O trabalho em equipe na atenção primária à saúde: situação de Portugal e do Brasil

Introdução: Na Atenção Primária à Saúde, nos contextos internacional e nacional, o trabalho em equipe tem sido reconhecido como estratégia decisiva para a organização de processos que visam à integralidade do cuidado, além de possibilitar melhorias na satisfação dos usuários com os serviços de saúde. Neste sentido, o objetivo, deste estudo, é analisar o trabalho em equipe na Atenção Primária à Saúde. Método: Trata-se de uma pesquisa em banco de dados secundários. Realizou-se três estudos: a) O trabalho em equipe na Atenção Primária à Saúde, em Portugal, pesquisa avaliativa, de natureza qualitativa, tipo estudo de caso descritivo, que representou um recorte dos resultados derivados da pesquisa integrada ao projeto “Implantação das Unidades de Saúde Familiar em Portugal”, que teve como procedimentos entrevistas semiestruturadas, roteiro de coleta de informações (check list) e análise documental. Foi realizada a estratégia de triangulação dos dados com análise de conteúdo; b) trabalho em equipe, acesso e qualidade na Atenção Primária à Saúde, no Brasil, estudo transversal, de abordagem quantitativa, realizado a partir dos dados obtidos da “Pesquisa de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica”, no Brasil, em 2013. Amostra composta de 17202 profissionais e 65391 usuários. Utilizou-se entrevista estruturada, com análise estatística realizada pelas frequências absolutas e relativas das variáveis através do programa Statistical Package for Social Sciences. c) satisfação dos usuários com o trabalho em equipe na Atenção Primária à Saúde, no Brasil, estudo transversal, de abordagem quantitativa, realizado a partir dos dados obtidos da “Pesquisa de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica”, no Brasil, em 2013. Amostra composta de 65391 usuários. Realizou-se análise estatística das frequências absolutas e relativas das variáveis através do programa Statistical Package for Social Sciences. Utilizou-se, ainda, o Teste X2 , com nível de significância de 5%; análise de regressão logística múltipla. O modelo final foi ajustado pelo teste de Hosmer/Lemeshow, o qual indicou um ajuste de 66%. Resultados: Sobre o trabalho em equipe na Atenção Primária à Saúde, em Portugal, destacou-se a formação das equipes de forma voluntária, por meio de afinidades pessoais, a existência de “carteira básica de serviços”, juntamente com x intervenções de vigilância, promoção da saúde e prevenção de doença, cuidados em situação de doença aguda, acompanhamento clínico de doença crônica e de patologia múltipla, cuidados domiciliares, interligação e colaboração em rede com outros serviços (cuidados hospitalares), sistemas informatizados nas unidades de saúde. Os dados revelaram dificuldades quanto ao atendimento domiciliar. No Brasil, foi destaque o processo de trabalho, com avanços relacionados a realização de planejamento e programação das ações e o apoio da gestão. Existência de território definido e de prontuários familiares. É destaque a agenda compartilhada e pactuada entre os profissionais. As equipes realizam acolhimento e reuniões, cujos temas, discutidos, giram em torno do processo de trabalho e planejamento. Os desafios, enfrentados, estão relacionados ao agendamento dos usuários; ao número de pessoas sob a responsabilidade das equipes; à existência de população descoberta nas áreas adscritas à Unidade de Saúde; à incipiência na ação intersetorial e ao pouco envolvimento da comunidade pelas equipes. Quanto aos fatores associados à satisfação do usuário foi marcante: a faixa etária; a escolaridade; a raça; se a falta de material prejudica o atendimento e se a equipe consegue marcar consulta para outros profissionais. Conclusões: Constatou-se o trabalho em equipe como elemento central no processo de mudança na Atenção Primária à Saúde, tanto no contexto de Portugal quanto no do Brasil, o qual ampliou o acesso e a qualidade na oferta de serviços de saúde e obteve, ainda, o reconhecimento social, mesmo que, em ambas as realidades, não tenha avançado na coordenação do cuidado e no estímulo à participação social. Os fatores, associados com a satisfação do usuário, estão relacionados diretamente ao cuidado prestado e refletem a expectativa, por parte do usuário, de resolução concreta de suas necessidades.

