Avaliação da assistência à saúde dos portadores de úlceras venosas atendidos no programa saúde da família do município de Natal/RN

Descriptive research aimed at evaluating the assistance offered to patients with venous ulcers, on lower limbs, attended by the Family Health Program (FHP) team, from the municipality of Natal/RN. The target population was composed of 74 patients with venous ulcers (VU), attended by the FHP teams in the 31 FHUs. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (protocol n.55/05). The data collection was performed in patients homes and in the FHUs, through structured interviews and physical examinations of patients with VU and non-participant observation during the changing of wound dressings in these Units and in users homes. The data was organized into an Excel electronic table and transported into the SPSS 14.0 program, for descriptive analysis on 2x2 contingency tables and inferential (Qui-Square χ2, Spearman Correlation, Binomial Proportion Test and p-value <0.05). The prevalence of VU (0.36/1000) in the target population (over 20 years of age) was greater than in the population registered in FHP (0.25/1000). We detected a greater prevalence in the age area of over 60 years (2.22/1000), with 2.98/1000 for females and 1.3/1000 for males (p-value=0.008). The sociodemographical and health characteristics of patients with VU revealed predominance of females (74.5%), elders over 60 years of age (67.6%), with fundamental education (74.3%), family earnings of up to 2 minimum wages (68.9%), retired (90.5%), ortostatic position (23.0%), inadequate sleep (59,9%), presence of CVI (100.0%), hypertension (44.6%) and diabetes (25.7%). As for the time of existence of the VU, 64.9% had over 1 year, and 35.1% less than 1 year), with predominance of one wound (67.6%). The changing of wound dressings is performed mostly at home, in and inadequate way, especially with incorrect cleaning techniques, likewise incorrect use of products and substances, and reduced participation of the FHP team on the evaluation and application of the dressing and choosing of products and substances. The compressive therapy is not part of therapeutic conducts for treatment in the FHUs. As for the evaluation of assistance to patients with VU, 90.5% were inadequate and only 9.5% adequate. The main inadequacy factors were the absence of: diagnosis (47.3%), consultation with and angiologist (63.5%), compressive treatment (100.0%), adequate optical therapy (98.62%), adequate dressing kit (70.3%), training for the changing of dressings (67.6%), following by the FHP team (51.4%) and performed exams (55.4%). We ve concluded that patients with VU mostly present now socioeconomical level and associated chronic diseases. Considering that assistance offered by FHP is non-systematic, fragmented, with no diagnosis planning, continual evaluation and evolution, we qualify the assistance as inadequate and with low level of solution, directly interfering on the maintenance of the VUs chronic state

Assistência de ar e volumes de aplicação na deposição de calda e no controle do arroz vermelho (Oryza sativa L.)

O trabalho teve como objetivo avaliar o efeito da assistência de ar junto à barra pulverizadora e de três volumes de pulverização na dessecação e deposição da calda em arroz vermelho, sob cultivo de nabo forrageiro, em áreas de recuperação de várzeas, utilizando o herbicida paraquat e o corante Azul Brilhante, respectivamente. Os volumes de pulverização foram 100; 200 e 300 L ha-1 da solução aquosa, contendo corante alimentício (1.500 mg L-1). Com ou sem a assistência de ar junto à barra, foram utilizadas pontas de pulverização de jato plano tipo AXI 110015 à pressão de 117,3 kPa, AXI 11002 e AXI 11003 a 276 kPa. A avaliação da deposição da pulverização deu-se em folhas de plantas de arroz vermelho. Os maiores volumes (200 e 300 L ha-1) pulverizados com a assistência de ar junto à barra pulverizadora proporcionaram maiores depósitos do corante em relação ao volume de 100 L ha-1. Não foram constatadas diferenças na deposição do corante para os volumes pulverizados, sem a assistência de ar junto à barra, tampouco entre os volumes de 200 e 300 L ha-1 com a assistência de ar junto à barra. As maiores percentagens de controle do arroz vermelho foram obtidas com a assistência de ar junto à barra, independentemente do volume pulverizado, equivalendo-se ao controle obtido com 300 L ha-1, sem o uso dessa tecnologia.

