Avaliação da satisfação das usuárias sobre a atenção à saúde da mulher no Rio Grande do Norte

This work discusses the evaluation of the satisfaction of the users on the women health care focusing on the quality of the primary care in the State of Rio Grande do Norte-BR. The main objective of this research is evaluate the satisfaction of the users about the actions applied to women health in the primary health care in Rio Grande do Norte, observing the information available through the Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB). The specific objectives are: the evaluation of aspects related to women health; the evaluation of the specific actions related to welcoming the pregnant and; the evaluation of the information related to the postpartum. This dissertation is characterized as an evaluative research made through a multicentric transversal study, using a quantitative approach, which is part of the External Evaluation of the PMAQ-AB in the State of Rio Grande do Norte, made by the Federal University of Rio Grande do Norte. Some secondary data of the interviews with the users who were in the Basic Health Units were used during the External Evaluation of the PMAQ-AB in Rio Grande do Norte. The sample was collected following these criteria: the users that were in the Basic Health Units to attend to any procedure; they must had used the services for at least one year; and they must had agreed to participate the research. The ones that were attending to the services for the first time and the ones that did not use the services for at least 12 months were excluded from the sample. To the data collection it was used a chart of variables/indicators with the following information to the analysis: Women Health Care, Specific Care of the Pregnant and Information about he postpartum. The descriptive analysis of the data were made through absolute and relative frequencies of the variables using the software Statistic Package for Social Sciences (SPSS) for Windows, version 22.0.0. The results show a positive picture of the satisfaction of the users about the actions of the primary healthcare in women health in the State of the Rio Grande do Norte. Another important analysis is the integration of the primary health care with other points of the Healthcare System aiming to reorient the Model of Healthcare as a starter of the access and quality of the services given to the users. Therefore, the evaluation of the satisfaction of the users in health care is essential among all the agents involved in the process of consolidation of the Unified Health System SUS. Also having the need of rethinking the professional practice, reorganizing the processes of work of the multiprofessional teams in health care, enabling financial resources, inputs and materials, planning and systematizing new actions of healthcare aiming to ensure a perfect health care to the people

Violência Sexual Infanto-Juvenil em Natal: uma avaliação do Programa Sentinela

Analyze the problem of sexual violence suffered by children and adolescents in the city of Natal / Rio Grande do Norte (RN), attended by the Programa Sentinela, a service aimed at combating sexual violence children and teenagers who serves on the council of Natal. Thus aims to review the implementation of the Programa Sentinela in Natal / RN, in the period 2001 to 2006, verifying that the program has contributed to the access of children and adolescents who are victims of abuse and sexual exploitation to fundamental rights under the Statute Children and adolescents (ECA) and the Local Plan and the National gainst Infanto-Youth Sexual Violence. It has a theoretical and methodological approach quantitative and qualitative, covering the issue of sexual violence against children and adolescents, as one of the expressions of economic relationships, gender, race and culture that make up the material and symbolic structure of society. It methodological procedure: review of literature on the subject and conducting interviews with professionals and families of children and adolescent victims of sexual violence. Investigate as the unit of analysis the Sentinel Program. The analysis on the governmental actions of this period on this social problem points to the continuity and little change in the care of victims of sexual violence: despite maintain features and palliative assistencialistas, favoring the "Network of Sexual Tourism", go through some innovations in terms of securing rights from the ECA, which is the need for transparency and democratization in the management of government policies. In research undertaken, Brazil will only be combating this type of crime when each of the social actors are actually doing their share, down taboos, facing corruption and strengthening a system of guarantee of rights, which target children and adolescents are unprotected, and often ignored by Brazilian society

Tratamento do Centro de Atenção Psicossocial para usuários de álcool e outras drogas CAPSad II Leste Natal/RN : uma avaliação da efetividade

