Avaliação clínica e microbiológica das condições de saúde oral dos receptores de transplante renal do Hospital Universitário Onofre Lopes, Natal RN

Introduction: The chronic immunosuppression promotes the development of changes in the oral cavity of the kidney transplant recipients (KTR), however with the exception of gingival overgrowth, little is known regarding the prevalence of oral lesions in this population. Objective: To evaluate the prevalence of clinical and microbiological conditions of the oral cavity of the recipients of kidney transplantation and the associated factors. Methods: This was a cross-sectional study which examined 96 clinical KTR and experimental where collected saliva stimulated them to identify Candida sp. Data collection consisted of evaluation stomatologic, socio-demographic, clinical aspects of transplantation, condition of oral hygiene and dental caries, yonder to questions about knowledge of oral alteration after transplantation. Results: Of the total, 66.7% of KTR had some type of oral manifestation. The most common was saburral tongue, followed by gingival overgrowth, with both oral manifestations related to gender and concomitant use of cyclosporine and nifedipine (p <0.05). Tacrolimus showed a protective effect for gingival overgrowth (OR = 0.13). The oral hygiene was associated with saburral tongue(p = 0.03) and severity of gingival overgrowth (p = 0.0001). Oral candidiasis was diagnosed in 17.7% of patients and Candida albicans was isolated most frequently in the saliva of RTR with a colonization of 58.3%. The average DMF-T increased with age. The method of oral hygiene was most used brush and toothpaste to 61.5%. Changes in the oral cavity was seen in 54.2% of KTR, citing as the main growth and gingival ulcers. Instructions for oral hygiene after transplantation were neglected for 61.5% of RTR. Dry mouth and halitosis were reported in 30.2% and 36.5% respectively. Conclusions: More the half of the KTR had at least one injury of the mouth, the immunosuppressive drugs and oral hygiene are associated with these alterations. Prospective cohort studies are needed to elucidate the relationship between oral manifestations and levels of drug and risk of oral manifestations occur over time. The kidney transplant recipients showed to be aware of oral alterations occurred after transplantation and uninformed about the oral hygiene instructions. With regard to hygiene, the incidence of caries was considered high, conditions of risk were identified and improvements in primary attention should be encouraged and reflected in the monitoring of renal transplant

Resiliência e velhice: um estudo de fatores de risco e de proteção na saúde do idoso

Resilience consists of a capacity to adapt and overcome situations of risk, from the aid of protective factors. This construct constitutes a process of preventive and multidimensional present in all stages of human development. During this development, it has been immersed in the elderly biopsychosocial changes resulting from the aging process. In this sense, there was a need for a multidisciplinary study, combining psychology, medicine, nursing, social work and gerontology in order to check the resilience, its risk factors, such as life events and health, and protection, such as self-esteem and social support. For this, we performed a descriptive exploratory study of cross-sectional nature, along with a convenience sample consisting of 65 elderly users of the public health of the district east of the city of Natal/RN, Brazil. This research allowed the collection of socio-demographic, economic, relational, physical, biological and psychological in understanding the aging process. It is observed that the studied sample socio-economic status and chronic health conditions in their own lives and their families, that demand for care and attention every day, are resilient, have faced significant losses, have positive self-esteem and social support perceived as external satisfactory. Given this multidimensional nature, the aging process deserves the attention of many professionals and health policies, seeking provide to the elderly a better living conditions and mechanisms that promote well-being and health

Legislação de rotulagem nutricional: instrumento de informação na promoção de escolhas alimentares - Natal-RN

