Avaliação do impacto do treinamento de clínica em hanseníase e sua contribuição para o aumento da detecção da doença no Estado do Rio Grande do Norte

Hansen´s disease is considered a serious public health problem. In 2006, the Ministry of Health reported that worldwide, Brazil ranked 2nd in the number of cases of the disease, surpassed only by India. The North region is the geographical area in Brazil that presents the most cases. In the state of Rio Grande do Norte, the disease is considered to be eliminated because its prevalence has been identified as 1 per 10.000 inhabitants, criteria established by the State Elimination Letter of 2005. Training programs have been offered by the Coordination for the Control of Hansen´s Disease Program of Rio Grande do Norte, PCH-RN since 1997, with the support of the English governmental agency Leprosy Relief Association, LRA, with no evaluation having been conducted. The objective of this study was to evaluate the training programs in clinical diagnosis of Hansen´s disease and their contribution to the detection of the disease in the state of Rio Grande do Norte. The study was conducted in seven municipalities that are known as Regional Public Health Units (URSAPs): São José de Mipibu URSAP I, Mossoró URSAP II, João Câmara URSAP III, Caicó URSAP IV, Santa Cruz URSAP V, Pau dos Ferros URSAP VI and Natal, capital city of the State, in the Metropolitan Region. Physicians and nurses of the Family Health Program PSF were interviewed as to their perceptions of the implementation of the training program in clinica diagnosis of Hansen´s Disease conducted by the PCH-RN. They evaluated their own practice and the training program. These professionals presented a positive evaluation of the program and gave suggestions for future courses. The results of this study suggest the need for permanent education. Data of the disease obtained from the official records of the Secretariat of Health and from the interviews indicate that health education is the means to control Hansen´s disease effectively

Saúde da família: uma estratégia de mudança no processo de produção dos serviços de saúde

The purpose of this study is to analyze, from the point of view of nurses, changes that took place in the process of providing health services after the introduction of the Family Health Program (FHP). It is na investigation of qualitative nature that uses semi-structured interviews as a main empirical approach tool. Six nurses from the city of Caicó, Rio Grande do Norte, who were working with basic care before the introduction of the FHP, within basic care, were: adscription and ties with the community; hospitality and the humanizacion of care-giving; decrease in cases of inpatient treatment; strengthening of the prevention of injuries and health promotion; improvemente of health indicatiors, finally, actions that point towads meeting the principles of wholeness, equity and universality as a declaration of the Brazilian National Health Care System (SUS). Nevertheless, in spite of all recognizable positive aspects, the FHP has some weaknesses, such as: the difficulty posed by colletive work; the mismatch between professional education and the demands of the current health standard; a poor physical infrastructure of the Basic Health Units; a high heath staff turnover and precarious work conditions. In addition to this, some strategies that can be used to help improve the process of providing health services have been pointed out, such as, coordination between sectors, continuous education, making work conditions less precarious and improving the means whereby heathy service management is conveyed,Tthus, finally, we understand that the FHP does bring forward meaningful changes to the process of provinding health services to strengthen the Brasilian National Health Care System (SUS), in spite of the fact that it lies within a scenario of adversities that can be overcome through the collective endeavor of the several social actors

Radiação solar em ambiente protegido cultivado com tomateiro nas estações verão-outono do Rio Grande do Sul

O crescimento e desenvolvimento de uma planta dependem da intensidade, qualidade e duração da radiação solar. Por esse fator ser de importância vital às plantas, o presente trabalho objetivou fazer uma avaliação sobre sua variação, bem como sobre a sua disponibilidade no interior do ambiente protegido durante o ciclo do tomateiro nas estações verão-outono em Pelotas, Rio Grande do Sul. O experimento foi conduzido de janeiro a junho de 2003 no Campus da Universidade Federal de Pelotas (latitude 31°52'S; longitude 52°21'W e altitude de 13m), em estufa plástica disposta no sentido Leste-Oeste, com área de 180m². A cultivar utilizada foi Flora-dade, semeada em 24/01/03, transplantada no dia 28/02/03, sendo a última colheita em 12/06/03. Avaliou-se a radiação solar global externa (Rgext) e interna (Rgint), transmitância, radiação fotossinteticamente ativa (RFA) e o albedo da cultura a partir de sensores eletrônicos conectados a um datalloger. Durante o ciclo da cultura, o total de Rgext foi 1161,21MJ m-2, enquanto a Rgint foi 881,85MJ m-2. A Rgint e a RFA apresentaram valores médios diários de 8,5MJ m-2 dia-1 e 3,4MJ m-2 dia-1, respectivamente. A transmitância média da cobertura plástica à radiação solar global foi de 76%. O albedo médio diário da cultura foi 0,23, com albedo de 0,17 nos estádios iniciais, 0,26 no período de máximo crescimento e 0,23 no final do ciclo.