The treatment for abusive users of alcohol and other drugs suffered significant modifications until arriving to the psychosocial model that is used by Centro de Atenção Psicossocial CAPSad II Eastern Natal/RN (Psychosocial Support Center). That model appears starting from Brazilian sanitary and psychiatric reforms which are expressed in the principles and propositions of Sistema Único de Saúde SUS (Unique System of Health). The Psychiatric Reform meant a rupture with the mental hospital and hospital centered treatment pattern which was destined to the abusive users of alcohol and other drugs. The new proposal offers the universalization, democratization, regionalization and completeness of the actions in the field of mental health. It gathers a strictly interdisciplinary health staff. The purpose of this study is to evaluate the effectiveness of the treatment for abusive users of alcohol and other drugs offered by CAPSad II Eastern Natal/RN. The evaluation used, as priority, the qualitative social research through an evaluating study starting from the non-experimental model. The methodological process used different instruments of data collection: bibliographical and documental researches, systematic observations at CAPSad II Eastern Natal/RN and, mainly, the semistructured interviews (21) that were accomplished with the professionals, users and relatives of CAPSad II Eastern Natal/RN. The investigation showed the effectiveness of the service and, therefore, CAPSad II Eastern Natal/RN constitute itself as the main confronting strategy to the mental hospital and hospital centered treatment pattern of caring the abusive users of alcohol and other drugs

A gestão do Sistema Único de Assistência Social em Currais Novos (RN)

The present paper analyses the social assistance management in small cities, starting from the reality of Currais Novos City. Its main objective is to analyse the management of this politic in the context of the Nacional Sistem of Social Assistance (SUAS) through the management instruments materialized in the city: Social Assistance Plan, Budget, Management Report, Information Management, Monitorizing and Evaluation. It reveals a discrepancy between the instruments purpose and their concretude, and it identifies the main challenges in order to make them real, revealing the contradictions of such politic, through which the advances relate with the retrocesses. It remarks, in this context, the debate about Public Management and some aspects of the trajetory of the Social Assistance management in the brazilian context and the configurations of (SUAS) and of the politics in Currais Novos city. Such path allows us to identify the feebleness in the city ways to adopt the (SUAS) criteria, which is much more effective in burocratic aspects than in the change of the Social Assistance conception and in the effective incorporation of the (SUAS) principles and guidelines. Thus, problems are identified in what concerns to the important aspects for its effectivation, with the human resources, financing and social control mechanisms. It makes possible to reafirm the importance of the analysed management instruments for the effectivation of one participative and democratic management, as well as the urgency of its materialization as one of the important ellements for this politic to happen as a right and to make a stop to the unconformities between the (SUAS) determinations and its materialization

A articulação da instrumentalidade no exercício profissional do assistente social em Natal/RN

Presents the discussion of practical and social dimensions that comprise the instrumentality (formative; theoretical and intellectual; investigative; technical-instrumental; and ethical-political) Social Work from research in social and occupational areas in which they operate social workers in Natal in Rio Grande do Norte. Chapters expose positions, experiences and reality of the respondents and the theoretical constructs and analytical, to understand: the evaluation of the training process, relating the teaching practice, the role of knowledge and the importance of research in professional practice of social workers, the seizure of technical-instrumental dimension, articulating demands, duties, powers and instruments, as elements that comprise it, and finally the ethical-political dimension, discussing the challenges of ethics and materialization of the ethical-political in daily work. In this sense, the dissertation sought add to production and academic debate about the work of the social worker, as well as contribute to their own professional practice, revealing how professionals articulate the practical and social dimensions that comprise the instrumentality in their daily work

Políticas públicas para a terceira idade: uma avaliação do Programa Idoso Cidadão da Prefeitura Municipal de Mossoró/RN

