Ateliê biográfico de formação profissional: prática socioeducativa em Escola Judicial

In recent decades, debates have intensified about (auto) biographical narratives as devices of socio-educational practices, aligned to the educational setting of the XXI century which have stimulated a new educational perspective woven with epistemological and methodological training throughout life. Towards that scenario, the continued training in Judicial School has occupied important space for constitutional effectiveness and, on the other hand, has grown the demands of expanding knowledge and enhancing training practices, in turn, judicial practices. The aim is to analyze the reflective Group through "Professional Training biographical Workshop" with Bailiffs such as socio-educational practices in socio Judicial School, in the city of Natal /RN. It has highlighted the questions that guided this study: 1. What paths of experiences and knowledge shared by the Law Officials, Federal Appraisers in "Professional Training biographical Workshop" as reflective Group? 2. How is organized the reflective Group as practice in socio-professional training setting? 3. What contributions narratives of themselves bring to the bailiff in reflective Group on Judicial School? The theoretical assumptions are supported in the lifelong training in methodological and epistemological dimension of (auto) biographical knowledge (JOSSO, 2008, 2010, 2012; PINEAU, 2005, 2006; DOMINICÉ, 2010; DELORY-MOMBERGER, 2006, 2008; FREIRE, 1987, 1996, 2001; PASSEGGI, 2008; 2010; 2011; 2012). In 2009, 09 (nine) civil servants in post of Federal Appraiser Justice Official, law graduates participated in this research through eight (08) "Biographical Workshops of Professional Training", consisting of biographical practices and scenarios, enabling oral and written narratives about a memory that has meaning, relationship and tessituras between files, facts and feelings that reveal the perception of self and other, as well as mobilize and weave the training process. The experiences of speaking, writing and reading were constituted of spaces that facilitating the reconstruction of the trajectory of training and career awareness-making, helping to re-signify labor relations and lead to their own professional design. From this study, the reflective properties of groups have emerged, consisting of Reflexivity, Experience, Historicity, Reversibility, dialog and formability processes, with paths to social and educational practices in which professionals identify the meaning and significance of self and of the profession that are exercising. The expectation is to continue with the spirit of research to emerge from the participants responses to training practices in Judicial School, aligned with the new knowledge of understanding the human being, not only an object of his work, but also a social subject, co-participant in the process of re-signifying life and work in a permanent way.

Serviços-escola de psicologia do Rio Grande do Norte: formação profissional e política pública de saúde em debate

The Psychology University Services is stablished normatively as an indispensable equipment to the recognition of the graduation courses of psychologists by the Brazilian Education Ministery. The Public Healthcare Policies (Universal Health System/SUS) constitutes itself as a input field of the professional category, but shows huge challenges in the formation of these professionals. The objective of this work is to analyse the functioning of the Psychology University Services (SEP) and the Superior Educational Institutions from Natal, understood as important formation devices to attend the actual demands of the psychologist's work on SUS. For this, it sought a) characterize the psychological practices developed in the SEP; b) relate the National Curricular Lines of Direction of the psychology courses to the skills and competences developed in the SEP to the performance on the public healthcare policies; c) mapping ways of including the SEP in the network designed by the healthcare policy. Interviews were performed with 13 academic supervisors, 8 field supervisors and technicians of superior level (TNC), along with 9 managers, being for of the Psychology University Services and 5 of the graduation programs. Questionnaires were also applied to 57 interns and 24 graduates. Besides that, two conversation circles were performed with the faculty and technician members from two of the Educational Institutions that were participating of the research, as well as a workshop with students and psychologists, promoted by the CRP 17. We observed that most part of the faculty members and managers know the DCN and comprehend that the formation is in process of change in what concerns to the extension of the formation to the performance of the psychologists in various contexts. However, most part of the TNC don't know about them. Moreover, the results point to the predominance of the assisting model based on the traditional clinic psychology, although the articulation with the public healthcare and social assistance networks can already be timidly visualized. Different modalities of practices in theses Psychology University Services were also detected, such as conversation groups, thematic workshops, organizational consultancies, team meetings with the interns and TNS in a daily basis, matriciament in mental health, therapeutic monitoring, among others. Yet, the SEP in Rio Grande do Norte are still isolated from the other courses that perform in the healthcare area and also from the services that compose the public healthcare and public policies.

