Seleção de categorias da Classificação Internacional de Funcionalidade, Incapacidade e Saúde para avaliação do paciente com acidente vascular cerebral em reabilitação

Stroke represents the first cause of disabilities among adults. Although different professions work together in treatment of stroke patients, all they use different terminologies for the description of the patients problems and it can constitute an impediment in the communication between the staff members. Thus, the multidisciplinary and interdisciplinary work would be facilitated if using a reference common tool, as the new International Classification of Functioning, Disability and Health (ICF). However, the ICF is very extensive and complex and due to its complexity, it has been evidenced the necessity to select its categories to become it more practical. The aim of the study was to investigate which categories of the ICF are more suitable to evaluate and to describe the stroke patient in the view of teachers and municipal public health professionals. It was a descriptive research, which involved 5 professors and 11 professionals of Physiotherapy that have worked at the health public area in Natal / RN. It was used the Delphi Technique in 3 rounds and the Likert Scale to select the categories among the ICF components. As result, from the 362 IFC categories, 94 were selected. The selected categories correspond to rehabilitative characteristics of Stroke patients in the universe of the Physiotherapy performance. The methodology applied was suitable to the studied object emphasizing the necessity of future studies for validation of the chosen categories

Risco ocupacional no contexto hospitalar

O presente estudo tem como objetivo conhecer as representações sociais sobre o risco ocupacional construídas por trabalhadores da saúde no contexto hospitalar. Trata-se de um estudo exploratório fundamentado no referencial teórico da Teoria das Representações Sociais realizado com duzentos e vinte trabalhadores da saúde pertencentes ao quadro permanente de um hospital público na cidade do Natal- RN. Os dados foram coletados através da Entrevista semi-estruturada e da Técnica da Associação Livre de Palavras. Na análise das informações utilizou-se o software Evoc 2000 e o Alceste. Os resultados indicam condições de trabalho desfavoráveis com desgaste físico e mental ao trabalhador da saúde, e, patologias pouco reconhecidas como ocupacionais em sua origem. Pode-se observar que as representações sociais construídas pelos trabalhadores da saúde, revelam o nível de conscientização desses trabalhadores referentes às consequências do ambiente de trabalho para sua saúde, referindo-se ao processo de trabalho hospitalar, como múltiplo e complexo pela dimensão tecnológica e pelos aspectos físicos, psíquicos e cognitivos

Caracterização sócio-demográfica, ocupacional e de formação profissional de manipuladores de alimentos e bebidas em uma capital da região nordeste do Brasil

Universidade Federal do Rio Grande do Norte

Estrutura econômica, mercado de trabalho e evolução sócio-ocupacional no Rio Grande do Norte 2001 a 2008: reflexo de uma condição mercantil e estruturalmente periférica

The aim of this thesis was to investigate the evolution of the socio-occupational status in Rio Grande do Norte from 2001 to 2008, based on the characterization of the socio-economic status of this State from the analysis of labor market norte-rio-grandense . The study, specifically, drew a comparison between the dynamics of the labor market in Rio Grande do Norte and the capital city, Natal. From this perspective, the purpose was to make a relationship between the social division of labor and its effects on the socio-spatial division, represented in the "macro scale" by the federal unit and the "micro level" for the capital; locus of economic and population concentration. The collection of data on the labor market had as a major source PNAD/IBGE, characterizing the labor market in many ways: people of working age, economically active population and employed and unemployed people, classified by age, sex, color, education, income and social protection condition. However, as for the socio-occupational division, we follow the methodology used by the research group on national television, based in IPPUR /UFRJ, called Monitoring of the Metropolis," which rallied twenty-four groups that aggregate the occupations found in the PNAD/IBGE, in eight groups of socio-occupational categories, according to the similarity between them. It was used in the socio-spatial cutting two relevant discussions, which are inter-related and were characterized as crucial points in developing the research problem: the former was related to the influence of the hegemony of merchant capital in the labor market in Rio Grande North and, the latter, it referred the socio-economic relations between the territory and the variable occupation. Lastly, the results all indicated that in Rio Grande do Norte, as a peripheral state, has suffered the devastating influence of the hegemony of capital purely commercial basis, where "wealth" of capitalism is generated through the sphere of mere movement of goods and services rather than a productive process due to the social relations of production more advanced. We have a little advanced economic structure, with a tertiary sector that has propagated under-employment or disguised unemployment. Similarly, the agricultural sector has been presented as an example of greater social degradation of working conditions in the state. The secondary sector, in turn, also was not behind this uncertainty; on the contrary, confirmed that condition, with poor levels of income, low education of the workforce and a high degree of social helplessness, even in the state capital, space full urban area, which although always appear with a favorable condition compared to Province, in practically most of the variables studied, was also reflected at the same time the author of a structurally underdeveloped condition

