Assistência a mulher com câncer de mama em um cenro de referência no Estado da Paraíba

The assistance to women who have breast cancer is studied in a Reference Center in Paraiba and also the way this assistance is performed in a School Hospital maintained by SUS (Single Health System) is questioned. Breast cancer demands institutional organization, provision of financial, material and human resources, requiring, from the health system, effective assistance with new technologies which make it possible for the population their access to specialized medical services although it not always is able to guarantee those services nor the rights which the legislation granted them, inhibiting a proper relationship between the health professional and the patient. The theme is discussed through a transdisciplinary knowledge view and has as its theoretical referential the contribution of classical and contemporary authors from the human and social sciences and, as an empirical research strategy, the structured interview. The objectives of the research were: identify how the assistance to women with breast cancer is carried on at a Reference Center on Oncology in Campina Grande, Paraiba, identifying their difficulties and their satisfaction with the received assistance; draw up a profile of the women with breast cancer who were assisted in this Reference Center; understand their gynecological and obstetric antecedents, life styles, age group and stage of the disease when the treatment started; check their knowledge about their rights and which benefits they had received. Most women ranged between 40 and 59 years old (63%), which corresponds to the risk range of developing breast cancer. As to their occupations, 38.3% were housewives and 30.1% retired, whose family income was among those who received between less than a minimum salary and one minimum salary (58.2%). This population was mainly constituted of married women (60.2%), whose most frequent schooling was an incomplete elementary school (27.6%) and complete elementary school (24.1%), which added up to 51.6%. It was observed that the majority of the women seemed to be satisfied with the assistance received, noting that a minimum care was enough to define this satisfaction, although it is perceived that the access to the health system does not ensure the ideal attention conditions they need; it was verified that the availability of the services and the assistance itself are seen (in the local culture) as a favor and not as a right. It is also observed that only 30% of the women mentioned that they knew about their rights and the most mentioned ones were the disease assistance (13%), the medicines (13%) and the treatment (12%), which represent the most important triad to face the disease and around which the oncologic assistance most focus on. It is concluded that the condition of the users´ minimum existential of a public health unit and the condition of belonging to a lower social stratum were variables that influenced the respondents´ satisfaction in relation to the assistance received but the importance of the Reference Center for the women with breast cancer´s assistance for the whole region cannot be denied as well as the need to broaden the way the policy of the oncologic assistance in Brazil in the local realm is seen

Envelhecimento populacional: um diagnóstico dos idosos institucionalizados, em Natal/RN

The aging process lived by the Brazilian population concurred to the transformation in the family models, causing difficulties related to the elderly care on the Family environment, a fact that is one of the main reasons for their institutionalization. Facing this scenario, the need of investigating how the elderly lives on the long-term facilities (ILPI) has aroused. In this study, it has been conducted an analysis of the populational aging process, contrasting the Rio Grande do Norte to Brazil and the Northeast Region, between 1980 to 2010. Faced with the realization of this process, and the rising number of long-term facilities for the elderly (ILPI), it was needed to make a rescue of the abiding laws regarding elderly institutionalization, on the scope of Natal, which surged after the 1988 Federal Constitution, checking what were the impacts on the assistance of the institutionalized elderly. Lastly, it were investigated the possible determinants associated with the institutionalization, in Natal-RN, considering the aspects of the family structure, family relationship, economic, health and well being of the elderly. The results showed that Rio Grande do Norte, particularly Natal, follows the national scene, since between 1980 and 2000 its population passed the intermediate level in the process of population aging for, in 2010, to be considered elderly. Throughout this process, it was observed that Natal has been adapting to the federal legislation, through the creation of the municipal policy, City Council and other relevant standards for the elderly, promoting significant changes in ILPI.However, philanthropic institutions needs better resources for their maintenance. In research with the elderly, it was found that although the majority of the elderly have declared themselves satisfied with life, they had indicators of impairment of functional capacity and cognitive, isolated social behavior and depression, affecting the life quality of these elderly. These results reflect the need for greater investment of public power in the drafting, implementation and monitoring of public policies aimed at promoting changes that raise the level of life quality of this segment of the population