A organização do dots em um distrito sanitário de Natal/RN, 2009

Tuberculosis is an ancient disease that remains a serious problem of Public Health, requiring a pressing attention. Advances in the knowledge and technology available to control it has not been sufficient to significantly impact on morbidity and mortality, especially in developing countries. To enable patient compliance with TB treatment, preventing the abandonment of this to ensure the correct use of medicines has been suggested the DOTS (Directly Observed Treatment - Short course) or directly Observable Short Course Treatment. This study focuses on the incorporation of two technical components of the DOTS strategy at the Family Health, namely, active search for respiratoy symptoms and Supervisioned Treatment (ST). The West Sanitary District was considered best suited to be the focus of study because it is assumed that those sites that were better structured would provide better information about the situation of the strategy in the municipality. Its purpose is to analyze the organization of DOTS as the active search for respiratory symptoms and Directly Observed Therapy in Health Teams Family belonging to a Health District in the city of Natal, Brazil. An exploratory descriptive study with a quantitative approach which involved health professionals from 11 units of Family Health, West Sanitary District, Natal, Rio Grande do Norte. We interviewed 62 professionals on the professional category, their involvement in the DOTS strategy, managers' contributions to the sustainability of the strategy, actions Search for symptomatic diagnosis and supervised treatment of TB cases and difficulties and facilities for the sustainability of the DOTS strategy. It is concluded that the actions taken by the professionals of the FHS West Health District are organized in more supervised treatment, a fact noted in their perceptions about DOTS

Tuberculose: conhecimentos, representações sociais e experiências da doença na visão do portador

Tuberculosis is considered one of the most ancient human diseases, cases were registered 3900 years before Christ, and it is currently regarded as a serious public health problem in the world due to several factors such as income mismanagement, precarious standard of life and some sort of prejudice comprised by the word tuberculosis. Taking this into consideration, it was developed a descriptive and exploratory study aiming at analyzing the social representations of tuberculosis made by its patient from the Unidades de Saúde da Família (Family Health Units a public health program) in Campina Grande City PB, in relation to the decentralization of the policies that administrate the disease. It was interviewed 34 tuberculosis patient that were being treated from 2007 to 2008. The age group of the interviewees varied from 10 to 60 years old, but most of them were between 36 and 60 years old (58,8%, n=20), some were young adult and adult (21 35 years old), with 11 (32,3%) respondents, and, less frequent, children and teenagers (11 20 years old), with 03 (8,8%) participants. Data was collected through semi-structured interview. The questions that guided the research were elaborated based on the operational recommendations of DOTS strategy; that is: access to laboratory examinations; medication guarantee; directly observed treatment. Besides that, the experiences of the patient were considered in their relation with the family and the different social groups. The analysis of the discursive material was submitted to the Analyse Lexicale par Context d un Ensemble de Segments de Texte software - ALCESTE 4.7. Data interpretation showed five categories for the social representations of the tuberculosis patient that participated in DOTS strategy: 1) the accessibility of the health assistance service; 2) the patient perspective of the disease; 3) the change in the operation of the productive life; 4) the signals and symptoms of the tuberculosis disease; 5) the rearrangement and mechanisms used to face the disease. The Central Nucleus reveals that tuberculosis is a transmissible disease that can be prevented by people through educational practices, health promotion, active search for symptomatic respiratory and control of the carriers communication; these mechanisms should be incorporated to the routine of all participants of the family health groups. The Intermediate Elements, based on quotidian life, as well as the individual experiences of the tuberculosis patient, reveals prejudiced attitude and beliefs that lead to isolation and restriction of interpersonal relationship. Peripheral Elements were constituted by themes that showed the patient feelings of indignation because of the social barriers they had to face in the Family Health Units during the treatment. These elements demonstrate a negative perspective of the representation concerning the accessibility, i.e. inadequate structure of the health service; long distance to the Health Centre, this factormakes it difficult for the patient to continue the treatment; scheduling delay; and limited service regarding other requests (doctor, dentist etc). One expects to contribute for the construction of a new perspective of the health question between the different agents who make the assistencial institutions and formation of professionals, either in central or local scope

