Saúde bucal no programa de saude da família: o caso do distrito sanitário norte em Natal - RN

The inclusion of the dentist in the Family Health Program (FHP) teams designates a reorganization of the mouth health care in your country and establishes a new scenario in Brazilian odontology, through of a new way to organize the basic health care, creating conditions to consolidate in mouth health practice actions, in the level of the basic attention, the validation of Unique Health System (UHS) constitutional principles. The purpose of this research is to verify if the actuation of mouth health teams (MHT) dentists, in Natal city north sanitary district, is tuned with FHP goals.The target research population was composed by all dentists working in Basic Health Units (BHU) of Natal north sanitary district. Fifth-eight questionnaires were applied and using open and closed questions we look for identify the functional characteristics of each BHU, the dentists professional attributions on each BHU, as well as the clinical procedures that they execute. This research also searched to identify the factors that facilitate and/or difficult the inclusion process and the dentists activities performance on these BHUs, as well as the necessary actions to north sanitary district MHTs to fulfill the objectives proposed by FHP. The results point that the inclusion of mouth health actions in north sanitary district FHPs brought the incorporation of new values to the used practices. Whoever, its necessary a more frequent evaluation of the carried actions, in a way they can be adapted to the real community necessities, and, is fundamental the data accompaniment, for that these serve of base for planning and redirecting activities, in a way that we do not have only a reproduction of traditional practices, fragmented and isolated, but a truly substitution of the traditional practices and a new way of promoting health

Análise dos efeitos da legislação urbanística na formação e crescimento do Bairro de Lagoa Nova: planos diretores de 1974, 1984 e 1994

To Analyze the Managing Plans of Natal in the decades of 1970, 1980 and 1990, identifying elements that had contributed for the growth of the Lagoa Nova quarter, capital one of the Rio Grande do Norte state. Ahead of the sped up growth of the urban centers, many times is not given to analyze which law had taken care of to its objective, and which the imperfections that had appeared during the application of these laws. To make the comparisons in you square them chosen at there distantinct times made possible to analyze the form as the ground of Lagoa Nova absorbed the proposals laws.Therefore toanalyze influences it of the Managing Plans, to make comparatives analyses between the urbanistics condicion, made possible to understand that the fabric urban of the quarter of Lagoa Nova is a true granary of information that it makes possible to the dedicated ones to the urban studies, a true field of analysis

Análise do estado da arte dos aspectos diagnóticos, periciais e jurisprudenciais das LER/DORT no contexto previdenciário das doenças do trabalho no Brasil

Objetivo: analisar o estado da arte dos aspectos diagnósticos, periciais e jurisprudenciais das LER/DORT (Lesões por Esforços Repetitivos / Distúrbios Osteomusculares Relacionados ao Trabalho) no Brasil. Materiais e Método: trata-se de pesquisa descritiva, de natureza qualitativa, com formato documental, utilizando-se a técnica de análise de conteúdo. A avaliação evolutiva da legislação previdenciária relacionada as LER/DORT foi realizada através da pesquisa no banco de dados disponibilizado pelo Governo Federal e mediante a consulta ao DATAPREV/Sislex. A avaliação dos aspectos diagnósticos foi instrumentalizada através, principalmente, de artigos científicos publicados entre 2003 e 2008, nas línguas portuguesa, inglesa, espanhola e francesa, relacionados com os métodos de diagnósticos complementares das LER-DORT (ressonância magnética, tomografia computadorizada, ultrassonografia e eletroneuromiografia). As jurisprudências foram obtidas através da busca dos julgados sobre o tema, entre 2003 e 2008, pertencentes ao Supremo Tribunal Federal, Superior Tribunal de Justiça, Tribunais Regionais Federais, Tribunal Superior do Trabalho e Tribunais Regionais do Trabalho. Resultados: foram identificados 48 artigos abordando os aspectos diagnósticos das LER-DORT, observando-se que os exames por ressonância magnética, ultrassonografia e eletromiografia demonstraram ser mais efetivos, dentro das suas especificidades, para a complementação do exame clínico de patologias relacionadas às LER-DORT. A análise das 123 jurisprudências selecionadas demonstrou, de forma geral, que as LER-DORT equiparam-se ao acidente de trabalho, devendo apresentar nexo de causalidade (atestado através de laudo médico-pericial) e, ainda, ensejam a ação por danos morais, a qual, devido à EC nº 45 passou a ser competência da Justiça do Trabalho. O Estado da arte dos aspectos periciais encontra-se representado pela vigência da Instrução Normativa n. 98/2003, a qual traz como aspecto fundamental a determinação de novos parâmetros a serem considerados na definição de um quadro de LER-DORT, dispondo, ainda, sobre a conduta ética que deve ser adotada pelo médico perito, bem como chama a atenção para a necessidade dessas doenças do trabalho serem comunicadas às autoridadades competentes, através da emissão da Comunicação de Acidente de Trabalho (CAT). Conclusão: as LER-DORT representam, hoje, um problema de importante impacto, não apenas previdenciário, mas também econômico em diversos países, nos quais o Brasil encontra-se inserido. Estudos sobre o estado da arte relacionados às LER-DORT são fundamentais para auxiliar na construção de um modelo crítico e consciente que colabore com a garantia de sustentabilidade do sistema previdenciário no Brasil

