639 resultados para pontuação de propensão


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

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(Objective) Assess the functional capacity and determine the difference between the means of functional capacity (basic and instrumental activities of daily living) and the age groups of elderly residents in an outlying area in the hinterland of Bahia/Northeast of Brazil. (Methods) Analytical study with cross-sectional design and a sample of 150 elderly individuals enrolled in four Health Units in the municipality of Jequié, Bahia, Brazil. The instrument consisted of sociodemographic and health data, the Barthel Index and the Lawton scale. (Results) In all, 78.00% of the elderly were classified as dependent in the basic activities and 65.33% in the instrumental activities of daily living. Using the Kruskal- Wallis test, we found a statistically significant difference between the means of instrumental activities and the age groups (p= 0.011). (Conclusion) An elevated number of elderly were classified as dependent in terms of functional capacity and increased age is related to greater impairment in the execution of instrumental activities of daily living

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This study aimed at assessing the interobserver reliability of the Brazilian-Portuguese version of the Berg Balance Scale (BBS). The assessment was made by physiotherapists with extensive or little clinical experience in non-institutionalized elderly individuals. Participants comprised 12 elderly subjects (10 women and 2 men) with mean ages of 75.8 ± 8.4 years (range = 63-87) and 18 physiotherapists with varying clinical experience. Inter-examiner reliability obtained for each scale item yielded weighted kappa value > 0.75 in 11 of the 14 items (varying from 0.37 to 1.0). The intra-class correlation coefficient (ICC) for the total sum of BBS scores between the two groups of physiotherapists was 0.996 (95% confidence interval, 0.987 0.999) with a Cronbach alpha coefficient of 0.996. We found no difference between the rater groups when we compared the sum score means obtained with the student s T-test (p = 0.86). Although some items had low reliability values, in general our results suggest that the Brazilian Version of the BBS showed good levels of interrater reliability and agreement when used by physiotherapists with different clinical practice levels and without previous training on non-institutionalized elderly patients. We concluded that the BBS can be useful as an important evaluation instrument on a protocol for Rehabilitation clinics. It may be used by various health professionals, as: Physicians, Physical therapists, Physical educators, Occupational therapists, Nurses and Phonoaudiologists, so confirming the interdisciplinary character of this study

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Introdução/objetivos: A avaliação do estado de saúde de idosos institucionalizados é considerada prática essencial à promoção e recuperação da sua saúde, a qual deve incluir a investigação de aspectos multidimensionais e multidisciplinares relacionados ao envelhecimento saudável. O estudo objetivou avaliar as condições de saúde dos idosos residentes em instituições de longa permanência (ILPI) do município de Natal RN. Métodos: Trata-se de um estudo descritivo, longitudinal, envolvendo seis ILPI filantrópicas, com uma população de 243 idosos. A coleta de dados se deu por meio de entrevistas com os idosos nas instituições mediante a aplicação de um questionário com informações sócio demográficas, saúde e institucionalização, além de várias facetas multidisciplinares que envolvem a escala de avaliação cognitiva (Mini Exame do Estado Mental); o índex de KATZ, para avaliação das atividades da vida diária e uma análise do estado nutricional com questões antropométricas (peso, estatura, circunferência abdominal) e Índice de Massa Corpórea. Participaram do estudo todos os idosos com idade igual ou superior a 60 anos, que aceitaram responder a entrevista e assinaram o Termo de Consentimento Livre e Esclarecido e/ou a impressão datiloscópica. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, sob parecer n° 164/2011. Resultados: Os participantes do estudo incluem 243 idosos, sendo a maioria mulheres (172 = 70,7%), com média de idade de 79 ± 9,44 anos. 124 idosos são solteiros (51,0%) e 66 viúvos (27,0%). A prática de atividades físicas não é rotina nas instituições, onde a maioria dos idosos (82,7%; n = 201) não realiza nenhum tipo de atividade. 78% dos idosos (n = 192) chegou a instituição sendo levados por familiares, enquanto que apenas 18% (n = 44 idosos) por vontade própria e 4% (n = 7 idosos) não souberam responder. Quanto aos aspectos cognitivos, identificou-se que 64,2% dos idosos (n = 156) apresentaram alterações significativas dentro da pontuação dos escores com restrições em responder aos demais questionamentos durante a entrevista por apresentarem limitações cognitivas e/ou dificuldades senso perceptivas.Conclusão: O presente estudo evidenciou alterações cognitivas na maioria dos idosos institucionalizados impossibilitando-os a continuidade da realização da avaliação global da saúde. A identificação correta da perda cognitiva em idosos é de suma importância para a equipe de saúde a fim de promover a detecção precoce de alterações cognitivas e a adoção de tratamento adequado, no sentido de contribuir para uma melhor qualidade de vida desta população

