Avaliação do impacto socioambiental de indústrias têxteis no rio Jundiaí - Macaíba/RN/Brasil

The contamination of aquatic environments is a phenomenon that dates back the origins of human civilizations and was amplified by the advent of industrial processes. The Jundiaí river , Macaíba's main water source, suffering discharge of effluents from various industries. The study work´s in two fronts, the environmental perception front was conducted through semistructured interviews whose textile effluent was appointed by the population as the main problem in the river. It was observed that nearly all respondents had concerns about the environment. In addition, there is an inclusion of individuals as the cause of the problem, because a significant part recognizes that its activities may cause damage to the environment and people's health. In other front, the experimental monitoring of water quality was conducted through ecotoxicological tests and physiochemical analysis that proposed to assess Pomacea lineata .Mysidopsis juniae isolated effect of textile effluent and its influence on the river compared with the limits established by Brazilian law. Although the physio-chemical analysis shows is inconclusive about the participation of the textile effluent in environmental contamination of the river, the ecotoxicological tests have shown to blunt the signal that the effluent may present a risk to aquatic organisms and consequently to human health. Thus, an interdisciplinary way it was possible to study the cause of the environmental problem identified by the population in the realization phase and measurable effect on water quality analysis in the river by means of the tests mentioned.

Avaliação imuno-histoquímica das proteínas BMP-4, FGF-8 e Sindecan-1 em tumores odontogênicos

The development and progression of odontogenic tumors have been associated with an imbalance in the activity of growth factors, adhesion molecules, extracellular matrix proteins and their degradation enzymes, angiogenic factors and osteolytic. Some studies have shown that interaction relationships inductive epithelial / mesenchymal determinants of Odontogenesis are mimicked by these tumors. The objective of this research was to investigate the immunolocalization of growth factors (BMP-4 and FGF-8) and Sindecan-1 structural protein in a series of odontogenic tumors presenting different biological behaviors, to contribute to a better understanding of the role of these proteins in tumor development. The sample consisted of 21 of the solid ameloblastoma, odontogenic keratocysts 19 and 14 odontogenic adenomatoid tumors. Increased Sindecan-1 immunostaining was seen in the epithelium of the lesions when compared with mesenchyme. In ameloblastoma and odontogenic keratocysts, this expression was higher than in AOT. Epithelial expression of BMP4 showed quantitatively similar in the three studied lesions; however, when anlisada mesenchymal immunoreactivity, was detected significant higher expression when compared to the ameloblastoma keratocysts. In ameloblastoma, mesenchymal expression was predominantly (p = 0.008), while in keratocyst higher expression in the epithelium was observed (p = 0.046). In all injuries, strong or moderate correlation was observed in the BMP-4 immunoreactivity in the epithelium and mesenchyme. FGF-8, no injury was observed difference between the immunoreactivity in the epithelium or mesenchyme, however in ameloblastoma positive correlation was found (Spearman correlation, rho = 0.857, p <0.001). The results of this study suggest that the three evaluated biomarkers actively involved in the pathogenesis of lesions, especially the expression of ameloblastomas indicating a strong interaction between parenchymal and stromal cells which may contribute to its marked aggressiveness.

Avaliação do efeito da inibição do reparo de sítios abásicos na resposta inflamatória celular

