Acidentes de Trabalho : análise em profissionais de enfermagem que atuam nas unidades de terapia intensiva e urgência Natal/RN

It is a descriptive-exploratory research, with a quantitative approach, aiming to characterize typical occupational accident suffered by the professionals from nursery group, in the Intensive Care Units and Emergency in a hospital in Natal-RN, trying to identify the factors that contribute to those accidents; to identify some information taken by those professionals related to the accident risks; to know the procedures taken after each accident. This sample is composed by 176 professionals that are 44 nurses and 132 nursing technicians/auxiliaries, collected from March to April 2010. The results related to the personal characterization of the nursery group showed that 31 (18.61%) are between the 36-40 years of age; 148 (84.09%) females and 96 (55.68%) had finished High School. Related to the professional characterization, 53 (30.11%) are nurses, and 123 (69.88%) nursing technicians and auxiliaries; 44 (25.00%) are working as nurses, and 132 (75.00%) as nursing technicians and auxiliaries; 45 (25.56%) are working in the nursery area between 15 to 20 years and 11 months; 53 (30.11%) are in this institution between 10 to 14 years and 11 months; 79 (44.88%) work in the ICU; 55 (31.25%) are working in this area from 1 to 4 years and 11 months; 110 (62.50%) like to work in this area; 161 (91.47%) work 30 to 40 hours per week; 90 (51,13%) have another employment. Related to knowledge about typical occupational accident, 167 (94.88%) said they know about it; 96 (54.54%) know the accident rules; 103 (58.52%) think it is important to talk about this subject in the nursery courses; 92 (52.27%) said this subject is important to be discussed in the work and 372 (87.73%) think education is necessary to reduce accident. Related to the data about accidents, 104 (59.09%) have suffered typical occupational accident, among them 69 (39.20%) have suffered it once; 47 (36.19%) did not register any accident; 60 (57.69%) were caring some patient during the accident; 47 (45.19%) of them occurred in the ICU; 50 (48.07%) professionals were working during the night period; 69 (66.34%) have suffered perforation; 86 (82.69%) had upper limbs affected; 64 (61.53%) were affected by needle; about the reason of the accident, 89 (60.54%) said it occurred due to carelessness. Related to the accident evolution, 88 (85.57%) did not need to remain off work after accident; 13 (81.25%) remained off work during 15 days; 87 (83.65%) had no sequelae and for 101 (97.11%) it was not necessary rehabilitation. We conclude that typical occupational accident can occur with young workers who admit a knowledge about the subject, however they do almost nothing to prevent it. We believe this research has contributed to the characterization of this kind of accident suffered by the nursery group of a public hospital in Natal, and it can stimulate the creation and reformulation of personal protection against typical occupational accident suffered by nursery professionals

Carga de trabalho de enfermagem e infecções relacionadas à assistência à saúde na unidade de terapia intensiva