Adjuvantes e assistência de ar em pulverizador de barras sobre a deposição da calda e controle de Phakopsora pachyrhizi (Sydow & Sydow)

Com o intuito de melhorar a cobertura da pulverização e diminuir as perdas na produtividade da cultura da soja, o estudo objetivou avaliar o efeito da adição de adjuvantes à calda combinado ou não ao uso da assistência de ar sobre a deposição da pulverização, controle de Phakopsora pachyrhizi H. Sydow & P. Sydow, perdas de produção (peso de 1000 grãos) e produtividade da cultura (kg ha-1). Dois experimentos a campo foram conduzidos na cultura da soja, variedade Conquista, safra agrícola 2008/09. Um deles no delineamento em blocos ao acaso com três doses de adjuvantes associados a um marcador cúprico combinadas a dois níveis de ar na barra de pulverização (0 e 29 km h-1), totalizando 6 tratamentos e 4 repetições. Outro experimento foi instalado no mesmo local do anterior. O delineamento experimental utilizado foi o de blocos ao acaso com 7 tratamentos: fungicida e dois adjuvantes associados ao fungicida, combinados a dois níveis de ar na barra de pulverização (0 e 29 km h-1), mais testemunha, e 4 repetições. Após a pulverização do fungicida piraclostrobina + epoxiconazole com diferentes tecnologias, procedeu-se a avaliação da severidade da doença através da estimativa da área abaixo da curva de progresso da doença (AACPD) e da produtividade da cultura da soja. A assistência de ar na velocidade máxima gerada pelo ventilador (29 km h-1), combinada ao fungicida piraclostrobina + epoxiconazole mais o adjuvante organosiliconado Silwet L-77 contribuiu para melhor controle da ferrugem asiática, proporcionando incremento na produtividade e no peso de 1000 grãos.

Deposição e perdas da calda em feijoeiro em aplicação com assistência de ar na barra pulverizadora

Com o objetivo de avaliar a influência da assistência de ar na deposição da calda de pulverização, em plantas de feijoeiro (Phaseolus vulgaris) aos 26 dias após a emergência (DAE), com pontas de pulverização de jato cônico vazio (JA-0,5 e JA-1) e jato plano (AXI-110015), e volumes de calda, foi realizado um experimento em delineamento inteiramente casualizado, utilizando como traçador o íon cobre. Alvos coletores (papel de filtro com 3 x 3 cm) foram afixados nas superfícies adaxial e abaxial de folíolos posicionados nas partes superior e inferior das plantas. Para aplicar a solução traçadora, utilizou-se pulverizador com barras de 14 metros, com e sem assistência de ar, volumes de 60 e 100 L.ha-1, e velocidade do ar correspondente a 50% da rotação máxima do ventilador. Após a aplicação, os coletores foram lavados individualmente em solução extratora de ácido nítrico a 1,0 mol.L-1, e a quantificação dos depósitos através de espectrofotometria. A assistência de ar não influenciou na deposição da calda tanto a 60 quanto a 100 L.ha-1. O maior volume proporcionou maiores depósitos, sendo constatadas elevadas perdas para o solo (mais de 60%).

Assistência de ar em barra de pulverização no controle da ferrugem asiática da soja

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Dessecação da aveia-preta (Avena strigosa Schreb) com herbicida de contato, em presença ou não de assistência de ar junto à barra do pulverizador, em diferentes volumes de calda

A tecnologia de aplicação dos produtos fitossanitários na agricultura pode ser aprimorada mediante a redução dos desperdícios. Com o objetivo de contribuir com tal avanço tecnológico, avaliou-se a eficácia de um herbicida com ação de contato, aplicado em pós-emergência com pulverizadores sem e com assistência de ar junto à barra, em diferentes volumes de calda. O experimento foi instalado no município de Ponta Grossa - PR, com a dessecação de aveia-preta (Avena strigosa Schreb) implantada em sistema de plantio direto sob a palha. Empregou-se a mistura herbicida formulada (SC) de dicloreto de paraquate (400 g ha-1) + diuron (200 g ha-1). O delineamento experimental utilizado foi o de blocos casualizados (DBC), em esquema fatorial 2 (pulverizador sem e com assistência de ar) x 5 (volumes de calda: 0; 100; 200; 300 e 400 L ha-1), com quatro repetições. A avaliação do efeito da dessecação se deu por meio da escala proposta pela Asociación Latinoamericana de Malezas (ALAM). A interação entre os fatores foi significativa, obtendo-se suficiência na dessecação a partir de 200 e 100 L ha-1, sem e com assistência de ar na barra, respectivamente.