Base excision repair (BER) proteins has been associated with functions beyond DNA repair. Apurynic/apyrimidinic endonuclease 1 (APE1) is a multifunctional protein involved in a plethora of cellular activities, such as redox activation of transcription factors, RNA processing and DNA repair. Some studies have described the action of the protein 8-oxoguanine (OGG1) in correcting oxidized lesions in promoters as a step in the transcription of pro-inflammatory cytokines. Despite being especially important in redox activation of transcription factors such as nuclear factor κB (NF-κB) and AP- 1, the repair activity of APE1 has not yet been associated with the inflammatory response. In this study, experimental and bioinformatic analysis approaches have been used to investigate the relationship between inhibition of the repair of abasic sites in DNA by MX, a synthetic molecule designed to inhibt the repair activity of APE1, and the modulation of the inflammatory response. The results showed that treatment of monocytes with lipopolysaccharide (LPS) and MX reduced the expression of cytokines, chemokines and toll-like receptors, and negatively regulated biological immune processes, as macrophages activation, and NF-κB and tumor necrosis factor (TNF-α) and interferon pathways, without inducing cell death. The transcriptomic analysis suggests that LPS/MX treatment induces mitochondrial dysfunction, endoplasmic reticulum stress and activation of autophagy pathways, probably activated by impairment of cellular energy and/or the accumulation of nuclear and mitochondria DNA damage. Additionally, it is proposed that the repair activity of APE1 is required for transcription of inflammatory genes by interaction with abasic sites at specific promoters and recruitment of transcriptional complexes during inflammatory signaling. This work presents a new perspective on the interactions between the BER activity and the modulation of inflammatory response, and suggests a new activity for APE1 protein as modulator of the immune response in a redox-independent manner.

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.

Avaliação da concentração de vitamina A materna e de neonatos prematuros e a termo

Vitamin A is an essential nutrient for many physiological processes such as growth and development, so that their adequate nutritional state is essential during pregnancy and lactation. Lactating women and children in breastfeeding are considered risk groups for vitamin A deficiency and some factors may increase the risk of vitamin A deficiency, such as prematurity. The aim of this work was to evaluate the vitamin A concentration in preterm and term lactating women and newborns by determination of retinol in maternal serum, umbilical cord serum and breast milk collected until 72 hours postpartum. 182 mothers were recruited and divided into preterm group (GPT; n = 118) and term group (GT, n = 64). In preterm group were also analyzed transition milk (7th-15th day; n = 68) and mature milk (30th-55th day; n = 46) samples. Retinol was analyzed by high-performance liquid chromatography (HPLC). Maternal retinol concentration in serum was 48.6 ± 12.3 µg/dL in GPT and 42.8 ± 16.3 µg/dL in the GT (p <0.01). Cord serum retinol was 20.4 ± 7.4 µg/dL in GPT and 23.2 ± 7.6 µg/dL in GT (p> 0.05). Among newborns, 43% of premature and 36% of term had low levels of serum retinol in umbilical cord (<20 µg/dL). In colostrum, the retinol in preterm and term groups had an average of 100.8 ± 49.0 µg/dL and 127.5 ± 65.1 µg/dL, respectively (p <0.05). The retinol average in preterm milk increased to 112.5 ± 49.7 µg/dL in transition phase and decreased to 57.2 ± 23.4 µg/dL in mature milk, differing significantly in all stages (p <0.05). When comparing with the recommendation of vitamin A intake (400 µg/day) GT colostrum reached the recommendation for infants, but in GPT the recommendation was not achieved at any stage. Mothers of premature infants had higher serum retinol than mothers at term; however, this was not reflected in serum retinol of umbilical cord, since premature had lower concentration of retinol. Such condition can be explained due to lower maternal physiological hemodilution and placental transfer of retinol to the fetus during preterm gestation. Comparison of retinol in colostrum showed lower concentrations in GPT; however the transition phase there was a significant increase of retinol content released by the mammary gland of preterm mothers. This situation highlights a specific physiological adaptation of prematurity, likely to more contribute to formation of hepatic reserves of retinol in premature infants.

