Evidências de validação de um protocolo para assistência às pessoas com úlceras venosas em serviços de alta complexidade

Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs . After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa ≥ 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity

Impacto urbano ocasionado por empreendimentos da construção civil no entorno da zona de proteção ambiental (zpa-6), Vila de Ponta Negra, Natal/RN

The process of urbanization in recent decades has generated considerable seriousness of problems relating to the use and occupation physical environment of cities. The concentration of population, economic activities and technological standards have reinforced an existing urban environment highly degraded as a consequence of the development style that leads to the predatory use of natural resources. In this context, cities as centers of production and consumption, have the most serious problems of environmental degradation. This study investigated the impacts of the municipal building projects to large-scale vertical in the town of Vila de Ponta Negra, Natal-RN, given the proximity to the Environmental Protection Area (ZPA-6) and considering its environmental importance , scenic, landscape and tourism for the city of Natal-RN. The fragility of the licensing process and the failure of the assumptions in the analysis, objective and subjective, for the granting of environmental permits for the building construction projects, specifically those set out in the surroundings of the Environmental Protection Area (ZPA-6) and fundamental importance of landscape and tourism for the city of Natal, has aroused the concern of local people in and of itself the Government, faced with the probable impacts that will affect greatly the Vila de Ponta Negra. The methodology used to achieve the intended objectives will be the literature review, questionnaire to the surrounding population and the Government, as well as findings on the spot, through the photographic record. The beneficiaries of the license, if the entrepreneurs, have been affected because of the granting of licensing act of investing large amount of capital in the works. Additionally, with distrust of the population, since they are to discredit the public system of environmental management have guessed by the probability of imbalance to the environment and structural damage to the Vila de Ponta Negra, where such failure to support energy, lack of regular supply of water , lack of sanitation and access roads sufficient for the flow of motor vehicles in these areas, among other factors. Thus, this work will contribute to the diagnosis and solutions to the problem in question, so that the Government will effectively fulfill its social management of ecologically balanced environment of continuing urban development in Natal, Brazil

A grande Argentina: um sonho nacionalista para a construção de uma potência na América Latina

Visa-se analisar a proposta de transformação da Argentina em uma potência econômica e militar hegemônica na América do Sul, levada a cabo por correntes de extrema-direita desse país, entre as duas Guerras Mundiais. Discutem-se os objetivos, conteúdos e fundamentação dessa proposta no contexto do cenário internacional e da conjuntura política argentina.

Estratégias argumentativas na construção do discurso ideológico: um estudo da produção didático-pedagógica do meb

This research studies the argumentative process developed by the Basis Educational Movement (MEB), using as corpus the booklet Viver é lutar , and other lesson plans of the Educational Rural Radio from Natal. It has as objectives reveal the argumentative strategies in the discursive production of MEB, exploring the meaning effects suggested by its production conditions, and the ideological positions defended, in addition to this, verify how the booklet and the radio classes dialogued in the argumentation of their theses. So, the study is guided by the Discourse Analysis presuppositions, by the Argumentation Theory, by the conceptions of Popular Education, as well as the conception language dialogical language conception, recurring to Bakhtin (1995). The research adopts the documental characteristic of qualitative nature with an interpretative basis. The analysis of the data permitted us to confirm that the pedagogical didactic material discourse of MEB was produced in a social-historical-ideological context in what the education was seen as a social liberation instrument, being able to transform the Brazilian people and the Brazilian unequal structure. The results reveal that the booklet and the classes assume a position remarkably in favor of the popular classes, structured by the argumentative techniques that intended to convince, and to persuade the auditorium. Thus, the argument was based initially on the convincing of youths and of adults for, afterwards, to construct a persuasion to the learners, in terms of referring to act on the reality to transform it, according to their desires of social justice