Os instrumentos de incentivo à produção e uso de biodiesel no Brasil: uma análise constitucional sob o princípio do desenvolvimento sustentável

The recent insertion of biodiesel derived from oily vegetables in the Brazilian energetic matrix calls for the study of some aspects that belong to it. The analysis of the carbonized energetic pattern concerns the paradigm of economic development that is constitutionally enshrined sustainable development which make environmental protection compatible with the needs of the economic rationality. This text is structured according to the ideas of modern hermeneutic that sees substantial value in the principles capable of create a harmonious relationship between law and society. The study of the constitutional principles to conduct a legal analysis about the National Program for Production and Use of Biodiesel - PNPB. The aim of the research is the study of PNPB ahead with the constitutional principles governing the economic order. To achieve this end we studied the sustainable development as a constitutional principle. We start with the notion that the thematic principles, and fundamental to understanding the dimension of sustainable development institute, since its concept is closely related to the applications of the principles enshrined in virtually all the constitutional order of the Western world. Then this was the National Energy Policy, initiating the approach by guiding principles of the National Energy Policy to develop the theme of public policy in the energy sector. Therefore, we studied the National Program of Biodiesel Production and Use - PNPB. From a technical introduction to the concept of biodiesel and a brief historical background, analyzing their advantages compared to fossil fuels predominantly used. Then it became a regulatory overview of the Brazilian legislation on the subject, central to understanding the plans and objectives pursued by the Brazilian government with encouraging the production of biodiesel. Finally discussed the tax incentives for production and use of biodiesel in Brazil. From the idea of federalism, characterized the tax as an instrument of state intervention in the economy. And finally it brought the tax incentives of Law No. 11.116/2005 in the face of the constitutional principles of economy and tax, and tax incentives from projects related to the Kyoto Protocol

A materialização da dignidade da pessoa humana e o cumprimento das penas privativas de liberdade

The current research come from need to analyze possibilities to materialize human dignity principle during freedom curtail penalties fullfilment, abreast finding that internal and international regulations dictate this is the way to be tread by Brazilian penitentiary system, however, verily, indignity, assistance missing, overcrownding, crime, in the end, barbarie reigns. The work will analyze two strands in order to effective the mentioned principle: the state responsability optics, such in internal scope, as internationally, abreast historical omission in satisfy Constitution, international treaties and laws; and also indicating penal execution alternative methods adoption as a way, bringing to fore a case study - called "apaqueano" method. With such desideratum will bring, first of all, considerations about consolidation process of human dignity principle, its concept and essential content. Furthermore, will address historical and philosophical evolution of freedom curtail penalties. As it follows, will be done an approach about constitutional and underconstitutional legislation that disciplines penalties fullfiling in Brazil, analyzing their main aspects, emphasizing the possibility to charge Brazilian state for disregarding mentioned standards. Next, will also be started a critical analyzis about international regulations, which forbids diminishing or cruel penalties or treatments, approaching human rights international treaties and conventions ratified by Braziland their incorporation and effectiveness in local Law, emphasizing monitoring forms and country international charging possibility for disregarding international regulations. Lastly, will advance to the real possibility to materialize human dignity principle in penalties fullfiling, based in a case study verification - the APAC (Associação de Proteção e Assistência aos Condenados) called method, analyzing the various theories about penalties grounding, with emphasis in their ressocializing function, as well as traditional penitentiary systems, and the theory adopted by vernacular order, in desideratum to contribute to improve national penitentiary system chaotic situation

Avaliação do desempenho reprodutivo do Cavalo-Marinho Hippocampus reidi (GINSBURG 1933) do estuário do Rio Potengi (Rio Grande do Norte, Brasil) com vistas ao seu cultivo em bases sustentáveis