Extração, caracterização e avaliação bioativa do extrato de Arrabidaea chica

The use of plants for medicinal purposes is ancient, with widespread application in medicinal drugs. Although plants are promising sources for the discovery of new molecules of pharmacological interest, estimates show that only 17% of them have been studied for their possible use in medicine. Thus, biodiversity of Brazilian flora represents an immense potential for economic use by the pharmaceutical industry. The plant Arrabidaea chica, popularly known as “pariri”, is common in the Amazon region, and it is assigned several medicinal properties. The leaves of this plant are rich in anthocyanins, which are phenolic compounds with high antioxidant power. Antioxidant compounds play a vital role in the prevention of neurological and cardiovascular diseases, cancer and diabetes, among others. Within the anthocyanins found in Arrabidaea chica, stands out Carajurin (6,7-dihydroxy-5,4’- dimethoxy-flavilium), which is the major pigment encountered in this plant. The present work aimed to study on supercritical extraction and conventional extraction (solid-liquid extraction) in leaves of Arrabidaea chica, evaluating the efficiency of the extractive processes, antioxidant activity and quantification of Carajurin contained in the extracts. Supercritical extraction used CO2 as solvent with addition of co-solvent (ethanol/water mixture) and were conducted by the dynamic method in a fixed bed extractor. The trials followed a 24-1 fractional factorial design, the dependent variables were: process yield, concentration of Carajurin and antioxidant activity; and independent variables were: pressure, temperature, concentration of co-solvent (v/v) and concentration of water in the co-solvent mixture (v/v). Yields (mass of dry extract/mass of raw material used) obtained from supercritical extraction ranged from 15.1% to 32%, and the best result was obtained at 250 bar and 40 °C, co-solvent concentration equal to 30% and concentration of water in the co-solvent mixture equal to 50%. Through statistical analysis, it was found that the concentration of co-solvent revealed significant effect on the yield. Yields obtained from conventional extractions were of 8.1% (water) and 5.5% (ethanol). Through HPLC (High-performance liquid chromatography) analysis, Carajurin was quantified in all the extracts and concentration values (Carajurin mass/mass of dry extract) ranged between 1% and 2.21% for supercritical extraction. For conventional extraction, Carajurin was not detected in the aqueous extract, while the ethanol extract showed Carajurin content of 7.04%, and therefore, more selective in Carajurin than the supercritical extraction. Evaluation of antioxidant power (radical 2,2-diphenyl-1-picrylhydrazyl – DPPH – sequestration method) of the supercritical extracts resulted in EC50 values (effective concentration which neutralizes 50% of free radicals) ranged from 38.34 to 86.13 μg/mL, while conventional extraction resulted in EC50 values of 167.34 (water) and 42.58 (ethanol) μg/mL. As for the quantification of total phenolic content (Folin-Ciocalteau analysis) of the supercritical extracts resulted in values ranged from 48.93 and 88.62 mg GAE/g extract (GAE = Gallic Acid Equivalents), while solid-liquid extraction resulted in values of 37.63 (water) and 80.54 (ethanol) mg GAE/g extract. The good antioxidant activity cannot be attributed solely to the presence of Carajurin, but also the existence of other compounds and antioxidants in Arrabidaea chica. By optimizing the experimental design, it was possible to identify the experiment that presented the best result considering the four dependent variables together. This experiment was performed under the following conditions: pressure of 200 bar, temperature of 40 °C, co-solvent concentration equal to 30% and concentration of water in the co-solvent mixture equal to 30%. It is concluded that, within the studied range, it is possible to purchase the optimum result using milder operating conditions, which implies lower costs and greater ease of operation.

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.

Avaliação do tratamento eletroquímico (direto e indireto) como alternativa de degradação do corante azul de metileno

Textile industry has been a cause of environmental pollution, mainly due to the generation of large volumes of waste containing high organic loading and intense color. In this context, this study evaluated the electrochemical degradation of synthetic effluents from textile industry containing Methylene Blue (AM) dye, using Ti/IrO2-Ta2O5 and Ti/Pt anodes, by direct and indirect (active chlorine) electrooxidation. We evaluated the influence of applied current density (20, 40 and 60 mA/cm2 ), and the presence of different concentrations of electrolyte (NaCl and Na2SO4), as well as the neutral and alkaline pH media. The electrochemical treatment was conducted in a continuous flow reactor, in which the electrolysis time of the AM 100 ppm was 6 hours. The performance of electrochemical process was evaluated by UV-vis spectrophotometry, chemical oxygen demand (COD) and total organic carbon (TOC). The results showed that with increasing current density, it was possible to obtain 100 % of color removal at Ti/IrO2-Ta2O5 and Ti/Pt electrodes. Regarding the color removal efficiency, increasing the concentration of electrolyte promotes a higher percentage of removal using 0,02 M Na2SO4 and 0,017 M NaCl. Concerning to the aqueous medium, the best color removal results were obtained in alkaline medium using Ti/Pt. In terms of organic matter, 86 % was achieved in neutral pH medium for Ti/Pt; while a 30 % in an alkaline medium. To understand the electrochemical behavior due to the oxygen evolution reaction, polarization curves were registered, determining that the presence of NaCl in the solution favored the production of active chlorine species. The best results in energy consumption and cost were obtained by applying lower current density (20 mA/cm2 ) in 6 hours of electrolysis.