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Universidade Federal do Rio Grande do Norte

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The study aimed to analyze the influence of chronic health conditions (CHC) on quality of life (QOL) of UFRN servers assaulted by CHC. It is a descriptive and cross-sectional study with prospective data and quantitative approach, accomplished in the ambulatory clinic of the Department of Server Assistance (DSA) of the Pro-Rectory of Human Resources, during three months. The sample was composed by accessibility, totaling 215 people, being 153 active and 62 inactive servers, in chronic health condition. The data were collected through the application of the sociodemographic characterization, health, environmental and laboral form, the Medical Outcome Study 36-Item Short Form (SF-36). The study was evaluated by the HUOL Ethics Committee (CAAE no. 0046.0.294.000.10), obtaining assent. The results were analyzed in the SPSS 15.0 program through the descriptive and inferential statistics. It was identified servants predominantly male (59,1%), under 60 years old, married or in stable union, Catholics, brown color, living in the capital and residents in own home. Regarding labor issues, there was a predominance of active servers technical-administrative with intermediate and medium level positions and small proportion of docents. Among the CHC, the non-communicable diseases - NCDs (95.8%) had a higher frequency, followed by persistent mental disorders - PMDs (18.6%) and, finally, the continuous and structural physical deficiency - CSPD (16.9 %). The QOL of servers was considered good, with a mean score of 72.5 points in the total score, with the most affected domains: physical (59.1), general health (66.2), bodily pain (66.3) and functional aspects (72.0). The mental health dimension (76.5) had a better average than the physical dimension (68.0 points). It was found that the decrease in QOL scores is significant statistically related to higher number of CHC (ρ <0.001), with no statistical significance regarding the functional situation (p = 0.259). The administrative technicians of elementary, primary, secondary levels and docents had the worst QOL scores. After the correlation analysis of CHC with the domains and dimensions of the SF-36, there was statistically significant, negative and weak correlation of the domains: functional aspect (ρ = 0.002, r = -0.207), physical aspects (ρ = 0.007; r = -0.183), vitality (ρ = 0.002, r = -0.213), social function (ρ = 0.000, r = -0.313), emotional aspects (ρ = 0.000, r = -0.293), mental health (ρ = 0.000 , r = -0.238), physical health dimension (ρ = 0.002, r = -0.210) and mental health dimension (ρ = 0.000, r = -0.298). The presence of PMD isolated or together, contributed to a lower SF-36 scores, being the domains variation of mean significant, except for bodily pain, general health and physical aspects. By correlating the categories of CHC and QOL, there was a weak correlation (r ≤ -0.376) and significant (ρ ≤ 0.011), mainly related to the NCD, PMDs and NCD + PMD, affecting the mental health, social function, emotional aspects, vitality and functional aspect domains. Front of the results, it was concludes that the servers quality of life is influenced by the CHC. Thus, it was inferred that the presence of CHC causes a negative effect on quality of life, leading the active and inactive servers to exposure their overall life activities and work over the years, due to the morbidity affected, mainly related to NCDs and PMDs. Descriptors: Quality of life. Chronic disease. Occupational Health. Nursing