Nos últimos anos, o tema velhice tem despertado mais a atenção de diversos setores da sociedade. O resultado disso é o aumento de reportagens, artigos, monografias, dissertações e teses sobre ele.O Brasil está caminhando para se tornar a sexta população de idosos no mundo, fruto do grande avanço tecnológico, intensificado na segunda metade do século XX, facilitando as conquistas da medicina, da saúde e da genética. Vale salientar que essa problemática está inserida em um contexto social, político e econômico específico, que é o da resignificação do poder local. É nessa conjuntura que situamos o presente trabalho, que é um estudo sobre a avaliação de políticas públicas. Nesse sentido, procuramos analisar a efetividade do Programa Idoso Cidadão, da Prefeitura Municipal de Mossoró. O quadro de referência teórico-metodológico situa-se na revisão da literatura sobre terceira idade, poder local e avaliação de políticas públicas, observação assistemática; e entrevista semi-estruturada com os gestores, os profissionais envolvidos e particularmente com os usuários do Programa, tendo como meta averiguar como esses agentes percebem a implementação e os resultados do Programa. Com este tratamento conceitual foi possível apreender as condições em que se deu o estudo sobre a efetividade do referido programa para o processo de inclusão dos idosos na sociedade. O Programa Idoso Cidadão é, sem dúvida, um avanço no trabalho com os idosos e na inclusão destes na sociedade. É um espaço para a construção da cidadania, embora apresente muitas limitações, principalmente na área física e no quadro profissional. Constatou-se que, de modo geral, o Programa atende às necessidades básicas de sua clientela. Portanto podemos dizer que a avaliação da efetividade dessa política de atendimento ao idoso se mostrou eficaz, uma vez que podemos perceber o quanto o programa é importante para a vida de seus usuários, promovendo a elevação de sua auto-estima e de sua aceitação como categoria social

O Processo de revisão do benefício de prestação continuada-BPC: uma lógica de exclusão ou inclusão social

This research comprises a study about the social assessment performed by the Social Worker in the review process of the Benefit of Continued Installment. The Benefit of Continued Installment was implemented in 1996 and guarantees a minimum salary to the deficiency person and to an elder with sixty five years or more and that proves not to have ways to support neither himself/herself nor his/her own family. It is a demand to include in the BPC that the maximum income of a family does not exceed ¼ of minimum salary and that every two years this benefit to be revised to evaluate its continuity based in its original conditions. This study was carried out in the municipality of Natal/RN, with thirteen social workers, being the collection of data performed through interviews and social assessments of the users that count with the benefit. The results show that the users selected by the criterion of the income, present a profile of poverty and deprivations demonstrated through several situations survived in its daily life, indicative of vulnerability. It was demonstrated that the Social workers has relative autonomy in the evaluations along with the users and that it denotes the necessity of inclusion. However, by following the imposed criteria, it corroborates with the logic of exclusion. So, it is identified in the Municipality of Natal/RN, following the orientation given the politics of social work at national level, the implementation of revision of the BPC, for the social workers, from rigorous processes of selection and exclusions

Avaliação sistemática de abordagens de derivação de produto

Product derivation tools are responsible for automating the development process of software product lines. The configuration knowledge, which is responsible for mapping the problem space to the solution space, plays a fundamental role on product derivation approaches. Each product derivation approach adopts different strategies and techniques to manage the existing variabilities in code assets. There is a lack of empirical studies to analyze these different approaches. This dissertation has the aim of comparing systematically automatic product derivation approaches through of the development of two different empirical studies. The studies are analyzed under two perspectives: (i) qualitative that analyzes the characteristics of approaches using specific criteria; and (ii) quantitative that quantifies specific properties of product derivation artifacts produced for the different approaches. A set of criteria and metrics are also being proposed with the aim of providing support to the qualitative and quantitative analysis. Two software product lines from the web and mobile application domains are targets of our study

Competitividade de destinos turísticos e o imperativo sustentável: avaliação de dimensões e atributos condicionantes no Pólo Costa das Dunas, RN, Brasil