Avaliação do efeito do liraglutida nos tecidos muscular e adiposo e nos parâmetros bioquímicos em camundongos Swiss submetidos à dieta de cafeteria e a atividade física

Obesity is a chronic metabolic disease characterized by adipose tissue formation excess leading to an increase in body fat mass, of multifactorial origin, produced mainly by poor eating habits combined with a sedentary lifestyle. Data consider obesity as a serious disease that affects the world's population, ranking fifth in death rates. Faced with this situation, individuals seek, increasingly, means to lose weight with less physical effort and food. In 2009 and 2010 the drug liraglutide was lauched in order to reduce weight in individuals with diabetes mellitus type 2, thus avoiding the emergence of other diseases. The aggravating factor is that obese nondiabetic individuals are making use of this substance, even if its use is not authorized by ANVISA (Brazilian Health Surveillance Agency). Thus the objective of this research is to evaluate the effect of liraglutide for muscle or fat tissues and biochemical parameters in Swiss mice submitted to cafeteria diet and physical activity. The study was approved by the Ethics Committee on Animal Use - CEUA (nº003 Protocol / 2014). For this study 74 animals (Swiss mice) were used, divided as follows: in the initial phase of this study, we carried out a pilot study (n = 10) divided into a control group (PCON) (n = 5) and cafeteria group (PCAF) (n = 5), in order to evaluate a cafeteria diet which was both attractive to the animals and that could provide an increase in adipose tissue. After the induction of the diet, animals were euthanized and as a result, the animals in the PCAF group showed an intra-abdominal adiposity 0.74 ± 0.05 g, taken as the parameter for increasing fat in animals. Subsequently the study base was conducted for this research where animals were used (n = 64) divided into 2 groups: the Cafeteria Study Base Group (EBCAF) divided as follows: cafeteria + exercise + liraglutide (CEL) (n = 8), cafeteria + exercise + saline (CES) (n = 8), cafeteria + liraglutide (CL) (n = 8) and cafeteria + saline (CS) (n = 8). The Chow Study Base group (EBR) was divided into: exercise + liraglutide (EL) (n = 8), exercise + saline + (ES) (n = 8), liraglutide (L) (n = 8) and saline solution (SS) (n = 8). All animals went through the submission process to the cafeteria diet, followed by exercise protocol through swimming and treatment with the test substance intraperitoneally (200 mg / mL / kg). After the treatments, the animals were euthanized and had the following parameters evaluated: the muscle tissue mass, adipose tissue mass and biochemical parameters. It was observed that the processing done with the exercise-associated liraglutide reduced adipose tissue mass significantly (0.32 ± 0.05 g) compared to the saline group (0.53 ± 0.07 g). There were no changes in the muscle tissue of the group which was treated and exercised (1.39 ± 0.03 g) compared to the saline group (1.33 ± 0.03 g). Regarding biochemical parameters it was evident that there were changes in these parameters. Interesting to note that, although blood glucose values have been changed, the animals did not become diabetic. Thus, it appears that physical activity together with liraglutide is eficcient to the loss of intraabdominal adipose tissue and the maintenance of lean body mass thereby generating a satisfactory result in the pursuit of quality of life and disease prevention.

