Hospital humano: etnografia da humanização hospitalar na perspectiva de usuários

This ethnographic work studies the experiences of patients admitted in public (PUH) and private (PRH) hospitals in the Brazilian northeastern region. 28 adult patients of different clinics participated in the study. Data were analyzed by the patient path method, consisting in a combination of complemented and articulated techniques free observation, participating observation, ethnographic interview and patient testimonials collected prospectively during the patients admissions, from their arrival and until their discharge. The analysis was carried out according to the Thematic Categories Analysis Technique and the data were interpreted pursuant to medical anthropology, healthcare humanization and healthcare promotion theoretical references. The ethical principles of Resolution 196/96 were followed. The human hospital, as revealed by the patient, highlights the significance of subjectivity. 225 (54.7%) out of 411 mentioned concepts were collected in a public hospital (PUH) and 186 (45.3%) in a private institution (PRH). The results show that the patient at the PUH and PRH ethnoevaluates different aspects of the healthcare professionals´ human and technical competence, the hospital´s functioning structure, the access to and the ethics in the financial management, and develops overcoming strategies for his stay at the hospital. This ethnoevaluation is mediated by different factors, namely: social and economic status, personality, religiosity, ironic speech, somber diagnosis and satisfied needs, prior hospital experiences and the conditions under which the interview was carried out. A pedagogic proposal for the hospital humanization must include structural, managerial and organizational changes of the offered services and use active methodologies aimed to the political resolution of problematic situations at work and the inclusion of affective and subjective factors, and become as well a tool for the collective learning. This study shows the importance for the user´s ethnoevaluation to be incorporated into the hospital management and care as a guideline in the decision making and clinical action, thus promoting practices that shall lead to a decent and humanized care. The multidisciplinary nature of this study allowed a wide understanding of the user´s perspective as a socially critical ethnoevaluator

Caracteristicas sodiodemogáficas, ocupacionais e de saúde na avaliação da qualidade de vida de professores da rede municipal de Natal/RN

Objetivo: Analisar as características sociodemográficas, ocupacionais e de saúde clínica/comportamental, e o impacto desses fatores na avaliação da qualidade de vida de professores da rede municipal de Natal/RN. Métodos: Estudo descritivo-analítico com corte transversal e amostra de 242 docentes. Foram utilizados os questionários Whoqol-breve e nórdico, além de questões referentes ao trabalho do Job Content Questionnaire (JCQ). Os dados foram submetidos à análise estatística com nível de significância p<0,05, sendo utilizada a regressão logística binária, para análise de fatores hierarquicamente agrupados. Resultados: O domínio físico apresentou maior comprometimento entre os professores com trabalho de alta exigência (p=0,043), com mais de 02 diagnósticos de doenças (p < 0,001), atividade física inadequada (p= 0,001) e com sintomas osteomusculares (p=0.025); o domínio psicológico entre os docentes com trabalho de alta exigência (p=0,043), com carga horária maior que 28 horas semanais (p=0,034), com mais de 02 doenças (p=0,012) e que praticavam atividade física inadequadamente (p< 0,001); o de relações sociais com tempo de trabalho inferior/igual a 18 anos (p=0,036) e que residiam em bairro diferente do que trabalhavam (p=0,027); e, por último, o domínio meio ambiente apresentou maior comprometimento entre os docentes com carga horária superior a 28 horas semanais (p=0,025), que exerciam a atividade com tempo inferior/igual a 18 anos (p=0,013) e com sintomas osteomusculares (p= 0,002). Conclusões: Os professores apresentaram uma avaliação comprometida da qualidade de vida e do seu estado de saúde, tendo as atividades laborais desenvolvidas por esse grupo de trabalhadores um impacto importante sobre os resultados demonstrados. Tais achados podem comprometer a efetivação da proposta das escolas promotora de saúde

