Doenças de Veiculação Hídrica em Trechos da Bacia do Rio Piranhas-Assu: ocorrência de bactérias oportunistas, caracterização epidemiológica e concepções de professores e agentes de saúde

Water is essential to life and all living organisms and their supply is necessary for economic development and quality of life of human populations, but their quality has been altered by human actions. In semi-arid northeast, the water is an issue of concern, especially its quality. This region is common to the construction of reservoirs that capture rain water, streams and temporary rivers in search of ease this situation, being intended for various purposes. Water scarcity is a limiting factor for the economic and social development of the region and contributes to the maintenance of waterborne diseases. About 80% of diseases that occur in developing countries are infected by waterborne pathogens. Therefore, this study aimed to determine in two environments that are part of semilênticos Armando Ribeiro Gonçalves reservoir, and a stretch of the river Assu, all located in the semiarid RN, the occurrence of opportunistic pathogenic bacteria; check the conceptions of teachers and health workers about the issues "waterborne diseases" and "bacteria" and a diagnosis of diarrheal diseases that affect the population in some municipalities of the semi-arid region of RN from a survey of epidemiological data. For identification of bacteria using commercial kits and the diagnosis of diarrheal disease was based on information from databases. The previous conceptions of teachers and health workers were obtained through questionnaires. The results confirmed the presence of opportunistic bacteria in the studied area, showing the importance of monitoring water quality. There was an under-reporting of cases of diarrhea pointing out flaws in the monitoring of Diarrheal Diseases and indicating the need to improve it. It was felt also the need to implement educational activities on topics dealt with both with teachers and health workers, since they were identified misconceptions on the subject

Avaliação do potencial mutagênico da água do açude de Lucrécia (RN- Brasil): um enfoque na relação saúde e ambiente

The water quality of many reservoirs in the world has been reduced due to percolation of contaminants to water, which can have natural or anthropogenic origin, increasing the level of genotoxic compounds in aquatic ecosystems. This fact has contributed to the reduction of environmental quality, and commitment the health of living beings that inhabit these ecosystems, including the human population. In this backdrop of reduced water quality, is the Lucrecia dam, which is a major surface water reservoirs by volume of semi-arid region of Rio Grande do Norte, and that has shown contamination by heavy metals, cyanobacteria toxic and the natural presence of Radon. The population that use this source has been showing high rates of cancer, popularly associated with the consumption of this water, with a prevalence about three times higher compared to the whole state of Rio Grande do Norte. Based on this, the present study aimed to evaluate the mutagenic potencial of surface water from the Lucrecia dam, using the Micronucleus Test in Tradescantia pallida (Trad-MN) and in human peripheral blood lymphocytes (CBMN) assay, as well as identify the concentrations of some heavy metals in this water. Water samples were collected on a dry season and a rainy season, in two distinct points. Moreover, in order to bring a completely view about the relationship of man-health-environment in this local, through the knowledge of knowing / acting environmental from residents of Lucrecia, and the use and perceptions they have about the dam of your city, a study of Environmental Perception was carried out with local residents. The results obtained for the both micronucleus test, showed significant results for the three points analyzed. The strongest mutagenic effect was observed in the dry season for both assays. Chemical analyses detected an increase of heavy metal levels in different points and season above the maximum allowed by legislation. Regarding the study of Environmental Perception with local residents, it was observed the knowledge of the environment that the residents have, as well as the strong ties and perceptions with the dam of the city. Thus, the combination of these two aspects (the genetic toxicity tests conducted in the dam together with analysis of environmental perception with the residents of Lucrecia) allowed to draw a more complete diagnosis on the local situation

Frequência de fatores de risco cardiovascular em voluntários participantes de evento de educação em saúde

