Centros de especialidades odontológicas: avaliação da atenção de média complexidade na rede pública da Grande Natal

The Specialized Dental Care Centers (CEO) were developed to provide specialized dental care to the population, given the accumulated needs of health since the past. They must operate as units of reference for the Oral Health Team of the Primary Care, complementing the dental procedures performed at this level of attention. This study aims to assess the performance of CEOs of the Grande Natal Health Region as a strategy of Secondary Care consolidation in oral health through users, dentists and managers. For this to try to identify factors about access, hosting and satisfaction with the service, the actions developed in these centers, integration between the CEOs and the Basic Health Units (UBS), considering the reference and counter reference. Data were collected through semi-structured interview, conducted in four CEOs, among 253 users, 31 dentists and 4 managers. It was submitted to descriptive statistical analysis and to content analysis by software ALCESTE 4.5. The results revealed that the specialties of prosthesis, endodontics and surgery were the most sought by 38.2%, 23.7% and 21.7% of respondents, respectively. It was noticed that among users aged 18 to 30 years-old the greatest demand is for the specialty of endodontics (44.4%) and over 50 years for prosthesis (76.4%). There is a weakness in the reference and counter reference between UBS and CEO, because part of users goes directly to the centers without going before to the Primary Care and the majority does not want to return to the dentist of Health Unit. Satisfaction with care was reported by 90.9% of users, because they resolved the problems needed and were welcomed by the team. But the delay in care was the main factor for not satisfaction. For most dentists, some users could solve their problems completely in Primary Care, which shows the existence of unnecessary referrals to the CEOs, however they consider the existence of limiting factors in UBS that compromise the service. Most dentists revealed that some users do not get to CEOs with the basic dental treatment done, and some of them do not counter reference users. It can be concluded that the studied CEOs are being resolutive for those who access them, offering necessary care for the population, and if they don t account with this service, will encounter obstacles to resolution of problems, ranging seek care service in particular, in another public sector, or even giving up treatment. However, it is perceived the need of professionals training to understand the importance of the reference and counter reference, to that they can better serve and guide users. It is also important that cities offer better conditions to UBS and CEOs, so they can work together, with complementary actions of oral health, seeking full care, aiming for better resolution to the users' health problems

Assistência odontológica diferenciada para crianças de 0 a 3 anos: avaliação de impacto no Serviço Público Municipal em Natal-RN

In Brazil, 0-5 years old children just have an oral health care system since 1990 s. Innumerable experiences of implantation of the attendance to the babies in the cities had appeared throughout the years, but it hasn´t been evaluated the comparative effect between children displayed and not displayed to the program. In this regard, the main of this research was describe the Early Childhood Oral Health Care in public health service in Natal, Rio Grande do Norte, Brazil and evaluate the impact of this specific oral health care for babies by comparison of indicators between exposed and non-exposed children. It was created an experimental group, formed by children covered by program which was paired, based on sex, age and socioeconomic status, with a control group, formed by uncovered children. After filling ethical application, the parents of children were questioned about some risk factors to dental caries and, in sequence, it was accomplish an oral examination in the child. It was verified the Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), dmf-s and verification of caries activity. The sample was 40 children in each group. The results showed, for VPI, a difference of 7 percentile points for the experimental group, however this difference had no statistical significance, obtained by Student s t test (p=0.314). In relation to GBI, the control group showed a low mean (0.8%) comparing with experimental group (2.77%) and this difference was statistically significant (p=0.003). The results for dmf-s and evaluation of caries activity showed no statistical difference between groups. Among the probable reasons for absence of impact of intervention, could be included: (a) the practice model was the same in two groups, or the difference was very weak and (b) the oral health care has intrinsic limitations for to impact on oral health in low income populations

Satisfação dos usuários e qualidade dos tratamentos protéticos realizados nos centros de especialidades odontológicas da grande Natal RN