Os cavalos-marinhos têm cativado a imaginação e a curiosidade dos seres humanos por centenas de anos. No entanto, nos dias de hoje, esses animais correm um sério risco de extinção por fatores como a pesca desordenada para suprir os mercados de peixes ornamentais e da medicina tradicional chinesa e principalmente, a destruição do seu habitat. Nesse contexto, é crescente o número de estudos sobre a ecologia, a biologia (reprodutiva, especialmente) e o cultivo de várias espécies do gênero Hippocampus, inclusive para fins conservacionistas e de recomposição de estoques. Duas espécies de cavalos-marinhos são encontradas no Brasil: Hippocampus reidi Ginsburg 1933 e Hippocampus erectus Perry. No entanto, as informações sobre essas espécies estão basicamente restritas ao seu grau de ocorrência ou a sua área de ocupação. No presente estudo, foi avaliado o desempenho reprodutivo de Hippocampus reidi do estuário do rio Potengi (05° 47' 42'' S; 35° 12' 34'' W), em Natal, Rio Grande do Norte. Para tanto, cavalos-marinhos grávidos (n = 38) foram coletados no referido estuário nos meses de setembro, outubro e novembro de 2008 e julho, agosto, setembro e outubro de 2009 e mantidos em laboratório até que liberassem os filhotes. O comprimento padrão (CPA), altura (ATA), volume da bolsa (VB) e peso úmido (PuA) dos adultos, bem como o comprimento padrão (CPF), altura (ATF), peso úmido (PuF) e peso seco (PsF) dos filhotes foram determinados. Os resultados obtidos mostraram que houve correlações significativas entre o CPA e a ATA (r²=0,171), CPA e PuA (r²=0,624), CPA e VB (r²=0,256), ATA e PuA (r²=0,788), PuA e VB (r²=0,211), CPF e ATF (r²=0,903) e CPF e PsF (r²=0,163). A análise de correspondência (AC) que associou as classes do comprimento padrão dos adultos (CPA) e o volume da bolsa de H. reidi ao número de filhotes mostrou que animais entre 19 cm e 21 cm e com volume de bolsa entre 3 mL e 4 mL foram os que liberaram o maior número de filhotes. Os resultados do presente estudo também indicam que o tamanho mínimo de captura recomendado pela CITES (10 cm de altura) para H. reidi deve ser revisto, uma vez que não foram encontrados animais menores que 13,5 cm que estivessem grávidos. Finalmente, o número médio de filhotes por desova obtido no presente estudo (n = 775 ± 398 filhotes) realçou o potencial reprodutivo de H. reidi e a necessidade de estudos adicionais com esta espécie