Prevalência de excesso de peso em pré-escolares na cidade do Natal

Obesity is currently considered a public health problem and there has been growing interest in the study of various aspects related to this infirmity such as: epidemiology, diagnosis, treatment, prevention and others. Thus, the purpose of this study was to determine the prevalence of weight excess and overweight in preschoolers in Natal, Brazil and relate them to variables such as gender, age, type of school (public or private) and zones of the city (east/south and north/west). This is a transversal study, carried out in Natal, Brazil between August and September 2004, in 20 public and 20 private schools/day care centers selected by the systematic sampling method. We measured the weight and height of 3721 students between the ages of 2 and 6 years. The children were stratified, according to age, into age group 1 (2 to 4 years) and age group 2 (5 and 6 years) and according to the region of the school, into north/west and east/south zones, the regions with the smallest and highest quality of life indices in the city, respectively. Children were considered to have weight excess when BMI ≥ 85th percentile, including those with BMI ≥ 95th percentile and overweight when BMI ≥ 95th percentile. The prevalence of weight excess was 26.5%, and of overweight 12.4%. There was greater prevalence of weight excess in the private schools and in the east/south zones. Overweight displayed the same epidemiologic profile, with a greater prevalence in private schools and in the east/south zones. The prevalence of weight excess in preschoolers in Natal, Brazil is high and is related, above all, to private schools and to those located in the highest quality of life areas. Therefore, prevention programs should be implanted in elementary schools in order to decrease weight excess and possible associated co-morbidities. This research project met the norms established by PPGCSa/UFRN and aimed at promoting the interrelation between different researchers and between different fields of knowledge, using multi and interdisciplinary concepts. This study was enriched by the interaction between the following professionals: pediatrician, pediatric gastroenterologist and physician nutrition specialist, pediatric endocrinologist, epidemiologist and biostatistician

Imagem corporal e fatores de risco em praticantes de caminhada da cidade do Natal-RN

Body image is the figure of our bodies built in our minds and the degree of dissatisfaction is often associated with risk factors identified by anthropometric measures. The purpose of this descriptive study was to evaluate the risk factors associated to morphological and functional variables associate to the perception of auto-image in middle-aged walkers of the south zone of the city of Natal. A hundred and thirty volunteers had been evaluated in four groups in function of the gender and age group. As measurement evaluations were used an auto-image perception questionnaire proposed by Stunkart of nine silhouettes numbered for both gender was applied; a weighing machine equipped with stadiometer for the body mass (kg) and stature (m) and the body mass index (kg/m2) that was calculated with base in measures of the body weight and stature and classified according to norms of the National Institute of Health (2000) as well as the systolic and diastolic blood pressure by a electronic digital device (DIGITRONIC). A metal anthropometric tape was used for the waist to hip ratio (WHR). It was used Analyses of variance (ANOVA) one-way, post hoc of Tukey and correlation of Spearman for the nonparametric data adopting the level of ρ≤ 0,05 for rejection of the null hypothesis. The body mass index indicated high factors of risk in the consisting groups. In all the groups were registered the desire to reduce their silhouettes. The body weight shows reduced when compared with the younger group in the male group of superior age group, while in the female group the inverse one occurs. The autoimage perception is associated with the classification of the waist to hip ratio in the female gender in the age group of the 50 to the 59 years and in the classification of the body mass index of all constituted groups. Significant associations had not been found for classification of the systolic and diastolic blood pressure in relation to the auto-image 41 perception. This thesis presents relation of interdisciplinarity and its contents have application in the fields of Physical Education, Medicine, Physiotherapy and Nursing

Violência institucional no âmbito da saúde reprodutiva : a percepção de mulheres usuárias do SUS, na cidade de Natal/RN