In recent decades, the search for quality care has been widely discussed by the institutions and health professionals. In this context, it is the nurse coordinator of the process of providing nursing staff, reflecting the commitment to quality of care. In this process, it is the appearance of Infections Related to health care and its potential association with the workload in nursing as a valuable indicator of quality of care. Thus, this research contributes to studies to characterize the demand of nursing work to promote a safe healthcare practice. This study aimed to identify the association of nursing workload with the number of cases of Ventilator-Associated Pneumonia, urinary tract infection and central venous catheter infection in the intensive care unit. This is a quantitative research approach, descriptive, cross-sectional and prospective, held at Unimed Hospital in Natal-RN. The study population consisted of all patients treated in the Intensive Care Unit, Hospital for a period of 90 consecutive days in 2011. The convenience sample was compostapelos patients admitted to the ICU during the period of data collection, a total sample of 286 patients. To perform the data analysis software were used: Statistica 6.0, SPPS (Statistical Package for Social Sciences) version 17.0 (2004) and Excel 2007. In the descriptive analysis, we used Measures of Central Tendency and Measures of Dispersion or Variability and the use of nonparametric tests. Of the 286 patients, 88 were from the ICU and 198 ICU II II. Males predominated in the ICU I (51.1%) and female ICU II (57.6%) patients in the ICU I were aged 61-80 years (39.8%) followed by greater than 80 years (39.8%). In the ICU II, most of the patients were aged 61-80 years (38.9%) and then from 41 to 60 years (24.2%). In relation to the class of TISS inlet predominant class II in the two ICUs (59.1%), followed by Class III also in the two units (34.6%). Most patients (70.6%) out of the ICUs belonging to class II TISS. In the ICU I, the average number of forms of the TISS 28 was 6, has in ICU II this value drops to 3.2 forms. The overall mean was 19.9 TISS points in ICU patients I and ICU II.the 17 points in the average hours required to provide adequate nursing care to patients in the ICU I found that is 10 , 7 hours, and the ICU II 9.2 hours. It was found that the time provided by the nursing staff were higher in ICU II, with an average of 19 hours available for nurses in this sector. In the ICU I, which showed higher need of available hours, it was found that the mean value of 12.7 available hours. It was found that only 2.4% of patients had these units Ventilator-Associated Pneumonia, 1.0% were infected central venous catheter and 1.4% of patients had urinary tract infection. Infection associated with health care occurs, on average, on the tenth day of hospitalization. In the ICU II, this average value extends to the twelfth day with an excess of 2.7 hours of nursing care while in ICU I value decays to the ninth day of hospitalization with a deficiency of 12-hour assistance. It is concluded that patients generally showed a need for classification of semi-intensive care and has been assisted in their need to load. As for his association with the Related Infections Health will assist this analysis could not be performed due to the small number of notifications in this period. It is suggested further study how other factors related to infections me a longer period of analysis

Ensino do processo de enfermagem: visão dos discentes de graduação de Natal/RN

The nursing process (NP) it s the systematized way of offering humanized care with the objective of reaching the expected results. The concern of the health and education institutions of elaborating implementation strategies of it is growing. The objective of this research was to know the vision of the senior students of the nursing graduation courses from Natal/RN, about the teaching of the NP. It s about a descriptive and exploratory study of the qualitative and quantitative type, done in five teaching institutions of the undergraduate nursing course of the municipality of Natal- RN in 2011. The research was composed by 48 students of the last 2 years of the nursing course. The gathering of the data was done through an online survey with open and closed questions via SurveyMonkey. For the quantitative data it was used the descriptive statistics from Microsoft Office Excel and for the qualitative data the Content Analysis of Bardin. The results pointed a predominance of female students (81,25%) with an age between 21- 39 years old (75,00%) and in the last year of the course (62,50%). As the opinion of the students about the NP two categories emerged: 1) Nursing Process as grounded method in scientific knowledge and established in two stages; 2) Nursing Assistance Quality, with two subcategories: Nursing Process as Nursing Practice and Nursing Process as instrument of improvement of the aid quality and promotion of well-being. In relation to the tuition of the NP the students (45,83%) said that the knowledge on the subject of the instructor was good; 81,25% reported that the professors use a traditional teaching methodology with the problem solving components and 45,83% answered that is addressed in specific disciplines in an isolated way starting from the professional line. The phase of NP that the nursing students have more difficulties of learning and implementing, being mentioned 22 times (29,70%). In relation to the student s difficulties, in the fields of supervised internships, in applying the NP it was stated for 83,50% that the barriers were related to the non implementation of the practice, overwork and the lack of trust of the nurse in the NP. The teaching-care strategies described as the internship fields were: the training of nurses to be able to contribute with the University in the implementation of the service and teaching; and the need of the universities to focus, continuously throughout the course, the NP with the involvement and incentive of the instructors in this process. These results show that the NP for the nursing students is a work methodology of the profession that needs to be implemented effectively in the practical reality for its teaching to turn effective and for the future professionals to be able to bring real contributions in the achievement of systematized actions trying to improve the assistance quality and the nursing actions. It is expected that this study could help bringing some strategies to facilitate the merging between theory and practice in teaching the NP and stimulate a discussion about the topic at the Nursing Schools where the research was held together with the coordinators, instructors and students