Mercado de trabalho e estrutura sócio-ocupacional: estudo comparativo entre as regiões metropolitanas de Fortaleza, Recife e Salvador 2001-2008

The economic transformations in the world, the end of World War II, listing significant changes in production structures and labor market in the world. Initially developed countries realize these changes and subsequently developing countries. The changes in production patterns, especially with the crisis of Fordism, peripheral countries further accentuated the problems in the workplace. Flexible accumulation, in turn, was responsible for significant changes in the labor market at the periphery of global capitalism. This restructuring process, in Brazil, begun from the end of the 1980s and early 1990s, being more accentuated the impacts on the labor market in the poorest regions of the country, particularly the Northeast. In that sense, this thesis aims to evaluate the job market in the metropolitan areas of Fortaleza, Recife and Salvador in light of the transformation process in the production structures and labor market and its influences in the 2000s. The time frame are the years 2001-2008. Data are from the National Household Sample Survey - PNAD and were drawn from the study proposal developed by the Centre of the Metropolis. The study shows that the labor market of the three metropolitan areas continues to be affected by the restructuring process of the late twentieth century. It found high rates of unprotected busy at work is more precarious conditions of employment for non-whites, women, adolescents / young and old. We also highlight the high percentage of employed persons earning income up 1.00 minimum wage, and a large number of persons employed in the tertiary and tertiary non-specialist. With the picture observed in the three metropolitan areas you can see the major problems in the labor market that proliferate, especially in the metropolitan context of the Northeast, with characteristics similar to those observed in the literature that investigated the labor market in 1990

Caracterização do acidente de trânsito e gravidade do trauma: um estudo em vítimas de um hospital de emergência de Natal

Descriptive exploratory study, with quantitative approach and prospective data performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGH), in Natal/RN, aiming to classify the type of motor vehicle involved in the accident, the public roadway s user quality and the more frequent injuries; to evaluate the severity of trauma in traffic accident victims; characterized the severity of the injuries and the trauma, and the type of motor vehicle involved. The population comprises 605 traffic accident victims, with data collected between October and December 2007. We used as a support for the evaluation of severity of injuries and trauma the Glasgow Coma Scale (GCSl), the Condensed Abbreviated Injury Scale (CAIS) and the Injury Severity Score (ISS). The results show that 82.8% of the victims were male; 78.4% were aged 18 to 38; the victims originating from the State s Countryside prevailed (43.1%); 24.3% of the population had completed middle-level instruction; 23.1% worked on commerce and auxiliary activities; most (79.4%) was catholic; 48.8% were married/consensual union; 76.2% earned up to two monthly minimum wages; Sunday was the day with the most accidents (25.1%); 47.4% were attended to in under an hour after the event; the motorcycle on its own was responsible for 53.2% of the accidents; 42.3% were attended to by the SAMU; 61.8% were victims of crashes; over half (53.4%) used individual protection equipment (IPE); 49.4% were helmets and 4.0% the seatbelt; 61.3% were motorcycle drivers; 43.3% of the accidents took place in the afternoon shift; from 395 drivers, 55.2% were licensed, and 50.7% among those had been licensed for 1 to 5 years; 90.7% of the victims had GCS1 between 13 and 15 points at the time of evaluation; the body area most affected was the external surface (35.9%); 38.8% of the injuries were light or moderate (AIS=1 and AIS=2); 83.2% had light trauma (ISS between 1 and 15 points). In face of the results, we can conclude that there is a risk for the elevation of injury severity and trauma resulting from traffic accidents, when these events are related to certain variables such as gender, age, weekday, the interval between the accident and the first care, ingestion of drugs, type of accident, the public roadway s user quality, the use of IPE, day shift, body regions and the type of motor vehicle involved in the accident

Violência ocupacional contra profissionais de saúde em um hospital de urgência. natal/rn, 2009