Financiamento e gasto público em saúde: o caso do Rio Grande do Norte

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Relações trabalhistas e estilo de vida do atleta profissional de futebol do Rio Grande do Norte

Brazilian Law n° 9.615 of 24 March, 1998 established new paradigms in the employment relations existent between the soccer athlete and the sport association, both of whom are accustomed to the former legislation. They do not seem to have organized themselves in the sense of understanding the practical effects of the legal precepts currently in force, raising doubts that hinder the professional practice of the former and the performance of the latter in relation to managing these human resources. The purpose of this study is to analyze the degree of knowledge displayed by the professional soccer athlete about the legal recourses at his disposal in relation to the employment relations established in his work contract, as well as investigating the stress habits and stress situations that he most often experiences. This descriptive study consisted of a sample of 105 players under contract with clubs participating in the final phase of the state soccer championship. A questionnaire was used as the data collection instrument, whose analysis allows us to verify the lack of knowledge, on the part of the subjects studied, about the laws that regulate their profession, as well as identifying the stress habits and stress situations that are most reflected in their lifestyle. The lack of knowedge of regulate norms of their profession influences, in a negative way, in the lifestyle of soccer professional athlete from Rio Grande do Norte, Brasil

A propaganda de medicamentos voltados à clínica obstétrica e/ou ginecológica e sua influência sobre a prescrição

INTRODUCTION: Drug advertisement stimulates self-medication and irrational use of medicines, especially when it starts to interfere in the prescription. Monitoring advertisements, as well as the observation of its influence on health professionals, prescriptions become necessary because of this public health problem. OBJECTIVE: The aim of this work was to analyze drug advertisements directed to gynecologists and/or obstetricians doctors relating them to the current legislation as well as its influence on prescription. METHODOLOGY: The sample was composed of drug advertisements divulged to the gynecologists and / or obstetricians doctors and was analyzed according to RDC96/2008. To evaluate the influence of advertisement on prescription, a questionnaire was administered to gynecologists / obstetricians doctors and prescriptions of a public maternity were also evaluated. RESULTS AND CONCLUSION: Concerning the advertisements analyzed, 48% complied fully with current legislation and 52% of the advertisements analyzed were in accordance to the RDC No. 96/2008 in most of the items evaluated. The doctors interviewed are used to receive the visits of propagandists, even in the public service, receiving gifts offered by the industry and believe that medicine advertisement tries to influence prescribing. Many of them use the material provided by the propagandist as a source for their prescription, although they present a critical view about them information. The use of trade name / mark on the prescription is a common practice among the doctors interviewed, even in the public service, suggesting there is an influence of medicine advertisement on the prescription

