Avaliação do desenvolvimento infantil e a influência dos fatores biopsicossociais em crianças com cardiopatia congênita

Child development is the result of the interaction of biological, psychological and social factors. Hostile environment, income, offered stimuli, as well as the presence of a chronic illness are issues that may interfere significantly. Considering the chronic diseases, we can identify congenital heart disease (CHD) is characterized by anatomical heart defects and functional and currently has presented an incidence of up to 1% of the population of live births. This research aimed to evaluate child development and verify an association with the commitment by biopsychosocial factors of children with and without CHD. Study participants were children from zero to six years, divided into three groups: Group1- 29 children pre-surgical congenital heart disease, Group2- 43 children post-surgical cardiac patients and Group3- 56 healthy children. The instruments used were a biopsychosocial questionnaire and the Screening Test Denver II. Of the total of 128 children evaluated, 66 (51.56%) are girls, and ages ranged from two months to six years (median 24.5 months). In G1 and G2 predominated acyanotic heart disease (55.2% and 58.1%). Regarding the Denver II reviews, children with heart disease had more development ratings "suspicious" and "suspect/abnormal", and 41.9% of children who have gone through surgery had characterized its development as "suspect/abnormal" . In the group of healthy children 53.6% were classified as developmental profile "normal" (p = ˂0,0001). On the areas of Denver II, among children with heart disease was greatest change in motor areas (p = 0.016, p = ˂0,001). The biopsychosocial variables that were related to a possible developmental delay were gender (p = 0.042), child's age (p = 0.0001) and income per capita (p = 0.019). There were no associations between the variables related to the treatment of disease, information, understanding of the disease and the way parents treat their children. In the group of healthy children showed that children who underwent hospitalization rates were more changes in development (p = 0.025) and the higher the number of admissions over these changes have intensified (p = 0.023). The results suggest that children with congenital heart disease have likely delayed development. It was also observed that there is a significant difference between the children who have gone through surgery, those who are still waiting for surgery only doing clinical follow-up. Changes in the development are more connected motor areas can be explained by the characteristic features of the disease and treatment, such as dyspnea, fatigue, care and limitations in daily activities. The gender and age appear to be decisive in the development as well as healthy children go through hospitalization experience. Already in children with heart disease, it was realized that social variables involved in the disease and the treatment did not affect the development. This question can be understood by means of protective factors and resiliency, as this population receives family and social support.

Características dos programas de residência médica em cardiologia do estado do Rio Grande do Norte

The present study had as goal to evaluate Rio Grande do Norte state’s medical residency programs (MRP) in Cardiology. It’s a descriptive study, including a documental analysis of the program’s accreditation processes (PAP) of cardiology’s medical residency in Rio Grande do Norte state in 2014 and the analysis of the resident’s perception about his professional education as a specialist in Cardiology. Beside the documental analysis of the PAPs, it was applied a semi-structured questionnaire with closed questions Likert style and open questions to all the current and former residents of the MRPs analyzed. Two MRPs in Cardiology were identified in Rio Grande do Norte state, one hosted in a public institution and the other in a private institution. The documental analysis showed a greater amount of preceptors with a good level of ownership on the public institution in comparison with the private one, as well as a bigger number of publications, participation in congresses and in book’s publications. The private institution presents a better Urgency’s infrastructure, with emergency room and cardiologic ICU. It IS clear that the residents are aware of how a good residency must work, as well as the strengths and fragilities of their own residences. Most of Onofre Lopes Universitary Hospital’s residents point out as a strength the organization, participation and quality of the preceptors, practice activities and scientific debates, great amount of patients and the visits and debates with the preceptors on the sickrooms. As the greatest fragilities, they emphasize the lack of a urgency service of their own and a specialized ICU. In Coração Hospital of Natal (HCor), it is listed as weak points the theoretic scheduling and the few ambulatory practices. As positive aspects, they report the preceptors, the agility on the execution of exams, a good number of serious patients and procedures. In both residences, it is seen a certain difficulty in accepting the important and mandatory items imposed by the rules of the Medical Residences’ National Committee, such as: biostatistics, bioethics, medical ethic, epidemiology and research methodology. Besides that, the residents recognize that both hospitals have a good infrastructure and technological support, especially in imaging methods. The evaluation of PRMCs identifies the strengths of each program and the aspects to be improved in both programs. It also allowed the observation of difficulties in accepting some regulations contained in the CNRM resolution by the resident, such as participation in activities such as biostatistics, epidemiology and research methodology as well as the improvement needs of specific technical training, such as in emergency care. Thus, our results make possible to develop strategies for continued improvement of PRMC in RN state. In addition, it enabled the preparation of the resident’s manual in cardiology, containing even a breakdown of resident evaluation system, which could serve as a model for other residency programs.