Aim: To evaluate user satisfaction and quality of prosthetic treatments performed in specialized dental clinics (CEOs) of Natal Metropolitan Region - RN. Methods: Cross-sectional study with subjects who underwent prosthetic CEOs in the cities of Natal, Macaíba, Parnamirim and Sao Goncalo do Amarante in the period 2007 to 2009. Data collection was performed by questionnaire, clinical examination of the oral cavity and examination of fabricated denture. This analysis involved the following aspects: retention, stability, aesthetics and prosthesis fixation. The variables are presented by means of absolute numbers and proportions. The determination of the association between the independent and dependent variables was conducted by the association of Chi-square test and Fisher exact test. Results: A total of 149 users, totaling 233 conventional dentures (148 upper and 85 lower). Most patients (56.4%) were rehabilitated with conventional complete dentures. The technical quality of the denture was regarded as satisfactory in the majority (52.7%), whereas the inferior dentures were rated as unsatisfactory in 90.5% of cases. Satisfaction with the prosthesis was 69.1% (N = 103). The average time to begin treatment was 3 months to receive while the prosthesis was 4 months old. The presence of injury from the upper prosthesis occurred in 21.5% of cases (N = 32), candidiasis being the most frequent (N = 18). The technical quality of the upper prosthesis (p=0,041), as well as retention (p=0,002) and stability (p<0,001) were significantly associated with user satisfaction. Conclusions: The specialized Dental clinics has been fulfilling its role of providing treatment of intermediate complexity for low-income population with the majority of satisfield patients, even when their dentures have problems of technical quality

Caracterização e modelagem dos sistemas de produção de caprinos leiteiros

The objectives of this research were characterizing the dairy goat production systems and model it using linear program. On the first step of this research, the model was developed using data from farms that was affiliated in the ACCOMIG/Caprileite, used a similar dairy goat production systems and have a partnership program with Universidade Federal de Minas Gerais . The data of research were from a structured questionnaire applied with farmers and monitoring of production systems during a guided visit on their farms. The results permitted identify that all farms were classified as a small and have a intensive production system. The average herd size had 63.75 dairy goats on lactation; it permits a production of 153, 38 kg of goat milk per day. It was observed that existing more than one channel of commercialization for the goat milk and their derivative products. The data obtained, on the first step of this research, was used to develop a linear program model. It was evaluated in two goat production systems, called P1 and P2. The results showed that the P1 system, with an annual birth and lactation during approximately 300 days was the best alternative for business. These results were compared with a mixed (beef and dairy) goat system in the semiarid region, which indicated merged with both systems. Therefore, to achieve profits and sustainability of the system, in all simulations it was necessary a minimum limit of funding of U.S. $ 10,000.00; this value permit earning of U.S. $ 792.00 per month and pay the investment within 5 years

Quando as mulheres se tornam mães: a história reprodutiva feminina numa visão evolucionista

In this thesis we tested evolutionary hypotheses, with empirically collected data, in a sample composed of pregnant Brazilian women. We consider that during pregnancy and soon after the baby's birth fundamental reproductive decisions take place, given the complete feminine involvement with the reproduction phenomenon. The results are presented in four empirical articles related to the history of female reproduction. The topics approached were mate selection, the life-history theory, the strategies of parental investment and postpartum depression. Data collection was accomplished through interviews with pregnant women and after the baby s birth, with a sample composed of women from two income classes (low income and middle class), in Natal, Brazil. With respect to mate selection, the results suggest that a real situation of reproductive mate selection shows significant differences when compared to the results obtained in studies involving potential mate selection (Article I). Considering the life-history theory, we have partially confirmed the hypothesis of the father`s absence influencing the development of the young female syndrome (Article II). In regard to parental investment strategies and the decrease of fatherhood uncertainty, we identified a larger attribution of the baby's resemblance after birth with the father, confirming our hypothesis (Article III). The results related to postpartum depression occurrence partially support the hypothesis that it is an evolutionary adaptation (Article IV). This thesis is part of a consolidation movement of Evolutionary Psychology in Brazil and it presents results on female reproductive history hitherto unpublished.

