Concepções de policiais militares sobre cuidados com a saúde

A ausência de cuidados do homem com a saúde representa um fenômeno significativo, pois contribui para o aumento da morbidade e mortalidade masculina por causas evitáveis. Essa realidade torna-se mais relevante quando se trata do policial militar, devido às peculiaridades do seu processo de trabalho. Visto isso, considera-se que os cuidados de saúde adotados por policiais militares atrelam-se ao entendimento de que possuem sobre os agravos à saúde, o qual perpassa por concepções de gênero e da profissão. Isso levou ao seguinte questionamento: Como o policial militar concebe os cuidados com a saúde. Objetivou-se analisar concepções de policiais militares sobre cuidados com a saúde. Trata-se de um estudo exploratório e descritivo, com abordagem qualitativa, desenvolvido junto a um Batalhão Militar do Comando de Policiamento de Natal, Rio Grande do Norte, Brasil. A coleta de dados foi realizada no período de junho a julho de 2013. Essa etapa foi antecedida pela anuência do Comandante Geral da Polícia Militar do Rio Grande do Norte, sob a aprovação do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, com o CAAE nº 15449713.7.0000.5537, e autorização formal dos entrevistados mediante a assinatura do Termo de Consentimento Livre e Esclarecido (TCLE), atendendo às exigências da Resolução 466/2012, do Conselho Nacional de Saúde, no que se refere à pesquisa com seres humanos. Participaram do estudo 21 policiais militares, do sexo masculino, que trabalhavam no policiamento ostensivo, não estavam de licença médica e apresentaram condições psicológicas e/ou físicas favoráveis para responder aos questionamentos. Os dados foram coletados por meio de entrevista semiestruturada mediante um roteiro constituído de duas partes: a primeira com questões sociodemográficas com vistas à caracterização dos participantes da pesquisa e a segunda com duas questões norteadoras relativas ao objeto de estudo. Os depoimentos foram tratados conforme o método de análise de conteúdo na modalidade de análise temática segundo Bardin. Desse processo, emergiram três categorias: hábitos de vida de policiais militares, repercussão do trabalho na saúde de policiais militares e atitudes de policiais militares em frente dos problemas de saúde. A análise dos dados foi subsidiada pelo referencial teórico do Modelo de Crenças em Saúde (Health Belief Model), de acordo com as variáveis vulnerabilidade e barreiras . Para respaldar a discussão dos resultados, buscou-se na literatura conhecimentos acerca da saúde do homem e do policial militar. Os resultados apontaram que os entrevistados procuram cuidar da saúde com práticas de exercícios físicos, alimentos saudáveis e preservação do sono. No entanto, vivenciam dores de coluna, ganho de peso, dificuldades para dormir, estresse e sofrimento psicológico. Diante disso, eles buscam apoio quando acometidos por agravos à saúde e reconhecem a necessidade de medidas de segurança durante o serviço. Portanto, notam a sua condição de vulnerabilidade em decorrência de seu ofício, porém enfrentam dificuldades na adoção de práticas preventivas de agravos a saúde. Mediante os resultados, faz-se necessário que o enfermeiro atuante junto a este público elabore, implemente e acompanhe estratégias de atenção a sua saúde

Enfermeiros pós-graduados: continuidades e rupturas no cotidiano profissional de hospitais universitários