Uma perspectiva de extensão do modelo de aceitação de tecnologia para explicar o uso de linguagens de desenvolvimento WEB: pesquisa com desenvolvedores Pyton e Java

The spread of the Web boosted the dissemination of Information Systems (IS) based on the Web. In order to support the implementation of these systems, several technologies came up or evolved with this purpose, namely the programming languages. The Technology Acceptance Model TAM (Davis, 1986) was conceived aiming to evaluate the acceptance/use of information technologies by their users. A lot of studies and many applications have used the TAM, however, in the literature it was not found a mention of the use of such model related to the use of programming languages. This study aims to investigate which factors influence the use of programming languages on the development of Web systems by their developers, applying an extension of the TAM, proposed in this work. To do so, a research was done with Web developers in two Yahoo groups: java-br and python-brasil, where 26 Java questionnaires and 39 Python questionnaires were fully answered. The questionnaire had general questions and questions which measured intrinsic and extrinsic factors of the programming languages, the perceived usefulness, the perceived ease of use, the attitude toward the using and the programming language use. Most of the respondents were men, graduate, between 20 and 30 years old, working in the southeast and south regions. The research was descriptive in the sense of its objectives. Statistical tools, descriptive statistics, main components and linear regression analysis were used for the data analysis. The foremost research results were: Java and Python have machine independence, extensibility, generality and reliability; Java and Python are more used by corporations and international organizations than supported by the government or educational institutions; there are more Java programmers than Python programmers; the perceived usefulness is influenced by the perceived ease of use; the generality and the extensibility are intrinsic factors of programming languages which influence the perceived ease of use; the perceived ease of use influences the attitude toward the using of the programming language

Progresso científico em pequenos ruminantes na primeira década do século XXI

O interesse pelos pequenos ruminantes aumentou nos últimos anos sob os aspectos produtivo e científico. No Brasil, caprinos e ovinos são os que despertam maior interesse econômico. Assim, este trabalho foi conduzido com o objetivo de discutir o progresso científico com caprinos e ovinos nos últimos dez anos. Foram pesquisadas várias bases de dados, entre elas as do Institute for Scientific Information (ISI), da Scientific Electronic Library Online - SciELO, da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES, do Instituto Brasileiro de Geografia e Estatística - IBGE e da Food and Agriculture Organization of the United Nations - FAO. Na última década, os pequenos ruminantes têm merecido especial atenção dos pesquisadores, o que pode ser comprovado pelo aumento de 41% nas publicações mundiais envolvendo estas espécies, o que foi acompanhado por aumento ainda mais expressivo, 219%, em âmbito nacional. A evolução também foi observada sob os aspectos metodológicos dos projetos, ressaltando a abordagem multidisciplinar nas pesquisas mais atuais. Nos últimos dez anos, houve crescimento do aporte de recursos para editais temáticos demandados pela sociedade e pela cadeia da carne e do leite, além da preocupação com qualidade, competitividade e sustentabilidade.

Fatores inibidores do uso de técnicas ambientais nos postos de combustíveis: um estudo de caso em Natal/RN