O memorial autobiográfico: uma tradição acadêmica do ensino superior no Brasil

The thesis has as object of study the autobiographical memmorials. The general objective is to describe the history of the memmorial as an academic tradition of higher education in Brazil. Considered a hybrid genre, memmorials are known for focusing on life stories from a scientific perspective. The investigation revolves around three intertwined branches: History of Education, educational practices and language usages, which allow us to conduct a dialogue with multiple theoretical-methodological references with a view to supporting our analyses. The corpus used for the analysis was made up of 40 autobiographical memmorials, distributed as follows: 16 academic memmorials, dated from 1935 to 1970; 07 academic memmorials, dated from 1980 to 2007; and 17 formation memmorials, dated from 1995 to 2000. In this corpus, we also included official documents, which relate to legislation contained in edicts, resolutions, ordinances, regulations, which we used with a view to: 1) getting to know and understanding the big picture of higher education regulation in Brazil and the aspects related to the higher education teaching career; 2) investigating the text of memmorials in the light of the injunctive discourse characteristic of the edicts and resolutions in which they were based. The analysis of the memmorial supported by the legislation which regulates it allowed us to reconstitute the image of the professor throughout 80 years in the Brazilian public university. For this purpose, the study was conducted in the theoretical-methodological perspective of the (auto)biographical research in Education and of the sociolinguistic studies on discourse genres and discursive traditions. The investigations reveal the memmorial as an academic genre in which the professor's academic-professional history and the history of the higher education teaching career in Brazil intertwine. Anchored in the Bakhtinian perspective on discourse genres, according to which the memmorials evolve and become more complex as their contexts of usage also evolve and become more complex themselves, the results of our analyses allowed us to correlate genre changes to the sociohistorical context and to its usage as an educational practice in the university, in the decades under study. Therefore, the analyses showed that these self-writings: go from latent subjectivity to pure objectivity from the 1930s to 1960s; they show total annulment of the subject from the 1960s to the 1970s; they reappear in the 1980s, having Professor Magda Soares' memmorial as perspective; they expand and diversify from the 1990s onwards, taking on a formative role and a perspective of future as well. So far as language usages are concerned, we investigated the relationship of the subject with the language, especifically the manifestation of alterity on the discursive tissue of the memmorials. In this branch, the analyses pointed to the influence of the authoritative discourse on the formation of the professor and of the injunction and reinventing discourses on the authorship process. Therefore, the autobiographical memmorial reveals itself as a specific expression of the Brazilian academy's cultural sphere and allows us to confirm the hypothesis that each memorial tackles a singular-plural situation, by presenting a dialectical articulation between private and public, according to the institutional structures, in which and with which the professor has already formed him/herself and with which he/she dialogues

Política de formação docente na América Latina :Argentina, Brasil e Chile

This work aims at studying the policies of teaching training and their impact in the actors and in the education systems of the countries in which these policies were implemented into the context of neoliberal reforms. We particularly studied these policies in three Latin America countries: Argentina, Brazil and Chile. The policies studied here are the ones implemented from the 90 s. However, the horizon of this study is at the beginning of the 80 s, period that starts one of the four intervention initiatives of education here studied: The Main Project of Education For Latin America and Caribbean (PROMEDLAC), which in 2002 goes into a new stage and it is called Regional Project of Education for Latin America and Caribbean (PRELAC), worked out by UNESCO as a request of government representatives of countries of the region, based on the suggestions of Declaration of Mexico , signed by them in 1979. These suggestions will be in the base of the other three initiatives: The Education For All (EPT); Ibero-American Conferences of Education (CIE) and The Hemisphere Action Plan of Education (PAHE), whose documents are the base to the production of an abundant legislation and normatization on education that created the parameters on which the policies of education reforms were worked out and implemented and the dynamism of our education systems from the last two decades of the twentieth century on. All these initiatives intend to work with objectives, projects and programs that, in some cases, in isolation or in groups, are under influence of their actions in a way that frequently it is difficult to identify which of them is the main responsible for some advances. It is important to stand out that not all of the suggestions produced by these initiatives were implemented as policies, and many of them to be implemented were changed in such a way that they were distorted, even they were a result of a multilateral deal, each country gave to them its own interpretation. Moreover, in all these processes the teaching entities had and keep having a fundamental role. The evidences, result of the evaluations of each initiative, show that education policies implemented produced advances in several aspects. They are still not the ideal ones, in truth, but they do exist. In relation to the teaching questions, there were and are still being implemented multiples and varied actions that did not have the expected impact in the education systems of the countries, objects of this study, but, many of them that go on, are promising and start to have a positive impact into the education systems. Even so, the teaching subject matter, even playing a central role in the agenda of all countries of the region, still represents one of the big challenges to the advance and improvement of our education systems

O cuidar de enfermagem e da família à pessoa idosa no domicílio: uma abordagem etnográfica