A presente pesquisa teve como objetivo analisar as transformações do cotidiano profissional do enfermeiro do hospital universitário após a realização do curso de mestrado. Trata-se de um estudo com abordagem qualitativa, realizado no Complexo Hospitalar Universitário da UFRN, composto pelo Hospital Universitário Onofre Lopes (HUOL), Maternidade Escola Januário Cicco (MEJEC), e Hospital de Pediatria Professor Heriberto Ferreira Bezerra (HOSPED) localizados em Natal-RN; e pelo Hospital Universitário Ana Bezerra (HUAB) situado em Santa Cruz-RN. A população foi composta por vinte e dois enfermeiros, com título de mestre em enfermagem, que trabalham nessas instituições. Após encaminhamento e aprovação pelo Comitê de ética em pesquisa, conforme Parecer nº 268.498 e CAAE: 13922713.1.0000.5537, as entrevistas foram iniciadas, utilizando-se um roteiro semiestruturado, organizado em questões orientadas em conformidade com os objetivos do estudo. Do material empírico, emergiram as categorias que foram trabalhadas com base na análise de conteúdo temática, tendo como aporte teórico os estudos de Agnes Heller acerca do cotidiano e os de Paulo Freire sobre educação e mudanças, buscando a possível interlocução entre esses autores. Os resultados demonstram que o cotidiano dos enfermeiros nos hospitais universitários, após cursarem o mestrado, modifica-se a partir da própria motivação em cursálo e do apoio institucional recebido. As continuidades e rupturas apontadas estão distribuídas nas categorias: a inércia da cotidianidade, na qual os enfermeiros relatam a dificuldade em mudar seu cotidiano devido à rotina exaustiva e à falta de apoio; reconhecem mudanças particulares, compreendendo a formação de um olhar crítico/reflexivo/analítico, e a qualificação para o ensino e pesquisa; e as rupturas do cotidiano, que se referem às mudanças ocorridas no serviço, como a melhoria da assistência, pela implantação de resultados; e uma prática diferenciada por ter um profissional qualificado. Portanto, considera-se que a realização do mestrado contribuiu para o crescimento do intelectual e profissional do enfermeiro e, consequentemente, para o serviço, no cotidiano do Complexo Hospitalar Universitário, sendo reconhecido pelos enfermeiros o compromisso com uma maior responsabilidade social. Porém, ainda são necessárias reflexões sobre maneiras de minimizar as dificuldades apontadas, como forma de incentivar essa qualificação

Trauma em idosos atendidos pelo serviço pré-hospitalar móvel

O The aim of this study was to characterize the occurrence of trauma in the elderly population served by the mobile pre-hospital service, in Natal, Rio Grande do Norte. This is a descriptive, transversal and quantitative approach and whose population consisted of 2,080 trauma victims. The sample, of systematic random type, consisted of 400 elderly people, aged from 60 years old, assisted by the Office of Mobile Emergency in Natal / RN, between January 2011 and December 2012. Data collection began after consent and assent of the institution of a Research Ethics Committee under No. 309 505. It was proceeded to documentary retrospective analysis of records of this service through a form of self-development, validated by expert judges considered reliable (α> 0.75) and valid (CVI = 0.97) in their clarity and relevance. Data were tabulated by the Statistical Package for Social Sciences, version 20.0. The results show that older victims have an average age of 74.19 years old, with a prevalence of female involvement by chronic diseases, especially hypertension, average usage of 2.2 routine medications with vital signs within normal limits. The trauma prevailed during the daytime, in the residence of the victims, north of the city and on weekends. Among the mechanisms of trauma were falls, traffic accidents and physical aggression, whose most common type was brain-cerebral trauma and the main consequences were suture wounds and closed fractures. Basic Support Units were as more driven to pre-hospital care (87.8%) and the main destination place consisted of a referral hospital for emergency of the state (57.5%). Among the most commonly performed procedures by nursing staff immobilization with rigid board and neck collar and the peripheral venipuncture, and the main component used for volume replacement to saline were highlighted. There was a significant relationship between the deaths and the mechanism of injury, mechanism of injury and procedures, except medication administration procedures carried out, except immobilization and unit for service. It is highlighted the prevalence of trauma in the elderly, poor follow-up Pre-Hospital Trauma Life Support protocol and the paucity of records and nursing procedures performed. There is need for a protocol of care specific to elderly trauma victims and education strategies for the prevention of such events

Assistência de enfermagem às urgências e emergências psiquiátricas no serviço de atendimento móvel de urgência em Mossoró-RN

This study aims to identify the concepts of professional nursing team on assistance in urgency and psychiatric emergencies in SAMU in Mossoró/RN, identifying the difficulties in implementing an emergency assistance to the user in psychiatric distress in this service and point strategies in pursuit of consolidation and expansion of comprehensive health care to the public. It is a descriptive research with qualitative and exploratory approach. The subjects were employees of the nursing staff of SAMU of that mentioned municipality. Semi-structured interviews are applied as tool for data collection. It was counted on the consent of the institution where the study was developed and approval by the Ethics Committee in Research of UFRN with CAAE No 17326513.0.0000.5537, besides signing the Informed Free Consent Term by the participants. Data analysis was done by means of thematic analysis proposed by Bardin. Thus , as a result of the research produced the following categories: mechanistic practice; dehumanization of care; need for qualification, barriers to assistance in urgency and psychiatric emergency and strategies in pursuit of comprehensive care, which proceeded in preparing two articles entitled "Nursing care to the emergency room and psychiatric emergencies in the mobile emergency care service" and "Barriers for emergency service and psychiatric emergencies in the mobile emergency care service". In the studied reality it was identified that nursing care offered to users in situations of urgency and psychiatric emergency is made based primarily on the use of chemical and physical restraints, as well as transportation to the general hospital, constantly using the police force support, which meets the guidelines of the Psychiatric Reform and thereby undermining the provision of an effective and humane care. This scenario is worsened by the lack of an organized network of services in mental health, where after the service the user is taken to a general hospital, considering that there is no ready or appropriate psychiatric emergency service as a Center of Psychosocial Care - CAPs III to reference it, thereby precluding the realization of a resolute and comprehensive care. Thus, it is concluded that nursing care is based on biologicist and medicine-centered model advocated by classical psychiatry, and that despite all the advances in psychiatric reform, still guides the mental health care, so the lack of service network organized in hierarchical and mental health, where the user in urgency and emergency service can be watched in full and the guidelines of the psychiatric reform can be realized in practice