The objective of this work was to investigate the factors that inhibit the use of Environmental Techniques in the Gas Station of the city of Natal/RN. For this, a survey with the aid of a questionnaire was used like research instrument. It s used a sample for convenience, not probabilistic. For collection of the data, it was used directly application of the questionnaire to the Managers or Assistant managers of the gas station, in accordance with its availability or presence. The data was collected in all the regions of Natal (North, South, East and West). The population in accordance with the data of the ANP of September 2005 is of 111 ranks and the collected sample was of 86. To carry through the analysis of the data of this research had been used softwares Excel and Statistic version 5.0, for Windows. The analysis of data is divided in two parts; descriptive analysis and analysis of groupings (clusters). The results showed that bigger part of the interviewed ones has between 30 and 39 years of age; they have second grade completed; they had declared to have little between and reasonable knowledge how much to the use of Clean Technology (CT) in gas station; and a small part of the interviewed ones had informed to have much knowledge how much the resolutions of the CONAMA established for the Gas Station. Of the searched ranks, the majority is national(76.7%); the most accurate practice environmental used in the gas station are: it collects selective of oil used or contaminated and ecological tanks - coated with strengthened fibre glass; great part of the interviewed ones (33.8%) informed that never the TL makes planning of referring future action; about of the half of the interviewed ones (84.9%) they had more declared that its employees have of none to a reasonable level of training for deal with problems that compromise the environment; the majority of the ranks (72.1%) functions has for more then six years. It is observed that almost all the interviewed ones (96.5%) evaluate as being important or very important the implantation of CT in Gas Station and the great majority (82.1%) evaluates the difficulty in if implanting these technologies in Gas Station as being easy or very easy. In the analysis of cluster, it was verified existence of two groupings (as much in the variable of the barriers and benefits), being that inside of each clusters exists homogeneity and between clusters exists heterogeneity. In reality, everything is important or very important in the opinion of the interviewed ones. There only exists a small significant difference that separates them in clusters

Produção de enzimas por fungos em fermentação semi-sólida utilizando bagaço de coco e pedúnculo de caju como substratos

The production of enzymes by microorganisms using organic residues is important and it can be associated with several applications such as food and chemical industries and so on. The objective of this work is the production of CMCase, Xylanase, Avicelase and FPase enzymes by solid state fermentation (SSF) using as substrates: bagasse of coconut and dried cashew stem. The microorganisms employed are Penicillium chrysogenum and an isolated fungus from the coconut bark (Aspergillus fumigatus). Through the factorial design methodology and response surface analysis it was possible to study the influence of the humidity and pH. For Penicillium chrysogenum and the isolated fungus, the coconut bagasse was used as culture medium. In another fermentation, it was used the mixture of coconut bagasse and cashew stem. Fermentations were conducted using only the coconut bagasse as substrate in cultures with Penicillium chrysogenum fungus and the isolated one. A mixture with 50% of coconut and 50% of cashew stem was employed only for Penicillium chrysogenum fungus, the cultivation conditions were: 120 hours at 30 °C in BOD, changing humidity and pH values. In order to check the influence of the variables: humidity and pH, a 2 2 factorial experimental design was developed, and then two factors with two levels for each factor and three repetitions at the central point. The levels of the independent variables used in ascending order (-1, 0, +1), to humidity, 66%, 70.5% and 75% and pH 3, 5 and 7, respectively. The software STATISTICA TM (version 7.0, StatSoft, Inc.) was used to calculate the main effects of the variables and their interactions. The response surface methodology was used to optimize the conditions of the SSF. A chemical and a physic-chemical characterization of the coconut bagasse have determined the composition of cellulose (%) = 39.09; Hemicellulose (%) = 23.80, Total Lignin (%) = 36.22 and Pectin (%) = 1.64. To the characterization of cashew stem, the values were cellulose (g) = 15.91 Hemicellulose (%) = 16.77, Total Lignin (%) = 30.04 and Pectin (%) = 15.24. The results indicate the potential of the materials as substrate for semisolid fermentation enzyme production. The two microorganisms used are presented as good producers of cellulases. The results showed the potential of the fungus in the production of CMCase enzyme, with a maximum of 0.282 UI/mL and the Avicelase enzyme the maximum value ranged from 0.018 to 0.020 UI/ mL, using only coconut bagasse as substrate. The Penicillium chrysogenum fungus has showed the best results for CMCase = 0.294 UI/mL, FPase = 0.058 UI/mL, Avicelase = 0.010 UI/mL and Xylanase = 0.644 UI/ mL enzyme, using coconut bagasse and cashew stem as substrates. The Penicllium chrysogenum fungus showed enzymatic activities using only the coconut as substrate for CMCase = 0.233 UI/mL, FPase = 0.031 to 0.032 UI/ mL, Avicelase = 0.018 to 0.020 UI/mL and Xylanase = 0.735 UI/ mL. Thus, it can be concluded that the used organisms and substrates have offered potential for enzyme production processes in a semi-solid cultivation