Corações e mentes desvendam o Sistema Único de Saúde : visões e vivências de estudantes de enfermagem

One of the Ministry of Health s attempts at contributing to making collective health more appealing to health students is the Experience and In-Service Training within the Reality of the Unified Health Service Project (VER-SUS). Hence, the object of this investigation is to survey learners views on the teaching of nursing based in the experiences they have lived through in the VER-SUS. Its purpose is to analyze the views and lived-through experiences of nursing students on how the VER-SUS contributed to their professional education. This is a study of the descriptiveexploratory type with a qualitative approach. Eighteen undergraduate students from the nursing program at the Federal University of Rio Grande do Norte (UFRN), former VER-SUS participants, took part in this study, from 2006 to 2009. Information was collected using focus group techniques guided by a set of questions and semistructured interview with open and closed questions. The information collected was analyzed using content analysis technique, of the thematic analysis type. The UFRN Research Ethics Committee approved of the survey pursuant to Report Opinion number 223/2010 and CAAE number 0105.0.051.000-10. Lived-through experiences and in-service training gathered from the VER-SUS have contributed meaningfully to health education, as they helped understand the role of the university and of a health and nursing education within the hegemonic model of education. According to the views and lived-through experiences of nursing students who took part in the SUS project it was extremely relevant to use active methodologies in the teaching-learning process and have the facilitators act as liaisons for the SUS. It follows from this study that the VER-SUS does contribute to a health-nursing education and brings the students close to the reality of the community

A busca de sintomáticos respiratórios de tuberculose na prática e perspectiva do agente comunitário de saúde nos distritos sanitários de Natal

The objective of this work - which is characterized analyze the search for symptomatic tuberculosis in practice and perspective of the Community Health Agent (ACS) in the districts of Natal. Methods: This is a cross-sectional study. The study population was 646 professionals, and conducted a probabilistic random sampling, stratified by districts. The data were collected from one instrument to collect data based on Primary Care Assesment Toll (PCAT) and analyzed by descriptive statistics. The sample consisted of ACS was 87% female. Among the study participants 58% completed high school and 120 months of exercise training (95% CI 111.9 to 129.5) on average. 90% were USF. The average follow-up of cases found were 2 cases of TB since the beginning of the career of the ACS and the last three years the average is presented in a case accompanied. The ACS received satisfactory ratings on the bond of trust with the user, so as access to homes in the community. The ACS reported for denying the fear of being positive result was the biggest reason for not performing the sputum. All units have a professional that responds to the Tuberculosis Control Program. Regarding the structural capacity of primary care settings for the diagnosis of TB, we observed satisfactory levels in different districts of pots for sputum collection, however, a point that deserves attention from managers is lack of materials for packaging sputum. Fear of positive result was one of the reasons for the refusal of sputum collection, followed by alcoholism. With regard to TB suspects, all responded that ACS always suspect when the user has TB coughs, but in all districts were noticed at low delivery of requests for applications for smear. BSR in TB control, is characterized in practice as a complex action goes beyond technical expertise and contact with the family that breaks with the Cartesian. The BSR is part of the ACS can perform them from the daily visits. We conclude that the ACS is difficult to achieve. This practice should not be the privilege of this actor, but the entire team of primary care. We must rethink the practices of TB care, seeing the health surveillance while aegis of the working process of primary care teams for early diagnosis and thereby reduce TB in communities

Temperaturas para a germinação de sementes de capixingui (Croton floribundus - Spreng - Euphorbiaceae)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Testes de vigor para avaliação de sementes de pepino

Dentro de um programa de controle de qualidade, a avaliação do vigor de sementes é fundamental e necessária para o sucesso da produção. O trabalho teve por objetivo comparar diferentes métodos para avaliação do potencial fisiológico de sementes de pepino. Para tanto, cinco lotes de sementes do híbrido Safira foram submetidos aos seguintes testes: germinação, primeira contagem de germinação, condutividade elétrica (4x50 sementes; 25ºC; 50 e 75mL; 12, 18 e 24h), germinação a baixa temperatura (4x50 sementes; 18ºC; contagens aos quatro e oito dias após a semeadura); envelhecimento acelerado tradicional (41ºC; 48, 72 e 96h) e com solução saturada de NaCl (41ºC; 72 e 96h). Pelos resultados obtidos, pode-se concluir que os testes de condutividade elétrica (50 e 75mL; 12, 18 e 24h) e de envelhecimento acelerado com o uso de solução salina (41ºC, por 72h), possibilitam a melhor identificação de lotes com diferentes níveis de qualidade fisiológica.

Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose

Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.

Evaluation and development of passion fruit (Passiflora alata Dryander) propagated by cutting and seet in conditions of commercial orchard

The present work was conducted in a fruit tree propagation area of the Plant Production Department of the Faculdade de Ciencias Agrarias e Veterinarias, Universidade Estadual Paulista (FCAV/UNESP) in Jaboticabal, SP, and also in a commercial orchard in Araguari, MG, with the objective to verify the potential of vegetative growth (stem diameter, height of plants and leaf number) of plants of passion fruit (Passiflora alata Dryander), gotten by cutting and seed, comparing the initial development of plants in the field. This experiment was carried out from January 2002 to February 2003. The experiment using seeds was conducted at a shadow house, and the one that used cuttings in an intermitent mist. The cuttings and seeds were collected from adult plants which came from Passifloraceae Active Germoplasm Bank (BAG) of the Plant Production Department of FCAC/UNESP. For the cuttings, it was used the intermediate part of the branches in stadium of vegetative growth. The seeds, in order to obtain the seedlings, had been sown in plastic trays. Cuttings and seedlings were transplanted to plastic bags with substrate in shadow house and with daily irrigation. They were acclimatized and planted on field, after 60 days. on field, the stem diameter, plant height and number of leaves were better for cuttings than for seedlings in Jaboticabal, SP. In Araguari, MG, stem diameter was larger in the seedlings, which plant heights and number of leaves were larger on cuttings.

Comportamento de maracujazeiros (Passiflora spp.) quanto à morte prematura

Na Universidade Estadual Paulista, Câmpus de Jaboticabal-SP, estudou-se o comportamento de Passifloráceas quanto à morte prematura de plantas, cultivadas em local com histórico da doença. O objetivo do trabalho foi avaliar o comportamento de diversos acessos de populações e espécies de maracujazeiros em relação a esta doença, sendo que as plantas resistentes deverão ser utilizadas como porta-enxertos de formas comerciais de maracujá-amarelo (Passiflora edulis Sims f. flavicarpa) e em programas de melhoramento genético. As espécies utilizadas foram P. edulis Sims, P. edulis Sims f. flavicarpa Degener, P. nitida H.B.K., P. cincinnata, P. giberti, P. laurifolia, P. morifolia, P. foetida e P. capsularis. em local com histórico da doença, plantaram-se mudas em número variável e em épocas distintas. A condução das plantas e os tratos culturais foram os recomendados para o maracujá-amarelo. A morte prematura das plantas ocorreu entre dois meses e dois anos da cultura no campo. P. giberti e P. nitida mostraram-se resistente à doença, independentemente do local de origem. Entre os demais acessos, não se encontraram fontes promissoras de resistência. Entretanto, novos acessos e novas espécies deverão ser estudadas na busca da resistência.

Enraizamento de estacas de espécies de maracujazeiro (Passiflora spp.) no inverno e no verão

O maracujazeiro está entre as principais frutíferas cultivadas no País, mas apresenta limitações no cultivo, ocasionando baixa produtividade, que pode ser superada através do uso da estaquia, clonando as melhores matrizes de alta produtividade. Com isso, o objetivo desta pesquisa foi avaliar o potencial de enraizamento de estacas no inverno e no verão, utilizando as espécies comerciais (P. edulis Sims f. flavicarpa Degener e P. alata Dryander) e os porta-enxertos (P. giberti N.E.Brown, P. nitida H.B.K. e P. setacea D.C.). Este experimento foi realizado no período de julho de 2001 a março de 2002, em câmara de nebulização intermitente, sob condições de telado (50% de sombreamento). As estacas foram coletadas de plantas adultas oriundas do Banco de Germoplasma Ativo (BAG) do Departamento de Produção Vegetal da Faculdade de Ciências Agrárias e Veterinárias da Universidade Estadual Paulista, Jaboticabal-SP (FCAV/UNESP) e de pomares comerciais, em julho de 2001 e em janeiro de 2002. A estaquia foi feita com a coleta da parte intermediária de ramos em estádio de crescimento vegetativo, no inverno e no verão. As estacas herbáceas tinham aproximadamente 15cm de comprimento, três nós e duas meias - folhas. As estacas foram tratadas com ácido indolbutírico (AIB) nas concentrações de 0; 500; 1.000 e 2.000mg.L-1, por cinco segundos, e plantadas em bandejas plásticas (40x30x10cm) com vermiculita de textura média, onde permaneceram por 60 dias. Houve influência do AIB e da época do ano no enraizamento, variando de acordo com a espécie. Sendo assim, P. giberti obteve o melhor desempenho em relação às demais espécies, com 73% de enraizamento no verão. A percentagem de enraizamento foi melhor para P. alata (58%) e para P. nitida (40%) no inverno e sem AIB. P. edulis f. flavicarpa enraizou apenas 23% no inverno, e P. setacea não enraizou. O número e o comprimento de raízes foram maiores no inverno. A sobrevivência de plantas não se diferenciou significativamente entre os tratamentos.