Saúde bucal no Programa Saúde da Família: uma avaliação do modelo assistencial

O objetivo deste estudo foi avaliar a incorporação da saúde bucal no Programa Saúde da Família no Rio Grande do Norte, com base na análise de fatores capazes de interferir no processo de mudança dos modelos assistenciais em saúde bucal. Esta avaliação tomou como referência três dimensões: o acesso, a organização do trabalho e as estratégias de programação. Foram sorteados 19 municípios no estado. Os instrumentos de coleta foram a entrevista estruturada aplicada a gestores e dentistas, a observação estruturada e a pesquisa documental. Foi possível identificar precariedade nas relações de trabalho e dificuldades no referenciamento para média e alta complexidade, na intersetorialidade, no diagnóstico epidemiológico e na avaliação das ações. A maioria dos municípios apresentou pouco ou nenhum avanço no modelo assistencial em saúde bucal. Os municípios que demonstraram avanços apresentaram alta expectativa de vida ao nascer, baixas taxas de mortalidade infantil, valores per capita entre os mais altos do Estado e altos valores de IDH-M. Concluiu-se que políticas públicas que contemplam aspectos além dos pertinentes ao setor saúde são decisivas para uma real mudança nos modelos assistenciais.

Saúde bucal no Programa Saúde da Família: uma avaliação do modelo assistencial

O objetivo deste estudo foi avaliar a incorporação da saúde bucal no Programa Saúde da Família no Rio Grande do Norte, com base na análise de fatores capazes de interferir no processo de mudança dos modelos assistenciais em saúde bucal. Esta avaliação tomou como referência três dimensões: o acesso, a organização do trabalho e as estratégias de programação. Foram sorteados 19 municípios no estado. Os instrumentos de coleta foram a entrevista estruturada aplicada a gestores e dentistas, a observação estruturada e a pesquisa documental. Foi possível identificar precariedade nas relações de trabalho e dificuldades no referenciamento para média e alta complexidade, na intersetorialidade, no diagnóstico epidemiológico e na avaliação das ações. A maioria dos municípios apresentou pouco ou nenhum avanço no modelo assistencial em saúde bucal. Os municípios que demonstraram avanços apresentaram alta expectativa de vida ao nascer, baixas taxas de mortalidade infantil, valores per capita entre os mais altos do Estado e altos valores de IDH-M. Concluiu-se que políticas públicas que contemplam aspectos além dos pertinentes ao setor saúde são decisivas para uma real mudança nos modelos assistenciais.

Praias urbanas e racionalidade ambiental: avaliação da gestão, das intervenções urbanísticas e dos usos na praia de ponta negra