Institutional violence ranges from the most widespread lack of access to the poor quality of services provided. It includes abuses committed by virtue of the unequal power between patients and professionals within institutions. The aim of this study was to analyze the perception of women with regard to this type of violence, in the services offered at a reproductive health facility belonging to the National Health System (SUS) in Natal, Brazil. Interdisciplinary perspective is important, in that it provides interaction and complementarity between various disciplines, favoring, in an integrated way, a thematic approach in research activities, teaching and extension, involving professionals, students and researchers in medicine, social services, psychology, nursing, anthropology and physical therapy. A quantitative/qualitative approach was used, involving a sample of 401 women, as part of a transversal observational study. In the qualitative stage, which consisted of participatory observation and semi-structured interviews, we used an intentional sample of 10 individuals. The data were analyzed using logistic regression techniques, correspondence analysis and categorical thematic content analysis, showing that the 2 questions that investigated directly the perception of institutional violence obtained affirmative response frequencies of 28.2% and 31.8%, respectively. In regard to data collected in a field diary related to participatory observation, the main complaints referred to the health providerpatient relation, translated into dissatisfaction with the interpersonal relationship and with the resolution of the specific demand that required care. From content analysis, we classified 4 categories: Access; Information; Health professionalpatient relation; and Respect/dignity. We identified 6 subcategories: Impossibility of choice; Repressed demand; Communication difficulty; Asymmetric interpersonal relations; Privacy/confidentiality; Disrespect. We concluded, therefore, that the data presented show that in the reproductive health care programs, there are indicators of institutional violence. However, it is difficult to approach this phenomenon, mainly because of the power relations involved in the patient-health care provider interaction, resulting from unawareness that determinate situations violate sexual and reproductive rights. This can be explained by sociostructural questions that reveal marked inequalities, ratified by issues related to violation of the rights of National Health System (SUS) patients

Níveis de homocisteína e desempenho cognitivo em uma amostra populacional de idosos da cidade do Natal-RN

The imprecision of the frontier that separates those cognitive deficits inherent to the human physiological aging process from those which represent the early signs of nervous system degenerative pathologies ,very prevalent among the elderly, has brought attention to the need of studies aiming to establish clinical and/or laboratorial criteria to allow this differentiation. Elderly people living in poor and developing countries are frequently exposed to precarious socioeconomic conditions which facilitate the development of an array of pathologies which have metabolic and nutritional dysfunctions as the established or proposed etiological agents. The levels of certain micronutrients, such as the vitamins B12 and B9 (folic acid), and of some intermediary metabolites, such as homocysteine are being thought of as etiological factors and/or as biological markers of a group of alterations which affect the normal functioning of the nervous system with important reflexes upon cognitive performance. This study aims to investigate the influence of homocysteine, B12 vitamin and folic acid levels on the cognitive performance of the low income elderly population. This transversal study took place in Natal, Rio Grande do Norte State, Brazil, and involved 205 dwelling elderly people, users of the Programa de Saúde da Família, a public healthcare program, maintained by the city s health authorities. A multidimensional questionnaire was used to assess the socio-demographic aspects and the overall health and nutrition conditions. The cognitive performance was measured by the use of the Portuguese version of the Mini Mental State Exam (MMSE). The serum levels of homocysteine, B12 vitamin and folic acid were determined by chemiluminescence. The association between the socio-demographic and serum levels of Hcy, B12 vitamin and folic acid was determined by multiple linear regression. Serum levels higher than 13.5 μmol/l, indicative of hyperhomocysteinemia (HHcy), were found on 25.4% of the sample, being more prevalent in men (p<0.05). Deficitary levels of folic acid (<5ng/mol) and of B12 vitamin (<193 pg/ml) were found on 3.9% and 10.2% of the sample respectively. A negative correlation was found between cognitive performance with both age and HHcy and a positive correlation was found between cognitive performance and schooling. The isolated HHcy R2 values were an explanation to only 4% of the variance of the MMSE scores. However, when associated with schooling and age, this model explains about 25% of this association

Avaliação da atenção à saúde de portadores de HIV no centro de referência para o tratamento da Aids em Natal/RN por profissionais e usuários do serviço

Objective: The aim of this study was to evaluate the health care of HIV/AIDS Reference Center for treatment of AIDS in Natal/RN for professionals and service users. Methods: This is an evaluative study with a quantitative approach, performed in the outpatient Giselda Trigueiro Hospital, in Natal (RN). The target population consisted of 313 patients with HIV and 34 professionals of the center. Data collection occurred from august 2007 to july 2008, with a structured form of interview, validated through a pilot study. The data were analyzed by descriptive and inferential statistics. Results: The evaluation of the service was considered unsatisfactory by 85.6% users. However, 58.8% of professionals considered it satisfactory. There was difference in the evaluation of the following indicators: the relationship professional users, offering support, timeliness of professional guidelines on the treatment. There was similarity in the following indicators: physical structure, respect for privacy, opportunity to make complaints, hospitality, convenience of schedules, availability of ARVs and laboratory tests, and ease of access. Conclusion: The results point to dissatisfaction of the users and professional satisfaction with the health care of people with HIV / AIDS in the service searched. It was found that the indicators used in this study may be considered relevant to evaluate the service in question, as well as monitoringparameters provide acceptable quality of health care by the National STD/AIDS