Resolutions of the Board of numbers 359 and 360, of December 23, 2003, relating to Nutrition Labelling for Packaged Foods, establish quality standards and provide the education activities for health consumption, since one of the factors that enable the selection of healthier foods are the food labels as an important part in nutrition education. This is a descriptive study with a cross-sectional design. To calculate sample size, it was considered a margin of error of 20%, confidence level of 95% and prevalence of 52.5% for verifying nutritional information in a pilot study conducted in 2007. A total of 145 subjects were interviewed, resulting in 371 consumers in Natal, Rio Grande do Norte, Brazil, in order to determine prevalence of consulting nutritional information contained on food labels as a nutritional guideline for consumers and its association with sociodemographic variables as well as identify the intervention measures suggested by intervieweds so that this information can be better used to select healthy foods. Twenty-five of the 69 supermarkets belonging to the Supermarket Association of Rio Grande do Norte (ASSURN) were randomly selected. Data collection relied on interviews and extensive direct observation, using a semi-structured form composed of eight closed questions, some of which were multiple choice, and ten open questions. The chi-square test was performed for statistical analysis, using Statistical Package for Social Sciences (SPSS) 15.0 software. Label information most consulted was: expiry date (91.6%); product brand (49.4%); nutritional information (47.0%); zero trans fat (32.9%); zero sugar content (12.8%); zero fat content (3.0%); rich in fibers (2.7%); whether light or diet (30.4%); list of ingredients (16.8%); whether the product contained gluten or not (4.1%). When asked about the importance of nutritional information, 96.8% of the subjects responded important or very important ; of these 46.6% and 3.8% reported partially or totally understanding the information presented. It was found that 41.6% of the consumers consulted nutritional information for dietary reasons related to nontransmissible chronic diseases and 35.7% to be able to choose healthier foods. The data show a significant association between motivation to choose healthier foods and higher family income and schooling (p<0.0001). The intervention measures mentioned to make nutritional information better understood and used were: information and orientation about nutritional information, provided by qualified professionals in the supermarkets, the commercial establishment or the product manufacturer (73.9%) and media disclosure about the nature, importance and purpose of nutritional information (42.9%). In despite of communication noises the consumers use the nutrition claim for the nutritional guidance, showing association with some demographic variables. However, they desire the implementation of intervention measures that can be contextualized in the political construction of nutrition education to promote healthy food choices

Escola ativa como semeadora de sonhos nas turmas multianuais: representações das(os) professoras(es) da microrregião de Mossoró-RN.

The issue of multi-classes in schools from the field and methodology for these classes is controversial and contentious, both in terms of teaching, monitoring and organizational, is the perspective of values, training and systematization of public policy. Why the strategy Methodological Active School facing those classes appeared as a significant and exciting topic of research. Thus, it was aimed to apprehend the social representations of active school by teachers (s) to understand the extent to which these representations influence the acceptance and use of the program strategies. Perceiving and analyzing also the various factors related to the management, monitoring and training needs of (the) teachers as alternatives to make this meaningful action. The study focused 112 teachers (s), which for over a year, worked in the program in six municipalities in the micro-region of Rio Grande do Norte / RN - Areia Branca, Baraúna, Grossos, Mossoró, Serra do Mel and Tibau. From this perspective relied on Social Representation Theory and the Theory of the Central Core, attending to the subjectivity of the object searched, inserted in the psychosocial field of knowledge, we opted for multi-methodological approach, using quantitative and qualitative techniques. However, the highlight was a projective technique Free Association of Words from the term Active School is .... The words were systematized by EVOC program, and also applied semi-structured interviews, focusing specific issues that led to trace the socio-demographic profile of (the) participants and wider issues about the object of study. The evocations, justifications and interviews provided the basis for the analysis of the content that followed the steps: formation of the corpus, the composition of the analysis and categorization. The results show the representations an attitude of acceptance and positive appraisal of the participants to the Active School Program. At the core, these representations are objectified around the words "action", "learning", "autonomy" and "interaction". Based on the premise that the representations have a duty to guide the practices and behavior, one can see that the positive attitude of the group favors a systematic methodology and acceptance of the program, but we must look at the changes in management, training, monitoring of (the) teachers (s) and support to schools.

Qualidade de vida na perspectiva de idosos institucionalizados no Município de Natal - RN