This dissertation addresses issues considered essential for sustainable development of urban waterfronts and beaches. Many of these spaces, even though they are of public authorities, economic market and general population interests - due to its landscape, its importance for recreation purposes and as a basis of " Sun and beach Tourism " (Turismo de Sol e Praia), among other factors - have shown aesthetic, health and cultural degradation, entailing environmental, economic and social losses and conflicts. Based on this perception, the research aims to understand the main reasons for these negative results for beach spaces. To this end, it was chosen the case study of a typical urban beach, Ponta Negra Beach, located in Natal, RN. Ponta Negra is associated with the "postcard" of the city and it has been deserving of municipal urban planning legislation that legally recognizes the importance of its landscape. Also it has received constant investments by the Government through urban projects, arguing to leave the site attractive to its users. Nevertheless, in the last fifteen years, the beach has lived with the expansion of its problems, such as those related to bathing water, to coastal erosion, and to the mangling of its natural surroundings. Social conflicts have also been frequent in this time frame: conflicts between residents of the waterfront and traders who work on the beach, between the traders themselves, between the managers of space and fishermen, between managers and formal and informal traders. Many of these social and environmental conflicts have taken such grand proportions that became legal matters. Assuming that the problems identified are related to the issue of rationality - understood as a system of values, norms and actions that relate means and ends - and upholding the need for focused research on "environmental rationality" to understand and interpret the dynamics of social and environmental problems encountered on site, the research that guides the study relies on the Mexican economist Enrique Leff's theory on "environmental rationality" which, briefly, can be defined as a system of values, norms, actions and means and ends relations based on the principles of environmental management and sustainable development. Among other aspects, rationality encompasses cross-sectional planning of public administration, the participation of society in the management of environmental resources, interdisciplinary reorganization of knowledge, the clash of opposing interests and the conciliation of common goals of different social actors. The study evaluates the relationship between "environmental rationality", as proposed by Enrique Leff, with the management, urban interventions and uses observed in Ponta Negra Beach. For that, some benchmarks were established and considered in the research as related to sustainable development of the "beachy" atmosphere. Analytical instruments chosen were the urban transformations and the environmental and social problems that have been the target of lawsuits. Also part of the study, the problems that were the subject of civil investigations, which are investigation procedures carried out by the Prosecutor's Office.

Praias urbanas e racionalidade ambiental: avaliação da gestão, das intervenções urbanísticas e dos usos na praia de ponta negra

This dissertation addresses issues considered essential for sustainable development of urban waterfronts and beaches. Many of these spaces, even though they are of public authorities, economic market and general population interests - due to its landscape, its importance for recreation purposes and as a basis of " Sun and beach Tourism " (Turismo de Sol e Praia), among other factors - have shown aesthetic, health and cultural degradation, entailing environmental, economic and social losses and conflicts. Based on this perception, the research aims to understand the main reasons for these negative results for beach spaces. To this end, it was chosen the case study of a typical urban beach, Ponta Negra Beach, located in Natal, RN. Ponta Negra is associated with the "postcard" of the city and it has been deserving of municipal urban planning legislation that legally recognizes the importance of its landscape. Also it has received constant investments by the Government through urban projects, arguing to leave the site attractive to its users. Nevertheless, in the last fifteen years, the beach has lived with the expansion of its problems, such as those related to bathing water, to coastal erosion, and to the mangling of its natural surroundings. Social conflicts have also been frequent in this time frame: conflicts between residents of the waterfront and traders who work on the beach, between the traders themselves, between the managers of space and fishermen, between managers and formal and informal traders. Many of these social and environmental conflicts have taken such grand proportions that became legal matters. Assuming that the problems identified are related to the issue of rationality - understood as a system of values, norms and actions that relate means and ends - and upholding the need for focused research on "environmental rationality" to understand and interpret the dynamics of social and environmental problems encountered on site, the research that guides the study relies on the Mexican economist Enrique Leff's theory on "environmental rationality" which, briefly, can be defined as a system of values, norms, actions and means and ends relations based on the principles of environmental management and sustainable development. Among other aspects, rationality encompasses cross-sectional planning of public administration, the participation of society in the management of environmental resources, interdisciplinary reorganization of knowledge, the clash of opposing interests and the conciliation of common goals of different social actors. The study evaluates the relationship between "environmental rationality", as proposed by Enrique Leff, with the management, urban interventions and uses observed in Ponta Negra Beach. For that, some benchmarks were established and considered in the research as related to sustainable development of the "beachy" atmosphere. Analytical instruments chosen were the urban transformations and the environmental and social problems that have been the target of lawsuits. Also part of the study, the problems that were the subject of civil investigations, which are investigation procedures carried out by the Prosecutor's Office.