As ações em saúde mental nos Núcleos de Apoio à Saúde da Família - NASF

The National Police for Basic Care (PNAB), regulated by ordinance nº2488 from October 2011, restates the Family Health Strategy (ESF) as a priority to the expansion, consolidation and qualification of basic attention to health matters in Brazil. In order to bring it about, city counsellors along with other federal entities ought to ordinate their work process deepening principals, directions and fundaments of Basic Care (AB). Besides ESF, the new PNAB expatiates on the Family Health Support Centres (NASF), reaffirming their role on broadening the scope of basic care actions and their improvements, ratifying their ability to share knowledge and support Basic Care professionals. All this considered, the purpose of this work is to investigate how NASF is currently structured in João Pessoa and what has been achieved by it on what concerns to mental health. Its main objectives are to analyse the practices of mental health professionals that are part of NASF teams and if they differ from what has been developed by the other members of the teams; to discuss the articulation of NASF in managing mental health measures on what concerns to internal organisatio n and to the city health network; to identify strategies used to organise such measures on mental health in Basic Care. To reach such goals, individual interviews have taken place two city health managers and four of NASF professionals that participated on the Mental Health Office as representatives of their sanitary districts. Also a focal group formed by various supporters of NASF was created, contemplating the diversity of professional categories involved with the teams and sanitary districts. It was possible to identify in NASF, in João Pessoa, an organisation based by the matrix support in which both management and basic care demands reflect a series of actions developed alongside with ESF. Amongst such actions, matrixing, home visits and the Singular Therapeutic Project (PTS) stand out. These activities have been discussed on the focal group and integrate the daily work of all NASF supporters despite their professional categories. NASF presents itself as a powerful strategy to SUS proper qualification and support to strengthen Basic Care and broaden family health teams‟actions.

iSalud: uma arquitetura para publicação e distribuição de sistemas de informação para o SUS

The Brazil Telehealth Networks Program was established by the Ministry of Health in 2007. Its main objective is to support professionals in Primary Health Care (PHC) by offering educational qualification, resulting in more favorable conditions to fixate the professional in remote areas. The formulation and management of telehealth services are performed by scientific and technical centers that are operated by public institutions of higher education and responsible for providing tools and services in the context of the regions where they are. However, one of the problems generated by this decentralization is the development of various tools with different types of language, architecture and without any regulation and integration of information with the Ministry of Health. Aiming to solve the above problem, we propose the specification, implementation and validation of an architectural model in the development and distribution of the Unified Health System software tools. This proposed architecture enables tools developed in telehealth center to be shared among the other centers, thereby preventing the unnecessary use of resources.

A produção do cuidado no período gravídico-puerperal: experiência de mulheres usuárias de serviços públicos de saúde

Despite numerous government projects aimed at reorganizing and qualifying obstetric and neonatal care in Brazil, it remains problematic, with repercussions for maternal and newborn mortality and humanized care of both the mother and child. The objective of this study was to analyze the care provided to women during the pregnancy-puerperium cycle, based on reports of public health service users regarding their pregnancy and delivery experiences, using comprehensiveness and humanization as reference. The study applied a qualitative approach and the methodological strategy consisted of listening to the women, in order to identify, based on the meanings of their discourse concerning their experiences with health services, continuities and discontinuities of care during the pregnancy-puerperium cycle. Study participants were women who gave birth at a municipal public maternity, residents of Natal, Brazil, who at the time of the interviews, were between 10 and 42 days postpartum. Seven women reported their pregnancy and delivery experiences at public services. As interviews and observation took place, the material produced was also analyzed, in order to achieve simultaneous production and data analysis. Using systematization, a dialogue was established between the women’s discourses and production in the field of Collective Health, with respect to concepts and discussion about obstetric and neonatal care as well as the Comprehensiveness and Humanization of such care. Participant discourses underscored aspects related to prenatal care starting at pregnancy and its repercussions as well as prenatal monitoring by health services; aspects associated with care during labor and delivery, as well as those involved in postpartum in the maternity, both with respect to newborn and maternal careç and lastly, puerperium care after discharge from the maternity. Analysis of results sought to identify lines of continuity and discontinuity in the comprehensiveness and humanization of care. Based on these lines and as final contributions of the study, the following paths were proposed to achieve comprehensive and humanized production of health care for women during the pregnancy-puerperium cycle: Path 1- Reassess care in the maternal and newborn health network, aimed at comprehensiveness in terms of guaranteeing access to the various services and technological resources available to enhance health and life. Path 2- Reorganize work processes in order to attain comprehensive and humanized care for women in the pregnancy-puerperium cycle. Path 3 – Qualify the professional-user relationship in care management during the pregnancy-puerperium cycle. Path 4 – Invest in the qualification of communication processes in the different dimensions of care during the pregnancy-puerperium cycle.