O envelhecimento é um processo multidimensional que envolve entre outros os aspectos físico-biológicos, sociais, econômicos e psicológicos. Ao avaliar essa fase da vida dentro de uma visão social e cultural, percebe-se que ser idoso ou não varia com as concepções culturais, sendo necessário investigar as variações que atuam no processo e rege o fenômeno sociocultural da realidade em que se está inserido. Com o aumento da população idosa mundial, esse processo tende a se intensificar. Estima-se que até em 2050 existam cerca de dois bilhões de pessoas com mais de 60 anos no mundo, e a maioria delas vivendo em países em desenvolvimento. No Brasil, acredita-se que existam, atualmente, cerca de 20 milhões de idosos. A normatização e legislação brasileira de amparo ao idoso em relação à saúde iniciaram-se a partir da Constituição Federal de 1988 e da Lei 8080 que regulamenta o Sistema Único de Saúde em 1990, em seus níveis de complexidade: atenção básica, média e alta complexidade. Para auxiliar nessa prestação dos serviços na atenção básica de saúde é importante observar as condições sociais, culturais, econômicas e de saúde dos idosos e seus familiares. Nesse sentido, a visita ao domicílio e a avaliação deste idoso em seu ambiente doméstico torna-se fundamental para acompanhar o cuidar prestado e o quanto esse processo irá interferir no sistema de saúde, na família e na qualidade de vida dos idosos. Neste contexto, o enfermeiro como integrante da Equipe de Saúde da Família, presta assistência à saúde do idoso no domicílio. Nesse sentido, o objetivo do estudo é analisar o cuidado de enfermagem e da família à pessoa idosa no domicílio com vistas à identificação das influências socioculturais. Trata-se de um estudo do tipo descritivo e de abordagem qualitativa, norteados por princípios teórico-metodológicos da etnografia com vistas ao estudo da influência dos aspectos culturais e sociais na assistência da família e do enfermeiro à idosos em domicílio. Foi realizado no município de Santana do Matos, RN, tendo como participantes, idosos, familiares e enfermeiros da equipe da ESF, definidos a partir da população do município e obtendo-se uma amostra intencional de 25 participantes: 6 enfermeiras, 10 idosos e 9 grupos familiares. Para a coleta de informações, utilizou-se observação, entrevista, diário de campo e grupo focal. Os resultados foram apresentados em forma de narrativa descritiva, na perspectiva dos conceitos de Boris Cyrulnik, com análise interpretativa cultural de Geertz, na busca dos significados e símbolos próprios da cultura da velhice de idosos e dos seus familiares, sobre cuidados que são realizados, tanto pela família, como pelos enfermeiros em domicílio. Observou-se que a família e o cuidador, dentro de sua realidade social e cultural, precisam ser mais compreendidos pela equipe de saúde para ser melhor orientados e capacitados na realização do cuidar de forma adequada. Por sua vez, os profissionais de saúde, em especial o enfermeiro, enfrentam dificuldades para realizar o cuidado ao idoso no domicílio como a grande demanda de atribuições na unidade de saúde como consultas e atendimentos; falta de transporte até os domicílios; extensão territorial do município e das áreas assistidas; número de pessoas atendidas por cada equipe; falta de compreensão dos profissionais de saúde quanto à importância da visita domiciliária na atenção básica. Entendem a necessidade de realizar ações de promoção em saúde, prevenção de agravos e de educação em saúde, além de reconhecerem a importância de uma melhor formação acadêmica para atuar nessa perspectiva e contribuírem para as mudanças necessárias na prática dos cuidados ao idoso em domicílio