Avaliação do efeito do liraglutida nos tecidos muscular e adiposo e nos parâmetros bioquímicos em camundongos Swiss submetidos à dieta de cafeteria e a atividade física

Obesity is a chronic metabolic disease characterized by adipose tissue formation excess leading to an increase in body fat mass, of multifactorial origin, produced mainly by poor eating habits combined with a sedentary lifestyle. Data consider obesity as a serious disease that affects the world's population, ranking fifth in death rates. Faced with this situation, individuals seek, increasingly, means to lose weight with less physical effort and food. In 2009 and 2010 the drug liraglutide was lauched in order to reduce weight in individuals with diabetes mellitus type 2, thus avoiding the emergence of other diseases. The aggravating factor is that obese nondiabetic individuals are making use of this substance, even if its use is not authorized by ANVISA (Brazilian Health Surveillance Agency). Thus the objective of this research is to evaluate the effect of liraglutide for muscle or fat tissues and biochemical parameters in Swiss mice submitted to cafeteria diet and physical activity. The study was approved by the Ethics Committee on Animal Use - CEUA (nº003 Protocol / 2014). For this study 74 animals (Swiss mice) were used, divided as follows: in the initial phase of this study, we carried out a pilot study (n = 10) divided into a control group (PCON) (n = 5) and cafeteria group (PCAF) (n = 5), in order to evaluate a cafeteria diet which was both attractive to the animals and that could provide an increase in adipose tissue. After the induction of the diet, animals were euthanized and as a result, the animals in the PCAF group showed an intra-abdominal adiposity 0.74 ± 0.05 g, taken as the parameter for increasing fat in animals. Subsequently the study base was conducted for this research where animals were used (n = 64) divided into 2 groups: the Cafeteria Study Base Group (EBCAF) divided as follows: cafeteria + exercise + liraglutide (CEL) (n = 8), cafeteria + exercise + saline (CES) (n = 8), cafeteria + liraglutide (CL) (n = 8) and cafeteria + saline (CS) (n = 8). The Chow Study Base group (EBR) was divided into: exercise + liraglutide (EL) (n = 8), exercise + saline + (ES) (n = 8), liraglutide (L) (n = 8) and saline solution (SS) (n = 8). All animals went through the submission process to the cafeteria diet, followed by exercise protocol through swimming and treatment with the test substance intraperitoneally (200 mg / mL / kg). After the treatments, the animals were euthanized and had the following parameters evaluated: the muscle tissue mass, adipose tissue mass and biochemical parameters. It was observed that the processing done with the exercise-associated liraglutide reduced adipose tissue mass significantly (0.32 ± 0.05 g) compared to the saline group (0.53 ± 0.07 g). There were no changes in the muscle tissue of the group which was treated and exercised (1.39 ± 0.03 g) compared to the saline group (1.33 ± 0.03 g). Regarding biochemical parameters it was evident that there were changes in these parameters. Interesting to note that, although blood glucose values have been changed, the animals did not become diabetic. Thus, it appears that physical activity together with liraglutide is eficcient to the loss of intraabdominal adipose tissue and the maintenance of lean body mass thereby generating a satisfactory result in the pursuit of quality of life and disease prevention.

Avaliação do cuidado de enfermagem na perspectiva da segurança do paciente em unidades de terapia intensiva: na visão de profissionais, pacientes e familiares