Um estudo no contexto da produção textual de um 9° ano do ensino fundamental

Cette recherche s'inscrit dans la linguistique de texte et vise à identifier, décrire, analyser et interpréter les événements de l'anaphore pronominale et de la répétition, exposer le montant et le pourcentage dês phenoménes respectifs dans Le corpus étudiés, que l accent sur le fonctionnement cohérente de ces phénomènes dans la construction du texte en termes de continuité et de progression thématique. Nous avons utilisé des procédures ethnographiques pour construire notre corpus d'enquête, composé essentiellement de textes produits par les étudiants de 9 ans d'école élémentaire de l'Etat, a la ville de Santa Cruz / RN. La recherche a été menée à partir des études sur l'anaphore pronominale faites par Milner (1982), Koch e Marcuschi (1998), Marcuschi (2000; 2005 e 2008), Koch (2002), Antunes (2005) e Adam (2008), et par des études sur la répétition présentés par Halliday e Hassan (1976), Beaugrande e Dressler (1997), Marcuschi (1992) et Antunes (2005). Comme le support technique, ont également utilisé les notions de cohésion définis par Halliday e Hasan (1976), Beaugrande e Dressler (1997), Marcuschi (2008) e Koch (2003). Dans l'analyse des textes, nous avons constaté que l'incidence de l'anaphore pronominale et de la répétition a été importante parce que les ressources étaient principalement utilisés par les étudiants pour promouvoir l'articulation cohérente des textes. Constaté que dans les textes narratifs ou argumentatifs anaphore pronominale promu l'entretien et la progression thématique prévu. Sur la répétition, nous avons observé que le maintien et la progression thématiques ont été conditionnés à la connaissance du sujet en discussion. Même si nous avons constaté que la répétition excessive de ces phénomènes dans le même texte, bien que la relation de promouvoir la cohésion, peut affecter le degré de caractere informatif

A construção da imagem de leitor em memórias de leitura

In this work, we analyzed reading memories of mother language teachers in continuing education context. Our objective was to understand how each individual has built his/her reader image. Our theoretical approach to the construction of selfimage was based on the concept of discursive ethos, understanding it with Charaudeau (2006) as something constructed in the intersection of glances (of the self and the other). To understand how each teacher has built his/her reader image in that intertwining of glances (of the self and the other) we are on the contributions of Bakhtin (2003, 2010b) on exotopic glance or distant/external glance. Therefore, in the analysis, we tried to capture the exotopic glance of the teachers about themselves in the various stages of their reader formation and from our exotopic look of researcher; we gave provisional finish of the reader image that teachers built of themselves. For the analysis, we adopted other theoretical assumptions: about genres, theme, composition and style, statement and social voices we based on Bakhtin (1997, 2003, 2010a, 2010b); on the notion of the discursive ethos we anchored in studies conducted by Maingueneau (2008a, 2008b); about reading, we adopted the theoretical references of Rojo (2005, 2008, 2009a, 2009b, 2009c, 2009d), Garcez (2002), Freire (2008) and Silva Neto (2007). For the discursive genre reading memories makes reference to the theme memory as well as is related to the context of teacher training, the study was supported in Aragão (1992) and Nóvoa`s (2007) theory. Situated in the area of Applied Linguistics, the research aligns with qualitative-interpretative approach of socio-historical basis. Finally, from the analysis of the corpus, data that emerged from the findings, we conclude by stating that readers have created images of themselves as active readers, readers interested in both readings, the ones respected and the ones unappreciated by the official culture