Avaliação de qualidade da unidade de diálise no Hospital Universitário Onofre Lopes - HUOL

Over the years there has been a broader definition of the term health. At the same time it was found also an evolution of the concept of health care which in turn has led to changes in the approach to delivery of health services and hence in its management. In this regard, currently the nephrology services have been searching for quality technical and social need. In view of these innovations and the quest for quality, it elaborated the general objective: to develop a quality assessment protocol for dialysis service Onofre Lopes University Hospital. It is an intervention project effected through an action research, which consisted of 4 steps. Initially was identified through a literature search in scientific literature, which quality indicators would apply to a dialysis unit being selected as follows: infection rate in hemodialysis access site, microbiological control of water used for hemodialysis and Index User satisfaction. Through critical reflection on the theme researched in the previous step, it was drawn up three data collection instruments, interview form type, applied between the months of October and November 2015. In addition to the information obtained, also made up of the use of information retrieval technique. The results were organized in graphs and tables and analyzed using qualitative and exploratory technical approach. Then a reflective analysis of the data obtained and the diagnosis of reality studied was traced and confronted with the literature was performed. The data produced in this study revealed that the Dialysis Unit of HUOL is much to be desired, considering that some weaknesses have been identified in its structure. Faced with this finding have been proposed, as a contribution and aiming to guide the development of future actions, suggestions for improvement that should be implemented and monitored to be assured overcoming these difficulties, allowing an appropriate organizational restructuring, and resulting in improved service public offered. It was concluded that for hemodialysis treatment results are achieved and positive, it is necessary to have physical structure and adequate infrastructure, multidisciplinary team specialized, trained and in sufficient quantity, well designed processes for professionals to have standards to be followed decreasing the chance to err, and a risk management system to detect and control situations that endanger patient safety.

Avaliação de qualidade da unidade de diálise no Hospital Universitário Onofre Lopes - HUOL

Over the years there has been a broader definition of the term health. At the same time it was found also an evolution of the concept of health care which in turn has led to changes in the approach to delivery of health services and hence in its management. In this regard, currently the nephrology services have been searching for quality technical and social need. In view of these innovations and the quest for quality, it elaborated the general objective: to develop a quality assessment protocol for dialysis service Onofre Lopes University Hospital. It is an intervention project effected through an action research, which consisted of 4 steps. Initially was identified through a literature search in scientific literature, which quality indicators would apply to a dialysis unit being selected as follows: infection rate in hemodialysis access site, microbiological control of water used for hemodialysis and Index User satisfaction. Through critical reflection on the theme researched in the previous step, it was drawn up three data collection instruments, interview form type, applied between the months of October and November 2015. In addition to the information obtained, also made up of the use of information retrieval technique. The results were organized in graphs and tables and analyzed using qualitative and exploratory technical approach. Then a reflective analysis of the data obtained and the diagnosis of reality studied was traced and confronted with the literature was performed. The data produced in this study revealed that the Dialysis Unit of HUOL is much to be desired, considering that some weaknesses have been identified in its structure. Faced with this finding have been proposed, as a contribution and aiming to guide the development of future actions, suggestions for improvement that should be implemented and monitored to be assured overcoming these difficulties, allowing an appropriate organizational restructuring, and resulting in improved service public offered. It was concluded that for hemodialysis treatment results are achieved and positive, it is necessary to have physical structure and adequate infrastructure, multidisciplinary team specialized, trained and in sufficient quantity, well designed processes for professionals to have standards to be followed decreasing the chance to err, and a risk management system to detect and control situations that endanger patient safety.

A PESQUISA ACADÊMICA SOBRE COMUNICAÇÃO POPULAR, ALTERNATIVA E COMUNITÁRIA NO BRASIL: análise de dissertações e teses produzidas em Programas de Pós-Graduação em Comunicação entre 1972 - 2012