A intervenção do poder judiciário no acesso a medicamentos no Rio Grande do Norte: uma análise sob a ótica das políticas nacionais de medicamento e de assistência farmacêutica

The present study aimed to evaluate the inclusion of the principles of the National Medicines Policy - PNM and the Pharmaceutical assistance - PNAF in the prosecution of lawsuits involving medicines. To fulfill this necessity , data collection was performed on the website by the Tribunal Rio Grande do Norte - TJ RN ( Rio Grande do Norte Court) , in 2012 . It was obtained 115 judgments, which were analyzed in order to generate Monitoring Indicators from lawsuits and conduct content analysis proposed by Bardin (2006). The results showed that : a) 100 % of the decisions were favorable to the author , b) 76 % of decisions were requests by the trade name of the drug , c) only one drug (eculizumabe) had not granted by ANVISA , d) 36 % of drugs were present in the list of standard medicines in SUS , 16 % of primary care block and 20 % of specialized component , e) 76 % of the decisions presented the request of at least 01 non-standard medicine. With regard to decentralization of PNM and PNAF we observed a commitment to this principle at judicial decisions, to see that municipalities and states are often forced to buy medicines of responsibility from another federal entity or other tertiary units as CACONs and UNACONS. The content analysis revealed that the argument from the judges used when you utter their decisions was that the right to health is recognized by Brazilian law as a fundamental right and should be guaranteed by the State for all its citizens. So, health is more than budgetary constraints of federal entities, which are severally liable for lawsuits , regardless the medication requested belongs or not to a particular block of a pharmaceutical assistance funding. Given these data, it is observed that there are gaps in the judgment when it comes to the insertion of the words and principles of PNM and PNAF, creating then the need for greater dialogue between the executive and judicial, so that they may consider relevant the effectiveness and application of such principles to minimize the negative consequences of the phenomenon of health judicialisation. Keywords: Judicialisation, Medicines, Public Policy, Pharmaceutical Care

Avaliação e monitoramento de políticas públicas: criação de um modelo sistêmico aplicado ao Instituto de Assistência Técnica e Extensão Rural do Rio Grande do Norte (EMATER-RN)

The nature of this thesis is interventionist and aims to create an alternative on how to control and evaluate the public policies implementation developed at the Institute for Technical Assistance and Rural Extension of Rio Grande do Norte State. The cenarium takes place in a public institution , classified as a municipality that belongs to the Rio Grande do Norte government and adopts the design science research methodology , where it generates a set of artifacts that guide the development of a computerized information system . To ensure the decisions, the literature was reviewed aiming to bring and highlight concepts that will be used as base to build the intervention. The use of an effective methodology called Iconix systems analysis , provides a software development process in a short time . As a result of many artifacts created by the methodology there is a software computer able of running on the Internet environment with G2C behavior, it is suggested as a management tool for monitoring artifacts generated by the various methods. Moreover, it reveals barriers faced in the public companies environment such as lack of infrastructure , the strength of the workforce and the executives behavior

Assistência odontológica diferenciada para crianças de 0 a 3 anos: avaliação de impacto no Serviço Público Municipal em Natal-RN