Educação em saúde em hanseníase: estratégia na educação básica, Parnamirim/RN

Leprosy is an ancient disease that still stands as a public health problem worldwide, especially in the considered developing countries. Of these, Brazil still has large areas of endemicity. The disease remains high among those younger than 15 years old. In this group, the national index achieves 0.6 every 10 000 inhabitants and reaches 2 in the North and Midwest of Brazil. Therefore, the plan of the Ministry of Health is to prioritize the fight against disease in critical areas, providing early diagnosis and timely treatment, especially for patients under 15 years old. This research aimed to: identify the knowledge of students from three schools of basic education in Parnamirim/RN about the risk of getting ill in leprosy; conduct them health education on this topic. An exploratory-descriptive study with quantitative and qualitative nature. Data collection consists of two steps: questionnaire and health education on leprosy. The study was approved by the Research Ethics Committee (REC) of UFRN through the opinion nº 204/2009. Quantitative data obtained were organized, categorized, typed and submitted to the Microsoft Office - Excel for quantitative analysis with simple percentage. Qualitative data were subjected to a content analysis according to Bardin. The sample consisted of 164 students of basic education, most of which is: 1st year of high school, from 11 to 15 years, in the afternoon shift, female gender, skin color white and residents in the municipality of Parnamirim/RN. Still, each student living with four people curiously did not respond in relation to occupation of the father. But the same answered their mother as a housewife and a family income of one to less than four minimum wages. There have been significant results compared the performance of health education in leprosy. Initially, students possessed little knowledge about leprosy. Subsequent to health education, most knew the answer about the disease, transmission, cause, where to get help in case of suspicion of leprosy and the need for the people who lives with leprosy patients to also seek for help, the understanding about if it is treatable or not. Content analysis has established the following themes: axis I, what I do not know about leprosy: cure, fear and prejudice. Axis II, what I know about leprosy, we identified: cure, effectiveness of health education and social exclusion in the past. It is considered the scope of the proposed objectives by matching the effectiveness of health education on leprosy in basic education in Parnamirim/RN; emphasizes, therefore, the importance of understanding the knowledge of public school students. It is expected of them to detect early cases of leprosy in their communities; encourage adherence to treatment as quickly as possible; prevent disability; reduce the stigma surrounding the disease.

Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose

Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária

People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconized in the scientific literature, interfering with wound healing and quality of life of affected. In this sense, the construction of a assistance protocol specific to people with venous ulcers (VU) can help professionals of the Family Health Strategy both in patient assessment as and in establishment of quality assistance. Thus, this study aimed to analyse the validity of a multiprofessional assistance protocol for people with venous ulcers in primary care by health professionals using Delphi technique. This is a quantitative study, the methodological type conducted in two steps: first step related to integrative literature review to subsidize the development of the protocol, then these aspects were organized and proposed to the judges of the study through the Delphi technique. The study was initiated after approval by the Research Ethics Committee. The first step was performed between August and September 2012, in the virtual library of health, in the page of the Coordination of Improvement of Higher Education Personnel, of Municipal Health Secretariat and international guidelines of associations and in the subsequent step carried out between September 2012 to January 2013, was performed search by Lattes platform of the National Council of Technological and Scientific Development, in order to identify health professionals in Brazil who act as judges of the instrument and then, via online, the form was submitted to them.The sample for the second step was 51 judges in the first round and 35 for the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach Kappa and CVI established were: request / realization / test results, demographic data, medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion location/ edema and pain treatment. After removal of items which have not obtained Kappa or CVI index established, it was found achieving optimal levels of these index for the categories. In the next step was the ressubmissão of protocol to judges through the Delphi technique in it was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2 phase and the other three categories remained the same Kappa and IVC of the previous phase. As for the average of evaluation requirements of the protocol was found that the scores assigned by the judges were higher in the second phase in nine of the 10 items, remaining the same in only one of the items indicating validity of the instrument before the consensus of the judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The formulation of this assistance protocol valid and reproducible will enable a reorganization and redesign of assistance, with standardization of actions and continuity of care for persons with venous ulcers in primary health care

Atuação do enfermeiro no acompanhamento do crescimento e desenvolvimento da criança