Câncer de boca e orofaringe: tendências e análise de sobrevida em Natal (RN)

Introduction: Mouth cancer is classified as having one of the ten highest cancer incidences in the world. In Brazil, the incidence and mortality rates of oral cancer are among the highest in the world. Intraoral cancer (tongue, gum, floor of the mouth, and other non-specified parts of the mouth), the accumulated survival rate after five years is less than 50%. Objectives: Estimate the accumulated survival probability after five years and adjust the Cox regression model for mouth and oropharyngeal cancers, according to age range, sex, morphology, and location, for the city of Natal. Describe the mortality and incidence coefficients of oral and oropharyngeal cancer and their tendencies in the city of Natal, between 1980 and 2001 and between 1997 and 2001, respectively. Methods: Survival data of patients registered between 1997 and 2001 was obtained from the Population-based Cancer Record of Natal. Differences between the survival curves were tested using the log-rank test. The Cox proportional risk model was used to estimate risk ratios. The simple linear regression model was used for tendency analyses of the mortality and incidence coefficients. Results: The probability after five years was 22.9%. The patients with undifferentiated malignant neoplasia were 4.7 times more at risk of dying than those with epidermoid carcinoma, whereas the patients with oropharyngeal cancer had 2.0 times more at risk of dying than those with mouth cancer. The mouth cancer mortality and incidence coefficients for Natal were 4.3 and 2.9 per 100 000 inhabitants, respectively. The oropharyngeal cancer mortality and incidence coefficients were, respectively, 1.1 and 0.7 per 100 000 87 inhabitants. Conclusions: A low survival rate after five years was identified. Patients with oropharyngeal cancer had a greater risk of dying, independent of the factors considered in this study. Also independent of other factors, undifferentiated malignant neoplasia posed a greater risk of death. The magnitudes of the incidence coefficients found are not considered elevated, whereas the magnitudes of the mortality coefficients are high

Significados e percepções do homem diante da gravidez de sua companheira com síndromes hipertensivas

The general aim of the research was to comprehend the Social Representations constructed by the man in the face of his companion s risk pregnancy caused by hypertensive syndromes. The study is of exploratory and descriptive character in a qualitative approach developed at two public maternity hospitals, both located in Natal-RN, with 65 men whose wives had undergone high-risk pregnancy. The project was submitted to the Ethics on Research Committee of the Federal University of Rio Grande do Norte, Brazil (CEP-UFRN), with favorable report no. 81/07. For data collection, the following multimethods were employed: a word free association test; a projective test for registering mental images; and a semistructured interview schedule. The speech contents were analyzed in accordance with the Theory of Social Representations and complemented by the Central Nucleus Theory. The discussion of the results was grounded on literary findings of the companion s participation in pregnancy as well as in risk pregnancy associated with hypertensive syndromes. The data showed fear as representation s central nucleus, while recollections of that feeling referred to death of both companion and child in addition to fear of the unknown. The categories preoccupation and carefulness, other feelings, and clinical picture of the disease represented components of the peripheral nucleus. The results concerning mental images followed the same category criteria of the word free association test fear, other feelings, preoccupation, carefulness, and clinical picture of the disease. After being processed in accordance with the principles of content analysis, the statements originated three thematic unities: fear and insecurity in the presence of the companion s risk pregnancy; attitudes of carefulness to the risk pregnancy of the partner; and humanized assistance during the companion s risk pregnancy. Considering the results, the conclusion is that the partner s risk pregnancy caused by hypertensive syndromes represents, for the man, feelings of fear, preoccupation, insecurity, lack of acceptance and information, as well as attitudes of carefulness. The results reveal necessity of reorganizing the obstetric assistance with an eye to including the man as participant in the reproductive process. That demands extension of humanized carefulness to the companion with a view to make him an active coadjutor in the assistance of high-risk pregnant