INTRODUCTION. Cardiovascular diseases (CVD) are the main cause of death in Brazil.OBJECTIVE. To evaluate the frequency of CVD risk factors In a population attending a health education community event.METHODS. Retrospective study that included 428 completed forms with clinical and demographic information of volunteers attending a public event, in May, 2006. Data were expressed by means and standard deviation or proportions and compared by Student's t test or Chi-square test. Associations between Arterial Hypertension (AH), Diabetes Mellitus (DM) and clinical variables were analyzed by multinomial logistic regression. Significance level was p<0.05.RESULTS. Mean age was 57 +/- 14years, and women represented 58% of the total population. The main cardiovascular risk factors were AH (39.5%), DM (15.4%) and dyslipidemia (25.89%). The frequency of unawareness about these risk factors was respectively 8.4%, 17.5% and 33.1%.. Family history of CVD was reported by 41% while only 67% reported having any information about DM or dyslipidemia. Among obese individuals (IMC >= 30 Kg/m2, 27.3% of the population), systolic blood pressure (133 +/- 16mmHg), diastolic blood pressure (84 +/- 11.5mmHg) and casual glycemia (124 +/- 52.5mg/dl) were higher when compared to non-obese (p<0.05). There was a significant association between obesity and dyslipidemia (p=0.04). Age and IMC were independently associated with AH and DM.CONCLUSION. The high frequency of modifiable cardiovascular risk factors in this population suggests the need for educational programs to promote primary prevention, mainly for the elderly and overweight. [Rev Assoc Med Bras 2009; 55(5): 606-10]

Caracterização das intervenções em grupo na rede básica de saúde em Natal-RN

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

A dívida da vida: redes clientelistas na saúde "de favor"

The relationship between mayors and patients Who use a Casa de Apoio in Natal, RN, shows us some traditional political features anda t the same time happens in na urban and modern context, regulated by a formal institution, the State. The Oestana, as is named this Casa de Apoio, offers daily that are paid by some City Halls located in the West of Rio Grande do Norte where people go away to capital from which they have medical and hospital care. This assistance includes paid services like accommodation, food, transportation, etc., as well as services that aren´t paid as information, support and hospital material, for example. When the patients access these service, they will gain a debt with a services provider (the mayor) which its eventually paid with the vote in the municipal elections. The goal is to understand the social, the political, the symbolic and mainly the life meaning of this relationship. Our research was developed by interviews with Oestanas users and regular visits to this house that showed a political bond regulated by moral and subjection, but is reconfigured by new social categories as the affection and the logical networks.

A CRONIFICAÇÃO NOS SERVIÇOS SUBSTITUTIVOS NA REDE DE SAÚDE MENTAL DE NATAL/RN

Brazilian Psychiatry Reform, through Psychosocial Care Strategy, has intended to build insane people care practices from community care services which contemplates the subjects complete lives. However, to change the traditional care ways demands the facing of a series of epistemological, political and cultural obstacles. One of the current challenges deals with patients aggravation processes, with management ways, with devices and with professionals, as well as with the assistance network. The purpose of this thesis was to investigate how these aggravation processes has been constituted in Natal mental healthcare network, understanding its effects in the work teams and patients. Theoretical and methodological perspective used was Institutional analysis was, subsidizing the usage of concept-tools as the implication analysis, selfmanagement and self-analysis, and restitution. The research was carried out at the Natal East Sanitary District Mental Healthcare Clinic, with the participation of technicians and patients. The research procedures were: literature and document research on the attendance and the analyzed theme; attendance registers analysis; participating observation of the institutional routine for three months and field log entries; talking groups, one with the team and one with the patients. Two main discussion points are shown: 1. The mental healthcare clinic organization logic and the intersector politics; 2. The work and management processes developed at the mental healthcare clinic. The analysis show diversity in the attended demands in the service, which has favored the patients aggravation, this device and the substitute network processes. The work processes are apart from the political sphere and from the managements processes. In this sense, we show the need to reevaluate the clinic device as well as the management models adopted in the Brazilian Psychiatry Reform context