The nurses assistance in monitoring the growth and development of children has been characterized mostly a service based on the biological dimension of illness, when in reality, the actions should be combined in the reorientation of care model of the Family Health Strategy. Thus, the research aimed to examine the role of nurses in the growth and development of children. This is an exploratory and descriptive, qualitative approach. The project was approved by the Ethics Committee of the Universidade Federal do Rio Grande do Norte under Opinion No. 191/2012. Data collection was developed in the Health Units from the city of Natal, RN, Brazil. Survey participants were nurses who worked in the Family Health Strategy for at least two years and who performed the monitoring of child growth and development in the health unit selected. Data were collected through an in-depth interview, and seized material from speeches was treated as categorical thematic analysis proposed by Bardin. This process revealed three themes, which were analyzed in the light of Relief Models and Process Work in Health and Nursing and discussed based on the findings literary. The results elucidated that nurses consider their performance satisfactory as it has favored the accession of mothers of children under one year nursing visits, contributing to the reduction of morbidity and mortality due to prevalent diseases, as well as the establishment of a connection between the professionals and mothers. It was shown that despite having a promotion and prevention with the use of lightweight technologies, the nurses also emphasized the care of mothers in complaints and signs and symptoms of children, followed by referrals to professionals in the unit or to other sectors. Furthermore, we found that the process of working nurses face challenges regarding the organizational structure of services and social situation of the family. Given these statements, it is observed that despite the strong interference from hegemonic health model in the performance of nurses, it is found that these professionals have been investing in promotion and prevention to injuries to children in care, with a focus on family context. Thus, nurses are embarking on making the reorientation of health care through the use of relational technologies, which has contributed to solving the integral care to the pediatric population

Um estudo do perfil de formação dos técnicos de segurança do trabalho no Brasil na perspectiva de sistemas de gestão de segurança e saúde ocupacional

This work provides great contribution to the documental study of the Work Safety courses offered by CEFETs in Brazil, under the perspective of safety management and occupational health, using as a referential the specification OHSAS 18001 (BSI, 1999), as well as directions provided by OIT (ILO, 2001). The theoretical research compares technical and managing competences of the projects of Work Safety courses at CEFETs with the international legislation mentioned above. For field research, questionnaires containing open and close questions were answered by teachers and students aiming at identifying the importance of technical and managing competences for the formation of Work Safety technicians, besides trying to identify which level of minimal formal knowledge should be required to perform managing activities in the area of Work Safety Management Systems and Occupational Health (SGSSO, in Portuguese). The results of the theoretical research point out differences between the projects of the Work Safety technical courses at CEFETs under the perspective of SGSSO. The field research shows that students and teachers opinions converge about most technical and managing competences. In relation to academic formation, the research suggests divergences to the criterion stated by the norm ISO 19011(ABNT, 2002)

Reconhecimento de voz através de unidades menores do que a palavra, utilizando Wavelet Packet e SVM, em uma nova estrutura hierárquica de decisão

The automatic speech recognition by machine has been the target of researchers in the past five decades. In this period have been numerous advances, such as in the field of recognition of isolated words (commands), which has very high rates of recognition, currently. However, we are still far from developing a system that could have a performance similar to the human being (automatic continuous speech recognition). One of the great challenges of searches for continuous speech recognition is the large amount of pattern. The modern languages such as English, French, Spanish and Portuguese have approximately 500,000 words or patterns to be identified. The purpose of this study is to use smaller units than the word such as phonemes, syllables and difones units as the basis for the speech recognition, aiming to recognize any words without necessarily using them. The main goal is to reduce the restriction imposed by the excessive amount of patterns. In order to validate this proposal, the system was tested in the isolated word recognition in dependent-case. The phonemes characteristics of the Brazil s Portuguese language were used to developed the hierarchy decision system. These decisions are made through the use of neural networks SVM (Support Vector Machines). The main speech features used were obtained from the Wavelet Packet Transform. The descriptors MFCC (Mel-Frequency Cepstral Coefficient) are also used in this work. It was concluded that the method proposed in this work, showed good results in the steps of recognition of vowels, consonants (syllables) and words when compared with other existing methods in literature