Análise dos indicadores de qualidade versus taxa de abandono utilizando método de regressão múltipla para serviço de banda larga

Telecommunication is one of the most dynamic and strategic areas in the world. Many technological innovations has modified the way information is exchanged. Information and knowledge are now shared in networks. Broadband Internet is the new way of sharing contents and information. This dissertation deals with performance indicators related to maintenance services of telecommunications networks and uses models of multivariate regression to estimate churn, which is the loss of customers to other companies. In a competitive environment, telecommunications companies have devised strategies to minimize the loss of customers. Loosing customers presents a higher cost than obtaining new ones. Corporations have plenty of data stored in a diversity of databases. Usually the data are not explored properly. This work uses the Knowledge Discovery in Databases (KDD) to establish rules and new models to explain how churn, as a dependent variable, are related to a diversity of service indicators, such as time to deploy the service (in hours), time to repair (in hours), and so on. Extraction of meaningful knowledge is, in many cases, a challenge. Models were tested and statistically analyzed. The work also shows results that allows the analysis and identification of which quality services indicators influence the churn. Actions are also proposed to solve, at least in part, this problem

Fatores da satisfação, fidelidade e recomendação em serviço de saúde: estudo em setor ambulatorial de hospital

This thesis deals with the factors affecting customer satisfaction, loyalty and recommendation in the health care sector. It is adapted a model proposed by Johnson et al. (2001) of quality and loyalty antecedent factors and it is conducted a survey with a sample of 109 customers of a hospital on the ambulatory in Natal city, a capital of a Northeastern State of Brazil. It is carried descriptive and multiple regression statistical analysis. The main findings related to satisfaction are that quality factors of doctor professionalism, clerical staff efficiency, consultancy room comfort, time to provide the medical consultancy but also hospital localization are the most significant factors affecting satisfaction. Regarding personal full loyalty, satisfaction with the hospital and affective commitment are the main factors yet for partial loyalty image and calculate commitment play the main role. For recommendation satisfaction, image and brand are the main factors. The overall model used fairly explains the satisfaction, loyalty and recommendation outcomes with varying factors regarding each final purpose, e.g. loyalty or recommendation

Melhoria da segurança pública: uma proposta para alocação de unidades policiais utilizando o modelo das p-medianas e do caixeiro viajante

The decrease in crime is one of the core issues that cause concern in society today. This study aims to propose improvements to public safety from the choice of points to the location of police units, ie the points which support the car and the police. For this, three models were developed in order to assist decision making regarding the best placement of these bases. The Model of Police Units Routing has the intention to analyze the current configuration of a given region and develop optimal routes for round preventative. The Model of Allocation and Routing for New Police Units (MARNUP) used the model of facility location called p-median weighted and traveling salesman problem (TSP) combined aiming an ideal setting for regions that do not yet have support points or to assess how far the distribution is present in relation to that found in solution. The Model Redefinition and Routing Unit Police (MRRUP) seek to change the current positioning taking into account the budgetary constraints of the decision maker. To verify the applicability of these models we used data from 602 points to instances of police command that is responsible for the capital city of Natal. The city currently has 31 police units for 36 of these 19 districts and police have some assistance. This reality can lead to higher costs and higher response times for answering emergency calls. The results of the models showed that in an ideal situation it is possible to define a distance of 500 km/round, whereas in this 900 km are covered by approximately round. However, a change from three-point lead reduced to 700 km / round which represents a decrease of 22% in the route. This reduction should help improve response time to emergency care, improving the level of service provided by the increase of solved cases, reducing police shifts and routing preventive patrols

Qualidade do serviço de informação digital :um estudo exploratório em web sites de Programas de Pós-Graduação