Organização espacial e processo saúde-doença no bairro Guarapes, Natal/RN

La santé et la maladie sont des objets de préoccupation dans la société. Tout au long de l'histoire de l'humanité, ils ont été traités sous différents yeux. La géographie est une façon de comprendre les processus liés à des questions de santé et de maladie, de façon privilégiée dans le but d'être une science concernées par la zone géographique où cela implique non seulement une structure de la matière, mais les personnes et les flux découlant de la relation est établie Entre la société et la nature. Un lien est établi entre l'organisation spatiale de la santé-maladie est au c ur de ce travail, avec la coupe Guarapes espace du quartier, situé dans l'ouest de la Région administrative de Natal (plus bolsão pauvreté de la ville) pour la période correspondante de la 1990 par 2004 (jalon important pour le bien et la dynamique des populations de la zone d'étude) et de réduire le temps de la recherche. Au cours de l'analyse procède à l'étude des formes de production et d'organisation de l'espace vécu. Depuis comprendre le quotidien des personnes souffrant d'un réseau de relations, motivés par les besoins et la solidarité qui génèrent des formes et des contenus qui façonnent l'aire géographique. Sur la base de revue de la littérature, la recherche empirique à travers la réalisation des feuilles de route des entretiens avec le représentant des gens du quartier (résidents, des dirigeants communautaires, des coordonnateurs pédagogiques, des infirmières et des agents de santé de la PSF). Outre les visites effectuées à l'Agence de régulation des services d'assainissement de la municipalité de Noël - ARSBAN, le Secrétariat spécial pour l'Environnement et Urbanisme - SEMURB, secrétaire du Travail et de la protection sociale SEMTAS, Secrétariat municipal de la santé - SMS. Sur la base de l'espace vécu voir que les éléments du quotidien local exercer une forte influence sur la santé et La maladie de la population étudiée, avec un accent sur les problèmes découlant de chômage, sous-emploi, l'insécurité et un manque d'assiduité de certains responsables de l'USF - Guarapes. La production et l'organisation de la région convergent à l'apparition de maisons, les rues et les petits commerces non équipés de l'infrastructure de base dédiée à la prise en charge des personnes favorables à l'occupation désordonnée et non planifiée pour plusieurs zones du district, ainsi que l'apparition De vecteurs transmetteurs de maladies

O uso do território pelos serviços privados de saúde em Natal/RN

Nowadays we can observe in Natal city, the development of the structure and the health s private service. However, the spatial distribution of these services will be marked by an uneven distribution on the places, what will be in according with the conditions offered by the same in each historical period. Accordingly, the objective of this job is analyze the use of the territory by the health s private service and the dynamics that promotes in Natal city in the technical scientific information period. Thus, seeking to search this goal, realized literature, documentary, empirical, considering the process of development and the spatial distribution of the health s private service in the city. From a topology we can observe that prevails in the city a service s concentration at all levels of complexity in only a few neighborhoods, being Tirol and Petrópolis, which are neighborhoods that have high densities of engineer system, bigger fluidity, and the best level salaries of the city, which present a greater number of these establishments. However, equal this concentration has occurred a dispersion of these services to other neighborhoods, as for example Lagoa Nova which is presenting the same attractiveness in the view of attributes territorial, begins to protect services presenting the same profile like the firsts. However, the city has a significant demand to this kind of service found in these neighborhoods, some events provided the emergency of another type of market of health s private service, that are those created to attend guests with a lower purchasing power, which will have their establishments in the same way selectively distributed in some areas of the city, which will not be the same pursued by the other, showing how selective is the installation of an enterprise guide by the logic of capitalism reproduction. So, the imperative of spatial selectivity presented by the health s private sector exposes an use of the differential territory for these services

Do mundo como norma ao lugar como forma: o uso do território pela estratégia da saúde da família

This work aims to check whether there is a congruence between the purposes of regulations imposed by SIAB and the materiality constitution of places where your information is produced, since our hypothesis is that there is a mismatch between the rules and forms, which means, between reality as it is in places and how the territory is scrutinized by the Family Health Strategy (FHS) as for the performance of their teams as to the generation of their information. For this, the methodology used was the literature, documentary and empirical research, in special about territorialization of the Family Health strategy of Natal-RN. From the empirical mediation was possible to see the gap between full exploration and information produced by the ESF and the reality of the places. Thus, we highlight the importance of considering the conditioning of geographical forms as a guiding principle of the strategy for Family Health

Saúde e saneamento no município de Galinhos-RN

The state of health and sanitation in the city de Galinhos/RN is alarming, considering that access to public water supply and sanitation is absent. This condition is further exacerbated by the demand of that area as a tourist destination, especially to celebrate the festivities as the carnival, catholic festival and activities of summer. The city population growth, at times above cited, carries the collapse of poor sanitation system. The work now directs the foregoing discussion to the links between health, sanitation and environment, understood as built environment. In this context, the understanding of socio-sanitary conditions of the council is essential in the process of examining the actions of human rebut on the quality of life of local people. Thus, we developed the analysis of primary and secondary data, to conduct a holistic analysis of the health and sanitation in the city in the existing scenario. We verified, in the course of the research, that the conditions for solve part of the problem are already evident. However, the lack of political and popular demobilization contribute to the maintenance of the status quo