Descriptive exploratory study, with quantitative approach, with data collected from April to May 2009, aiming to identify the types of occupational violence affecting professionals on the nursing and medical staff in an emergency hospital service in Natal/RN, over the last 12 months; to identify emergency sectors where occupational violence episodes took place; to characterize aggressors on each type of occupational violence; to know the procedures adopted after each violent act targeting nursing and medical staff professionals; and to know the consequences of violence suffered by the nursing and medical staff professionals. The sample consisted of 26 nurses, 95 nursing assistants/technicians and 124 physicians, for a total of 245 professionals. The results showed that 50.61% of the professionals were women, aged 41 to 45 (22.45%), with post-graduate studies (51.43%), married (60.82%); 21.22% had 16 to 20 years of experience in the profession and in emergency practice; working 40 weekly hours (86.12%); and working both the day shift and the night shift (70.21%); 27.35% consider violence to be a part of their profession and the patient s companions as an important risk factor (86.53%); couldn t inform whether there was a specific established procedure for reporting occupational violence (45.71%); 73.06% suffered occupational violence in the 12 months; 70.20% verbal assault, 24.08% moral harassment, 6.12% physical assault, and 3.67% sexual harassment; 66.67% of the patients took part in the physical assault; the companions, in verbal assault (58.14%); and the health staff in moral harassment (69.49%); facing episodes violence, 37.65% of the professionals reported the fact to their co-workers; 57.25% uffered from stress as a consequence; on 4.71% of the episodes the professionals had to be bsent from work, resulting in 75 days of occupational violence-related absence. We conclude here was a high rate of occupational violence in the researched population, with verbal ssault and moral harassment as the most frequent violence types. Because factors related to ccupational violence were very diverse, actions seeking to confront this problem shouldn t be limited to the work environment itself. Education ought to be one of the most effective ctions for avoiding or minimizing these events occurrence

Um estudo do perfil de formação dos técnicos de segurança do trabalho no Brasil na perspectiva de sistemas de gestão de segurança e saúde ocupacional

This work provides great contribution to the documental study of the Work Safety courses offered by CEFETs in Brazil, under the perspective of safety management and occupational health, using as a referential the specification OHSAS 18001 (BSI, 1999), as well as directions provided by OIT (ILO, 2001). The theoretical research compares technical and managing competences of the projects of Work Safety courses at CEFETs with the international legislation mentioned above. For field research, questionnaires containing open and close questions were answered by teachers and students aiming at identifying the importance of technical and managing competences for the formation of Work Safety technicians, besides trying to identify which level of minimal formal knowledge should be required to perform managing activities in the area of Work Safety Management Systems and Occupational Health (SGSSO, in Portuguese). The results of the theoretical research point out differences between the projects of the Work Safety technical courses at CEFETs under the perspective of SGSSO. The field research shows that students and teachers opinions converge about most technical and managing competences. In relation to academic formation, the research suggests divergences to the criterion stated by the norm ISO 19011(ABNT, 2002)

Modelagem de arranjos institucionais para implementação da diretriz de sistema de gestão de segurança e saúde ocupacional da organização internacional do trabalho ILO/OSH 2001 no brasil

The commitment assumed by Brazil to ILO in order to pursue actions toward the ILO/OSH-2001 adoption in the country poses the issue of modeling the institutional arrangement the set roles and relationship between government, standards organizations, health and safety organizations, professionals and other institutions to deploy the ILO/OSH-2001. This Thesis develop institutional arrangement models based on the current model and also in the ISO 9000 scheme and others. It is studied the US case with OSHA and VPP, the OHSAS 18001 and ANSI/AIHA Z-10, in addition to actual context of the regulating norms NR s. The scenarios developed are put to evaluation on feasibility, potential changes and effects on current MTE auditors work scheme. The main results are five scenarios developed and that the MTE auditors tend to be reactive to the change toward the ILO/OSH-2001.

Uma contribuição à reformulação da norma regulamentadora 13 (NR-13) na perspectiva da adoção de sistema de gestão de segurança e saúde ocupacional

This Master s Thesis deals with an analysis of the Regulatory Standards NR-9 e NR-13 on the perspective of occupational health and safety management systems (OHSMS) such as ILO deployed ILO/OSH-2001. Since the revamped OHSAS 18001:2007 complies with the ILO/OSH-2001 model it is used as benchmark to compare against the NR-9 and NR-13. The analysis suggests that the NR-9 has some important features present on the OHSAS 18001:2007 but lacks important others. The NR-13 turns out to be far from a modern model of OHSMS such as OHSAS 18001:2007 and a deep reformulation should be done in order to achieve the Brazil commitment with ILO to adopt OHSMS. Also, a small survey with companies with ISO 9000 certificates suggests that a NR-13 revised toward OHSMS would be welcome, but also that some more advanced issues present in ILO/OSH-2001 should be imposed by law in order to be achieved

Efeitos cognitivos e emocionais do estresse ocupacional em profissionais de enfermagem

Objective: Investigating the indicators of stress, anxiety, depression and the cognitive changes in members of the nursing team at Santa Casa de Misericordia de Assis - SP. Methods: 66 nursing professionals participated in the study, evaluated by psychological and cognitive tracking instruments. Results: The stress experience was not homogenous in the nursing team; high scores in the depression tracking were associated to low cognitive scores. Conclusion: Nursing auxiliaries and technicians were affected by stress. Therefore, workers healthcare should be provided for the whole nursing team.