A produção do cuidado no período gravídico-puerperal: experiência de mulheres usuárias de serviços públicos de saúde

Despite numerous government projects aimed at reorganizing and qualifying obstetric and neonatal care in Brazil, it remains problematic, with repercussions for maternal and newborn mortality and humanized care of both the mother and child. The objective of this study was to analyze the care provided to women during the pregnancy-puerperium cycle, based on reports of public health service users regarding their pregnancy and delivery experiences, using comprehensiveness and humanization as reference. The study applied a qualitative approach and the methodological strategy consisted of listening to the women, in order to identify, based on the meanings of their discourse concerning their experiences with health services, continuities and discontinuities of care during the pregnancy-puerperium cycle. Study participants were women who gave birth at a municipal public maternity, residents of Natal, Brazil, who at the time of the interviews, were between 10 and 42 days postpartum. Seven women reported their pregnancy and delivery experiences at public services. As interviews and observation took place, the material produced was also analyzed, in order to achieve simultaneous production and data analysis. Using systematization, a dialogue was established between the women’s discourses and production in the field of Collective Health, with respect to concepts and discussion about obstetric and neonatal care as well as the Comprehensiveness and Humanization of such care. Participant discourses underscored aspects related to prenatal care starting at pregnancy and its repercussions as well as prenatal monitoring by health services; aspects associated with care during labor and delivery, as well as those involved in postpartum in the maternity, both with respect to newborn and maternal careç and lastly, puerperium care after discharge from the maternity. Analysis of results sought to identify lines of continuity and discontinuity in the comprehensiveness and humanization of care. Based on these lines and as final contributions of the study, the following paths were proposed to achieve comprehensive and humanized production of health care for women during the pregnancy-puerperium cycle: Path 1- Reassess care in the maternal and newborn health network, aimed at comprehensiveness in terms of guaranteeing access to the various services and technological resources available to enhance health and life. Path 2- Reorganize work processes in order to attain comprehensive and humanized care for women in the pregnancy-puerperium cycle. Path 3 – Qualify the professional-user relationship in care management during the pregnancy-puerperium cycle. Path 4 – Invest in the qualification of communication processes in the different dimensions of care during the pregnancy-puerperium cycle.

A construção da identidade profissional de licenciados em Música da UFRN: um estudo de narrativas autobiográficas

Aims to understand the construction of the professional identity of undergraduate in Music UFRN, through the study of autobiographical sources of these subjects, checking their formative dimensions and their (re) meanings established throughout life stories. To do so, shows a brief presentation of the study and the main motivations of the author to do it; expresses the life story of the researcher and their training courses in music career; analyzes the historical overview of the route Search (Auto) biography as research and training approach (JOSSO, 2010; NÓVOA; FINGER, 2010; SOUZA, 2007; PASSEGGI; SILVA (2010b) and DELORY-MOMBERGER, 2012); It presents some reflections and discussions about the construction of identity, beyond the concepts and perceptions of the training and professional representations of this building (DUBAR, 2005); discusses the historical background regarding teacher training in Brazil and Music Education; describes the ways and methodological resources used for data collection and implementation of this research, namely, a reflective open questionnaire and autobiographical essays; It presents the life stories of the undergraduate students of the Music course and its educational and musical dimensions; Lastly, it presents a reflection about the paths taken. The results indicated that the autobiographical essays make it possible to understand the ways and social relations in the various identified training dimensions, in addition to realize that the family contexts and the first musical social contacts in informal settings, enable the licensees, an identification with the possible career lecturer in Music, as well as the main reasons for this choice. We conclude, therefore, that the experiences and musical experiences throughout life favor the construction of professional identity and that in the course of training, such experiences make ways to (re) define the musical experiences, as well as the (re) thinking their professional career.