Acompanhamento do crescimento e desenvolvimento da criança: a participação das mães da área rural

The accompaniment of growth and development is the central thrust of child care in primary health care in order to contribute to the reduction of infant morbidity and mortality and promote healthy development. Despite its importance, the family health unit located in rural Parazinhocounty experiences the problem of frequent absences of children to follow-up consultations. Thus, this study aims to analyze the participation of mothers in the accompaniment of growth and development of children in the Family Health Strategy. This is an exploratory, descriptive study with a qualitative approach with the method action research, developed with mothers who are part of the monitoring of the growth and development of children in the rural area of the municipality of Parazinho/RN from May to October 2014. Data collection was performed using the focus group techniques, participant observation and individual interviews. Data were analyzed using thematic analysis of categorization. The study was approved by the Research Ethics Committee, under the opinion embodied 617,559 and CAAE 28598014.7.0000.5537. In step situation analysis, were conducted two focus groups, attended by a total of 14 mothers of different rural locations. From the speeches, one realizes that they have a satisfactory understanding of the monitoring of the growth and development of the childwas a learning moment. The nurse was mentioned as key professional that actionof accompaniment. The main reason that mothers to abandon consultations is access to health services, due to the distance from their homes to the basic unit, the shortage of public transport for the movement of users and delay between the service and the back home. As a strategy to try to tackle these problems, at the suggestion of their mothers was created Monitoring of Growth and Development Itinerant, where the FHS team moved to rural locations, performing activities related to children's health. Mothers who participated in the action approved the initiative as improving access and care of health needs, despite indicate dissatisfaction as the poor infrastructure and little privacy in consultations. Therefore, it is concluded that, despite the difficulties encountered often for lack of management support and involvement of some professionals, the monitoring of growth and development itinerant proved to be an important tool in solving the problem of access to services oriented to the health of child, in addition to functioning as a space for the realization of health education, becoming, since then, an activity inherent in family health team schedule.

O papel dos quintais urbanos na segurança alimentar, bem estar e conservação da biodiversidade

Residential homegardens have environmental and social roles in the urban environment. These green spaces can potentially minimize the impacts caused by the growth of cities, being an alternative to connect fragmented areas or offer refuge to wildlife and therefore support the conservation of biodiversity. In addition, the homegardens demonstrate a leading role in increasing human well-being by promoting socialization opportunities, contact with nature, local culture as well as improvements in food security for the urban families. Nevertheless, it is still unclear what specific characteristics of homegardens can act effectively in the conservation of the biodiversity, as well as in the construction of food security and well being of the homegardeners and their families. The first chapter of this thesis analyzed the diversity of plant species (native and exotic) and assessed the contribution of different types of urban gardens (ornamental and forest gardens alike) in the presence of wildlife such as birds, monkeys and lizards. In the second chapter we evaluated the contribution of those gardens to the welfare and food security of their owners. In order to do this, 41 gardens were visited in Pium, a southern coastal town in the northeastern Brazil, which also happens to be in a periurban region undergoing rapid urban expansion and pressure from the real estate market. We surveyed the planned biodiversity and fauna associated with homegardens. The data related to food security and welfare were sampled through interviews with the person in charge of taking care of the gardens. These interviews covered issues on the supply of food from the garden and absence of chemical products, as well as aspects of the GNH indicator (Gross National Happiness). The results showed that these homegardens generally contribute little to the maintenance of native plant species (native species = 29/ total = 187). From its main features, the gardens were classified as ornamental, forest gardens and forest farms. These groups had a different effect on the presence of the animals studied and the last two contained most of the sampled native species. The diversity of plants and trees was a good predictor of the presence of birds and monkeys. Thus, the contribution of yards for the conservation of biodiversity depends on the type of garden: some even can have negative effects on conservation. These results can direct new approaches to detailed understanding of gardens and also of public policies applied to urban planning. The results of the second chapter showed that the two types of forest gardens contributed to household food security, for providing food and medicinal herbs, which mostly did not have pesticides and chemical 12 fertilizers. But the three groups of gardens are important components for the well being of their stakeholders. Gardens help promote the transmission of knowledge on agriculture, socialization, contact with nature and bring up feelings related to peace and harmony. Thus, forest gardens can be considered important means to get through public projects and policies designed to encourage biodiversity and promote food security and well-being in urban areas