Jornalismo e narrativas transmidias: a reportagem no contexto da convergência

The transmedia storytelling is a phenomenom recently conceptualized theoretically (JENKINS, 2009), arising from ficcional mediatic products and disseminated as well by the use on other fields. This search aims to analyze how the transmedia storytellings can be applied to journalism on the basis of an specific genre, the reporting. To that, take as reference theoretical developments performed by brazilian authors (FECHINE et al., 2011, 2012, 2013), on the basis of televisive fiction, which culminated on concepts as transmediation and transmedia contents and deepened the comprehension and the research in this area. Thenceforth, this study propone a problematization and apropriation of this theoretic support for the journalism field, using, for that, a comprehension of journalistic production on a speech level, as well as its social practices (newsmaking). The empiric research also take two different paths. First, analyze a group of reportings, in which there is transmediation, in order to verifying the configuration of the transmedia phenomenom - more specifically of the transmedia storytelling - and its particularities to journalism. Then, develops an investigation, based on the etnographic method, of the productive routine on the special reporting section of the Jornal do Commercio (Recife/PE), aiming to investigate the conditions of transmediation in this range and the practices that favor and difficult the employment of transmedia storytelling. The result are, therefore, compared and related, with the goal of providing multidimensional view of the phenomenom

Formação de caudas maxwellianas no Contexto da rotação estelar

In this Thesis, we analyzed the formation of maxwellian tails of the distributions of the rotational velocity in the context of the out of equilibrium Boltzmann Gibbs statistical mechanics. We start from a unified model for the angular momentum loss rate which made possible the construction of a general theory for the rotational decay in the which, finally, through the compilation between standard Maxwellian and the relation of rotational decay, we defined the (_, _) Maxwellian distributions. The results reveal that the out of equilibrium Boltzmann Gibbs statistics supplies us results as good as the one of the Tsallis and Kaniadakis generalized statistics, besides allowing fittings controlled by physical properties extracted of the own theory of stellar rotation. In addition, our results point out that these generalized statistics converge to the one of Boltzmann Gibbs when we inserted, in your respective functions of distributions, a rotational velocity defined as a distribution

A coleção mossoroense e a construção dos mitos: Dix-Sept Rosado, o herói imolado

This research comprises a study on the values and ideals attributed to Dix-sept Rosado, by the Coleção Mossoroense journal. Local researchers demonstrate how the Coleção Mossoroense constructs an image of Mossoró, forming in the members of the city an identity with the place, a social cohesion or creating one forms to see and to say about the Mossoró city. The Coleção Mossoroense, through Vingt-un Rosado together with its family, established a form of seeing and identifying of the Mossoró s population with the city, just because it associated and it was, at the same time, a movement at the same time social (civic parties for example), political (the domination of the Rosado s family) and cultural (the books and theatrical parties about the city). The conjunction of the Coleção Mossoroense as and with a social movement, cultural and political was capable to establish a social identity, a subjective constituent . With this background, it was possible to make a study of the image attributed to Dix-sept Rosado, by the Coleção Mossoroense, through an analysis of the inherent discourse in the works by Bakhtin (1989) and Bourdieu (2000), of and on Dix-sept Rosado in the Coleção Mossoroense based on. The image of Dix-sept Rosado was constructed by the Coleção Mossoroense after its death, and the responsible for this was Vingt-un Rosado, which was the chief-editor of the Coleção Mossoroense up to 2006, year of its death. The Coleção Mossoroense built an image of Dix-sept Rosado as an enterprising man, progressive and innovator, of great capacity of leadership and oratory (a conductor of the crowds ), popular and charismatic, an honest and dynamic politician. This image made by the Coleção Mossoroense, although when enhancing in surplus the qualities of Dix-sept Rosado have as objective to transmit an image of a heroic personage, it has some relation with the reality. Dix-sept Rosado was a man identified with its locality. This can resemble a regional nationalism. The attitudes of Dix-sept Rosado must be understood inside of a broader social context, of a time marked by the populist politics. Qualities also appreciated and developed inside of a specific historical context and determined both national and locally. The Coleção Mossoroense enhances the qualities of Dix-sept Rosado so that the current politicians of the Rosado s family can establish a link of continuity in its contemporary political practice

Uma medida de calor específico sem calorímetro

Várias técnicas têm sido desenvolvidas para se obter o calor específico de sólidos e líquidos, incluindo a construção de experimentos de baixo custo para o ensino médio. Neste trabalho propomos uma maneira simples de se obter o calor específico de sólidos e líquidos. Por meio de curvas de calibração de resfriamento podemos estimar graficamente a perda de calor do sistema para sua vizinhança, e medir o calor específico do alumínio. Esta aproximação permite introduzir uma discussão sobre o processo dinâmico da troca de calor entre dos corpos.