Aerofotos convencionais e imagens orbitais TM/LANDSAT no mapeamento morfopedológico em Santa Bárbara D'Oeste (SP)

Foram estudados, com o auxílio de fotografias aéreas, aspectos qualitativos e quantitativos do relevo e da rede de drenagem de solos de uma área de Santa Bárbara D'Oeste, SP. Esta região compreende 14.625 ha, onde foram selecionadas bacias hidrográficas de 3ª ordem de ramificação e amostras circulares de 5km². As unidades de mapeamento simples ou associações de solos são: Latossolo Vermelho Escuro, Podzólico, Litossolo + Podzólico, Terra Roxa Estruturada + Latossolo Roxo distrófico. Após a caracterização das feições fisiográficas, da área de ocorrência desses solos, foram realizados dois mapas morfopedológicos. No primeiro utilizou-se fotografias aéreas verticais pancromáticas na escala 1: 35.000 (data de 25/6/78) e no segundo imagens orbitais do sensor Thematic Mapper do LANDSAT-5, nas bandas 3, 4 e 5 e composição colorida 3/4/5 na escala 1: 100.000 (data de 12/9/91). As análises qualitativas e quantitativas do relevo (índice de declividade média) e rede de drenagem (densidade de drenagem, freqüência de rios, razão de textura) mostraram-se eficientes na diferenciação das unidades de solo estudadas, tanto em bacias hidrográficas como em amostras circulares. A utilização de fotografias aéreas, permitiu maior riqueza de detalhes na precisão dos limites das unidades de mapeamento e no maior número de unidades de mapeamento discriminadas em relação as imagens orbitais. A composição colorida 3/4/5 permitiu diferenciar os Latossolos argilosos dos Latossolos de textura média, assim como o Latossolo Húmico.

Radon surveys in Brazil using CR-39

In this work results of two radon daughters survey in Brazil are presented and discussed. Some methodological problems concerning the first survey are pointed out which were corrected for the second survey in order to make a realistic long-term measurement of radon decay products in the air. The technique employed in both surveys was the alpha-spectroscopy using CR-39. The reliability of this technique as well as the results of the second survey are discussed, which indicate a poor correlation between radon and its decay products in the air at the researched dwellings. (c) 2005 Elsevier Ltd. All rights reserved.

Comportamento da produção de espécies reativas de oxigênio em miocárdio de ratos submetidos a treinamento de baixa intensidade em diferentes temperaturas

INTRODUÇÃO: A prática de exercício físico proporciona aumento da produção de espécies reativas de oxigênio (ERO) resultantes do metabolismo aeróbio e, gera uma quantidade significativa de calor, em conseqüência da produção de energia, resultando em sobrecarga orgânica. A associação entre ERO e exercício, e entre exercício e variações da temperatura ambiente têm sido estudadas, contudo, há escassez de informações que considere a associação entre produção de radicais livres no miocárdio e atividade física em temperatura elevada. OBJETIVO: Comparar a produção de ERO em miocárdio de ratos submetidos ao treinamento de baixa intensidade em diferentes temperaturas. MÉTODOS: Foram utilizados 20 ratos Wistar, machos, jovens, peso (250 a 280g), divididos em quatro grupos: G1 (n = 5) expostos ao treinamento e calor (39º ± 1C); G2 (n = 5) expostos somente ao calor durante o mesmo período de G1, sem treinamento; G3 (n = 5) expostos ao treinamento em temperatura ambiente (22º ± 1C); G4 (n = 5) expostos à temperatura ambiente sem treinamento. O treinamento foi realizado em esteira rolante climatizada por cinco semanas, evoluindo 5 minutos a cada duas sessões finalizando em 60 minutos em baixa intensidade 8m/min. O ambiente foi controlado entre 39 ± 1ºC e 22 ± 1ºC e entre 40 e 60 % de umidade relativa. A lipoperoxidação foi avaliada por Quimiluminescência (QL). A análise dos dados foi realizada a partir do teste Two Way ANOVA para análise da QL e t de student para a Capacidade Antioxidante Total (TRAP). RESULTADOS: A análise da QL revelou uma curva de emissão de luz significantemente mais baixa para o grupo exposto ao exercício em normotermia comparado aos sedentários mantidos no calor. A análise da TRAP mostrou diminuição em todos os grupos experimentais em relação ao G4. CONCLUSÃO: Concluiu-se que houve níveis menores de produção de ERO nos grupos submetidos somente ao calor ou somente ao exercício.