Promoção da alimentação saudável na atenção primária à saúde: contribuição para construção coletiva do saber-fazer

The recognition of the food as determinant and health-disease process etching requires new explanations and interventions of the food and nutrition policy action and demand health care model based on the completeness of the actions and focused on health promotion. This study, characterized as research-action of interventionist character, sought to develop strategies to support the transverse insertion of healthy eating promotion in professionals practices a core of support for the health of the family and a family health strategy Unit in the city of Natal, capital of Rio Grande do Norte, from the analysis of perceptions and work processes of these teams. Several methodological strategies were adopted: Dialectical Hermeneutical Circle, direct observation, reflective and Thematic Meetings Workshop "Rethinking the educational practices for promoting healthy eating". For data logging, search diaries - SD were used and moments. The analysis of procedural form occurred in conjunction with research participants, in constant movement of reflection-action-reflection, based on hermeneutics-dialectic. About the results, in relation to the promotion of health, showed the following insights: health promotion and disease prevention-related harms; health promotion related to quality of life and well-being, in its various dimensions; health promotion as a responsibility of the State; health promotion related to the actions of health education; health promotion as an expression of efficaciousness and accessibility to health services. Regarding healthy nutrition, predominated the perceptions relating to nutritional aspects. With regard to food and nutritional education - FNE, it was observed a predominance of perception of FNE as information, guidance and knowledge transfer for changes of dietary practices. As regards the working process, it was observed that among the actions for health promotion, educational activities predominate, such as lectures, conversations, groups that mostly occur in fragmentary form, without joint planning teams, varying according to the professionals and the moment of work in which they are carried out. The results pointed to the need for reorganization of the work processes, in the context of intra-and intersectoral coordination and the construction of new technologies, such as: Health project of the territory – HPT, Unique Therapeutic Project- UPT, Expanded Clinic and educational practices, Shared with active teaching and learning methodologies. From the results we believe that it is necessary to "thought reform", from changes in vocational training and strengthening of the permanent education spaces, whereas the complexity that involves feeding, food and nutrition education and health promotion. The reformation of thought must be articulate and closely tied to the production of knowledge and practices that encourage intersectoral approach, the transversality, dialogue and democratic and supportive attitude, based on the collective construction of know-how. We hope that this study can contribute with reflections and initiatives that encourage building practices that promote healthy eating in primary health care, in terms of completeness of the care and the attainment of food security and nutrition.

Abordagem da ergonomia para avaliação do treinamento simulado das equipes de resposta à emergência em lançamentos de veículos aeroespaciais

This dissertation introduces a study that aims to analyze the simulated training of emergency teams and proposes recommendations for the current training system in order to improve the collective skills and resilience of these teams when facing possible critical situations, triggered by possible accident occurrences during aerospace vehicle launching operations in the Barreira do Inferno Launch Center in Parnamirim / RN. This is a field, exploratory, descriptive, explanatory, and a case study with a qualitative approach. Therefore, we adopted the ergonomics approach, using the situated method of ergonomic work analysis (AET), combining observational and interactive methods. The relevance of this research is characterized by the contributions to minimize the human and material hazzards resulting from possible accidents in these operations, the scientific contribution of the AET for simulated emergency training analysis in the launching operations of aerospace vehicles - which are complex and involve risk of accidents - and consequently, the scientific contribution to the current process of recovering the Brazilian Space Program. The survey results point to problems of various kinds in the current simulated training system which compromise the safety of the operations. These problems are grouped into four categories: technological, organizational, team training and from the activity itself, regarding more specifically communication and cooperation (among the team members and these ones with other sectors involved in the launching operation) and regarding the coordination of actions. We propose: a) a new training model, from the creation and application of scenarios based on postulated abnormalities, which could simulate real critical situations, in order to train and improve the skills of the emergency response teams especially in terms of communication, coordination and cooperation; b) restructuring and reorganizing the current training system, based on the formal establishment of a managing staff, on the clear division of responsibilities, on the standardization of processes, on the production of management indicators, on the continuous monitoring, on the feedback from trainees about the quality of the training and on the continuing and frequent training of emergency teams.