In Brazil, 0-5 years old children just have an oral health care system since 1990 s. Innumerable experiences of implantation of the attendance to the babies in the cities had appeared throughout the years, but it hasn´t been evaluated the comparative effect between children displayed and not displayed to the program. In this regard, the main of this research was describe the Early Childhood Oral Health Care in public health service in Natal, Rio Grande do Norte, Brazil and evaluate the impact of this specific oral health care for babies by comparison of indicators between exposed and non-exposed children. It was created an experimental group, formed by children covered by program which was paired, based on sex, age and socioeconomic status, with a control group, formed by uncovered children. After filling ethical application, the parents of children were questioned about some risk factors to dental caries and, in sequence, it was accomplish an oral examination in the child. It was verified the Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), dmf-s and verification of caries activity. The sample was 40 children in each group. The results showed, for VPI, a difference of 7 percentile points for the experimental group, however this difference had no statistical significance, obtained by Student s t test (p=0.314). In relation to GBI, the control group showed a low mean (0.8%) comparing with experimental group (2.77%) and this difference was statistically significant (p=0.003). The results for dmf-s and evaluation of caries activity showed no statistical difference between groups. Among the probable reasons for absence of impact of intervention, could be included: (a) the practice model was the same in two groups, or the difference was very weak and (b) the oral health care has intrinsic limitations for to impact on oral health in low income populations

A ação do psicólogo na assistência social: interiorização da profissão e combate a pobreza

A pobreza, como uma das manifestações da questão social , é elemento constitutivo do padrão de desenvolvimento capitalista, extremamente desigual, em que convivem acumulação e miséria. Nas últimas décadas, sob a égide do ideário neoliberal, verifica-se um incremento em políticas de combate à pobreza no Brasil, de caráter focalizado e compensatório, tanto por meio de ações diretas de transferência de renda, quanto pelo fortalecimento de serviços e programas voltados às populações pobres, com a estruturação do Sistema Único de Assistência Social, hierarquizado em Proteção Social Básica e Especial. A participação do psicólogo nas equipes profissionais do CRAS constitui um importante elemento para a discussão da inserção desse profissional no campo das políticas sociais no Brasil, considerando os limites estruturais postos pelo caráter compensatório dessas políticas, e a construção de estratégias que possam resultar em uma mudança efetiva nas condições de vida das camadas mais pobres da sociedade. Aliado a isso, por meio do ingresso na política de assistência social, um número significativo de profissionais psicólogos passa a atuar em cidades pequenas e médias, fora dos tradicionais centros urbanos, constituindo um movimento de interiorização da profissão . O objetivo do presente trabalho é analisar a ação profissional do psicólogo na assistência social no contexto nas políticas de combate à pobreza em municípios do interior do Rio Grande do Norte. Realizou-se entrevistas semiestruturadas com psicólogos atuantes nos CRAS de 17 municípios de pequeno e médio porte do estado. As informações foram sistematizadas com auxílio do software QDA Miner v. 3.2. A perspectiva defendida neste trabalho refere-se à funcionalidade das práticas psicológicas no contexto das políticas de combate à pobreza brasileiras na atualidade, ao reforçar os ideais neoliberais de naturalização da questão social e responsabilização dos indivíduos pela sua condição social, além de, em grande parte, desconsiderar as particularidades e singularidades que marcam os territórios de ação. Todavia, é possível depreender alguns modos de ação profissional que estão na contramão dos mais frequentemente encontrados nesse campo. Esses modos se revelam no cotidiano do CRAS como formas diferentes de compreensão do saber fazer profissional, resultados de um posicionamento político e de uma formação profissional que buscam romper com o tradicionalismo e conservadorismo da Psicologia e do campo da assistência social

O trabalho docente em psicólogo e o enfrentamento da violência contra crianças e adolescentes: uma experiência teresinense

In this thesis I discuss the role of the psychologist as a university professor and as intellectual from a specific context and also from a specific query. The context is the city of Teresina, capital city of Piauí state, which is peripheral in Brazil s northeast region. The defiance here is to build a critical psychological tradition that will deal with the challenges imposed by the reality of poverty and socio-economic backwardness of the region. The greatest difficulty is the lack of a public institution of learning that carries out instruction, research and extension with commitment to social transformation, and with the production of a psychological knowledge that is able to understand local reality. I take it that the undergraduate course in Psychology at UESPI [State University of Piauí] is the only one in Teresina that can take over such mission. The query is confronting violence against children and adolescents that defies us to ethically and politically commit to solidarity toward fragile human beings in need of adult involvement in order to survive this daily inhumanity. The involvement of psychologists from Teresina in this must result from a social commitment and a technical competence to deal with prevention and therapeutic consideration toward the victims. This dissertation is divided into three parts: the first is a study on the curriculum and the performance of psychologists, which revises the academic output in Brazil and envisages new queries to the theme, such as the role of teaching inside the curriculum, and presents social security (including Medicare) as the privileged field in which Brazilian psychologists perform. The second part contains a study on the concepts of childhood, adolescence and violence, which presents a consideration on the strategies to confront violence against children and adolescents. In the last part I discuss the role of the psychologist as teacher and intellectual in the context undergraduate course in Psychology at UESPI [State University of Piauí] from the commitment to the protection of children and adolescents