A construção da identidade profissional de licenciados em Música da UFRN: um estudo de narrativas autobiográficas

Aims to understand the construction of the professional identity of undergraduate in Music UFRN, through the study of autobiographical sources of these subjects, checking their formative dimensions and their (re) meanings established throughout life stories. To do so, shows a brief presentation of the study and the main motivations of the author to do it; expresses the life story of the researcher and their training courses in music career; analyzes the historical overview of the route Search (Auto) biography as research and training approach (JOSSO, 2010; NÓVOA; FINGER, 2010; SOUZA, 2007; PASSEGGI; SILVA (2010b) and DELORY-MOMBERGER, 2012); It presents some reflections and discussions about the construction of identity, beyond the concepts and perceptions of the training and professional representations of this building (DUBAR, 2005); discusses the historical background regarding teacher training in Brazil and Music Education; describes the ways and methodological resources used for data collection and implementation of this research, namely, a reflective open questionnaire and autobiographical essays; It presents the life stories of the undergraduate students of the Music course and its educational and musical dimensions; Lastly, it presents a reflection about the paths taken. The results indicated that the autobiographical essays make it possible to understand the ways and social relations in the various identified training dimensions, in addition to realize that the family contexts and the first musical social contacts in informal settings, enable the licensees, an identification with the possible career lecturer in Music, as well as the main reasons for this choice. We conclude, therefore, that the experiences and musical experiences throughout life favor the construction of professional identity and that in the course of training, such experiences make ways to (re) define the musical experiences, as well as the (re) thinking their professional career.

A educação profissional em debate: uma avaliação política da formação para o trabalho ofertada pelo SENAC/RN através do Programa Nacional de Acesso ao Ensino Técnico e Emprego

In this study, we present a political evaluation of how SENAC/RN perceives PRONATEC, emphasizing all ideological principles, aims and theories that this institution reproduces and reinforces while playing this professional qualification program. We intended to reveal ideological aspects that inspire SENAC’s perception of PRONATEC, pointing the actual interests hidden by those aspects. Our starting question is: What ideologies, objectives and theories that are explicitly or implicitly reinforced by Senac in implementing PRONATEC? In the research, we consider the hypothesis that transferring the responsibility about PRONATEC from public to private institutions is something that impoverishes the professional formation process, once the program ends up subordinated to private institution’s ideological, political and economic interests. The methodological approach chosen was the single case study. As data source, we used broad literature survey, official files of PRONATEC and SENAC, official information about the program and personal interviews. At the end of the research, we present elements that show some “flexibility” on PRONATEC due to SENAC’s interests, offering a superficial professional formation, commonly dissociated from a propaedeutic education, focusing on the need of adaptation e consensus of works around a society project. In this regard, despite PRONATEC is payed by public resources, it’s been used by SENAC as a fortifier of this institution on professional education market, in an hegemonic and neoliberal construction of a model of society.

A educação profissional em debate: uma avaliação política da formação para o trabalho ofertada pelo SENAC/RN através do Programa Nacional de Acesso ao Ensino Técnico e Emprego

In this study, we present a political evaluation of how SENAC/RN perceives PRONATEC, emphasizing all ideological principles, aims and theories that this institution reproduces and reinforces while playing this professional qualification program. We intended to reveal ideological aspects that inspire SENAC’s perception of PRONATEC, pointing the actual interests hidden by those aspects. Our starting question is: What ideologies, objectives and theories that are explicitly or implicitly reinforced by Senac in implementing PRONATEC? In the research, we consider the hypothesis that transferring the responsibility about PRONATEC from public to private institutions is something that impoverishes the professional formation process, once the program ends up subordinated to private institution’s ideological, political and economic interests. The methodological approach chosen was the single case study. As data source, we used broad literature survey, official files of PRONATEC and SENAC, official information about the program and personal interviews. At the end of the research, we present elements that show some “flexibility” on PRONATEC due to SENAC’s interests, offering a superficial professional formation, commonly dissociated from a propaedeutic education, focusing on the need of adaptation e consensus of works around a society project. In this regard, despite PRONATEC is payed by public resources, it’s been used by SENAC as a fortifier of this institution on professional education market, in an hegemonic and neoliberal construction of a model of society.

