Dondo, assessing the extent to which local reality enables the inclusion of the community in the management of local tourism resources. For this, was showed the inclusion of local-based tourism in the current context of rural development, was identified and organized systematically the factors that influence the implementation of local-based tourism in the study area and was verified as far as possible the study area corresponds to the constraints identified, showing how local-based tourism can best been encouraged. Was adopted a qualitative methodological approach to both the procedures and data processing, but also by critical approach, using bibliographical research, semi-structured interviews that fell on the group of public administrators who work in tourism and community leaders. The critical analysis was based on the principles of sustainability o Sachs particular ecological, social, cultural, economic, space, beyond the analysis of political and institutional aspects. The survey results show that the district of Dondo has a potential for implementing a model of tourism development on a local basis, since it is rich in natural and cultural research, benefits from good network accessibility in the context of the market in the region, the population live according to their habits and customs and value their identity. There is also a good cooperation between community members, although not in tourism, a fact which is observed through the lever of community participation in associations, cooperatives, working in areas such as agriculture, fishing, environment, civic education etc. It also has public funding sources to augment or stimulate local investment. Despite obstacles such as inexistence of policies and local plans for tourism development, lack of awareness of tourism, lack of basic infrastructure, as well as equipment and facilities to support tourism, the results shows that these problems can be solved through a public commitment from both government, and community through a joint planning and participation

Agente comunitário de saúde: perfil adequado a realidade do Programa Saúde da Família?

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

Avaliação e progressão continuada: o que a realidade desvela

Este artigo aborda a compreensão da avaliação no interior da implantação do Regime de Progressão Continuada no Estado de São Paulo. Ao penetrar nos intrincados caminhos da realidade escolar, por meio da pesquisa qualitativa, acompanharam-se sistematicamente durante um ano escolar 4 turmas de alunos (uma de cada ano do ciclo I, ainda do Ensino Fundamental de 8 anos), nos momentos coletivos da escola: horário de trabalho pedagógico coletivo, reuniões de pais e mestres, conselhos de classe/série, eventos; e, ainda, realizaram-se entrevistas com 7 profissionais envolvidos com as turmas (5 professores, coordenadora pedagógica e diretora escolar) e com 124 alunos. Observou-se que a avaliação informal ganha forte expressão nessa nova forma de organização escolar, revelando, também, novas formas de manutenção da seletividade e da exclusão escolar. Por meio da análise das práticas avaliativas e das contribuições dos diversos atores da escola, evidencia-se a presença da seletividade escolar, mas com configuração diferenciada: a exclusão branda e/ou a eliminação adiada.

Romance e realidade na ficção brasileira contemporânea

Este trabalho é uma reflexão sobre a representação do real no romance Inferno provisório, de Luiz Ruffato, considerando as proposições de Claudio Magris acerca da forma romanesca moderna e sua possível transformação nas últimas décadas. O objetivo é questionar de que modo o projeto estético do romance incorpora uma visão em profundidade do real, originando um princípio ético de análise e crítica da sociedade contemporânea.

Educação para a mídia: propostas europeias e realidade brasileira

Partindo-se do estudo das práticas relacionadas à educação para a mídia propostas no cenário europeu, este ensaio observa a possibilidade de inserção dessas práticas no cenário brasileiro. Discutem-se o kit de educação para a mídia, sugerido pela UNESCO, e propostas sobre esse tema em evidência na França, Espanha, Portugal e Inglaterra. O objetivo é mostrar que, embora as sugestões europeias dialoguem com boa parte das idéias prestigiadas no Brasil, por tratarem de um contexto diverso, elas tendem a dificultar o tratamento de questões essenciais a um programa de trabalho sobre mídia na escola brasileira.

Paulo Emílio Salles Gomes: a compreensão da realidade brasileira através da crítica de cinema

O objetivo deste artigo é compreender o papel intelectual desempenhado por Paulo Emilio Salles Gomes na sociedade brasileira. Partindo da análise da sua crítica de cinema no jornal O Estado de São Paulo, nos anos 1950, busco caracterizar o processo de construção do empenho político e cultural voltado para a construção de uma sociedade democrática no Brasil, que se desdobrava nas análises sobre o cinema, e a realidade brasileira nas décadas de 1960 e 1970.