Being available as a tourist destination is a necessary condition but not enough for the expansion and success of tourism activity. To be successful, tourism requires investment, inputs, appropriate planning and management, like any other economic activity. A fundamental goal of the destination management is to understand how the competitiveness of a tourist destination can be improved and sustained. Competitive position of tourism can be measured and assessed by various models. Evaluating the indicators of competitiveness of a tourist destination involves a multivariate analysis, ranging from issues directly related to tourism activity itself to the indirect factors. These are elements that are interrelated and that together will point out the competitive condition of this destination. From the definition and characterization of competitiveness, sustainability and management in the context of tourist destinations, understood as the main concepts of this study, we present the main theoretical and methodological models of assessment of competitiveness of tourist destinations in the literature and represent the state of the issue in the scientific treatment of the subject. These models, designed by researchers from several countries and applied in different tourist destinations, are confronted about their structure, indicators considered and localities in which they were applied. The aim of this study was to know and evaluate the condition of tourist competitiveness of the destination Pólo Costa das Dunas, from the constraints attributes of superior performance of the evaluation model of tourist competitiveness of destinations Competenible, suggested by Mazaro, and that suit the requirements of international market aware of the strength and importance of sustainability. The condition of competitiveness of tourist destination in Rio Grande do Norte Pólo Costa das Dunas was moderate. The competitive strengths and weaknesses of the destination Pólo Costa das Dunas revealed through the dozens of sustainable attributes of the model Competenible showed guidelines and initiatives that can be taken to guide strategic decisions related to their planning and management. Thus, this study should serve as support for strategic planning and long-term management of the sector and as a crucial tool for making decisions related to public policies, sectoral investments, monitor processes, strategic planning, direction and control of the local and regional tourism development of destinations

Participação social e designação de espécie-bandeira: ações complementares à conservação de um parque estadual em área urbana

Facing environmental problems the planet appears several alternative preventive and control on behalf of the equation between development and environmental protection. One of the alternatives implemented in Brazil to conservation of biodiversity was the creation of protected natural areas regulated by the National System of Conservation Units (SNUC). This is an integrated study of the Comunication / Environmental Conservation, which prioritizes social participation as a complementary in the conservation process, the particular case of the Dunas do Natal State Park, the first conservation area in Rio Grande do Norte, for full protection. It takes into account the roles environmental, scientific and Park, which harbors a unique biodiversity, including endemic species and the fact being located in an urban area. It proposes the use of two complementary instruments, such as strategies for conservation. Considering the various individual experiences, it was analyzed the perception that the community is directly related to the Park. From this promoted the democratization of information about the park, its biodiversity and conservation. As another conservation tool, it was suggested the use of a flagship species for the park, or a body chosen symbol for environmental or social reasons, in order to protect and conserve certain natural environments, from the understanding and co -community participation. In this case, as proposed flag Coleodactylus natalensis species, the lizard-the-litter, to be endemic remnants of Atlantic Forest Park as having the type locality, be one of the smallest species of the world, South America's lowest-dependent shadow of the forest, sensitive to human action and therefore very vulnerable. This suggestion finds support in the degree of public acceptance that interacts directly with the Park, as a result of the evaluation of their perceptions. It was further observed in this study that this symbology to be used in order to promote the democratization of the Park and its biodiversity has an identification result, curiosity and probable involvement of the population with the issues of the Park

Avaliação do risco ocupacional de trabalhadores expostos a agrotóxicos no município de Touros/Rio grande do Norte

The use of pesticides is being used intensively with severe consequences for exposed farmers. This study aimed to describe the socioeconomic and health profiles of 60 farmers in the city of Touros / RN through the questionnaire recommended by: (International Commission for Protection against Environmental Mutagens and Carcinogens (ICPEMC). The analysis of these data allowed to prove the importance of knowledge about the socioeconomic and health profile of rural farmers as a way to understand the reality of this population, that is vulnerable to exposure due to the lack of knowledge and conditions. Aiming to analyze the frequency of micronucleus (MN) and other nuclear abnormalities in oral mucosa cells of 54 farmers that work in the city of Touros / RN it was applied the micronucleus test (MN) in oral mucosa. Our results showed an increased frequency of MN and other nuclear abnormalities related to the exposure and effects of pesticides on health. Based on the results, it is clear that farmers are using pesticide in the wrong way and compromising their health. A Cordel has been developed as a method to taking the results to the people affected by the pesticides. Therefore this study alerts to the need for profound changes in the social, cultural and health context to reduce health risks for both people and for the environment