Influência da estratigrafia mecânica no desenvolvimento de falhas distensionais em bacias do tipo Rifte: contribuição da modelagem física

In the last decades, analogue modelling has been used in geology to improve the knowledge of how geological structures are nucleated, how they grow and what are the main important points in such processes. The use of this tool in the oil industry, to help seismic interpretations and mainly to search for structural traps contributed to disseminate the use of this tool in the literature. Nowadays, physical modelling has a large field of applications, since landslide to granite emplacement along shear zones. In this work, we deal with physical modelling to study the influence of mechanical stratifications in the nucleation and development of faults and fractures in a context of orthogonal and conjugated oblique basins. To simulate a mechanical stratigraphy we used different materials, with distinct physical proprieties, such as gypsum powder, glass beads, dry clay and quartz sand. Some experiments were run along with a PIV (Particle Image Velocimetry), an instrument that shows the movement of the particles to each deformation moment. Two series of experiments were studied: i) Series MO: We tested the development of normal faults in a context of an orthogonal (to the extension direction) basin. Experiments were run taking into account the change of materials and strata thickness. Some experiments were done with sintectonic sedimentation. We registered differences in the nucleation and growth of faults in layers with different rheological behavior. The gypsum powder layer behaves in a more competent mode, which generates a great number of high angle fractures. These fractures evolve to faults that exhibit a higher dip than when they cross less competent layers, like the one of quartz sand. This competent layer exhibits faulted blocks arranged in a typical domino-style. Cataclastic breccias developed along the faults affecting the competent layers and showed different evolutional history, depending on the deforming stratigraphic sequence; ii) Series MOS2: Normal faults were analyzed in conjugated sub-basins (oblique to the extension direction) developed in a sequence with and without rheological contrast. In experiments with rheological contrast, two important grabens developed along the faulted margins differing from the subbasins with mechanical stratigraphy. Both experiments developed oblique fault systems and, in the area of sub-basins intersection, faults traces became very curved.

Estudo da resposta Th17 no transplante renal alogênico: contribuição do eixo quimiotático CCR6/CCL20 e dos polimorfismos gênicos em IL17A e IL17RA

Kidney transplantation is the best treatment for patients who have lost kidney function. Renal transplant patients require accurate immunosuppressive drugs to prevent rejection. In this process T helper cells of the immune system perform key role in the immune response to the graft, and recently the Th17 cells has been investigated by production of IL-17 potent proinflammatory cytokine whose role in the rejection has also been described. Increased of Th17 cell expression has an important association with the development of rejection in renal microenvironment, however the likely mechanism is not well understood. This study aimed to evaluate the Th17 response from the influence of the chemotactic axis CCR6/CCL20 and genetic variants in IL-17 and IL-17RA. We conducted a case-control study involving 148 patients transplanted at the University Hospital Onofre Lopes/UFRN in which assessed by immunohistochemistry protein expression of IL-17 and chemokines CCR6/CCL20 and by PCR-RFLP genetic variants in IL17A and IL17RA. Our results showed no influence of genetic polymorphisms on the outcome of the graft or the protein expression of IL-17. In renal graft microenvironment found several sources producing IL-17: tubular epithelial cells, glomerular cells, neutrophils and cell interstitial infiltration, in turn the expression of chemotactic axis CCR6/CCL20 was restricted to the tubular epithelium cells. There was a slight positive linear correlation between the presence of IL-17 and expression of chemotactic axis CCR6/CCL20 in the microenvironment of renal graft. Therefore, we believe that, combined with our results, further studies with increased "n" sample and greater control over the variables involved in obtaining the renal specimen, can determine more clearly the influence of chemotactic axis CCR6 / CCL20 and polymorphisms in cytokines related to Th17 profile on the control of this cell subtype response in rejection processes to renal allograft.