A regionalização da saúde no Rio Grande do Norte: Elementos para a compreensão da dinâmica dos lugares

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Lugar, saúde e informação: os círculos de informação da atenção básica do SUS no contexto na disputa pelo conceito de saúde

Through the analysis of the informational activity at the primary care of SUS at the scale of places, this dissertation has as central objective to observe the dispute for the concepts of health and sickness, in the ambit of Brazilian Health Movement, featuring, on one hand, the clinic, biomedical or flexnerian line hegemonic, scientifically restrict and the primary frame of references for the Brazilian health politics and on the other hand a multiplicity of new proposals and critic thoughts to the current model, which have , as common characteristic, the worry with a territorial way of thinking the health context, therefore beyond the biological processes. On the first chapter we jut out with details these scientific and ideological movements, on a wider way, but also on the specificities of the public health s information politics. On the second chapter we analyze the downward health information circle at the basic care, observing the operational processes of the information s technical systems SIAB and e-SUS. On the third and last chapter, we give references to think about an upward health information circle, centered on the places, ruled by the notions of autonomy, organic solidarity and communicational density. It would possess, as method s primary horizon, the local organization of production and managing of information through the work of the Health Community Agent, privileging therefore the urgency of the most contingent needs of the people in theirs every day s life

Satisfação e percepção do usuário do SUS sobre o serviço público de saúde

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A saúde na percepção do adolescente

Na fase da adolescência, o indivíduo experimenta os melhores índices de saúde, os quais podem ser mantidos e/ou melhorados, dependendo da percepção e valorização dos mesmos, influenciando na sua qualidade de vida. O estudo avaliou a opinião de adolescentes (n=493) da Fundação Mirim do Município de Araçatuba - SP, quanto à saúde geral e bucal, bem como sua percepção sobre elas, por meio questionário semiestruturado, durante o ano letivo de 2006, já que os mesmos possuem acesso à atenção à saúde bucal e palestras sobre saúde. Dentre os entrevistados 34,5% conceituaram a saúde como coisa ou algo que precisa(mos) cuidar; 26,6%, como bem-estar; 18,1%, como a própria existência; e 14,5%, como ausência de doença. em relação aos conceitos de saúde bucal, 68,4% definiram como higiene; 16,2%, como aparência; e 15,5%, como ausência de doenças bucais. A percepção desses jovens quanto a sua saúde em geral foi para 46,5%, ótima, e 44,1%, boa, enquanto que a da sua saúde bucal foi para 53,6%, boa, e 24%, ótima. Pode-se concluir que os adolescentes têm uma ideia tanto sobre saúde geral como saúde bucal, porém a classificação é menor no que tange à saúde bucal, pois envolve aspectos afetivos, estéticos e sociais. Ademais, percebe-se a necessidade de programas educativo-preventivos direcionados a esse grupo.

Auditoria no Sistema Único de Saúde: o papel do auditor no serviço odontológico

A auditoria, na saúde, verifica os processos e resultados da prestação de serviços, pressupondo o desenvolvimento de um modelo de atenção adequado, de acordo com as legislações vigentes. Nesta pesquisa, objetivou-se analisar as atividades da auditoria no Sistema Único de Saúde no serviço de saúde bucal, buscando demonstrar as ações e a sua inserção nas três esferas de governo. Foram realizadas análise documental e levantamentos bibliográficos sobre os sistemas de auditoria e o papel do auditor no serviço odontológico desde 1969. Os resultados mostraram que foram encontrados seis artigos sobre auditoria odontológica no SUS e que a atuação do auditor odontológico é abrangente no gerenciamento do sistema, consistindo no controle, na avaliação, na supervisão e na orientação, bem como na garantia da participação social e acesso aos serviços. Na saúde bucal o auditor analisa, monitora e fiscaliza o planejamento das estratégias e os procedimentos efetuados; realiza o cadastramento dos profissionais, das unidades de saúde e a programação física orçamentária; viabiliza os dados para o sistema de informação e o pagamento dos serviços prestados; examina o cumprimento das pactuações, dando um enfoque educativo e não mais policialesco à resolubilidade dos problemas. Conclui-se que existem poucos estudos sobre auditoria odontológica no SUS e que o sistema de auditoria é um instrumento administrativo confiável e essencial para os gestores no desenvolvimento das ações de saúde.