O Serviço Ambulatorial Móvel de Urgência (SAMU) no contexto da reforma psiquiátrica: em análise a experiência de Aracaju/SE

This research investigated professional practices from Mobile Urgency Care Service (Serviço Ambulatorial Móvel de Urgência - SAMU) at psychiatric cases of the city of Aracaju/SE, Brazil and its possible articulations to psychosocial services network. The regulation no. 2048 of 11/05/2002 from Ministry Health establishes National Urgency Policy and designates that psychiatric cases are SAMU's responsibility. Then, it is necessary to propose an analyze of psychiatric urgency service under anti-asylums social movements standpoint, mainly because this service is responsive in assisting a person in crises. Fieldwork was developed in two phases. First one was made with SAMU workers and the information were produced by recorded semi-structured interviews. Results of this first phase indicate that urgency psychiatric conception from SAMU workers is based on aggressiveness concept; delays at psychiatric cases support and low training in mental health care which means several difficulties to emergency service. Although, we noticed that SAMU use asylum procedures at psychiatric cases like ropes and odder instruments to contain people. The second step of our research was to attend meetings to build a new psychiatric urgencies protocol for SAMU to define practices to auxiliaries, vehicular conductors and medical support regulation. Therefore, open interviews were accomplished with some participators and follows-up to psychiatric case on board of SAMU's cars. Afterwards we discussed how the urgency paradigm, that influence the protocol draw and as consequence distort what we believe is the essentially function of this device, that is to give care support to persons in crises and produce articulation to psychosocial services network

Comportamento sócio-espacial de pessoas em movimento :um estudo exploratório no calçadão da Avenida Engenheiro Roberto Freire

People-environment interaction, focus of Environmental Psychology studies, presupposes that space influences behavior and vice-versa. Despite of the importance of dynamic reciprocity, there are a few works that treat the mobility condition of the people experimenting space. The present study investigates environmental perception of users of the Engenheiro Roberto Freire Avenue sidewalk, one of the few places in Natal for physical activities practicing, where most people are in intense and continuous movement. A few questions for this study where made: In what way does the individual realize the environment while he is moving? How do reciprocal man-environment relations occur there, according to a mobility context? What are the main difficulties and easiness in man-environment interaction under this condition? The search for these answers is based on concepts of social-spatial human behavior - especially personal space, territoriality, density and crowding and contributions of Barker´s Ecologycal Psychology. Considering that the physical space in this case is multifaceted and the perception of theses scenarios is governed by multiples senses and stimuli, it was defined a multi-methodological route: (i) observation participative in loco; (ii) identification of the main behavior settings at the area; (iii) categorization of the activities occurring at the place; (iv) application of a semi-structured interview; (v) images registered and (vi) construction of the researcher s log. The perception of oneself and others in movement in the environment, immersed in a intricate web of inter-actions, makes people develop mobility strategies, many times unconsciously, with the aim of ensuring satisfaction in its activities. Since the Eng. Roberto Freire Avenue sidewalk is an equipment public-urban largely used by the population of Natal, the reflection of the mobility effectiveness in the users environmental perception is expected, providing suggestions for future studies in this field of knowledge

Um enfoque psicológico da educação ambiental no contexto da gestão: uma experiência de Fernando de Noronha