Avaliação do acesso aos serviços de reabilitação física para vítimas de acidentes de trânsito: caminhos para melhoria da qualidade do sistema de saúde

The Physical Rehabilitation services (PR) are of fundamental importance in combating the global epidemic of Traffic Accidents (TA). Considering the numerous physical and social consequences of the survivors, quality problems in access to PR are a hazard to recovery of victims. It is necessary to improve the management of quality of services, assessing priority dimensions and intervening in their causes, to ensure rehabilitation available in time and suitable conditions. This study aimed to identify barriers to access to rehabilitation considering the perception of TA victims and professionals. The aim is also to estimate the access to rehabilitation and their associated factors. This is a qualitative and quantitative study of exploratory nature developed in Natal / RN with semi-structured interviews with 19 health professionals and telephone survey to 155 victims of traffic accidents. To explore barriers to access the speeches were transcribed and analyzed using the Alceste software (version 4.9). During the interviews used the following guiding question: “What barriers hinder or prevent access to physical rehabilitation for victims of traffic accidents?”. The names of classes and axes resulting from Alceste was performed by ad hoc query to three external researchers with subsequent consensus of the most representative name of analysis. We conducted multivariate analysis of the influence of the variables of the accident, sociodemographic, clinical and assistance on access to rehabilitation. Associations with p <0.20 in the bivariate analysis were submitted to logistic regression, step by step, with p <0.05 and confidence interval (CI) of 95%. The main barriers identified were: “Bureaucratic regulation”, “Long time to start rehabilitation”, “No post-surgery referral” and “inefficiency of public services”. These barriers were divided into a theoretical model built from the cause-effect diagram, in which we observed that insufficient access to rehabilitation is the product of causes related to organizational structure, work processes, professional and patients. Was constructed two logistic regression models: “General access to rehabilitation” and “Access to rehabilitation to public service”. 51.6% of patients had access to rehabilitation, and 32.9% in public and 17.9% in the private sector. The regression model “General access to rehabilitation” included the variables Income (OR:3.7), Informal Employment (OR:0.11), Unemployment (OR:0.15), Perceived Need for PR (OR:10) and Referral (OR: 27.5). The model “Access to rehabilitation in the public service” was represented by the “Referral to Public Service” (OR: 23.0) and “Private Health Plan” (OR: 0.07). Despite the known influence of social determinants on access to health services, a situation difficult to control by the public administration, this study found that the organizational and bureaucratic procedures established in health care greatly determine access to rehabilitation. Access difficulties show the seriousness of the problem and the factors suggest the need for improvements in comprehensive care for TA survivors and avoid unnecessary prolongation of the suffering of the victims of this epidemic.

Contribuição da poliacrilamida parcialmente hidrolisada em associação com a bentonita em fluidos de perfuração aquosos

In this study, we investigated the effect of addition of partially hydrolyzed polyacrylamide (HPAM) and bentonite in the physicochemical properties of acquous drilling fluids. Two formulations were evaluated: F1 formulation, which was used as reference, containing carboxymethylcellulose (CMC), magnesium oxide (MgO), calcite (calcium carbonate - CaCO3 ), xanthan gum, sodium chloride (NaCl) and triazine (bactericidal); and F2, containig HPAM steady of CMC and bentonite in substituition of calcite. The prepared fluids were characterized by rheological properties, lubricity and fluid loss. Calcite was characterized by granulometry and thermal gravimetric analysis (TGA). The formulation F2 presented filtration control at 93◦C 34 mL while F1 had total filtration. The lubricity coefficient was 0.1623 for F2 and 0.2542 for F1, causing reduction in torque of 25% for F1 and 52 % for F2, compared to water. In the temperature of 49 ◦C and shear rate of 1022 s −1 , the apparent viscosities were 25, 5 and 48 cP for F1 and F2 formulation, respectively, showing greater thermal resistance to F2. With the confirmation of higher thermal stability of F2, factorial design was conducted in order to determine the HPAM and of bentonite concentrations that resulted in the better performance of the fluids. The statistical design response surfaces indicated the best concentrations of HPAM (4.3g/L) and bentonite (28.5 g/L) to achieve improved properties of the fluids (apparent viscosity, plastic viscosity, yield point and fluid loss) with 95% confidence, as well as the correlations between these factors (HPAM and bentonite concentrations). The thermal aging tests indicated that the formulations containing HPAM and bentonite may be used to the maximum temperature until 150 ◦C. The analyze of the filter cake formed after filtration of fluids by X-ray diffraction showed specific interactions between the bentonite and HPAM, explaining the greater thermal stability of F2 compared to the fluid F1, that supports maximum temperature of 93 ◦C.