Avaliação das condições higiênico-sanitárias da produção de refeições à base de carne da alimentação escolar no município de Natal-RN

The National School Nutrition Program is the oldest program in the country directed at food and nutrition safety. Its aims are to offer nutritional food as a supplement to students of public and philanthropic schools. Studying school nutrition transcends the investigation as a purely social program, given that it reaches the fields of public health, nutrition and food, using a wide variety of approaches. Thus, it is characterized by a multidisciplinary study, where the disciplines work side by side in distinct aspects of a single problem. Aim: This study aims to assess hygiene practices during the preparation of meat-based meals in public schools in the city of Natal, Brazil. Methods: A list was applied at 27 schools to identify the procedures of good food preparation practices. In addition, cooking and meal distribution temperature were measured and a microbiological analysis of the final preparation and of the water used in preparing it was performed. For microbiological analyses of the food, we analyzed coliforms at 45°C, coliforms at 35°C and Enterococcus, and for the water, we analyzed thermotolerant coliforms and total coliforms, using the methods recommended by APHA, 1995. Results: Most of the schools did not meet the required standards in all the variables related to good food preparation practices, except for the time spent preparing the meat, in which 89% were within the norm. Cooking temperature of the meals was within the standard; however, the temperature at distribution and the time spent dispensing the meals were inadequate. Of the 27 schools, 22 (81.5%) showed the presence of coliforms at 35° C in at least one meal sample and 18 (66.7%) had values above the recommended limit for coliforms at 45°C. The presence of E. coli was identified in 6.1% of the samples analyzed. The presence of Enterococcus was not found at any of the schools. With respect to the water, the North district of the city was the only one that did not meet the standards for the two indicators evaluated. The contamination found was not associated with the hygiene or food storage problems observed. Conclusions: The results show that the hygiene-sanitary conditions of meat-based public school meals were unsatisfactory, demonstrating the need for improvements in the production process to preserve the health of the student population. Multidisciplinarity: Researchers from the areas of food microbiology, nutrition, public health and statistics took part in this study, a decisive factor for characterizing the research as multidisciplinary

Avaliação das condições higiênico-sanitárias de manipuladores de alimentos e utensílios de mesa de escolas públicas municipais de Natal, RN

In Brazil school food is constitutionally guaranteed to public school students at the preschool and elementary level. This food must be nutritious, hygienic and sanitary. The aim of the present study was to assess the hygienic/sanitary conditions of food and table utensil handlers in municipal public schools in Natal, Brazil. In total, 27 public schools were assessed, using a checklist and microbiological analysis of the hands and table utensils. For the microbiological analyses of the hands, coliforms were analyzed at 45ºC and for the utensils aerobic mesophilic bacteria, using methods recognized by AOAC, 2002 and APHA, 1992, respectively. Most of the schools studied did not exhibit good food and utensil handling practice procedures in any of the variables analyzed. It was shown that 74.1% of the handlers received no periodic training, 51.9% did not undergo annual health examinations and 100% did not practice proper hand hygiene, which reflected significantly (p < 0.05) in hand contamination, where fecal coliforms were detected on 55.6% of the hands analyzed. With respect to the utensils, it was found that 100% of the schools studied did not follow correct hygiene practices and most were classified as very bad ; that is, aerobic mesophilic bacteria values above the limits established by PAHO (Pan American Health Organization), with schools in the north and south districts recording the highest percentages. The results show that the hygienic-sanitary conditions of the food and utensil handlers in the schools studied were inadequate, demonstrating the need for implanting good handling practices aimed at protecting the health of children that take part in the program and offering safer foods. Researchers from the areas of food microbiology, nutrition, public health and statistics participated in this study, a decisive factor for characterizing it as multidisciplinary