A descriptive and exploratory Study, quantitative in nature, with the aim to assess the Quality of Life (QL) of the elderly leaving in a Long Residence Institution (LRI) according to their own perception. It was conducted in six Public Institutions of Long Residence for Seniors, in the municipality of Natal - RN, in the period of July to August 2007. The data was collected using two structured interview forms: the first, containing questions about socio-demographic aspects and the second - the WHOQUOL-OLD, prepared by the World Health Organization to assess elderly s quality of life. The reference population was 266 old persons, and a random sample, of 43, being 28 women and 15 men, who account for 30%. The results indicated there is a predominance of older women (65.1%) and the average age is 76.6 years; the predominant religion is the Catholic - 44.2% and, 32.6% are unmarried without children. As for schooling and precedence, 41.9% are illiterate and 67.4% come from the rural area. The time of residency in the institution goes between 1 to 5 years for 69.8% of the elderly, 37.2% of them residing in the institution for not having another option. Most elderly informed using medicines. 51.3% said they are taking anti-hypertensive. As for the other aspects of QL: sensory aspects, autonomy, past, present and future activities, social participation, death and dying and intimacy, the WHOQOL-OLD, showed an average total score of 52.9% (scale of 0 to 100), with a tendency to neutrality, denoting that the elderly, in this study, evaluated their QL as neither satisfactory or unsatisfactory. Of all the facets of the instrument of QL, the sensory facet secured the highest average scores (68,1%), showing that the elderly are "happy" in the situation in which they find themselves, not showing significant disabilities. The facet of autonomy, which refers to the independence and the ability to make decisions on their own life, received the lowest average scores (40.7%), showing the dissatisfaction of the elderly on this aspect. The evaluation of the elderly on other facets were: social participation (48.2%); activities past, present and future (44.6%) and intimacy (50.6%), all perceived as neither unsatisfactory or satisfactory. On the item death and dying, the elderly people declared themselves satisfied, with average score of 65.5%. The analysis of the reliability of the WHOQOL-OLD by the Cronbach Alpha showed 0.57, considering the 24 items that cover the instrument, showing regular internal reliability of the instrument, in our reality. The result is probably due to differences between the regions south and east and the broader sociocultural diversity. We believe that the elderly in this study, tended to realize their QL as neutral, considering it as neither unsatisfactory or satisfactory, result likely related to the resignation with the destine, characterized, at the time, by the finitude of life, feeling very common among elderly, or perhaps, even for an accommodation, often accompanied by discouragement, present in the daily life of many of them

O acolhimento no ambulatório de um hospital universitário na visão de usuários

This present study of quantitative/qualitative approach, aims to analyze the outpatient care at the Hospital Universitário Onofre Lopes (HUOL), and, having as guide, the reception of the user. In this regard were invited and interviewed 20 users. Besides the interviews, conducted in a period of 45 days, in this same period of time was used a field diary for more significant notes of observations more significant. In the analysis, we drafted the socio-demographic profile of the group and identified their main complaints, problems and suggestions. For this, we have built graphics, tables and pictures, in addition to standing out their testimony, as a resource for better understanding of the subjective aspects. The theoretical reference consisted of documents from the Ministry of Health about the reception and humanization, and the studies of Merhy, Franco, Pinheiro, Matumoto, Mariotti, Teixeira, among others. The results show the ambulatory of HUOL as a privileged space and of credibility, where users commonly, find answers to their problems. However, these same users were unanimous in saying the difficulties they face in obtaining consultations, from the basic unit, until the hospital. Regarding the service, although they feel satisfied as for the assistance received, they list a series of problems, of structural relationship order: lack of visual signalling, information, wheelchairs, hygiene, in the waiting rooms that offer some comfort, besides the inattention of some professionals. In summary, in the study, undertaken now, we cannot say that there is in the reality studied, the reception, in its full meaning, but the HUOL as hospital-school, has all the potential to accomplish it

Qualidade de vida de pessoas com úlceras venosas atendidos no ambulatório de um hospital universitário

Descriptive study aimed to analyze the quality of life (QOL) of patients with venous ulcers (UV) outpatient clinic of a university hospital in Natal / RN. The aim of the study population was composed of 50 patients with UV treated at the cardiology clinic of a university teaching hospital at the tertiary level. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol 279/09). Data collection was performed over a period of two months by the very a masters degree and an academic nursing through the application of a form concerning the socio-demographic, clinical, and health care, and the instruments WHOQOL and WHOQOL - old. The data were analyzed with SPSS 15.0, using descriptive and inferential statistics presented in the form of tables, charts and graphs. Of the surveyed, female predominance, age range 59 years, Catholic, low education, married, with up to 03 children, not working, retired, or with occupations requiring long periods in one position, wage income of up to 02 minimum wages, inadequate sleep, patients with chronic venous insufficiency and other chronic diseases such as diabetes and hypertension, were taking medications for treatment, being a minority to IVC. In patients with predominant only one injury, time of injury up to five years, inadequate rest, pain, edema and lesions colonized. The assistance the UV patients began treatment of the injury until four months after the onset of the ulcer, and services primary health care most wanted, access to angiologist by reference form, commuted by public transportation, received support regarding the treatment of injuries. The topical product most used in the lesion was healing, and few were using compression therapy. respondents suffer discrimination in society, showed changes in quality of life after the occurrence of ulcer in relation to leisure, pain, restriction of social / school / transportation; barring employment / financial / social ladder; Physical appearance / discrimination and restriction of domestic activity. These changes were related to the time of injury and found that the more chronic injury is the most negative changes occur in their QV (ρ = 0.000). Analyzing the characteristics of QV measured by the WHOQOL-bref, we found for the two general questions they are dissatisfied with their health (ρ = 0.023) and all areas have significant difference compared with the worst QV have the injury of more than 5 years (ρ = 0.000). The QV measured by the WHOQOL-old, we found that these patients had no changes from the time of injury. We conclude that the QV of patients with UV was considered unsatisfactory when compared to the time of injury on more than 5 years which shows that the quality of life worsens with time the chronic UV.