Ações de detecção precoce do câncer de mama realizadas por profissionais da estratégia saúde da família

This study is an exploratory descriptive study with a quantitative approach. The objective was to identify the actions for the early detection of breast cancer conducted by the health professionals of the Family Health Strategy in the Trairi region of the State of Rio Grande do Norte, Brazil. The research was conducted in nine municipalities of the region. Data were collected by means of a questionnaire with 52 Family Health Strategy professionals, 30 nurses and 22 physicians, that work in the region. Analysis was conducted using descriptive statistics. The results were organized and discussed in three areas: Knowledge about the early detection of breast cancer; Actions for early detection detection of breast cancer, and Difficulties experienced in the screening actions for breast cancer. The results indicate that these professionals (100%) have knowledge of the signs and symptoms of breast cancer and that the majority (96,2%) conduct screening actions in accordance with the recommendations of the Ministry of Health. However, a considerable number (55,8%) of these professionals encounters difficulties while conducting the screening procedures in his work setting. The difficulties varied from those of a personal nature to those of access to the procedure, such as the unavailability of sufficient quotas of screening exams. We conclude that the majority of health professionals execute the screening actions for breast cancer in their work settings according to the recommendations of the Ministry of Health, even though they encounter difficulties in the conclusion of the mammography and ultrasound exams, essential procedures in the early detection of breast cancer. We understand that these professionals demonstrate knowledge of secondary prevention even though they do not execute all the actions necessary for early detection primarily because they are impeded by the blockage of access to exam quotas. We conclude that, in spite of the difficulties experienced, the procedures for the early detection of breast cancer are being executed by the majority of the Family Health Strategy professionals in the Trairí region, specifically the clinical examination of the breast, orientation of breast self examination, requests for mammography and ultra sound examinations. Measures are needed that can mediate the difficulties, that will permit the realization of secondary prevention procedures with the population at risk in the region. We suggest training and actualization courses on the complete screening process that includes a wide discussion of the new legislation that provides the mammography exam for women over 40 years. We believe that the acquisition of such a work perspective for the early detection of breast cancer, along with knowledge of health vigilance and of breast cancer, will enhance integral health care of women that constitutes an aim of the nurse and the family health team

O cuidar de enfermagem e da família à pessoa idosa no domicílio: uma abordagem etnográfica