Desempenho muscular e equilíbriu postural em idosas frágeis residentes na comunidade

Human aging is physiological process causes alterations in several systems of the organism. In the musculoskeletal system, a main change is the decreased muscle strength, that in the lower extremity, compromises the ability to respond quickly with enough strength to prevent falls, causing alterations in postural balance. Currently, many researchers have study the human frailty, defined as a multifactorial syndrome, with excess of vulnerability to stressors, reducing ability in maintaining or regulating homeostasis. Its characteristics are directly related to physical function. Aim: To analyze muscle performance and postural balance in frail and pre-frail elderly women, and to compare them according with the frailty phenotypes criteria proposed by Fried 2001. Method: 39 frail elderly women living in the community, aged 65 years and older, were assessed muscle performance of lower extremity using isokinetic dynamometer and postural balance using Berg s balance scale and computerized baropodometry. Results: There was significant difference in plantar flexor, knee flexor and knee extensor strength, in anteroposterior (AP) oscillation with eyes open and on Berg s scores between groups. A weak correlation was observed between strength and balance. Conclusion: The results suggest that the frail elderly present worse muscle performance in lower extremity and worse postural balance compared to the pre-frail elderly. There were correlations between muscle performance and balance impairments in these elderly, but several variables are also involved in maintaining postural balance

Efeito imediato da estimulação elétrica neuromuscular seletiva do músculo VMO em pacientes com síndrome da dor femoropatelar

Patellofemoral pain syndrome (PFPS) is described as anterior or retropatellar pain knee in the absence of other pathologies and is frequently associated with dysfunction of the vastus medialis oblique (VMO). However, several studies have demonstrated the inability to selectively activate this muscle through exercise. To evaluate the effect of Neuromuscular Electrical Stimulation (NMES) selective VMO in women with syndrome. We evaluated thirty-eight women: twenty in the control group (24.15 ± 2.60 years) and eighteen diagnosed with PFPS (25.56 ± 3.55 years). Both groups were evaluated before and after a protocol of electro stimulation. To measure for comparing groups before and after treatment, we assessed the extensor torque concentric and eccentric knee through an isokinetic dynamometer, the intensity (Root Mean Square - RMS) and the onset of activation (onset) of VMO compared to the vastus lateralis (VL) in two types of exercise: open and closed kinetic chain. . Statistical analysis was performed using SPSS 15.0, with a significance level of 5%. Results: Our data showed an increase in the intensity of activation (RMS) of the VMO muscle after NMES in both study groups. During concentric contraction the RMS of the VMO before the NMES was 105.69 ± 32.26 μV and after a single intervention was 122.10 ± 39.62 μV (p = 0.048) for the control group. In the group with PPS, we found a similar behavior, with RMS of the VMO before NMES of 96.25 ± 18.83 μV and 139.80 ± 65.88 μV after the intervention (p = 0.0001). However, there was no evidence in the RMS value of VL muscle. The onset was calculated by subtracting the onset of VL by the onset of VMO. For the group with PFPS, the onset before the intervention was -0.007 ± 0.14 ms, indicating a delay of the VMO relative to VL, and after NMES was 0.074 ± 0.09 ms (p = 0.016), showing an activation previous VMO to VL. The same occurred for the control group. We also observed that NMES increased knee extensor power during the concentric contraction in both groups. Before the intervention the mean power was 28.97 ± 9.01 W for the PPS group and after NMES was 34.38 ± 7.61 W (p = 0.0001). Conclusion: We observed an increase in electromyographic activity of the VMO and also an anticipatory effect of this muscle