Currently, many companies pay attention to the necessities of change of attitude in relation to the use of the natural resources and the environment quality of its products, mainly to keep a positive and competitive image in the market. This new concept of management associates the productive activities to the care with environment using the education of environment as a tool of programs of qualification directed toward the promotion of pro-environment behaviors. For effectiveness of this management it is essential the attachment of the employees and the major understanding of the importance of the preservation of the environment. This was the objective of the qualification process carried out in a lodge in Fernando de Noronha island. The purpose of this study, therefore, was to verify the power of this management system which fulfills the objectives of the environmental education. It was applied questionnaires to employees of three Inns and carried out a interview, in one Inn, with the participants of the program of qualification. The analysis of the data showed that the actions as care with the environment are strongly associates to the management system, which includes garbage control, as well water economy. It was observed that the environment accomplishment (EcoAntro) of the employees with environment decreases in proportion to their qualification. In the same way, as higher the instruction level, of the speaker and/or of the father, less is the apathy for environmental questions. It was also noticed that the knowledge about the development sustainability was very poorly used by the interviewed. The pro-environment behavior mentioned before, is not necessarily related to a local autonomy posture that could express a behavior related to job but not to environment it self. Therefore, a complete understanding about the reverberation of environment information an all the placed factors in a life stile facing a construction of sustainability remains as a question to be studied in future researches

Entre a hegemonia e a polissemia: a Política de Educação e Desenvolvimento para o SUS no contexto do Brasil contemporâneo

The proposal of the Unified Health System Policy (SUS) has been considered one of the most democratic public policies in Brazil. In spite of this, its implementation in a context of social inequalities has demanded significant efforts. From a socio-constructionist perspective on social psychology, the study focused on the National Policy for Permanent Education in Health for the Unified Health System (SUS), launched by the Brazilian government in 2004, as an additional effort to improve practices and accomplish the effective implementation of the principles and guidelines of the Policy. Considering the process of permanent interdependencies between these propositions and the socio-political and cultural context, the study aimed to identify the discursive constructions articulated in the National Policy for Permanent Education in Health for the Unified Health System (SUS) and how they fit into the existing power relations of ongoing Brazilian socio-political context. Subject positionings and action orientation offered to different social actors by these discursive constructions and the kind of practices allowed were also explored, as well as the implementation of the proposal in Rio Grande do Norte state and how this process was perceived by the people involved. The information produced by documental analyses, participant observation and interviews was analyzed as proposed by Institutional Ethnography. It evidenced the inter-relations between the practices of different social actors, the conditions available for those practices and the interests and power relations involved. Discontinuities on public policies in Brazil and the tendency to prioritize institutional and personal interests, in detriment of collective processes of social transformation, were some of obstacles highlighted by participants. The hegemony of the medical model and the individualistic and curative intervention practices that the model elicits were also emphasized as one of the drawbacks of the ongoing system. Facing these challenges, reflexivity and dialogism appear as strategies for a transformative action, making possible the denaturalization of ongoing practices, as well as the values and tenets supporting them

O Serviço Residencial Terapêutico: cartografias de um híbrido no contexto da desinstitucionalização em saúde mental

This thesis seeks to uphold the idea that the therapeutic residential service, as hybrid device and recent process of deinstitutionalization in mental health, works as a problem producer while it also indicates challenges and potentialities in this process, the attention on mental health and on its own care production. To that end, we work with the prospect map with which we approach reality as the subjectivities production field which transformations and intensities are the major thought propellants. From this perspective, it was possible to produce three "purpose maps" from meetings with actors and groups involved with the TRS and the theoretical study carried out. On the first map we mapped the conditions of possibility of this device and its design in the midst of the process of institutionalization and health policies. We indicate on it the TRS configuration as a hybrid and we hassled its proposition as a means of "social rehabilitation" that can work as a social homogeneity mechanism. On a second map, we cartographied mental captures through images and ways historically built from madness presented in the biopolitical contemporary game and we indicated that the resistance to such catches should be built on a politic daily basis as important vectors of the institutionalization process in mental health. Finally, on a third map we mapped the carefulness produced in the TRS, by analyzing the transition psychiatric hospital - TRS and the caregivers´ team work. On this mapping, the care, for the weakness in the coresponsibility field, is reveled crossed by mental, disciplinary and normality elements, but it is also built in resistance born from links in the intersubjective field of the caring work. We conclude, then, that the TRS power and the deinstitutionalization process itself were in building and strengthening affective labor micro political networks of life and liberty producers