Seleção conjugal e as mulheres re-casadas no mercado de casamentos em uma comunidade de baixa renda no nordeste brasileiro

A presente pesquisa partiu de uma revisão teórica dos assuntos relacionados à seleção sexual proposta por Charles Darwin, passando para evolução dos sistemas e da psicologia do acasalamento humano. Os estudos práticos, divididos em dois momentos, foram coletados numa comunidade litorânea de baixa renda no nordeste brasileiro, na qual as mulheres tiveram pelo menos duas uniões estáveis até a data da coleta, no ano de 2008. Nas primeiras análises, foram contempladas as expectativas dessas mulheres em relação aos atributos dos parceiros. E posteriormente, o perfil e valor das mesmas entraram em perspectiva. De uma forma geral, foi constatado que as mulheres, no primeiro casamento, de fato realizam matrimônios com parceiros mais parecidos com o que consideram ideal do que os posteriores. Assim como as segundas e subseqüentes uniões apresentam uma ligeira queda no valor (no mercado de casamentos) desses homens quando comparados aos primeiros companheiros levando em consideração indicadores biosocioeconômicos como idade, escolaridade e renda (status socioeconômico).

Padrão de distribuição e caracterização morfológica de fibras serotonérgicas nos núcleos da linha Média/ intralaminares do tálamo do mocó (Kerodon rupestris)

The midline/intralaminar nuclei form a remarkable group of nuclei of the medial and dorsal thalamus. The midline nuclei, in rats, comprises the paratenial nuclei (PT), paraventricular (PV), intermediodorsal (IMD), reuniens (Re) and rhomboid (Rh). The intralaminar nuclei comprises the central medial (CM), paracentral (PC), central lateral (CL) and parafascicular (PF). Such nuclei have dense serotonergic innervation originating from the brainstem, especially from the so-called ascending activation system. These nuclei, in turn, send projections to various cortical and subcortical areas, specifically to limbic areas, which suggests the important role of this neurotransmitter in the limbic circuitry. The aim of this study was to characterize the distribution pattern and morphology of serotonin fibers in the nuclei of the midline and intralaminar thalamic of rocky cavy (Kerodon rupestris), a tipical rodent from brazilizan northeast. To reach this aim we used four rock cavies adults. Following the transcardially perfusion with paraformaldehyde and brain microtomy steps was performed immunohistochemistry for serotonin (5-HT), Nissl technique and subsequent achievement and image analysis to characterize the cytoarchitecture of these nuclei and the serotonergic fibers visualized. An analysis was made of Relative Optical Density (ROD) to semi-quantify the concentration of serotonin fibers in the areas of interest. Thus, we observed a cytoarchitectonic arrangement of these nuclei similar to that found in rats. In case of fibers distribution, those immunoreactive to 5-HT were presented in a higher concentration according as ROD in the midline nuclei relative to intralaminar; Re being the core which has a higher pixel value followed by the PV , Rh, IMD and PT. In intralaminar CL showed higher pixels, followed by nuclei CM, PC and PF. The serotonergic fibers were classified as number of varicosities and axon diameter, therefore find three types of fibers distributed through this nuclear complex: fibers rugous, granular and semi-granular. In PV fibers predominated rugous; in PT fibers predominated granular; IMD, CL and PF fibers were represented by semi-granular and Re, Rh, PC and CM fibers showed granular and semi-granular. Morphological characterization of serotonergic fibers and differences in density between the nuclei may suggest different patterns of synaptic organization of this neurotransmitter beyond confirming his large repertoire functional

Elaboração e avaliação de indicadores comportamentais de aderência ao tratamento hemodialítico