Educação profissional e tecnológica de turismo no Brasil: análise através da percepção de docentes da rede federal de educação

The increasing pace of technological change and innovation in the labor market are important landmarks that contribute to accelerate the improvement of vocational and technological education. The need to analyze the educational processes is correlated with this dynamic in order to respond to the pedagogical processes and inherent to the labor market needs in evidence. This research theme is centered on targeted education process for tourist activity that is premised on improving the quality of services, taking as analysis parameter technological higher education in the federal education network (IF), covering the design, similarity and the differences in the courses offered, the axis of Tourism, Hospitality and Leisure instituted by the National catalog Technological Colleges and the National Science and Technology Department in Brazil. The research also aims to investigate the design and implementation of these upper and search courses emphasize the importance of training for students. The research is exploratory qualitative from survey data on the websites of the Ministry of Education, was adopted as a research procedure the questionnaire sent to coordinators via institutional email courses, to collect data in order to obtain results about Technological Education Federal Education Network. The survey results show that most courses offered by technological higher education in the federal education network (IF) is the Tourism Management, we noted that this option is the result of the ease in assembling the structure of the courses in relation to others; teachers have this type of education a more practical option for students coming to the conclusion that the courses undergo a fragile process, stating that the formation lies only in the student's interest in obtaining the higher diploma course without concern for quality this academic background, demand for courses is by being fast graduation. Even as a result of the design and development of Political and Pedagogical projects it was found that they are built in the most collegial many of them without the participation of a pedagogue; about the permanence of the student identified a high dropout rate, occurring in some campuses to migration to the traditional higher education, a BA in tourism. Thus, this work aimed to contextualize the technological higher education in tourism, presenting the reality of the current situation, aiming to discuss the phenomenon from the description made by all subjects and the research object, knowledge of which is due to experience the federal education network that was able to bring the essence of the matter.

Projeto SB Brasil 2010 - pesquisa nacional de saúde bucal revela importante redução da cárie dentária no país

O Projeto SB Brasil 2010, planejado e executado por órgãos do SUS, nos âmbitos federal, estadual e municipal, e de universidades brasileiras, por meio de Centros Colaboradores do Ministério da Saúde se constitui em recurso de valor estratégico para aprofundar os conhecimentos sobre os agravos bucais no país, e dá contribuição inestimável para orientar os rumos da PNSB e avançar na construção de um modelo de atenção pautado na Vigilância à Saúde

Projeto SB Brasil 2010 - pesquisa nacional de saúde bucal revela importante redução da cárie dentária no país

O Projeto SB Brasil 2010, planejado e executado por órgãos do SUS, nos âmbitos federal, estadual e municipal, e de universidades brasileiras, por meio de Centros Colaboradores do Ministério da Saúde se constitui em recurso de valor estratégico para aprofundar os conhecimentos sobre os agravos bucais no país, e dá contribuição inestimável para orientar os rumos da PNSB e avançar na construção de um modelo de atenção pautado na Vigilância à Saúde

Pirometamorfismo em calcários da formação Jandaíra, bacia potiguar, nordeste do Brasil