O Psicólogo no campo do Bem-Estar: cartografias de práticas na saúde e assistência social

The study focuses on the psychology and Social Well-being Policy encounters. The objective is to understand how the psychologists in the health services of Natal, RN, specifically in the Basic Health Units and social assistance, experience their daily practices. The methodology included observation and interviews of 13 psychologists regarding their daily activities and forms of practice in these services. We utilized an interview protocol directed at the affective memory and the professional life history of these technicians. Field notes were used to produce a cartography of the encounter intensities experienced by the researcher in the investigated context. The data analysis enabled the construction of the following analytic axes: 1) Work processes and proximity/ distancing points between these fields; 2) Forms of government and life management in the well-being context; 3) Experiments of self in the daily services. The first axis showed the precariousness of working conditions (remuneration issues, lack of structure, of training and autonomy for the activities). In the second axis the identified care forms produced in these fields indicated an adherence to the production of ideal subjects characterized as autonomous, productive, healthy and aware of own rights . These were considered normative insofar as they express attempts to break with the established patterns. In the third axis, many technicians experienced constraint with the daily activities because they found themselves in contexts that were adverse to the habitual forms of action. This situation provoked two distinct forms of positioning: a) action expressed by compassion, pity and resentment; b) investment in the practices themselves, so as to overcome its limits and to respond innovatively to the difficulties and/or challenges that these contexts provoke

A constituição da identidade em crianças vítimas de abuso sexual

Subject s identity is constituted in the relation with the other, which is characterized by dialeticity, and is configured as an identification and/or recognize movement, and strangeness and/or distance. In social interactions, people with whom subject relates himself assign meanings to him and, from these, the subject will ressignify, producing sense about himself. In other words, is through these interactions that subjects organizes themselves, recognize what is yours, and acquire the sense about themselves. It can be highlighted, too, the social-historic context s importance in the self-constitution process, whereas, from this, the subject produces particular forms of perception about reality charged with cultural meaning. Thus, the self-conception, the manners of thinking, of being, of relates, of take position against experiences, coming from values internalization, roles and related, are permeated by the manner witch the others relates themselves with the subject. However, when the relation with the other happens to be in a violent way, like in children sexual abuse, there are implications in the subjects constitution, whereas violates his physical and psychological integrities, as well as the rights of dignity, respect and even healthy physical, psychological and sexual developments. Therefore, this work aims to investigate how the identity process is constituted in children victims of sexual abuse. As specific aims the research proposes: 1) to characterize the relations between child and abuser, before and after the abuse act; 2) to identify images that the subjects, abuse victims, have about themselves and; 3) to identify the features of subject s relation with their own body. Toward this aims, procedures involving drawings, painting, collage, photography, activities with cardboard, colored pens, glue and tissue snips. The research took place at the Social Assistance Specialized Reference Center, where there is the treatment of children who suffered of rights violation, which includes sexual abuse. The research subjects were 3 girl children, between 6 and 10 years old, victims of sexual abuse. The corpus analyses was done through Thematic Content Analysis, structured in three meaning nucleus: 1) self-reference without the explicit attendance of other s discourse; 2) self-reference with the explicit attendance of other s discourse; 3) The other abuser. The analysis indicates that children, research subjects, have deteriorated images about themselves, about their bodies, which is consistent with the studies in the children and adolescents sexual violence field. In the other hand, were identified, too, self-references with positive values in the cases with mention about their way-of-being, which can be read as important to subject s development. About the other s discourse towards the subjects, were identified positive observations and found that these can contribute to subject s self-image reorganization. The contribution of negative comments, on the other hand, was showed in a more clear and incisive form in subject s constitution. There is, yet, an overvaluation of the other s discourse, so the meanings attributed toward them by the other are internalized, overshadowing the self-appreciation. To conclude, it can be highlighted that the need of psychological accompaniment of the children victims of sexual abuse, based on the possibility of this trauma experience elaboration, trying to overcome, as well as can be expected that this research s results contributes to the practices of professionals who work with subjects who have their rights violated