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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La beauté dans la Gymnastique Rythmique (GR) s est esquissée comme condition de son existence. Pour son analyse, nous avons eu recourt au discours sur le pouvoir de Foucault (1971, 1979, 1987, 1988, 1997, 2003) et à sa relation avec la production de savoirs. Basés sur cette compréhension, nous avons réfléchi sur les relations de pouvoir dans la GR qui se sont établies et consolidées grâce à la réglementation de sa pratique, dans lequel le Code de Pointage a un rôle prépondérant. Ainsi, la GR a construit sa beauté à travers les temps au moyen de jeux de force où la gestualité de corps performatiques, à travers la discipline, a été prépondérant. Cette dernière a configuré des sens attelés à la coercition-résistence des corps: la production de discours. C est en pensant à une beauté comme ume trame de discours construits par ces relations de pouvoir-savoir des investissements du corps dans la Gymanstique Rythmique que nous nous posons les questions: Comment le Code de Pointage réglemente la gymanstique rythmique et sportive au sujet de la construction de la beauté ? Quelle est la relation entre les pouvoirs et les savoirs impliqués dans cette réglementation ? Nous avons donc pour objectifs de rechercher la beauté dans la Gymnastique Rythmique comme savoir produit à partir des relations du pouvoir circonscrites dans les règles de la modalité et de discuter la beauté à partir de la relation pouvoir/savoir comme réflexion pour le milieu de l éducation physique. Nous avons utilisé comme méthodologie la technique de l analyse de contenu (Bardin, 1977) afin d analyser le Code de Pointage de la GR dans sa version 2005-2008. Nous avons également fait usage des images de gymnastes comme moyen analogique pour amplifier le sens des discussions. La lecture fluctuante nous a permis de sélectionner des unités significatives et d organiser nos discussions en trois axes thématiques qui composent le premier chapitre intitulé « La beauté réglementée ». Dans ce chapitre, nous discutons les spécificités de la GR, la prescription de l utilisation du temps et de l espace et la configuration du geste technique à partir de l analyse de son code de ponctuation. Dans le deuxième chapitre, « Le corps beau transcende la règle », nous réalisons quelques réflexions destinées à l éducation physique à partir de la discussion du chapitre antérieur en prenant pour cible trois sujets : Pouvoirs et Savoirs, Technique et Style, Beauté et Éducation. Nous avons ainsi constaté que la beauté de la Gymnastique Rythmique contemporaine est entourée par sa réglementation, mais a été et continue à être dessinée par des mécanismes de pouvoir-savoir tout au long de sa trajectoire historique. Malgré l existence de conditions pour la beauté dans le Code de Pointage de la GR, il existe la possibilité de la création du propre style par la gymnaste, par la possibilité de vivre l improvisé et l imprévu, de sensibiliser le public, parce que le pouvoir crée des savoirs et le corps, qui se dépasse, créera toujours de nouvelles formes d être beau. La constatation que le Code de Pointage produit une beauté et que la gymnaste la reconstruit continuellement en en réactualisant les règles est une réflexion importante pour l éducation physique: elle réaffirme que le corps n est jamais seulement soumis, que même dans la soumission il est capable de produir du savoir, d être beau et de créer de nouveaux sens pour la Culture de Mouvements

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On the beginnings of the XXI century the brazilian universities was claimed by the Government and by the society to rebuild your ways of selecting students. Many questions are behind this theme, that goes since the concernings of the higher education institutions about select and graduate students, and now also students from disadvantaged sectors of the society; but also about personal issues, like concerns of the everyday of millions of youngs that integrates the brazilian society and that need to decide about your professional future after the finish of the Basic Education. The present thesis has as objective analyse the processes of the transition between the Basic Education and Higher Education on the point of view of students that achieved a place on the public university. This study was accomplished on the Federal University of Rio Grande do Norte [UFRN on the original language], that implemented an Access and Social Inclusion Policy (PAIS [on the original language]) on the year of 2003, and since than a series of social actions had been developed. Among the main, we highlight the Inclusion Score action, an adicional score [on the entrance selection exam] for graduated students from public schools, which considers social and economic criteria and the academic development of these candidates on your Basic Education. Through quizzes and interviews with the graduated university students from public network, we could know the social, economic and academic profile of the students that entered on the UFRN by the time of the development of your PAIS, your schools and university trajectories, revealing some of the dilemmas, strategies, difficulties and personal cost of those that try to remain on the educational system besides the adversity conditions of schooling. For the theory foundation, we use authors like Bourdieu (1992, 1996, 2003); Coulon (1993, 2008); Ramalho (2004, 2007, 2008, 2010); Ramalho, et al (2011); Charlot (2001, 2003, 2005); Zago (2011); Nogueira, Romanelli e Zago (2011), among others, that contributed for a better analysis and understanding of thought and actions of the students in your own formative trajectories. Although we know that the educational inequalities are many, we found that the UFRN policy brought and is bringing many significant results, on the perspective of contribute with the increase of access for graduated students from the public network, and with the inclusion of these on the university