The present study aims the characterization of thermally affected carbonate rocks from Jandaíra Formation in contact with Paleogene and Neogene basic intrusions in the region of the Pedro Avelino and Jandaíra municipalities (RN), northeastern Brazil. For this study, field, petrographic, x-ray diffraction, electron microprobe, and whole rock litogeochemistry data of carbonates were undertaken. The thermally unaffected limestones are classified like wackstones, grainstones and packstones. They may constitute carbonates grains of benthic foraminifera, echinoderm spines, ostracods, algae, corals, bivalves, gastropods, peloids and intraclasts. The porosities are classified like vug, intraparticle, interparticle, intercrystal and moldic types. The major minerals are calcite, ankerite and dolomite; the detrital are montmorillonite, pyrite, limonite, quartz and microcline. The thermally affected limestones are very coarse to very fine-grained and light to dark gray color. The fossiliferous components totally disappear, and the porosity tends to disappear. With the data obtained, it can be inferred that the carbonate protoliths would be calciferous to dolomitic limestones, both with small amount of clay minerals. Crystalline carbonates from dolomitic protolith have rhombohedral calcite and iron oxides / hydroxides, making the rocks much darker. The carbonates from calciferous protolith have a wide variation of grain size according to the recrystallization degree, increasing toward contact with the basic bodies. In this group, it was identified the minerals lizardite and spinel in weakly to moderately affected samples, and spinel and spurrite in strongly affected rocks, as well as calcite, that occur everywhere. The geological context (shallow level diabase intrusions), the crystallization of the pyrometamorphic minerals spurrite and olivine, and comparison with diagrams from the literature allow estimating temperatures and pressures around 1050-1200 °C and 0.5-1.0 kbar, respectively, for PTOTAL=PCO2. The post-intrusion cooling would have afforded the releasing of metasomatic / hydrothermal fluids, allowing the opening of the metamorphic system, with possible contribution of chemical elements from host units (sandstones, shales) and from basic intrusions. This would induce hydration of previous phases, allowing the formation of serpentine, chlorite and brucite. The results discussed here reveal the strong influence of the heat from basic intrusions within the sedimentary pile. Whereas in the offshore portion of the basin occur sills with up to 1000 m thickness, the understanding of pyrometamorphism might be useful for understanding and measuring the thermally affected rocks.

Pirometamorfismo em calcários da formação Jandaíra, bacia potiguar, nordeste do Brasil

The present study aims the characterization of thermally affected carbonate rocks from Jandaíra Formation in contact with Paleogene and Neogene basic intrusions in the region of the Pedro Avelino and Jandaíra municipalities (RN), northeastern Brazil. For this study, field, petrographic, x-ray diffraction, electron microprobe, and whole rock litogeochemistry data of carbonates were undertaken. The thermally unaffected limestones are classified like wackstones, grainstones and packstones. They may constitute carbonates grains of benthic foraminifera, echinoderm spines, ostracods, algae, corals, bivalves, gastropods, peloids and intraclasts. The porosities are classified like vug, intraparticle, interparticle, intercrystal and moldic types. The major minerals are calcite, ankerite and dolomite; the detrital are montmorillonite, pyrite, limonite, quartz and microcline. The thermally affected limestones are very coarse to very fine-grained and light to dark gray color. The fossiliferous components totally disappear, and the porosity tends to disappear. With the data obtained, it can be inferred that the carbonate protoliths would be calciferous to dolomitic limestones, both with small amount of clay minerals. Crystalline carbonates from dolomitic protolith have rhombohedral calcite and iron oxides / hydroxides, making the rocks much darker. The carbonates from calciferous protolith have a wide variation of grain size according to the recrystallization degree, increasing toward contact with the basic bodies. In this group, it was identified the minerals lizardite and spinel in weakly to moderately affected samples, and spinel and spurrite in strongly affected rocks, as well as calcite, that occur everywhere. The geological context (shallow level diabase intrusions), the crystallization of the pyrometamorphic minerals spurrite and olivine, and comparison with diagrams from the literature allow estimating temperatures and pressures around 1050-1200 °C and 0.5-1.0 kbar, respectively, for PTOTAL=PCO2. The post-intrusion cooling would have afforded the releasing of metasomatic / hydrothermal fluids, allowing the opening of the metamorphic system, with possible contribution of chemical elements from host units (sandstones, shales) and from basic intrusions. This would induce hydration of previous phases, allowing the formation of serpentine, chlorite and brucite. The results discussed here reveal the strong influence of the heat from basic intrusions within the sedimentary pile. Whereas in the offshore portion of the basin occur sills with up to 1000 m thickness, the understanding of pyrometamorphism might be useful for understanding and measuring the thermally affected rocks.

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.