Introduction: This work intents to characterize behavioral indicators of tack to the hemodialysis treatment in a sample of carrying patients of chronic kidney failure (CKF) in the great Natal/RN. The therapeutical adherence represents the agreement degree between the patient behavior and the health team lapsings. The CKF is the gradual and irreversible loss of the renal function, being the hemodialysis treatment an important alternative to assist or to substitute the kidneys. Method: The sample consisted in 80 chronic kidney patients in hemodialysis treatment in two located clinical centers in the region of the great Natal, RN. It was used as instruments (a) a protocol of clinical data collection, (b) the Millon Index of Personality Styles (MIPS) and (c) a script of halfstructuralized interview. Results: The results show a balance between the genders (51% of female and 48.8% of the male sex), average age and equal average time of dialysis respectively to the 43,4 years (±13,25 years) and 22,04 years (±4,24 years). The marital status of half of the sample is married, predominating basic education (43.6%) and a familiar income until a minimum wage (43.8%). It had been defined six physicianlaboratorial indicators to evaluate the therapeutical adherence, further the use of the evaluation of the health team and the patient themselves. Thus, there was an average adherence around 55.97% of the sample ±18.37%). However only between selfassessment of the patients about the adherence and the assessment made by blood pressure post-dialysis indicated a significant association (p=0,029, qui-square test). On the other hand, there was a significant association (p <0.05, chi-square test) among the criteria for treatment adherence and issues investigated in the interview - the perception on the quality of the health services provided to patients, the difficulties following the prescribed diet, the characterization of the days between dialysis sessions and the perception of patients about the dialysis sessions. It was also noted a significant association (p <0.05, Levene test) between adherence to therapy and scales that constitute the MIPS. The health team characterized the patients more adherent behavior as an attitude of acceptance of the treatment, looking actively for their implementation, for more information and knowledge, and establishing a positive communication with the team and with other patients. Similar results were confirmed by the MIPS evaluation. According to that assessment the more compliant patients adopt a more optimistic attitude, trying to act or adapt themselves to their environment, processing cognitively both concrete and objective information, such as more speculative and symbolic information. In addition they establish a gregarious, cooperative, submissive and flexibly pattern of interpersonal relationships to social demands. These characteristics managed to explain 55.7% of the adherence variation according the health team and 23.3% of the variation according the CaxP laboratory indicator. Conclusions: The MIPS shown to be able to identify the most and least adherent to therapy patients. The use of different adherence indicators is important for an evaluation covering the different facets of this process. The adhesion levels are observed within registered by the relevant literature. There is need for further studies with a larger sample to deepen the data findings in this work

Iniciação sexual e fatores associados: um estudo com adolescentes escolares

A iniciação sexual é um marco significativo na vida do indivíduo, ocorrendo geralmente na adolescência. Importantes transformações biopsicossociais ocorrem nesta fase, denotando vulnerabilidades à vida do adolescente, dentre elas, as decorrentes da iniciação sexual, sendo o risco de infecção pelo HIV/aids a mais grave. A infecção pelo HIV/aids constitui atualmente um importante problema de Saúde Pública, estando os jovens no centro da epidemia mundial. No Brasil, dados do último boletim epidemiológico, lançado em 2013, apontam para a tendência de aumento de sua prevalência na população jovem. Desta forma, o presente estudo teve por objetivo investigar a associação entre iniciação sexual e o perfil sociodemográfico, o indicador de conhecimento das formas de transmissão do HIV/aids e fatores biopsicossociais autoestima e habilidades sociais, em adolescentes de 16 a 19 anos, de ambos os sexos, estudantes do nível médio técnico integrado, do Instituto Federal de Educação, Ciências e Tecnologia do Rio Grande do Norte, Campus Natal. Trata-se de um estudo transversal, cuja amostra foi constituída aleatoriamente por 200 alunos que responderam de forma anônima a quatro instrumentos: perfil sociodemográfico, questionário da Pesquisa de Conhecimentos, Atitudes e Práticas na População Brasileira (PCAP), Escala de Autoestima de Rosenberg e o Inventário de Habilidades Sociais para Adolescentes de Del-Prette (IHSA). A análise estatística dos dados foi realizada através do teste qui-quadrado de Pearson e do exato de Fisher (α <5%). A média de idade para a primeira relação sexual foi de 15,96 anos, com o início mais cedo para o sexo masculino. Verificou-se associações estatisticamente significativas entre iniciação sexual e as seguintes variáveis: idade, sexo, situação conjugal, religião, renda familiar, autoestima e o repertório de habilidades sociais. Observou-se ainda que apenas 11% dos adolescentes possuíam conhecimento correto acerca das formas de transmissão do HIV/aids. Conclui-se que os esforços para a prevenção das DST/aids precisam ser direcionados a campanhas e programas mais eficazes, que considerem não somente o caráter informativo, mas também os fatores psicossociais já que estes mostraram-se associados ao início da vida sexual

Política de transferência de renda e desenvolvimento local: o programa Bolsa família no município de Pedra Grande/RN