Fatores determinantes da decisão sobre a prática da cesariana em Natal-RN

O objetivo deste estudo é analisar os fatores que contribuíram para as diferentes decisões para o parto cesáreo e a ligadura de trompas entre as mulheres de 18 a 45 anos de idade no Município de Natal, no Nordeste do Brasil, no ano de 2000. Tratou-se de um estudo longitudinal, originado da base de dados de um Estudo Multicêntrico, envolvendo outras localidades do Brasil, composta de mulheres em idade fértil que procuraram o serviço público ou privado. Foram realizadas três entrevistas: no início da gestação, no mês anterior à data provável do parto e até um mês após o parto, perfazendo um total de 433 entrevistas, sendo finalizada com uma amostra de 269 mulheres. O estudo satisfez a um critério de elegibilidade, abrangendo uma amostra das mulheres de 18 a 40 anos de idade, que residiam em Natal e que estavam grávidas no máximo, na 22a semana de gestação, e procuraram o serviço público ou privado para a realização do pré-natal. Não entraram no estudo, aquelas mulheres que faziam um acompanhamento em ambulatórios especiais (hipertensão ou diabetes gestacional, HIV/AIDS). A análise consistiu, primeiramente, num estudo descritivo, seguido de uma discussão sobre a trajetória do desejo à realização do parto e testou-se a significância estatística dos partos com variáveis socioeconômicas. Sequencialmente adotou-se uma análise bivariada centrada nos testes de associação, onde foi considerada a variável tipo de parto como sendo a variável resposta e as demais variáveis, relacionadas à condição sóciodemográfica e a saúde reprodutiva da mulher, como sendo as variáveis de risco ou independentes. Para o cálculo da razão de chance (OR), foi utilizado o modelo de regressão logística múltipla. Das 269 mulheres entrevistadas, 56,0% foram submetidas ao parto normal. Este tipo de parto foi desejado independente da categoria, por 71% das entrevistadas. Os resultados mostraram como fatores determinantes para cesárea, o serviço ser privado (OR = 5,6), a mulher ter idade acima de 20 anos (OR=2,87), ser primípara (OR=4,56) e a realização de ligadura de trompas (OR=12,94). Independente da parturição, 84% das mulheres do serviço público foram submetidas a um parto normal, enquanto que, 74% das primíparas do serviço privado, fizeram uma cesárea. Os resultados sinalizam um distanciamento efetivo entre o desejo por um tipo de parto e a sua realização, quando os fatores considerados, não foram somente técnicos, podendo, também, refletir a falta de prática do parto normal, pelo obstetra e a necessidade de uma maior consciência ética nos procedimentos obstétricos, de modo a favorecer uma maior abertura na participação da gestante na escolha pelo tipo de parto

Avaliação clínica e microbiológica das condições de saúde oral dos receptores de transplante renal do Hospital Universitário Onofre Lopes, Natal RN

Introduction: The chronic immunosuppression promotes the development of changes in the oral cavity of the kidney transplant recipients (KTR), however with the exception of gingival overgrowth, little is known regarding the prevalence of oral lesions in this population. Objective: To evaluate the prevalence of clinical and microbiological conditions of the oral cavity of the recipients of kidney transplantation and the associated factors. Methods: This was a cross-sectional study which examined 96 clinical KTR and experimental where collected saliva stimulated them to identify Candida sp. Data collection consisted of evaluation stomatologic, socio-demographic, clinical aspects of transplantation, condition of oral hygiene and dental caries, yonder to questions about knowledge of oral alteration after transplantation. Results: Of the total, 66.7% of KTR had some type of oral manifestation. The most common was saburral tongue, followed by gingival overgrowth, with both oral manifestations related to gender and concomitant use of cyclosporine and nifedipine (p <0.05). Tacrolimus showed a protective effect for gingival overgrowth (OR = 0.13). The oral hygiene was associated with saburral tongue(p = 0.03) and severity of gingival overgrowth (p = 0.0001). Oral candidiasis was diagnosed in 17.7% of patients and Candida albicans was isolated most frequently in the saliva of RTR with a colonization of 58.3%. The average DMF-T increased with age. The method of oral hygiene was most used brush and toothpaste to 61.5%. Changes in the oral cavity was seen in 54.2% of KTR, citing as the main growth and gingival ulcers. Instructions for oral hygiene after transplantation were neglected for 61.5% of RTR. Dry mouth and halitosis were reported in 30.2% and 36.5% respectively. Conclusions: More the half of the KTR had at least one injury of the mouth, the immunosuppressive drugs and oral hygiene are associated with these alterations. Prospective cohort studies are needed to elucidate the relationship between oral manifestations and levels of drug and risk of oral manifestations occur over time. The kidney transplant recipients showed to be aware of oral alterations occurred after transplantation and uninformed about the oral hygiene instructions. With regard to hygiene, the incidence of caries was considered high, conditions of risk were identified and improvements in primary attention should be encouraged and reflected in the monitoring of renal transplant