Função compras no setor público: fatores preponderantes para o alcance da celeridade dos pregões eletrônicos da Base Aérea de Natal

This study discusses the issue of deadlines in the purchasing process within the Federal Public Administration. Your main goal is to analyze the main factors that influenced, mainly in the implementation of sub-phases of electronic trading in BANT, in 2014, as service to the principle of celerity. The research is descriptive since they were identified and analyzed the factors that influenced in terms of purchases, through direct observation and interviews. Based on the theoretical framework, the purchasing function, four dimensions of analysis were established: "Legislation and procurement processes", "Structure and Organization of the purchasing department", "purchasing systems" and "Human Resources of the purchasing department." Analysis showed that, unlike what happens in the private sector, the public procurement sector has not reached a strategic status within organizations, which brings harmful consequences to the speed of the purchases. It was found that there is a need for greater involvement of the purchasing department staff and criers in the formulation of the organization's purchasing strategies and that these purchases elements present, about their attitudes, a hybrid profile, proactive regarding specifications of the items, but reactive in relation to the need to urgently purchase, due to the lack of a better plan, which overloads the work of the sector. The observation of these strategic aspects of the procurement function in BANT influenced the finding that the lack of staff and expertise in investments plus the lack of rigor and formality of legislation, among other factors, contributed mainly to the lack of speed of processes.

A prescrição de medicamentos por enfermeiros na atenção primária à saúde no Brasil: caracterização, normatização, formação e lições aprendidas.

O papel do enfermeiro como prescritor vem se ampliando em muitos países nos últimos anos, em diferentes situações e amplitudes de ação, se configurando como prática avançada na enfermagem. No Brasil, a prescrição de medicamentos por enfermeiros está prevista na Lei do Exercício Profissional desde 1986, e permite a esse profissional, a prescrição de medicamentos estabelecidos em programas de saúde pública. Esse estudo tem como objetivo geral analisar as determinações e perspectivas da prescrição de medicamentos por enfermeiros nos protocolos da Estratégia Saúde da Família. Os objetivos específicos são: apreender a atual situação internacional da prescrição de medicamentos por enfermeiros em comparação a essa prática no Brasil identificando semelhanças e diferenças; identificar os contornos legais e normativos da prescrição de medicamentos por enfermeiros no Brasil apontando sua história, tendências e desafios; caracterizar o modelo de prescrição de medicamentos por enfermeiros nos protocolos de Atenção Primária à Saúde no Brasil; investigar possíveis lacunas entre formação, capacitação, autoavaliação e prática da prescrição de medicamentos na Atenção Primária à Saúde na perspectiva do enfermeiro. Trata-se de Estudo de Caso Exemplar com abordagem qualitativa através de Revisão Bibliográfica, Análise Documental e Grupo Focal com enfermeiros. A análise dos dados deu-se por meio da Análise de Conteúdo e Análise Qualitativa de Conteúdo. Os resultados revelam que a categoria da enfermagem contribuiu para a legalização da prescrição, porém não para a sua legitimação; na Atenção Primária à Saúde, essa atribuição está consolidada por meio de protocolos e legislação, embora sem estratégia clara de acompanhamento pelo Ministério da Saúde; observa-se resistência em algumas normatizações dentro do setor saúde. Quanto aos protocolos, observou-se não há exigência de pré-requisitos na maioria deles; há possibilidade de diagnóstico pelo enfermeiro na gravidez, nutrição infantil e doenças sexualmente transmissíveis; observou-se variados graus de autonomia; amplo grupo de medicamentos prescritos por enfermeiros. Dos 37 participantes do Grupo Focal, 97,3% eram do sexo feminino; 54% formados há menos de 10 anos, 27% entre 10 e 20 anos, 16,2% há mais de 20 anos; 83,8% com especialização em Saúde Pública. Todos os enfermeiros relataram insuficiência da disciplina de farmacologia para instrumentalizar a prática prescritiva. Destacou-se a necessidade de pós-graduação; a importância da experiência clínica; falta de discussões e capacitação. Apenas alguns se autoavaliaram como competentes para prescrever, outros revelam medo de reação adversa a medicamentos. Conclui-se que há tendência da prescrição de medicamento por enfermeiros permanecer apenas na legalidade e o principal desafio é alcançar a legitimidade. Confirma-se uma prática prescritiva sem requisitos, diversidade de orientações induzindo a multiplicidade de ações que pode afetar a qualidade da prescrição. Há lacunas entre formação, capacitações e exigências cotidianas da prescrição de medicamentos por enfermeiros na Atenção Primária à Saúde. No Brasil se faz premente pesquisa para avaliar o impacto, a qualidade e a segurança da prescrição de medicamentos por enfermeiros. A experiência internacional sugere também que essa prescrição deve ser apoiada pelo coletivo de enfermeiros, com robusto plano de capacitação nacional, além de governança e apoio local.