The Family Scolarship Program while public politics of intersectorial form developed by Social Development Department and Famine Combat having with partner the Education Department and Health Department inaugurate in the country a new integrity way of the public politics, reinforcing a precept of 2004 Social Protection National Politics (PNAS 2004) that places the social protection while allied to the social and human development. The research INCOME TRANSFER AND LOCAL DEVELOPMENT: the family scolarship program in Pedra Grande-RN municipally had as aim to avaluate the permanent Family Scolarship Program as a possible element in local development of Pedra Grande-RN municipally understood as capacity expansion and improvement of life quality from its users. For this means we elaborate specifically the families` socio-economical profile; we avaluate the program repercussion in these families` lives; we analyse in which proportion occurred the capacity expansion and improvement of life quality of the users. The methodologic process was constituted by: literarture review about Income Transfer, Social Vulnerability, Development and Public Politics Avaluation to the criation of a theoric picture analysis. The documental research joined to the Social Development Department and Famine Combat of Pedra Grande Municipally Hall to obtain of the aims, program goals, and the profile of users. And finally, carrying out the interviews with the managers and experts of the Municipally Program and focal groups with the users to avaluate the permanent of the Program starting by the points of view of those ones. It was verified that the program expand the capacity (food, consumer goods and services, bank services access and wages) and improvement in life quality of the users. Nevertheless, there are deficiencies in coming with conditionality and from the use of resources the by families users

Mídia e gênero: análise crítica da violência contra a mulher no telejornalismo

This thesis is consisted of a theoretical and empirical study about the treatment given by media, particularly on telejournalism, to violence against women. It aims to analyze and reflect about the role of media, particularly television, on the process of reproduction of patriarchy system of gender on the context of Brazilian society, from content and narrative news about crimes committed against Andreia Rodrigues and Eliza Samudio. In light of the critical perspective, we seek to apprehend the particularities of patriarchy as a system of domination and subjugation of women, and also reveal the involvement of traditional means of media on reproduction and maintenance of inequality between men and women. To apprehend that reality, we had as guidance a critical social theory, grounded in historical-dialectical materialism which enabled us to apprehend the phenomenon under investigation actually enrolled in a dynamic and contradictory reality. The research had qualitative approach. We appeal to the specialized literature of the area from classical and contemporary authors. We conducted a content analysis of categorized matters, and interviews with individuals involved in issues of gender and / or communication. The critical examination of the matters indicated that television journalism is permeated by the contradictions inherent in social life, means that states and restates the ideology of ruling classes, their values and worldviews, but also express conflicts and social demands. The study revealed that prevails on television playing stereotypes and gender inequalities. We could also see that violence against women gets a sensationalist overblown approach and with no insights on the social relations that determine and base it.

Mídia impressa e meio ambiente: um estudo da cobertura da mortandade de peixes no estuário do Rio Potengi, Natal-RN

Environmental issues are becoming increasingly habitual to the media, particularly when calamities are involved. A feature of environmental disasters is that they disclose both environmental crises and the media limitation in reporting them. The research tried to contribute to the subject through the study of press media coverage of a large fish kill along an estuary in the State of Rio Grande do Norte, Brazil, in 2007. Thematic content analysis of newspaper reports identified the predominance of a superficial and denunciative coverage, lacking an educational perspective, and with little contribution to formation of a critical sense in readers. It also has identified the precarious treatment of those scientific concepts that could substantiate the actual causes of mortality of tons of aquatic fauna

Territorialidade e pesca: atualidades e tradições no uso dos recursos pesqueiros na comunidade litorânea da praia da Pipa Rio Grande do Norte