O envelhecimento é um processo multidimensional que envolve entre outros os aspectos físico-biológicos, sociais, econômicos e psicológicos. Ao avaliar essa fase da vida dentro de uma visão social e cultural, percebe-se que ser idoso ou não varia com as concepções culturais, sendo necessário investigar as variações que atuam no processo e rege o fenômeno sociocultural da realidade em que se está inserido. Com o aumento da população idosa mundial, esse processo tende a se intensificar. Estima-se que até em 2050 existam cerca de dois bilhões de pessoas com mais de 60 anos no mundo, e a maioria delas vivendo em países em desenvolvimento. No Brasil, acredita-se que existam, atualmente, cerca de 20 milhões de idosos. A normatização e legislação brasileira de amparo ao idoso em relação à saúde iniciaram-se a partir da Constituição Federal de 1988 e da Lei 8080 que regulamenta o Sistema Único de Saúde em 1990, em seus níveis de complexidade: atenção básica, média e alta complexidade. Para auxiliar nessa prestação dos serviços na atenção básica de saúde é importante observar as condições sociais, culturais, econômicas e de saúde dos idosos e seus familiares. Nesse sentido, a visita ao domicílio e a avaliação deste idoso em seu ambiente doméstico torna-se fundamental para acompanhar o cuidar prestado e o quanto esse processo irá interferir no sistema de saúde, na família e na qualidade de vida dos idosos. Neste contexto, o enfermeiro como integrante da Equipe de Saúde da Família, presta assistência à saúde do idoso no domicílio. Nesse sentido, o objetivo do estudo é analisar o cuidado de enfermagem e da família à pessoa idosa no domicílio com vistas à identificação das influências socioculturais. Trata-se de um estudo do tipo descritivo e de abordagem qualitativa, norteados por princípios teórico-metodológicos da etnografia com vistas ao estudo da influência dos aspectos culturais e sociais na assistência da família e do enfermeiro à idosos em domicílio. Foi realizado no município de Santana do Matos, RN, tendo como participantes, idosos, familiares e enfermeiros da equipe da ESF, definidos a partir da população do município e obtendo-se uma amostra intencional de 25 participantes: 6 enfermeiras, 10 idosos e 9 grupos familiares. Para a coleta de informações, utilizou-se observação, entrevista, diário de campo e grupo focal. Os resultados foram apresentados em forma de narrativa descritiva, na perspectiva dos conceitos de Boris Cyrulnik, com análise interpretativa cultural de Geertz, na busca dos significados e símbolos próprios da cultura da velhice de idosos e dos seus familiares, sobre cuidados que são realizados, tanto pela família, como pelos enfermeiros em domicílio. Observou-se que a família e o cuidador, dentro de sua realidade social e cultural, precisam ser mais compreendidos pela equipe de saúde para ser melhor orientados e capacitados na realização do cuidar de forma adequada. Por sua vez, os profissionais de saúde, em especial o enfermeiro, enfrentam dificuldades para realizar o cuidado ao idoso no domicílio como a grande demanda de atribuições na unidade de saúde como consultas e atendimentos; falta de transporte até os domicílios; extensão territorial do município e das áreas assistidas; número de pessoas atendidas por cada equipe; falta de compreensão dos profissionais de saúde quanto à importância da visita domiciliária na atenção básica. Entendem a necessidade de realizar ações de promoção em saúde, prevenção de agravos e de educação em saúde, além de reconhecerem a importância de uma melhor formação acadêmica para atuar nessa perspectiva e contribuírem para as mudanças necessárias na prática dos cuidados ao idoso em domicílio

O cidadão técnico em enfermagem :analisando as mudanças na sua profissionalização

The study analyzes the changes occurring in the professional qualification of the Nursing Technician in the Natal School of Nursing. It provides a historical discussion of Brazilian professional education, of the pertinent legislation in this type of teaching, and the repercussions related to the institutionalization of the Educational Directives Law. It interprets the discourse of the graduates of the complementary course of nursing auxiliary to nursing technician, for the year 2002, using the collective subject analysis and individual interviews. These revealed changes in the areas of knowledge-learning, knowledge-doing, knowledge-being, and an awakening to other changes besides the challenges being confronted. In this sense, nursing as a participant in a society that is effervescent with process changes, interacts socially, politically and professionally in this context, able to experience advances and retrogrades, depending on its political competency

Impactos da legislação ambiental brasileira na exportação de camarão: um estudo com exportadores de camarão do Rio Grande do Norte

Brazilian exportations come growing in a constant form in the last years, stimulated for the globalization and public politics directed toward the increase of the internal surplus. In this context the objective of this work was to investigate the perception of the shrimp exporting entrepreneurs of Rio Grande do Norte, with relation to the impact of the Brazilian environmental legislation in the companies competitiveness at the external market. From data collected from the controllers of the companies, it was used a survey methodology, with exploratory and descriptive character. The results found in this study indicate that the companies, in general way, understand that the environmental legal requirements do not confuse nor help in the search and conquest of new international markets. A little more of the half of the researched companies, does not see the legislation rigid as important factor of competitiveness. However a sufficiently significant percentage, already has a more strategical vision on the subject, or at least already it heard to speak on such possibility