Mapeamento das dissertações e teses referentes à subárea da comunicação popular, alternativa e comunitária (CPAC) desenvolvidas nos Programas de Pós-Graduação em Comunicação stricto sensu no Brasil, de 1972 a 2012. Dentre os objetivos estão localizar as pesquisas; os autores; sua distribuição no tempo e espaço; identificar as instituições e orientadores que impulsionam a subárea; definir as abordagens teórico-metodológicas; e apontar autores/conceitos referência. Por meio de pesquisa exploratória e aplicação de quatro filtros, chegou-se a uma amostra final de 102 pesquisas, 87 dissertações e 15 teses, submetidas à análise quantitativa, por meio de Análise de Conteúdo a partir de partes pré-definidas (Resumo, Palavras chave, Introdução, Sumário, Considerações Finais e capítulo metodológico, quando presente), e a uma análise qualitativa do conteúdo completo das 15 teses. O método que orienta esta pesquisa é o histórico dialético, na perspectiva da busca de uma análise de conjunto e atenta às contradições e mudanças que o objeto está implicado; e a pesquisa bibliográfica que a fundamenta se ancora em autores como Jorge González, Cicilia Peruzzo, Regina Festa, Pedro Gilberto Gomes, Gilberto Giménez e Augusto Triviños e foi realizada com o apoio do software NVivo. Resultados quantitativos indicam: a) predominância de pesquisas sobre comunicação comunitária (68%) b) predominância de estudos empíricos (79%); c) a variedade de denominações atribuídas às experiências pelos pesquisadores; d) a constante luta das classes populares por democratização da comunicação e por direitos sociais ao longo dos anos; e) a influência e importância dos intelectuais orgânicos nas experiências estudadas, f) problemas metodológicos; g) UMESP, USP e UFRJ como instituições protagonistas, e, h) Cicilia Peruzzo e Raquel Paiva como as que mais orientam teses e dissertações sobre a temática. Quanto à análise qualitativa verificaram-se alguns critérios que permeiam a CPAC: 1) a definição de classes subalternas; 2) a importância da participação ativa das comunidades nos processos de comunicação; e 3) formas, conteúdos e objetivos que se complementam e dão identidade às experiências

Pesquisa-ação em programas sociais : Delineamento metodológico de uma experiência

Neste artigo apresentamos o delineamento metodológico de uma experiênciade pesquisa com o método de pesquisa-açao junto aos recursos humanos de um convênio do Programa Segundo Tempo do Governo Federal do Brasil, a qual se constituiu parte de um trabalho de dissertaçao de mestrado apresentado ao Programa de Pós Graduaçao em Educaçao Física da Universidade Federal do Rio Grande do Norte

Pesquisa-ação em programas sociais : Delineamento metodológico de uma experiência

Neste artigo apresentamos o delineamento metodológico de uma experiênciade pesquisa com o método de pesquisa-açao junto aos recursos humanos de um convênio do Programa Segundo Tempo do Governo Federal do Brasil, a qual se constituiu parte de um trabalho de dissertaçao de mestrado apresentado ao Programa de Pós Graduaçao em Educaçao Física da Universidade Federal do Rio Grande do Norte

Pesquisa-ação em programas sociais : Delineamento metodológico de uma experiência

Neste artigo apresentamos o delineamento metodológico de uma experiênciade pesquisa com o método de pesquisa-açao junto aos recursos humanos de um convênio do Programa Segundo Tempo do Governo Federal do Brasil, a qual se constituiu parte de um trabalho de dissertaçao de mestrado apresentado ao Programa de Pós Graduaçao em Educaçao Física da Universidade Federal do Rio Grande do Norte

El autocuidado y apoyo social de mujeres de un proyecto de seguimiento mamográfico en Porto Alegre/Brasil

Objective: Identify preventive self-care practices and analyze the configurations of the network support for women with and without breast cancer registered in a mammography-monitoring project from Porto Alegre/Brazil.Method: a mixed sequential delimitation was performed, which expanded the results of the quantitative step (cross and correlation section) in a qualitative step (narrative interviews). 37 women diagnosed with breast cancer (group 1) and 72 without this diagnosis (group 2 – monitoring) participated. The following instruments were used: Assessment Questionnaire Self-care Ability (ASA-A) and Assessment Questionnaire Perceived Social Support and Community. There were performed descriptive analysis and comparison of means (t test and ANOVA) between the two groups. To deepen the understanding of the data, we selected four women with breast cancer with extreme levels on the scale of Social Support to participate in the biographical narrative interviews.Results: the analysis indicate that women who had breast cancer have better self-care practices than the women from the monitoring project (t = 1.791, P = 0.027). As for the analysis of social support, there were no statistically significant differences between the two groups. All participants have an average level of perceived social and community support. It was highlighted by the qualitative data that it was after the diagnosis of breast cancer that women lived self-care aspects they had not previously experienced.Conclusions: the self-care was significantly bigger in the group of women with breast cancer, where the cancer diagnosis was a trigger to increase self-care.