Implementação da avaliação 360º do residente no programa de residência médica em cardiologia e clínica médica do Hospital Universitário Onofre Lopes (HUOL).

A residência médica é uma modalidade de ensino de pós-graduação destinada a médicos, funciona em instituições de saúde, sob a orientação de profissionais médicos de elevada qualificação ética e profissional, sendo considerada o “padrão ouro” para a formação do especialista. A utilização do método de avaliação 360 graus na residência médica visa a avaliação integral dos médicos residentes, preenchendo lacunas que a avaliação cognitiva isolada deixa, quando utilizada como método único. Essa avaliação proporciona uma avaliação mais global do médico residente, já que inclui sua autoavaliação, avaliação pelos pares, pacientes e equipe de saúde. O objetivo deste estudo foi definir instrumentos de avaliação para implementar a avaliação 360 graus no programa de residência médica em cardiologia da UFRN e capacitar os docentes e preceptores do citado programa para avaliação de desempenho clínico do residente. Trata-se de estudo exploratório, prospectivo e descritivo, envolvendo quatro médicos residentes do programa de residência médica de cardiologia e 20 de clínica médica, esses durante o rodízio de cardiologia do programa de residência médica (PRM) em Cardiologia do Hospital Universitário Onofre Lopes (HUOL), além de 13 preceptores/docentes do PRM em Cardiologia do HUOL. Para implementação do novo modelo avaliativo na residência médica foram programadas três etapas, sendo a primeira a elaboração dos instrumentos de avaliação para a avaliação 360 grus; a segunda, o planejamento e a capacitação dos preceptores do PRM em Cardiologia do HUOL; e a terceira, o início das avaliações 360 graus dos residentes do PRM em Cardiologia e Clínica Médica, durante o período de janeiro de 2014 a março de 2015. Foram avaliados, no total, 24 residentes até o momento, sendo quatro residentes da cardiologia (três residentes do primeiro ano e um residente do segundo ano) e vinte residentes da clínica médica (sendo doze residentes do primeiro ano e oito residentes do segundo ano). Foram realizadas autoavaliações por oito residentes, sendo essas consideradas difíceis pela maioria dos residentes. A avaliação por pares foi realizada por 6 residentes, sendo o desempenho dos pares considerado acima do esperado em todos os itens da avaliação. A avaliação pela equipe de preceptores e equipe multiprofissional com feedback ao final das avaliações mostrou que os residentes de clínica médica do primeiro ano apresentam desempenho acima do esperado em relação ao humanismo, ética e profissionalismo, enquanto os do segundo ano apresentaram desempenho abaixo do esperado no item referente ao exame físico. Quanto aos demais domínios da avaliação todos estiveram dentro do esperado. Dez pacientes avaliaram os oito residentes, sendo tais avaliações positivas no sentido da qualidade da assistência prestada e das informações fornecidas pelos residentes. O método de avaliação 360 graus foi implementado na residência de cardiologia do Hospital Universitário Onofre Lopes da UFRN, tendo sido realizada em quatro residentes. A maioria dos preceptores e equipe multiprofissional da residência estão capacitados para utilização do método de avaliação.