Technological advances combined with healthcare assistance bring increased risks related to patient safety, causing health institutions to be environments susceptible to losses in the provided care. Sectors of high complexity, such as Intensive Care Units have such characteristics highlighted due to being spaces designed for the care of patients in serious medical condition, when the use of advanced technological devices becomes a necessity. Thus, the aim of this study was to assess nursing care from the perspective of patient safety in intensive care units. This is an evaluative research, which combines various forms of data collection and analysis in order to conduct a deepened investigation. Data collection occurred in loco, from April to July 2014 in hospitals equipped with adult intensive care unit services. For this, a checklist instrument and semi-structured interviews conducted with patients, families, professionals were used in order to evaluate the structure-process-outcome triad. The instrument for nursing care assessment regarding Patient Safety included 97 questions related to structure and processes. Interviews provided data for outcome analysis. The selection of interviewees/participants was based on the willingness of potential participants. The following methods were used to collect data resulting from the instrument: statistical analysis of inter-rater reliability measure known as kappa (K); observations from judges resulting from the observation process; and added information obtained from the literature on the thematic. Data analysis from the interviews was carried out with IRAMUTEQ software, which used Descending Hierarchical Classification and Similarity analysis to aid in data interpretation. Research steps followed the ethical principles presented by Resolution No. 466 of December 12, 2012, and the results were presented in three manuscripts: 1) Evaluation of patient safety in Intensive Care Units: a focus on structure; 2) Health evaluation processes: a nursing care perspective on patient safety; 3) Patient safety in intensive care units: perception of nurses, family members and patients. The first article, related to the structure, refers to the use of 24 items of the employed instrument, showing that most of the findings were not aligned with the adequacy standards, which indicates poor conditions in structures offered in health services. The second article provides an analysis of the pillar of Processes, with the use of 73 items of the instrument, showing that 50 items did not meet the required standards for safe handling due to the absence of adequate scientific guidance and effective communication in nursing care process. For the third article, results indicate that intensive care units were safe places, yet urges for changes, especially in the physical structure and availability of materials and communication among professionals, patients and families. Therefore, our findings suggest that the nursing care being provided in the evaluated intensive care units contains troubling shortcomings with regards to patient safety, thereby evidencing an insecure setting for the assistance offered, in addition to a need for urgent measures to remedy the identified inadequacies with appropriate structures and implement protocols and care guidelines in order to consolidate an environment more favorable to patient safety.

O olhar das instituições de previdência sobre a casa e a cidade: promoção, financiamento e avaliação de imóveis

The investments of Caixas and Institutos de Aposentadoria e Pensões (CAP and IAP) in homes of Natal, between the decades of 1930-60, helped to boost up the local real estate market in consolidation at the time. Inserted in the first national policy on social housing in the country, these operations have demanded the creation of a wide qualified organizational structure, which would be from the "Central Offices" of Rio de Janeiro to the decentralized units of the federal states. The professionals linked to the Local Agencies have developed, on this matter, from activities related to the design and construction of residential complexes, to the daily study of financing proposals in isolated units. As from these studies, the evaluation of shelters was essential to the effectiveness of the policy, resulting in the production of data on the market value of the properties by observing and issuing judgments upon the living quarters of different social groups. Given these considerations, the aim here is to contribute to the understanding on how to operate these real estate actions in the legitimization of boundaries about the urban space and dwellings available to workers in Natal. Therefore, the views of the city and constructions expressed by the evaluating engineers in their technical reports have been taken as the focus. Being the main primary sources of work, these reports are part of the edifices process of CAP/IAP regarding Natal, whose content is systematized in the database "Enterprises", the HCUrb Research Group. In addition, there were used local newspapers at the time and interviews with professionals as complementary sources. It was found that, in general, the evaluations have configured – in a more everyday dimension of bureaucratic routines - a vehicle, among others, circulating ideas about "home" within the social security institutions, being imbued with assumptions historically constructed about the "modern habitat". Filled in loco, the reports expose the clash between modernizing ideals in vogue and clear limitations in the city scenario at the time. Fragmented images of the town are given to read through the labels assigned to the evaluated sites – these being coated of certain "scientific" character - which both legitimated and contributed to the dynamics of appreciation/depreciation of the soil and to the socio-spatial differentiation. Contradictions were evident in the endorsement given by the technicians when financing of admittedly precarious homes for insured disadvantaged categories at the local level - such as industrial workers - while strict regulations were imposed to new construction, designed, above all, to better paid categories. By identifying raters engineers as urban agents, members of a technical-focused operating system for safety and efficiency in the real estate investments of those authorities corporatist, it is desired the usefulness of further studies on these characters, their training, professional activity and participation in the construction of discourses and practices of intervention about the city and its buildings, discussing individual and grouped interests that were left behind.

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

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

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

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

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

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