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Descriptive exploratory study, prospective, with quantitative approach, performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGHC), in Natal/RN, aiming to identify injuries by body area and wound severity on drivers who suffered motorcycle accidents, evaluate the severity of injuries and trauma on these drivers and identify the existence of association between wound and trauma severity and some of the accident s characteristics. The population comprised 371 motorcycle drivers, with data collected between October and December 2007. We used as instruments the Abberviated Injury Scale (AIS), Injury Severity Score (ISS) and the Glasgow Coma Scale (GCE1). The results show that, concerning characterization, there was a predominance of the male gender (88.4%), aged between 18 and 24 years (39.90%), originating from the Natal metropolitan region (55.79%), with fundamental-level instruction (51.48%), catholic (75.78%), married (47.98%). 23.18% work on commerce-related activities and 75.20% have income of up to 2 minimum wages. As for the accident s characteristics, the predominant shift was the afternoon (46.36%), received up to one hour after the event (50.67%), transported by countryside ambulances colleagues and relatives (51.21%), 25.34% had the accident on Sunday; 53.91% suffered falls and vehicle rolls; among the collisions there was a predominance of the motorcycle-automoblie type (28.03%); 52,6% were licensed and among these 50.76% had up to one year of license; 65.50% declared not having suffered previous accidents; 65.77% declared waring helmets in the time of the accident; 57.41% said not to have used drugs, and among those who used, alcohol was the most consumed (98.10%). The lowest score evaluated by GCS1 (3 to 8) was linked to drivers who suffered accidents on Saturday (10.3%), those who were not wearing helmets (14.29%) and the victims of motorcycle-pedestrian/animal crashes (13.33%). The body areas most affected had AIS between 1 and 3 (95.76%) and were: external surface (39.90%) and head/neck (33.20%). As for trauma severity, the highest scores (ISS>25) belonged to those who consumed alcohol (30.73%), suffered falls or vehicle rolls (48.9%) and those attended to 3 hours or longer after the accident (50%). We conclude that for motorcycle drivers who suffered accidents, age, gender, weekday, type of accident, use of drugs and the absence of helmet use signal both to the risk of occurrence of these events, as well as for the greater severity of injuries and trauma.