A documentação odontológica sob a ótica dos cirurgiões-dentistas de Natal-RN

The dental documentation or handbook is a collection of documents produced by the professional with diagnostic and therapeutical purpose where the inherent information to the buccal and general health of patients are registered. The register and proper filling of these documents, taking care of the ethical and legal requirements, provide to the dentist the possibility to contribute with justice in cases of human identification and makes of these documents an essential element of evidence in the ethical processes, administrative, civil and criminal against the dentists. Ahead of this fact, understanding such requirements and the importance of the dentist to register himself adequately, this research verified the knowledge of Natal (RN) City s dentists with relation to the elaboration of the dental handbook, investigating the concepts and the importance attributed to the handbook, identifying the documents more used and filed by these professionals, besides inquiring the legal value of filed documents and the filling time of these ones. The sample was constituted by 124 dentists, who had answered a questionnaire, after having been randomly selected ITom a list of professionals subscribed in the Dentistry Local Council/RN Section. The analysis of the results showed that majority of the participant citÍzens (52,3%) confers to the dental documentation the clinical importance, followed by the legal and forensic-dentistry importance; 59,3% of the searched professionals do not distinguish satisfactorily or they do not observe differences between the dental handbook and the clinical filing card, the X-rays, the dental certificates, the prescriptions, the directions and the receipts; between the documents of common use to clínical and specialist ones, the contract of rendering of services and term of ITee and cleared up consent are the documents less used by the professionals. It was still verified, that only 13,1% of the sample register the signature of the patients in the clinical filing card, making it more credibility to be presented in judgement. In the same way, copies of dental certificates and prescriptions evaluated and signed by the patients are filed respectively by only 13,5% and 9,4% ofthe searched professionals and 50% ofthe sample, keep these documents filed for an indeterminate period of time, that is, these professionals have the guard of the handbook and they do not intend to disdain it, although 85,5% of the sample does not recognize the real proprietor of the handbook. It is concluded that a great part of the dentists is unaware about the importance of the dental documentation, and neglect its elaboration, leaving themselves exposed to several kinds of penalties foreseen in the legislation

A Perda Auditiva Induzida pelo Ruído (PAIR) na formação odontológica: conhecimentos e níveis de exposição

The rationalization of work in the Dentistry has been taking the professional to work for ways and systems based in the ergonomics, turning their work efficient and less tiring. Since their academic formation, the dentists surgeons are concerned with the high productivity in clinic and with the final result of the work, neglecting the way as it is executed, which reduce their work capacity and exhibits them to occupational diseases that could be minimized and/or forewarned. This research had as the main objective to investigate the knowledge of the Dentistry academics of Rio Grande do Norte Federal University concerning the Noise-induced Hearing Loss (NIHL), relating them at the noise levels that they are exposed, as well as to the preventive measures taken during the clinical activities. Was observed that 95% of the individuals know that the dentist surgeon is a professional in risk for NIHL. Among the causes of NIHL, the one that obtained the largest frequency citation was the high-speed handpieces, reminded by 92,4% of the academics. Among the students which enumerated protective measures for NIHL, 92% mentioned the use of the ear plugs, although 97% of the researched have told do not use any kind of preventive measure related to the noise. Was also observed that 96% of the academics notice the noise during the clinical attendance, what inconvenience 28,1% of them. Related the noise levels, the high-speed handpieces of the academics presented a medium value of 80,5 dB varying from 72,3 to 88,3 dB. The average of the ambient noise observed at the Integrated Clinic was about 74,8 dB. In spite of the noise levels in this research were observed below the established limits of tolerance by the legislation, they can provoke damages to the Dentistry professionals' health, or that suggests the need of an intervention and use of immediate preventive measures able to generate a healthy atmosphere of work and less risky

Redesenho das configurações estruturais na gestão universitária: ações derivadas da inovação e flexibilidade na legislação pós-LDB 1996