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.

Biossegurança e a saúde do trabalhador na assistência a pacientes em tratamento onco-hematológico

In recent years, the biosafety has been made possible a new look which are based the conceptions of health and illness process, as well as human needs. This new vision is focused on health vigilance that is referenced specifically in this study to the worker s health. The health of workers is essential for the prevention and control of epidemics and outbreaks of diseases as well as emerging and reemerging diseases. The present study wants to show the importance of biosafety measures for health workers, showing them through the concepts in their daily work. It is also to direct the use of biosafety measures in the care of oncology and hematology patients care, because of its infection susceptibility. OBJECTIVES: To analyze the conceptions of health workers in the biosafety pratice to the patients in oncological and hematological treatment in an oncological institution in Natal / RN, as well as make a socio-demographic profile of these workers and to know their difficulties to adequate biosafety measures. METODOLOGIA: The research is exploratory descriptive with qualitative approach, using the technique of oral history. The use of this technique is justified for the possibility of analyze the conceptions of health workers in the face of biosafety measures. From the definition of analysis categories that have emerged in the study. The categories were: daily work, education, occupational risk and onco-hematological care. The research population was the health workers who provide care to patients in oncological and hematological treatment. The study was conducted in the League against Cancer, in Natal / RN, specifically in the unit Luiz Antonio Hospital. Data collections were conducted from June to August of 2011 and were interviewed sixteen employees who assist in oncology and hematology. Structured interviews were conducted in three shifts, given the prospects of expanding the possibilities of analysis of the biosafety concepts. After data collection, the interviews were analyzed qualitatively by the technique of oral history. This genre, thematic oral history is a modern resource used for preparation of documents, files and studies concerning the social experience of people and groups with the construction of a script prior to the interview moment (MEIHY, 2002). ANALYSIS OF INFORMATION: It was made a reflection about the concepts and practices of professionals who take care of patients in oncology and hematology as well as its relation to biosafety measures. The speech of employees revealed that the adoption has been very supportive of these standards, although some have been highlighted gaps in the understanding of employees in relation to biosafety and the proposed categories. CONCLUSION: The analysis of information showed that biosafety has been cited by employees as an immeasurable benefit to safety and occupational health. And the strengths marks in their understanding were: the excellence of care and safety in occupational diseases risk reduction and infections resulting from their work activities, despite some difficulties in adopting appropriate biosafety standards

Clima e cultura de segurança do paciente em uma maternidade escola: percepção dos profissionais de enfermagem em terapia intensiva