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Venous ulcer (VU) is a lower limbs injury resulting from inadequate return of venous blood in feet or legs. Although it is not a deadly disease, it causes chronic wounds, which seriously undermine patients´ quality of life (QOL) and sometimes leads to drastic family, social, economic and psychological changes. In this sense, there are several aspects that may influence the venous ulcers patients´ QOL. The study´s objective aimed on the association of socio-demographic and health, health care and clinical injury on UV patients‟ QOL. Analytical studies, which consider the complexity of factors involved in changes in UV patients‟ QOL has a cross-sectional and quantitative approach. The HUOL Ethics Committee approved this project (n.279/09). The collection of data lasted a period of 3 months in 2010 and it took place at the clinic of Angiology at Hospital Universitário Onofre Lopes (HUOL). The data sample consisted of 60 patients treated by UV angiologists in the HUOL Surgical Clinic. The results were analyzed with SPSS 15.0 by descriptive and inferential statistics. The study was based on UV patients that were predominantly female, average age of 61.4 years, that had low education level and low family income, with occupations requiring long periods of standing or sitting, but mostly retired, unemployed or laid off due to the disease and/or due to chronic diseases associated with the UV. The study took also into consideration patients that used inappropriate products, that were improperly treated by a professional caregiver, that lacked of adequate guidance and compression therapy, that performed no lifting of the lower limbs and regular exercise, that the time of injury were greater than or equal to six months, that were missing specific laboratory tests. The study‟s reference were on recurrent lesions, medium to large lesions area, bed of the lesion (injuries) with fibrin and/or necrosis, with amount of exudate with medium to large, odorless and no signs of infection, with tissue loss between 1st and 2nd degree, without collecting swab or biopsy and with pain. In general, QOL of researched individuals were considered low, the maximum score was 69 points, which the areas that were mostly influenced were the total scores of QOL functional capacity (0.021), emotional (0.000) and social functioning (0.080). Of the 60 individuals, 53.3% had scores between 40 and 69 points in SF-36, and they had the best scores in sociodemographic and health variables (ρ = 0.049). In respect to the assistance and injury characteristics, patients who scored between 40 and 69 points in SF-36 had better scores on these characteristics. By combining the socio-demographic variables, health, and handling characteristics of the injury, we observed a significant difference (ρ = 0.032) when linking them with the QOL total scores. When analyzing separately the domains of the SF-36 scores on the quality of life, we find that the areas that showed statistical significance were functional ability (ρ = 0.035), appearance (ρ = 0.019), emotional (ρ = 0.000), and mental health (ρ = 0.050). Among the socio-demographic characteristics studied, gender and marital status contributed more to the reduction of QOL and among the variables of assistance and the injury, orientation, reference and area of UV contributed the most. By analyzing these five variables all together in accordance with the overall score obtained in the quality of life, we found a significant correlation (ρ = 0.002); with 6.23 times more chances of patients have better QOL in the presence of these five positive factors. By conducting the Mann Whitney U test between all the five demographic variables, health, and clinical care, we found that this combination also proved to be significant (ρ = 0.006). Therefore, patients with these five variables positive tend to have a better QOL. Based on these results, we reject the null hypothesis (H0) and accept the alternative hypothesis (H1) proposed in this study because we noted that the QOL of patients with UV is associated with sociodemographic and health, health care and clinical aspects of the injury

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The attention with safety of the patients is important in the quality of the nursing and health care. In the pre-hospital care, such care is essential on site with the purpose of avoiding possible consequences to the individual, ensuring a fast and appropriate care, with improvement of the morbidity and reduction of the mortality. This medical attention is equally associated with the significant risks of adverse events and serious mistakes, which can be reduced with the awareness of the professionals, organization and quality management. It is a descriptive, transversal research, of quantitative approach, with the objective of identifying the risks for the safety of the patient during the mobile pre-hospital care under the view of the nurses, in a city of the Brazilian Northeast. The sample was formed by 23 nurses. The inclusion criteria: to have at least two years of experience and accept to participate on the research. The data collection was done in two steps, first photo collection, through the adapted method of photographic analysis, and the second with the application of questionnaire, divide in two parts: socio-professional data and digital photo punctuation instrument of the patient s safety. The majority of the nurses had an average working time in the mobile pre-hospital care of six years and six months, in the age group of 38 to 53 years old (69,56%) and with Lato sensu specialization (73,91%), being (29,41%) emergency and (29,41%) in intensive care. The (74%) have the Advance Cardiac Life Support (ACLS) and (100%) have the Pre-Hospital Trauma Life Support (PHTLS); (91, 30%) know the thematic safety of the patient. On the pictures it was observed a bigger variability of the categories (risks) where 44% of variance emerged on the first picture of the research. The pictures 4 and 9 with the average below 5 were classified as very insecure, while pictures 7 and 3 with an average above 7, very secure. On the results of risks observed for the patient s safety in the mobile pre-hospital care five categories emerged: organization and packaging of the equipment and materials, routines and specificities in the mobile pre-hospital care, risks on the management of medications, for traumas and infections. Starting from the analysis of these risks, it was proposed ten steps for the safety in the mobile pre-hospital care: 1- Identify the patient; 2- Safety related to prevention of infection; 3- Safety in the management of medications; 4- Safety and standardization of the packaging of equipment and materials; 5- Attention to the specificities of the mobile pre-hospital care; 6- Incentive and value the participation of the patient and family; 7- Promote the communication with the central of regulation; 8- Prevention of traumas and falls; 9- Protect the skin from additional injuries; 10- Understand the benefit of all the equipment in the ambulance. The multiple risks and their emerged combinations on the research indicate a variety of actions to be developed and stimulated, like the use of steps for the patient s safety in the mobile pre-hospital care which contributes with the aid and management of risks, reduction of mistakes, disabilities and death