Avaliação do desempenho funcional de crianças com paralisia cerebral de acordo com níveis de comprometimento motor

Contextualization: Several studies have examined the mobility of this group of children, however little is known about the impact of motor function in activities of daily living, considering the seriousness of their neuromotor damage. Objective: Identify the functional differences of children with Cerebral Palsy with different levels of motor dysfunction and correlate these differences with the areas of mobility, self-care and social function in functional ability and caregiver´s assistance of these children. Methods: An l analytical cross-section search was developed, which were part 70 children / families aged from 4 to 7.5 years, in the Rehabilitation Center for Children. As tools were used the Pediatric Evaluation Disability Inventory (PEDI) and the Gross Motor Function Classification System (GMFCS). Data analysis was performed by ANOVA and Pearson's correlation tests. Results: The results show the functional variability of children CP in different severity levels of motor disfunction This variation was observed in the areas of mobility, self-care and social function. The results also showed a strong correlation between the domains mobility and self-care, mobility and social function. Conclusions: The variability shown by the children with CP, suggests the use of PEDI and GMFCS as this association appears to increase the understanding of how the gross motor functions are related to activities of daily living, describing the best commitments and their degree of impact on functional activities. This correlation demonstrates how mobility is crucial to evaluate the performance and guide the therapeutic practice, to develop the children´s potencial, and guide the caregiver in stimulation

Risco de contagio pela HIV e as medidas de biossegurança: Significados atribuídos no kcontexto da formação do profisional de saúde

Estudo com abordagem qualititativa, teve como objetivo geral, analisar as representações sociais sobre o risco de contágio do HIV construídas por estudantes universitários portugueses da área de saúde, apontando-se aspectos psicossociais à adoção das medidas de biossegurança. A coleta de dados foi realizada no período de fevereiro a junho de 2007, com a participação total de 486 estudantes da área de saúde de instituições de ensino superior, em Lisboa (Portugal), distribuídos em 248 de Medicina, 168 de Enfermagem e 70 de Medicina Dentária. Os estudantes concordaram em participar da primeira etapa da coleta de dados, constituída por um Teste de Associação Livre de Palavras com seis temas indutores de respostas e um questionário. Na segunda etapa, caracterizada por uma entrevista semi-estruturada , participaram 60 estudantes, sendo 20 de Medicina, 24 de Enfermagem e 16 de Medicina Dentária. Os dados coletados foram processados pelos sofwares SPAD-T e ALCESTE e discutidos com suporte teórico da Teoria das Representações Sociais. Os resultados revelam representações sociais atribuídas ao HIV e aids através das palavras: vírus, incurável, medo, toxicodependencia, discriminação, sofrimento e morte. Ao pensar no cuidado para o paciente, os estudantes assinala para um fazer com dificuldade e inexperiência, que gera nervosismo e medo. Em relação ao risco de contágio do HIV, os participantes associam a proteção, medo e sangue, atribuíndo sentidos as medidas de biossegurança pela proteção com luvas e preservativo, influenciado principalmente por ser uma doença incurável e que causa sofrimento e discriminação. As conclusões revelam que as representações sociais atribuídas a aids e ao risco de contágio do HIV fortalece a proteção e o cuidado para uso de medidas de biossegurança. A compreensão desses significados no processo ensino-aprendizagem devem ser assumidos como instrumento norteador para a formação do profissional da saúde pelas instituições responsáveis