This paper is set in a scenario in which higher education institutions suffer from external pressure to increase efficiency. The legislation after the Law of Directives and Bases for Education (LDBE), from 1996, is characterized by the fragmentation in its implementation, raising a concern with flexibility and innovation in several normative devices as well as aspects that must be incorporated to its organizational structure. The policies examined in this thesis are: Distance Education (DE); Law of Innovation and the Program of Support to Restructuring and Expansion of Federal Universities (PSREFU). This thesis aims to observe to what extent the characteristics of innovation and flexibility, which mark the new post- LDBE educational legislation, influence the organizational redesign of the Federal University of Ceará (UFC). For being about implementation policies, using contingency approach in order to collect the internal dynamics permeating the redesign of higher education institutions, the thesis focuses on the impacts caused by flexibility and innovation. This is a qualitative research, with case study methods, archive research and semi-structured interviews with members of the university administration. The results don t allow us to confirm the adoption of a more flexible and innovative configuration in the university but it is possible to identify the presence of those elements in the implementation changes, characterizing the hybrid structure. The changes mainly expose the extension of the management of projects to the administrative and academic components related to the institution. In terms of projection, the study found changes in the elements which characterize the current setting and the tendency of the university for adopting a diverse organizational structure. However, if the decentralization of management persists, the academic units may adopt their own structural solutions, but with no evidence of changes in the professional organization in most units. In this perspective, this thesis states that there are difficulties when incorporating innovation and flexibility to their organizational structure, which lead to improvised solutions, superposing skills through the redundancy of structures created with the same purpose or copying exogenous solutions

Geografia, turismo e meio ambiente: uma nova face do litoral dos municípios de Extremoz e Ceará-Mirim

La presente pesquisa contempla reflexiones referentes de la actividad turística en la organización socio-espacial en el litoral de las comarcas de Extremoz y Ceará-Mirim, región de la Grande Natal. Nuestro objetivo principal es el estudio de las transformaciones del espacio y de sus implicaciones socio-ambientales en curso en el proceso de producción del espacio turístico en el litoral de las referidas comarcas desde 1997 hasta 2007, momento de importancia publica-privada que, a partir del PRODETUR, tuvo la base para el incremento de las potencialidades turísticas. En este sentido, varias fueron las técnicas para una mejor compresión de las aspiraciones y de la percepción de los actores envueltos con la actividad turística (comerciantes, turistas, populación y poder publico local) para conocer cuales son sus consideraciones en cuanto a los cambios que proceden de la implantación de la actividad turística en el lugar, cuanto a la mejora de la calidad de vida, de la generación de empleo y de renta, comercialización, conservación, preservación del ambiente, cumplimiento de la legislación, afirmación cultural así como las acciones puestas en ejecución en las comarcas. Para tal necesidad, se buscó analizar los datos estadísticos a partir del uso de los cuestionarios con preguntas estructuradas y semi-abiertas como instrumento de colecta de información que les era correlacionada con la opinión de los actores locales de modo que podamos formar y entender los elementos básicos que son parte de los espacios turísticos en foco. Fueran utilizadas fotografías aéreas de las comarcas de Extremoz y Ceará-Mirim, provistas por el IDEMA, con la intención de percibir acerca de los cambios del espacio y las implicaciones socio-ambientales de la área en estudio. Concluimos en función de los resultados que el modelo de Turismo concebido por lo Brasil, estimulado y financiado por lo Gobierno Federal, está insertado en el contexto de la economía global y, por lo tanto, el Estado del Rio Grande del Norte, en específico los espacios litoraneos de las comarcas de Extremoz y Ceará-Mirim, que poseen características similares a este modelo, con sus particularidades, que si traduzca por la exclusión social, formas de apropiación privada de los espacios público y áreas de protección ambiental como las playas, las dunas y las lagunas, el desacato o no el cumplimiento de la legislación ambiental, aumento de las desigualdad de renta en una región que posee una problemática social grave y sin inversión, implantación de la infraestructura, ausencia de política pública local, donde los intereses económicos son prioridad delante de las aclamaciones populares. Se sugiere un repensar cuanto al modelo actual de desarrollo adoptado, que el planeamiento sea pautado en base a la participación integrada de los varios agentes implicados con la actividad turística, incluyendo en la medida del posible, las aspiraciones de la población local como precusoras de sus reales necesidades, donde esta acción interactiva contestará ciertamente en un esfuerzo significativo en la construcción de un nuevo paradigma, modelo del desarrollo sustentable, siendo posible superar gradualmente el incremento de la pobreza, de la exclusión y de los impactos ambientales, donde la calidad de vida sea factor fundamental