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The objective of this study was to investigate the environmental perception of: People with common-sense knowledge on the desertification process in RN. People with scientific knowledge on the desertification process in RN. Focal points in the combat at desertification of the RN and public ministery representant with actions in interinstitutional articulations promoter (and/or relative actions) at the desertification process in the RN. The research was carried in the city of Natal-RN and in two small cities of the Seridó region (RN): Caicó and Currais Novos. The research carried, is classified as exploratory and 22 people were interviewed. The research includes: The propension/intensity of the desertification in the RN and in the Seridó region; Evaluation of the knowledge of those interviewed, concerning the subject desertification ; Problems in order to combat desertification; Causes of desertification; The profile of the interviewed. The results of this present study indicate that the a desertification process is more agressive in the Seridó region than in the state of RN, being the two following: the absence of preocupation of the affected population with the process and the escarcity of governamental recurses, indicates how problems greather in the combat to the phenomen. Decreasing of produtivity in the agriculture and increasing of the migration to the urbans centers have been the main consequences of the process, that have at water scarcity, deforestation and extraction of argil (being this, regional factor), relevant variables in the influence to the surgiment of the desertification process of the RN

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This study presents a comparative analysis of methodologies about weighted factors considered in the selection of areas for deployment of Sanitary Landfills, applying the methodologies of classification criteria with scoring bands Gomes, Coelho, Erba & Veronez (2000); Waquil et al, 2000. That means, we have the Scoring System used by Union of Municipalities of Bahia and the Quality Index Landfill Waste (IQR) which are applyed for this study in Massaranduba Sanitary Landfill located in the municipality of Ceará Mirim /RN, northeastern of Brazil. The study was conducted in order to classify the methodologies and to give support for future studies on environmental management segment, with main goal to propose suited methodologies which allow safety and rigor during the selection, deployment and management of sanitary landfill, in the Brazilian municipalities, in order to help them in the process to extinction of their dumps, in according of Brazilian Nacional Plan of Solid Waste. During this investigation we have studied the characteristics of the site as morphological, hydrogeological, environmental and socio-economic to permit the installation. We consider important to mention the need of deployment from Rio Grande do Norte State Secretary of Environment and Water (SEMARH), Institute of Sustainable Development and Environment of RN (IDEMA), as well, from Federal and Municipal Governments a public policies for the integrated management of urban solid waste that address environmental preservation and improvement of health conditions of the population of the Rio Grande do Norte

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In today s global society, companies have become even more competitive with the abundance of information that prospective clients have available to them. This way the tourist services has appropriate the distribution using electronics ways as information for doing acquirement services. This work, shows the adopted provision of on-line tourist services does have suited apportionment for factors and buy decisions. The method used is a survey applied to the tourists, at international airport Augusto Severo, no matter why the visit reason to Natal city, at all, they were 210 people, being the chief variables evaluated the tourist perception of facility, utility, benefits, amenity and pleasure from the Internet s use, under the terms at the tourists experiences from the WEB about to acquisitions and researches. The results acquaint that the younger tourists or less experts tourists, in visit to Natal, demonstrated greater bias to the Internet s use than the other people. By the way women have a larger representation as a consumer from the WEB and finally, people along greater study tends to adopt. The work s contribution provides greater knowledge for the tourism executives about how might use the Internet, as well as bring forward a scene propitious for the on-line diffuseness service