Comunidade fitoplanctônica como discriminador ambiental em açude eutrófico tropical semiárido (Barragem Armando Ribeiro Gonçalves, RN) e divulgação científica para reflexão social

The knowledge of the phytoplankton community, as an integral and dynamic processes of eutrophication, provides information essential for proper management and handling. A growing problem of cyanobacteria in reservoirs around the world as a result of artificial eutrophication processes, generating a particular concern, because some species produce cyanotoxins, which can cause adverse effects on human health. The present work aims to characterize the spatial and temporal dynamics of phytoplankton, assessing their potential as ecological indicator of water quality in reservoirs semiarid region. The samples of water were collected monthly between 2009 and 2011, at three points along the dam Armando Ribeiro Gonçalves / RN. In each sample were measured physico - chemical analysis of water and biological components. We conducted a scientific dissemination activity, with distribution and reading primer on eutrophication, informative talk about water quality, questionnaires and performing a play in a public school in the city of Itajá / RN. The reservoir was considered eutrophic in three points, taking into account the values of chlorophyll -a and phosphorus, adopted to characterize eutrophic environments of semi-arid areas. High density of cyanobacteria, with a maximum value of 2.227.862 cél.ml- 1 and minimum of 43.456 cél.ml- 1 was recorded in lentic and semilêntico points throughout the study, exceeding the levels of drinking water (20.000 cél.ml- 1) established in 2.914/2011 Ordinance of the Ministry of Health of Brazil. All samples contained microcystin, and 44 % had values superiores1μg L- 1. The thermal pattern of the water column showed micro stratifications with differences of less than 1 ° C from five feet deep. The distribution pattern was the type profile clinogrado with oxygen deficit in the bottom of the reservoir. Oxiclina from 10 meters depth was observed during the rainy season (May-June) in the two years of study. The phytoplankton community was represented by 10 functional groups: S1, M, H1, Lo, P, F, Sn, P, W2 and R. The assessment of the ecological status of the system by the index Q showed poor water quality. The results of the study show that the vertical variations were less pronounced than the seasonal variations of cyanobacteria and phytoplankton community in general in the reservoir. The presence of cyanotoxins confirms the need for the monitoring of water quality and measures to reduce eutrophication in water supply reservoirs semiarid RN and demonstrates the challenge for water managers and health authorities to ensure water quality and consequently minimize risks to human health. Compared to the lecture, the primer was considered more efficient in sensitizing the participants, featuring a dynamic practice, differentiated learning, create opportunities for students to rethink attitudes of respect and care for the environment, and shall have the opportunity to learn the subject content from your reality and living environment. The knowledge generated from the activity of scientific were seen as essential for raising awareness of some of the region`s environmental problems , such as eutrophication

Alcoholic women and men: a comparative study of social and familial aspects and outcome

Objetivos: A proporção de ocorrência de alcoolismo em homens e mulheres tem uma variação de 14:1 até 2:1, mostrando a necessidade de estudos específicos para a população feminina. O objetivo deste estudo foi analisar o perfil e a evolução de alcoolistas, segundo gênero e gravidade da dependência. Métodos: Realizou-se um estudo longitudinal retrospectivo de 114 homens e 57 mulheres alcoolistas (CID-10), inscritos no ambulatório da Faculdade de Medicina de Botucatu, no período de 1990-1994 e avaliados até julho de 1997. Utilizou-se um questionário semi-estruturado, e, para avaliação da gravidade do alcoolismo, o Short Alcohol Dependence Data. Resultados/Conclusões: Os principais resultados mostraram que a estrutura familiar estava comprometida com: relacionamento difícil para 55,6% das mulheres e 65,7% dos homens; violência familiar em 74,1% das mulheres e 61,1% dos homens. As mulheres iniciaram a ingestão mais tarde que os homens (p=0,01), em geral com seus cônjuges (p=0,00). Não houve diferença de evolução no tratamento entre os gêneros. Os principais fatores associados à melhor resposta ao tratamento, independentemente do sexo, foram: nível de gravidade de dependência do álcool (dependentes leves e moderados apresentaram 5,59 vezes mais chances de melhorar do que os dependentes graves); ser praticante de alguma religião (2,3 vezes mais chances de melhora do que os pacientes que não eram praticantes); e tempo de seguimento no programa, negativamente correlacionado a chances de melhora (0,68 vezes menos chances de melhora que aqueles que permaneceram por tempo menor em tratamento).