This dissertation of Mestrado investigated the performance and quality of web sites. The target of the research is the proposal of an integrated model of evaluation of services of digital information in web educational sites. The universe of the research was constituted by eighteen Brazilian Universities that offer after-graduation courses, in the levels of mestrado and doutorado in the area of Engineering of Production. The adopted methodology was a descriptive and exploratory research, using the technique of systematic comment and focus group, for the collection of the data, using itself changeable independent dependents and, through the application of two instruments of research. The analysis protocol was the instrument adopted for evaluation and attainment of qualitative results. E the analysis grating was applied for evaluation and attainment of the quantitative results. The qualitative results had identified to the lack of standardization of web sites, under the attributes of content, hierarchy of information, design of the colors and letters. It of accessibility for carriers of auditory and visual special necessities was observed inexistence, as well as the lack of convergence of medias and assistivas technologies. The language of the sites also was evaluated and all present Portuguese only language. The general result demonstrated in grafico and tables with classification of the Universities, predominating the Good note As for the quantitative results, analysis method ed was estatistico, in order to get the descriptive and inferencial result between the dependent and independent variaveis. How much a category of analysis of the services of the evaluated sites, was found it props up and the index generality weighed. These results had served of base for ranking of existence or inexistence the Universities, how much of the information of services in its web sites. In analysis inferencial the result of the test of correlation or association of the independent variaveis (level, concept of the CAPES and period of existence of the program) with the caracteristicas, called was gotten categories of services. For this analysis the estatisticos methods had been used: coefficient of Spearman and the Test of Fisher. But the category you discipline of the Program of Mestrado presented significance with variavel independent and concept of the CAPES. Main conclusion of this study it was ausencia of satandardization o how much to the subjective aspects, design, hierarchy of information navigability and content precision and the accessibility inexistence and convergence. How much to the quantitative aspects, the information services offered by web sites of the evaluated Universities, still they do not present a satisfactory and including quality. Absence of strategies, adoption of tools web, techniques of institucional marketing and services that become them more interactive, navigable is perceived and with aggregate value

Construção e implementação do Balanced Scorecard em uma organização educacional: o caso do Serviço Nacional de Aprendizagem Comercial do Rio Grande do Norte SENAC RN

The changes that have taken place in the organizational environment in recent decades have led to new performance measurement systems being proposed, given the inadequacy of traditional models. The Balanced Scorecard (BSC) emerged as an instrument to translate financial and non-financial assets into real values for all interested parties in the organization, allowing the introduction of strategies to achieve the desired goals. Research shows that most errors committed with the use of this method are related to the implementation process. Thus, the aim of this dissertation is to analyze the process of building and implementing the BSC in an organization. This empirical exploratory study is based on the classic case study method, which enables the researcher to work with a set of evidence, including direct observation, interviews and document analysis. The results show that the use of BSC in the company investigated posed problems during the process of building and implementing the method. These problems were caused mainly by the lack of involvement on the part of upper management and the team s scant knowledge of Balanced Scorecard. One of the gains obtained from adopting the system was the introduction and/or consolidation of a culture of strategic planning and participative management. The continuous implementation phase was highlighted in the monitoring program, created by the organization in an attempt to reverse existing problems, using the BSC as a third generation strategic management system, which led to significant gains, better use of the system and stronger management practices

Fatores que afetam a satisfação de pacientes em serviços de saúde :um estudo em setor ambulatorial de hospital

This thesis shows concepts and models related to customer satisfaction measurement, focusing in detail on patients satisfaction evaluations in a policlinic sector of a hospital located in Natal RN. To reach this aim, two hundred and fifty one patients of this hospital were interviewed. The methodology approach includes a theoretical basis through a review and study of previous research on the topic, governmental initiatives and management systems which deal with excellence and need more reports concerning customers perceptions about satisfaction. Furthermore, it was included some models of nationals index about customer satisfaction. The Norwegian model was used in this thesis. The use of this approache, together with a multiple regression analysis, led to results that shows the factors which affect patients satisfaction in a policlinic sector. They are four as following: The evaluation of physician attendance; its results; simplicity of accessibility when health services are needed; and both support and tranquility given by the hospital. The study results can support researches of a conceptual model to determinate the aspects which affect the patient s satisfaction and could be a contribution to a development of a national costumer satisfaction index

Otimização de escalas de serviço de tripulações estudo de caso em uma empresa de transporte urbano na região metropolitana de Natal/RN