Hepatite C crônica em serviço de referência no nordeste do Brasil: um estudo retrospectivo de dezoito anos de acompanhamento

Chronic Hepatitis C is the leading cause of chronic liver disease in advanced final stage of hepatocellular carcinoma (HCC) and of death related to liver disease. Evolves progressively in time 20-30 years. Evolutionary rates vary depending on factors virus, host and behavior. This study evaluated the impact of hepatitis C on the lives of patients treated at a referral service in Hepatology of the University Hospital Onofre Lopes - Liver Study Group - from May 1995 to December 2013. A retrospective evaluation was performed on 10,304 records, in order to build a cohort of patients with hepatitis C, in which all individuals had their diagnosis confirmed by gold standard molecular biological test. Data were obtained directly from patient charts and recorded in an Excel spreadsheet, previously built, following an elaborate encoding with the study variables, which constitute individual data and prognostic factors defined in the literature in the progression of chronic hepatitis C. The Research Ethics Committee approved the project. The results were statistically analyzed with the Chi-square test and Fisher's exact used to verify the association between variable for the multivariate analysis, we used the Binomial Logistic regression method. For both tests, it was assumed significance p < 0.05 and 95%. The results showed that the prevalence of chronic hepatitis C in NEF was 4.96 %. The prevalence of cirrhosis due to hepatitis C was 13.7%. The prevalence of diabetes in patients with Hepatitis C was 8.78 % and diabetes in cirrhotic patients with hepatitis C 38.0 %. The prevalence of HCC was 5.45%. The clinical follow-up discontinuation rates were 67.5 %. The mortality in confirmed cases without cirrhosis was 4.10% and 32.1% in cirrhotic patients. The factors associated with the development of cirrhosis were genotype 1 (p = 0.0015) and bilirubin > 1.3 mg % (p = 0.0017). Factors associated with mortality were age over 35 years, abandon treatment, diabetes, insulin use, AST> 60 IU, ALT> 60 IU, high total bilirubin, extended TAP, INR high, low albumin, treatment withdrawal, cirrhosis and hepatocarcinoma. The occurrence of diabetes mellitus increased mortality of patients with hepatitis C in 6 times. Variables associated with the diagnosis of cirrhosis by us were blood donor (odds ratio 0.24, p = 0.044) and professional athlete (odds ratio 0.18, p = 0.35). It is reasonable to consider a revaluation in screening models for CHC currently proposed. The condition of cirrhosis and diabetes modifies the clinical course of patients with chronical hepatitis C, making it a disease more mortality. However, being a blood donor or professional athlete is a protective factor that reduces the risk of cirrhosis, independent of alcohol consumption. Public policies to better efficient access, hosting and resolution are needed for this population.

Formação profissional do cuidador de idosos em instituições de longa permanência

The old caretaker's work seeks to minimize suffering and morbidity resulting from physical, cognitive and emotional limitations of these individuals, being a practice permeated by the uniqueness of the subjects involved, therefore, a process in constant construction. In this notion, the caregiver's role is crucial to assist the elderly in everyday life, aiming at improving their quality of life. This study has descriptive and analytical character with quantitative and qualitative approach aimed to investigate the professional training of active caregivers in long-term stay institutions for the Elderly (ILPIs) in Natal/RN in the year 2014. For this, semi-structured interviews were conducted with 63 caregivers employed in nine ILPIs, representing 75% of the professionals performing activities in these institutions. The interviews captured data on the socioeconomic profile, the perception about the profession and training of caregivers. Data were analyzed by observation of absolute and relative measures of central tendency of the numeric variables frequencies. It was found that most caregivers had poor socioeconomic status and had no specific training course to practice caregiver role. However, among those who carried out courses, most reported that the content covered during the training gave security to perform the practice, although they have shown a contradiction when referred to the need to build capacity. The perception of care is mainly related to love and care for the other while the choice of profession is associated with care practice itself. The results also indicate the presence of a low level of formal training for the exercise of the occupation, also revealing the weaknesses ranging from the absence of a core curriculum that can guide the formation, compounded by the low educational professionals in focus.