Aplicabilidade do Rorshach na avaliação psicológica do autismo

This study investigates the applicability of the Rorschach Method for evaluating the personality of people with Autism Spectrum Disorder (ASD).The relevance of this study is justified by the limited number of investigations published in the research literature concerning the use of psychological tests used for evaluating the personality of individuals with ASD. The Rorschach Method was chosen as an appropriate instrument considering it reveals the personality s basic structure, including characteristics of the affectivity, sensuality, inner life, mental resources, psychic energy and general characteristics and intellectual state of the individual. The general objective of this investigation consisted of verifying the applicability of the use the Rorschach Method in the evaluation of the characteristics of people's personality with autism spectrum disorder (ASD).The study also sought to identify perceptive factors of the personality structure of individuals with ASD, provide contributions of the understanding of this syndrome, seeking the establishment of possible therapeutic interventions starting from diagnostic by Rorschach Method. In addition, this investigation aims at verifying the adequacy of using the Rorschach Method as an instrument for evaluating the personality characteristics of individuals with ASD and its possible use in Brazil, starting from preliminary normative results. Participants consisted of 44 youngsters and adults, both genders with age range 14 - 39 years-old (average: 23.5 years-old) distributed in 2 groups. Group 1: composed with 22 youngsters and adults with clinical diagnosis of autism spectrum disorder (communication impairments, social interaction deficits, restricted and repetitive interests and activities); Group 2: composed with 22 youngsters and adults with typical behavior. The participants were paired to gender and age, individually. The Mann-Whitney and Wilcoxon tests were applied to evaluate statistical differences between the groups, considering demographic and social data. The results indicate the presence of restricted interest or difficulty in the expression of the social and affective interaction of people with ASD. However, the need of broader normative studies concerning the use of personality evaluation instruments for people with ASD is warranted. These investigations could help understand the psychic dynamism of this population, offering subsidies that can be added to the current techniques of diagnosis. The Rorschach Method is susceptible to application but it is necessary to respect the individual limitations of these people and to establish more criterions about the spectrum

Caminhos e descaminhos da adesão ao tratamento anti-hipertensivo :um estudo com usuários do Pacha (Programa de Assistência e Cuidado da Hipertensão Arterial) do Hospital Universitário Onofre Lopes

The high blood pressure is a multifactorial chronic disease which possesses emotional and social features in the illness appearance and evolution and in the adherence to the treatment which involves a decision-making through patient so that he or she process the necessary changes on harmful living habits. Adhesion, traditionally, it is referred to the patient to answer to the doctor orientations or of other health professional, about the appearance to the appointment with a doctor, about the use of medicine or lifestyle changes and maintaining this adhesion is the main problem to be overcame. It is expected the adhesion will ever be a continual, stable and satisfactory action, disregarding the complexity of subjectivity processes which permeate the sicken. This research aimed to investigate the difficulties which the person with high blood pressure has to adhere to the treatment, from the signification processes which give sense to the actions dealing with the adhesion. The study was carried out with 48 users of assistance program to the high blood pressure patient from Hospital Universitário from Natal RN, between 40-65 age. The answers were submitted to a double analysis process: 1) answer systematization in categories and codes and admission in statistical program SPSS (Statistical Package of Social Science), for generation of descriptive statistics; 2) Sense and signification analysis which permeated the deepener statement and interpretatively. The greater difficulties found are present on low-salt and law-calorie diets, in the dealing with everyday feeling and stress, being these factors cited as direct motive to the high blood pressure, regardless of interviewee s sex. It is observed there is not adhesion, but adhering, as an experienced everyday process. This work contributes with its results, assessing the used strategies by program with the aim of increasing the adhesion rates