This work aims to "build" rostering urban bus crews to minimize the cost of overtime. For this purpose a mathematical model was developed based on case study in an urban transport company in the metropolitan region of Natal. This problem is usually known in the literature as the Crew Scheduling Problem (CSP) and classified as NP-hard. The mathematical programming takes into account constraints such as: completion of all trips, daily and maximum allowable range of home and / or food. We used the Xpress-MP software to implement and validate the proposed model. For the tested instances the application of the model allowed a reduction in overtime from 38% to 84%

Especificação e implementação de um protótipo de serviço web para buscas baseadas em contextos compartilhados definidos a partir de sintagmas e relacionamentos

The popularization of the Internet has stimulated the appearance of Search Engines that have as their objective aid the users in the Web information research process. However, it s common for users to make queries and receive results which do not satisfy their initial needs. The Information Retrieval in Context (IRiX) technique allows for the information related to a specific theme to be related to the initial user query, enabling, in this way, better results. This study presents a prototype of a search engine based on contexts built from linguistic gatherings and on relationships defined by the user. The context information can be shared with softwares and other tool users with the objective of promoting a socialization of contexts

Método Fuzzy para auxílio ao diagnóstico de câncer de mama em ambiente inteligente de telediagnóstico colaborativo para apoio à tomada de decisão

Breast cancer, despite being one of the leading causes of death among women worldwide is a disease that can be cured if diagnosed early. One of the main techniques used in the detection of breast cancer is the Fine Needle Aspirate FNA (aspiration puncture by thin needle) which, depending on the clinical case, requires the analysis of several medical specialists for the diagnosis development. However, such diagnosis and second opinions have been hampered by geographical dispersion of physicians and/or the difficulty in reconciling time to undertake work together. Within this reality, this PhD thesis uses computational intelligence in medical decision-making support for remote diagnosis. For that purpose, it presents a fuzzy method to assist the diagnosis of breast cancer, able to process and sort data extracted from breast tissue obtained by FNA. This method is integrated into a virtual environment for collaborative remote diagnosis, whose model was developed providing for the incorporation of prerequisite Modules for Pre Diagnosis to support medical decision. On the fuzzy Method Development, the process of knowledge acquisition was carried out by extraction and analysis of numerical data in gold standard data base and by interviews and discussions with medical experts. The method has been tested and validated with real cases and, according to the sensitivity and specificity achieved (correct diagnosis of tumors, malignant and benign respectively), the results obtained were satisfactory, considering the opinions of doctors and the quality standards for diagnosis of breast cancer and comparing them with other studies involving breast cancer diagnosis by FNA.

Determinação de Chaveamento para Recomposição do Serviço em Redes de Distribuição de Energia Elétrica em Média Tensão Através de Métodos Baseado em Parâmetros de Sensibilidade

The reconfiguration of a distribution network is a change in its topology, aiming to provide specific operation conditions of the network, by changing the status of its switches. It can be performed regardless of any system anomaly. The service restoration is a particular case of reconfiguration and should be performed whenever there is a network failure or whenever one or more sections of a feeder have been taken out of service for maintenance. In such cases, loads that are supplied through lines sections that are downstream of portions removed for maintenance may be supplied by the closing of switches to the others feeders. By classical methods of reconfiguration, several switches may be required beyond those used to perform the restoration service. This includes switching feeders in the same substation or for substations that do not have any direct connection to the faulted feeder. These operations can cause discomfort, losses and dissatisfaction among consumers, as well as a negative reputation for the energy company. The purpose of this thesis is to develop a heuristic for reconfiguration of a distribution network, upon the occurrence of a failure in this network, making the switching only for feeders directly involved in this specific failed segment, considering that the switching applied is related exclusively to the isolation of failed sections and bars, as well as to supply electricity to the islands generated by the condition, with significant reduction in the number of applications of load flows, due to the use of sensitivity parameters for determining voltages and currents estimated on bars and lines of the feeders directly involved with that failed segment. A comparison between this process and classical methods is performed for different test networks from the literature about networks reconfiguration

Estudo da qualidade de serviço de uma aplicação VoIP em ambientes wireless com handoff

This work deals with experimental studies about VoIP conections into WiFi 802.11b networks with handoff. Indoor and outdoor network experiments are realised to take measurements for the QoS parameters delay, throughput, jitter and packt loss. The performance parameters are obtained through the use of software tools Ekiga, Iperf and Wimanager that assure, respectvely, VoIP conection simulation, trafic network generator and metric parameters acquisition for, throughput, jitter and packt loss. The avarage delay is obtained from the measured throughput and the concept of packt virtual transmition time. The experimental data are validated based on de QoS level for each metric parameter accepted as adequated by the specialized literature