Avaliação de Desempenho Organizacional: Análise Comparativa dos Modelos Teóricos e Pesquisa de Aplicação nas Instituições de Ensino Superior da Região Metropolitana de São Paulo

As Instituições de Ensino Superior (IES) brasileiras têm passado por grandes desafios devido ao aumento da concorrência. Paralelamente, no campo da Administração, um tema que tem sido estudado de forma recorrente são os modelos de avaliação organizacional. Nesse contexto, foi realizada uma pesquisa com o objetivo de identificar e comparar os principais métodos e indicadores de avaliação de desempenho organizacional desenvolvidos na literatura e sua forma de utilização nas IES da Região Metropolitana de São Paulo – RMSP. Com base em análise sistematizada da bibliografia consultada foram identificados 19 modelos de avaliação de desempenho, resumindo-se suas principais características, pontos fortes e fracos. Realizou-se, adicionalmente, uma análise comparativa destes modelos com base na consideração de 18 aspectos classificados em 5 grupos: clientes e mercado; econômico-financeiros; gestão e organização; recursos humanos; e sociedade em geral. Por meio de «survey» junto aos gestores de 14 significativas IES foram identificados seus formatos e indicadores de avaliação de desempenho organizacional constatando-se que a maioria realiza avaliação de desempenho por meio de modelos, sendo o «The Balanced Scorecard» o mais utilizado. Entre os 19 indicadores de desempenho pesquisados, os quatro utilizados com mais frequência e também considerados de maior importância pelas IES são os relacionados: à demanda por ensino; aos clientes, ou alunos; à qualidade e eficiência dos processos; e a aspectos econômico-financeiros. É possível levantar a hipótese de que a importância dos dois primeiros deve-se ao fato de serem relevantes direcionadores de receita, a do terceiro, ser direcionador de custo, e a do quarto, ser a síntese dos resultados.

A lectoescrita em alunos surdos a frequentar o ensino bilingue: avaliação da eficácia de um programa de treino

As crianças surdas, integradas num contexto educativo bilingue, aprendem a ler e a escrever numa língua oral-auditiva, língua com caraterísticas diferentes da língua que adquirem naturalmente que é visuo-espacial. A Língua Gestual Portuguesa é a língua materna dos surdos, constituindo-se a Língua Portuguesa, no modo oral e escrito, como a sua segunda língua. Face à escassez de instrumentos facilitadores do desenvolvimento das competências de leitura e escrita em crianças surdas, esta investigação visa avaliar a eficácia do programa de treino da competência lectoescrita para alunos surdos a frequentar o ensino bilingue – Programa PODER. O programa de intervenção concebido desenvolveu-se num processo de investigação-ação e foi aplicado a seis alunos surdos, a frequentar o 2.º ano de escolaridade do ensino básico, numa Escola de Referência para a Educação Bilingue de Alunos Surdos. As respostas obtidas, através de questionários aos alunos surdos (6), foram analisadas qualitativamente. Para medir o índice de legibilidade do texto e a facilidade de leitura, no Pré-teste e no Pós-teste de lectoescrita aplicado aos alunos surdos, utilizou-se o “Índice de Legibilidade de FleschKincaid Grade Level” e o “Índice de Facilidade de Leitura de Flesch” (ambos baseados no comprimento das palavras e das frases). Os resultados obtidos indicam que o Índice de Legibilidade fica situado entre 7,0 e 10,0, o recomendável e o Índice de Facilidade de Leitura enquadra-se no Nível A1 – Utilizador Básico. Os dados afiguram-se expressivos para a validação do programa de treino e prova da sua eficácia, no desenvolvimento da competência lectoescrita de alunos surdos integrados no ensino bilingue. Deste estudo, retiram-se implicações para a intervenção psicoeducacional da lectoescrita junto de alunos surdos que frequentam o ensino bilingue.