Atividades preventivas realizadas pelos cirurgiões-dentistas do PSF de Natal-RN

Family Health Program (FHP) presents itself as a restructured model on basic cares besides having prevention practices and promotion in health as essential parts. According to that, the purpose of this study is to perceive which prevention practices in oral health are accomplished by the dentists from the FHP of Natal-RN as well as the way they have been developed, the knowledge basis to execute the procedure and the use of evaluation instruments by the dentists and by the Oral Health Co-Ordinator. A list of dentists participating on the FHP of Natal in March, 2006 (n= 91) was obtained so it was possible to formulate a structured interview. After excluding those with less than six months attending to the program, and considering the loss, eighty dentists got to be interviewed. It had questions about individual and group preventive procedures, sources of basement to develop the activities and to verify the impact and evaluation instruments. Besides that, an interview was made with the Oral Health Co-Ordinator about the evaluating process and the existence of a protocol as well as about document analysis in the Ambulatory Informations System Unique Health System (AIS-UHS), Information of Basic Care System and Pact of Recorder. The main individual activities consist on Oral Hygiene Orientation (87,5%) and Fluoridization (95%). Group activities remain at scholar groups acts(91,25%) being fluoridization done by 91,25% and educative activities by 86,25% mainly through speeches (61,25%).Orientations about oral cancer were detached on the aged group (39,96%)and hypertensive and diabetic group (19,51%), as well as integration with the health team was respectively 21,93% and 39,02%. Speeches and talk rounds are the main activities for aged, hypertensive and diabetics, and are also expressive to pregnant women. For pregnant women and babies group predominate hygiene and diet orientation. About the evaluation instruments 73,75% of the dentists do not consider their existence, despite 73,75% consider that actions have impact specially due to a increase of hygiene and decrease of caries index on the children. The main sources of basement are clinical experience (42,5%) and preparative courses (33,75%), only 7,5% mentioned population need and local reality. The Oral Health Co-Ordinator related the Attention Pact Recorder and records from the AIS - UHS as evaluation source but also detached the lack of epidemiologic surveying. She mentioned the increase of supervised brushing as a positive result and detached the hardness of the professional to act inside the family and as a team. The AIS-UHS records showed that fluoridization is more used individually and the supervised brushing is predominant as a group action, besides that educative activities at the Health Establishment predominate due to actions at the community. Facing the results, it was verified the act in different groups, special attention given to scholars, as well as focus the activities on caries giving less emphasis to other oral problems. Despite that, there was no epidemiologic instruments or data of the local reality to guide the actions and to be part of the planning and evaluation process

Atenção precoce do câncer de mama :um olhar sobre o cotidiano institucional de uma unidade de saúde de Natal

Breast cancer has been considered a grave global public health problem due to its increase in incidence, in women s mortality and in the amount of financial resources spent on the therapeutic interventions used in the treatment of this neoplasia. However, this scenario presents some variations. In developing countries, the incidence of breast cancer is increasing but, on the other hand, the mortality is declining among patients because of public health actions toward early diagnostic that also result in cure of patients and decreasing levels of physical and psychosocial stress. In Brazil, we face of both the increasing number of breast cancer incidence and number of mortalities. Almost always the reason for that is a delayed detection that will provide a late diagnostic. The early detection of breast cancer has been studied in several researches. Some of them are concerned with women s experiences. Despite that, there is a lack of researches on dynamic comprehension of early attention to breast cancer from the health professionals points of view. The present research was carried out at the Unidade Mista de Felipe Camarão (UMFC) and it was conducted with 11 professionals who work in the Family Health Program (PSF). The aim was to understand how early diagnostic and attention to breast cancer is being planned, discussed and accomplished by health professionals in their day-to-day actions. Semi-structure interviews were held individually with each professional, in a way that they could feel free to express their ideas about several issues. All the information from these interviews was analyzed and discussed using an Institutional Ethnographic approach. It was observed that the actions of health professionals working with early detection of breast cancer does not take place in a vacuum; they occur within institutional, relational and social ways. This interdependence influences their actions and points of view on the theme