Prevalência e fatores de risco para transtornos mentais comuns entre estudantes de medicina

OBJETIVO: Estimar a prevalência de transtornos mentais comuns entre estudantes de medicina e respectivos fatores de risco. MÉTODOS: Estudo transversal realizado com 551 universitários de um curso de medicina de Botucatu, SP. Utilizou-se questionário auto-aplicável investigando aspectos sócio demográficos, relacionados ao curso e o Self Reporting Questionnaire. Para análise dos dados empregaram-se os testes de qui-quadrado e regressão logística. RESULTADOS: Participaram 82,6% dos alunos matriculados no curso, predominando mulheres (61%), jovens (60% 20-23 anos), procedentes de outros municípios (99%). A prevalência de transtornos mentais comuns foi de 44,7% associando-se independentemente a: dificuldade para fazer amigos (RC=2,0), avaliação ruim sobre desempenho escolar (RC=1,7), pensar em abandonar o curso (RC=5,0), não receber o apoio emocional de que necessita (RC=4,6). Embora na primeira análise a prevalência tenha se mostrado associada ao ano do curso, esta associação não se manteve na análise multivariada. CONCLUSÕES: A prevalência de transtornos mentais comuns mostrou-se elevada entre os estudantes de medicina, associando-se a variáveis relacionadas à rede de apoio. As experiências emocionalmente tensas como o contato com pacientes graves, formação de grupos, entre outras, vividas nos últimos anos do curso, são provavelmente potentes estressores, especialmente para sujeitos com uma rede de apoio considerada deficiente. Sugere-se que instituições formadoras estejam atentas a esse fato, estabelecendo intervenções voltadas ao acolhimento e ao cuidado com o sofrimento dos estudantes.

Avaliação das subclasses IgG1 e IgG3 na doença hemolítica perinatal

A doença hemolítica perinatal (DHPN) ainda é um problema clínico. Nenhum teste isolado prediz, com segurança, a gravidade do quadro hemolítico. O objetivo do presente estudo foi determinar as subclasses de anticorpos IgG1 e IgG3 por citometria de fluxo no soro de 42 gestantes isoimunizadas e correlacionar os dados obtidos com a gravidade da DHPN. A distribuição dos fetos ou neonatos segundo a gravidade do quadro hemolítico evidenciou 13 casos com doença leve, 16 casos com doença moderada e 13 com doença grave. As subclasses foram detectadas em 33/42 (79%) amostras. A subclasse IgG1, isoladamente, foi evidenciada em 14/33 (42,4%) casos. Na relação entre gravidade da doença e subclasses de IgG, observou-se que IgG1 isolada foi encontrada em todos os grupos, e os valores da mediana de intensidade de fluorescência (MIF) foram significativamente mais altos nas formas mais graves da DHPN (p<0,01). Contrariamente, os valores da MIF para IgG3 se apresentaram mais homogêneos em todas as categorias (p=0,11). A presença de IgG3 parece, portanto, estar mais associada à hemólise leve. A associação das subclasses IgG1 e IgG3 está relacionada à situação clínica mais grave, o que se deve, possivelmente, à presença de IgG1 associada. Apesar dos altos valores para IgG1 e a associação de IgG1 com IgG3 indicarem maior gravidade da DHPN, sugere-se que outras variáveis sejam analisadas conjuntamente, uma vez que os relatos existentes na literatura, até o momento, não dão suporte para seu uso como instrumento exclusivo de avaliação de gravidade e prognóstico da doença.