Since the publication of the report "To Err is Human" by the Institute of Medicine (IOM) , which estimated that between 44.000 to 98.000 Americans die annually as a result of errors in health care, patient safety spent gaining prominence, emerging studies assess the safety culture by measuring the safety climate. In this context, the aim of this study was to identify safety culture perceived by nursing professionals working in the intensive care unit of a maternity school in Natal/RN through the Security Attitudes Questionnaire (SAQ). This was a descriptive study, cross-sectional and quantitative approach undertaken in the Intensive Care Unit Maternal and Neonatal a maternity school in Natal/RN. The project was submitted to and approved by Brazil Platform Zip/UFRN under number 309 540 and CAAE 16489713.7.0000.5537. It was used to collect data two instruments: a questionnaire in order to collect socio-demographic data of the subjects and the Questionário Atitudes de Segurança , a cultural adaptation to Portuguese of the instrument of the World Health Organization titled Safety Attitudes Questionnaire - (SAQ ) Short Form 2006. The collected data were analyzed quantitatively by the organization in electronic databases in Microsoft Excel 2010 spreadsheet and exported to statistical software for free access to be coded, tabulated and analyzed using descriptive statistics. The study included a total of 50 nurses, 31 and 19 of the NICU Maternal ICU, predominantly female, mean age 35 years, median time of 10 years training and working in maternity, mostly, less than 05 anos. As a result, two articles were produced. The first refers to the first two domains of the instrument entitled "climate of teamwork" and "climate security" . The scores of the two areas were slightly higher in Maternal ICU compared to the NICU, but no sector has reached the ideal minimum score of 75: in the first domain Maternal ICU had an average of 74.77, with medians of 75 and 100, while Neonatal ICU reached an average of 69.61 with median also 75 and 100, while the second field means were 69.35 and 66.01 for Maternal and Neonatal ICUs respectively, with a median of 100 in the two sectors. The second article relates to the field "Perception Management Unit and Hospital", which 9 assessed the perception of management units and motherhood by professionals. In general, the items of the domain in question also obtained scores below the ideal minimum: 63.68 to 51.02 and maternal ICU for neonatal, featuring a clear separation between the management and the professionals who work in direct care. These findings indicate a warning sign for the institution and point to the need to implement actions aimed at patient safety

Gestão de resíduos sólidos: um estudo da conscientização ambiental em uma cidade do Brasil

The present study inserts on the international environmental thematic, approaching the integrated management of solid waste and the participation of the social actors in the search of the sustainable development. The awareness in combining it still describes a Selective Collection Program SCP of solid waste, in partnership with the municipal public power, in the development of joint actions that result in better alternatives of waste management in the urban centers, providing better life quality for the population and conservation of the environment. The aim of this research is to study problematic of the management of solid waste under the point of view of the environmental awareness and the participation of the population in a city of Brazil. In this matter, the target of the work is focusing on the strategy of solid waste management, through the attitudes and the respondents behaviors to aid in the making decision of the public manager related to the implantation of a selective collection program in Natal/RN. The methodology used in this work constitutes in the application of a questionnaire with scales of the type Likert being constituted of variables that compose the aspects of attitudes and of behaviors, besides a social-demographic scale. For analysis statistics is used the Pearson s Chi-Square Method in order to verify the dependence of the associations between the social-demographic variables and the attitude and the behavior ones. The results appear for a larger participation in a SCP, since this provides a better quality of life of the population (28,3 %), followed for offering a financial advantage (27,3%). Other results indicate the existence of the variables that exercise influence on the environmental awareness of the population to its demographic aspects

Tradução e adaptação transcultural do instrumento de avaliação prenatal selfevaluation questionnaire

Introduction: The human gestation period is 40 weeks. This is the essential time for maternal psychosocial adaptation, in which there is the intense transformation of a life without offspring into a life with one or more children. The Pregnancy Self-Evaluation Questionnaire (PSEQ) has 79 items, subdivided into seven subcategories: acceptance of pregnancy, identification with the maternal role, well-being of mother and baby, preparing for labor, control in labor, relationship with the mother and the relationship with the partner. Objective: To translate and cross-culturally adapt the instrument PSEQ to be used with Brazilian women. Methods: It is a cross-sectional observational study. We followed some methodological steps to achieve the cross-cultural adaptation of this measuring instrument. They are: translation, synthesis, back translation, analysis of the committee of specialists and pre-test. Another questionnaire was applied to characterize the socio-demographic and clinical status of the pregnant women (n = 36). The descriptive statistics was gotten through the average, standard deviation (SD), absolute and relative frequency. The statistical test used for the analysis of the internal consistency was Cronbach's alpha coefficient, using SPSS version 17.0. Results: The volunteers had low socioeconomic status, average age of 25.1 years (± 5.52), and average gestational age of 25.9 weeks (± 8.11). 58.3% of these volunteers had not planned their current pregnancy. The pretest showed that 75% of pregnant women found the questionnaire easy to understand. There was an average of 76.9 (± 3.23) answered items among the participants. Regarding the instrument PSEQ, the identification with the maternal role was the subcategory which showed the highest average 24.8 (± 5.6), while the relationship with the mother had the lowest average 15.4 (± 7.7). The internal consistency ranged from 0.52-0.89. Conclusion: The translation and cross-cultural adaptation of the PSEQ to Portuguese language were carried out with methodological rigor and can be considered an instrument with good internal consistency