The need for sustainability in the exploitation of natural resources in coastal areas has been out in recent years, as well as the social and cultural sustainability of traditional communities in these regions. Coastal and estuarine wild areas are influenced directly or indirectly by a set of human activities such as artisanal fishing. Therefore, there is a demand for an integrated design of these areas and according to the landing values, a pattern of unsustainable development of national marine fishing activity. The study was conducted in the coastal community of Praia da Pipa, Tibau do Sul municipality, RN, between june 2009 and june 2010 and aimed to characterize the fishery performed, its socio-economic strategies and fishing areas, as well as to identify ichthyofauna, to assess the sustainability of the major resources and to identify cultural traits related to artisanal fisheries, their problems and prospects; linking tradition and the present fishing activity carried out in the community. For this study, a total of 67 structured interviews were collected, including qualitative and quantitative data. A total of 133 fish landings and direct observations were performed. Informants were identified according to one of the following categories: fishermen, vessel masters and members of the local population with offspring. Applications SPSS 10.0, Paint.Ink and Microsoft Office Excel 2007 were used for tabulation and analysis of results. Local fishermen are, on average, 25 years fishing, have 40 years old and the average monthly income is up to 03 minimum wages. The local fleet consists of 20 vessels, that uses different line sizes and types of networks, operating in 21 fishing grounds and showing a reduction in the vessel numbers by 66% in the last decade. We recorded 76 species of fish, captured by the local fleet and the top 5 were quantitatively analyzed serra spanish mackarel (Scomberomorus brasiliensis), little tunny (Euthynnus alleteratus), yellowtail snapper (Ocyurus chrysurus), red snapper (Lutjanus analis) and common snook (Centropomus undecimalis), accounting for 46,5% of production in the period. The capture of these species was composed mostly of adults. Data analysis showed a significant decrease of the local fishing activity over the last decade due to the weakness displayed by the political-social category, the devaluation of local knowledge and the emergence of new sources of income through increased tourism. The characteristics of the fishing community suggest it to pass through significant changes as the appreciation of their cultural and traditional aspects. We identified a tendency to sustainability of main species caught, suggesting that public policies to be adopted locally comply with the current characteristics of fishing undertaken in the community and knowledge of fishermen related to the environment, allowing environmental, as well as social and cultural sustainability of the community involved.

Sustentabilidade ambiental do cultivo intensivo de Tilápias (Oreochromis niloticus) em tanques-rede e a capacidade de suporte de quatro reservatórios em uma região semi-árida tropical

Intensive production of tilápias, in cages or net tanks, has been proposed as an alternative to increase fish production, that would generate income and offer animal protein in different tropical and subtropical countries. However, this system of production enriches the aquatic environment with nutrients, principally nitrogen and phosphor derived from the dejections of the metabolism of food and eventual food surpluses consumed by the fishes; the alimentation of the fishes in this production modality is dependent on fish food. The emission of these nutritions in levels above the limit that the system is capable metabolize can provoke a phenomenon called eutrofization, putting in risk the quality of water for public and for fish production activities. In this context the work had as a goal to evaluate the trófico state of the four reservoirs for intensive production of tilapias in net-tanks, in other words, he maximum fish production that the reservoirs are able to hold, keeping the desired quantity of nutrient concentrations in water for public use. The results of the four ecosystems in the Boqueirão de Parelhas reservoir showed that it s possible to have an intensive production of tilapias in net tanks, in this environment the annual average concentration of phosphor, was below the considered critical limits to deflagrate the process of eutrofization in semi-arid regions. The carrying capacity of the Boqueirão de Parelhas reservoir depends on the conversion of the feeding facts and phosphor content in the food but it should vary between 100 and 300 tons per year over a variation in the conversion feeding factor of 1,7 to 2,0:1 and a variation in the P in the food of 0,7 to 0,9%

A educação informal para o consumo infantil e juvenil na televisão e na mídia

The consumption has become a major pillar of modern capitalism and at the same time, one of the factors that relate to social inequality. Karl Marx developed the theory of historical materialism which maintains a history of society determined by class struggle and the! exploitation of man by man. Considered to be overtaken by those who believe that Marxism is synonymous with real socialism, the Marxist ideals seem more present than in the Western world which each individual takes the individualization (loss of sense of public and collective) and the alienation by the work. Weassumed we could work on these issues in student education, even in elementary school, through questioning of the consumer society, with the criticism of television and the media, the main promoter of the current sense of consumption, as an initial step that could lead to future autonomy of theindividual. The theory of ideology and ideas of Paulo Freire's liberating education theory permeated the experience that happened as a participant observation of groups in the discipline of sociology in the unit 2 of the Colégio Pedro II in Rio de Janeiro, the state capital, an institution under the direct administration Ministry of Education. Wehave found fertile ground in which the students were able to understand and question the meaning of advertising media