Efeitos da inclinação da esteira na marcha de indivíduos hemiparéticos crônicos

Objective: To examine the effects of treadmill inclinations on the walking of hemiparetic chronic subjects. Design: Observational descriptive study. Location: Laboratory of human movement analysis. Participants: Eighteen subjects, 10 men and 8 women were evaluated, with a mean age of 55.3 ± 9.3 years and the time since the injury of about 36 ± 22.8 months. Intervention: Not applicable. Main Outcome Measures: All subjects were evaluated for functional independence (Functional Independence Measure - FIM) and balance (Berg Balance Scale). Angular variations of the hips, knees and ankles in the sagittal plane were observed, as well as the speed of the movement (m/s), cadence (steps/min), stride length (m), cycle time (s), step time on the paretic leg and on the non-paretic leg (s), support phase time and balance phase time on the paretic leg (s) and the ratio of symmetry inter-limb as subjects walked on a treadmill at three conditions of inclination (0%, 5% and 10% ). Results: There were angular increases in the initial contact of the hip, knee and ankle, amplitude increase in the hip between 0% and 10% (37.83 ± 5.23 versus 41.12 ± 5.63, p < 0,001) and 5% and 10% (38.80 ± 5.96 versus 41.12 ± 5.63, p = 0,002), amplitude increases in the knee between 0% and 10% (47.51 ± 15.07 versus 50, 30 ± 12.82, p = 0,040), extension decreases in the hip, dorsiflexion increases in the balance phase and in the time of support phase from 0% to 5% (0.83 ± 0.21 versus 0.87 ± 0, 20, p = 0,011) and 0% and 10% (0.83 ± 0.21 versus 0.88 ± 0.23, p = 0,021). Conclusion: The treadmill inclination promoted angle changes as such as the increase of the angle of the hip, knee and ankle during the initial contact and the balance phase and the increase of the range of motion of the hip and knee; furthermore, it also promoted the increase of the support time of the paretic lower limb

Estudo comparativo da marcha de indivíduos hemiparéticos no solo e na esteira

The purpose of the study was to compare hemiparetic gait overground and on the treadmill. Seventeen chronic stroke patients were included in the study. They walked overground and on a treadmill level at the same speed. The Qualisys Medical AB motion analysis system was used to quantify the joint kinematic of the paretic lower limb and the spatio-temporal parameters on the two conditions: overground walking and treadmill walking on three samples of 5-minutes. During the first sample, the subjects walked on the treadmill with greater cadence, shorter stride length, shorter step time on the lower paretic limb, greater range of motion in the hip and knee, greater knee flexion at the initial contact, more extension of the knee and lower dorsiflexion of the ankle at the stance phase. It is important to emphasize that the maximal knee flexion and ankle dorsiflexion just occurred later on the treadmill. Comparisons between each walking sample on the treadmill hadn t revealed any changes on the gait parameters over time. Nonetheless, when analyzing the third walking sample on the treadmill and overground, some variables showed equivalence as such as the total range of motion of the hip, the knee angle at the initial contact and its maximal extension at the stance phase. In summary, walking on a treadmill, even thought having some influence on the familiarization process, haven t demonstrated a complete change in its characteristics of hemiparetic chronic patients

Avaliação eletromiográfica de músculos inspiratórios em hemiparéticos / Eliete Moreira Colaço

The objective was measured by surface electromyography (EMGs), the activity of inspiratory muscles during incremental test in subjects with hemiparesis and show its correlation with the Functional Independence Measure (FIM). Were included in the study 32 individuals hemiparetics and 14 healthy as control group. We performed an evaluation of lung function and anthropometric data. The EMGs were performed during the incremental test with Threshold ® (15, 30, 45 and 60% of MIP) and during maximal inspiratory pressure (MIP). The electromyographic findings were calculated by the signal amplitude (RMS). All data were initially analyzed by Kolmogorov-Smirnov, the anthropometric characteristics of both groups were tested with the Levene and then intra-subject analysis (hemiparetic hemithorax and healthy hemithorax) and inter-group analysis (experimental group and control group) by paired and non-paired Student t tests and Pearson correlation. In intra-subject comparison was observed less activation (p <0.01) of the sternocleidomastoid muscle, scalene and diaphragm paretic side in both sexes - for the Threshold ® incremental test (15, 30, 45 and 60% of the MIP) and during maximal inspiratory pressure (MIP). In inter-group comparison, there was reduced activity in the diaphragm and the scalene, in hemiparetics males and females, respectivelly, during the same test. Our results demonstrate the existence of reduced electromyographic activity of inspiratory muscles in hemiparetics, including changes between different genders and suggests the need of further studies to assess the effects of specific training of inspiratory muscles.