Determination of crude protein, crude fiber and crude fat in twenty-five genotypes of kale (B-oleracea var. acephala)

The aim of the study was to determine the percentage of crude protein, crude fiber and crude fat (ether extract) of 25 genotypes of kale from the Germplasm Bank of Instituto Agronomico de Campinas and of one genotype grown in the region of Jaboticabal-SP. The plants were cultivated in the field, and the leaves after collection were pre-dried in a convection oven at 65 degrees C for 72 h. Afterward, the leaves were analyzed for crude protein, crude fiber and crude fat (ether-soluble materials). Significant differences were detected among the different genotypes for all the characteristics examined. of the genotypes studied, six showed more than 30% crude protein: HS-20 (32.56%), Comum (31.70%), Couve de Arthur Nogueira 2 (31.16%), Pires 2 de Campinas (30.63%), Manteiga 1-916 (30.36%), and Manteiga de Ribeirao Pires I-2446 (30.03%). In relation to crude fiber, the highest percentage was seen in the genotype Manteiga de Mococa (10.92%), differing significantly from the other genotypes studied. With regard to crude fat, the highest percentage was found in the genotype HS-20 (3.72%), and Pires 1 de Campinas (3.34%). of the genotypes tested, HS-20 stood out among the others, showing both the highest percentage of protein and fat.

Análise dos marcos teóricos e estruturais do currículo de graduação em enfermagem no Rio Grande do Norte

This research had as its guiding question: what theoretical and structural milestone of graduation nursing curriculum of public universities in the State of Rio Grande do Norte? The objectives of this study were: Analyze theoretical and structural milestones of graduation nursing curriculum of public universities in the State of Rio Grande do Norte; Identify the theoretical milestone and training models that guide the structural milestones of nursing curriculum courses of public universities studied; Analyze the training concepts of curriculums from the voices of the coordinators of the courses. This is a qualitative study, analytical, with discussions of the documentary and empirical research. Ten teachers participated who act as coordinators of the graduation courses in nursing or academic advisors, in UFRNCentral Campus in Natal and Health Sciences College (Facisa), in Santa Cruz-and on UERN -Campus Caicó, Mossoró and Pau dos Ferros. The information collected by interview was analyzed by sociology or symbolic cartography of Boaventura de Sousa Santos. The research was approved by the Research Ethics Committee of the UERN by the CAAE: 03610912.7.0000.5294. All the participants signed the Free Consent and clarified Term The results and discussion were presented in four scientific articles. The first article, titled the Pedagogical projects in nursing analysis in the light of the symbolic cartography, features the use of cartographic method in the researches and in the study of nursing curriculums. In the article The Analysis of theoretical-philosophical, structural and referential milestones in nursing curriculums, these milestones are renowned in curriculums of UERN and UFRN. The main challenges faced in the implementation of supervised internship in nursing provide a reflection on the difficulties that the internship supervisors present, especially with the relationship between education/service and the articulation theory/practice. In the last article are discussed the changes in nursing training from the former student profile, who won a boost from the curricular changes proposed by the national curriculum guidelines. The study concluded, by the analysis of theoretical and structural milestones of nursing curriculum courses of public universities of Rio Grande do Norte, that there is an explicit intention to train nurses for the health system and a search on innovative teaching projects in accordance with the national curriculum guidelines for the area of nursing. The thesis defended in this investigation was that the curriculum of public institutions of higher education in nursing in the State of Rio Grande do Norte advanced from a training focusing on biologicist model, flexneriana guidelines, for teaching able to articulate the health with the social, political and cultural issues