Diagnóstico da comercialização de produtos da medicina popular em feiras livres do semiárido do Rio Grande do Norte: avaliações socioeconômicas e sanitárias, com proposta de legislação específica

Historically, man has empirically acquired knowledge about the therapeutic applications of extracted elements of the natural environment in which belonged. Such knowledge over time culminated in the formation of traditional health systems. Among its features, the use of bioactive plant species - medicinal plants - stands out for its efficiency and high popular acceptance. Despite its importance for public health, the population still has in the open-air fairs the main source for the acquisition of the species used. In these spaces, the trade generally occurs informally, under unfavorable conditions to the quality of the products and to the financial sustainability of the business. In this context, this study aimed to characterize the socioeconomic, cultural and sanitary aspects related to the trade of medicinal plants in municipalities of a semiarid region of Rio Grande do Norte, and additionally, proposing a specific legislation to the activity. Socioeconomic data were collected through on-site interviews, guided by structured form. The observations about the hygienic and sanitary adequacy of physical facilities and practices employed at the point of sale /environment were conducted and recorded with the use of assessment tool developed for use in open markets. The adequacy of medicinal plants to consumption was determined by microbiological analysis. The activity was carried out by individuals who are aged between 21 and 81 years of age, low educational level and low-income, predominantly males. The data showed a tendency to extinction of the activity in all the districts studied. It was observed in all the fairs studied hygiene and sanitation inadequacies that characterized very high health risk, representing in this way, the high probability of Food Transmitted Diseases outbreaks Such conditions were reflected in the high percentage of inadequacy to the consumption of the analyzed medicinal plants samples, illustrating the potential health risk to consumers. To contribute to the correction of hygiene and sanitation inadequacies observed in the studied open-air fairs, educational interventions were made to the training of traders in Good Practices. As a complement, was drafted a specific legislation for the marketing of folk medicine's products in open-air fairs. Such actions, products and its developments will contribute significantly to improving the quality of products available to the population and the preservation of activity, potentially reducing the risks to public health.

Percepção da equipe de saúde, discentes e usuários sobre a comunicação com indivíduos surdos na atenção primária

The study aimed to identify in the professionals and students of health courses that work in a health Basic Unit in the city of Natal/RN their perceptions of the care of deaf patients, and with the population's needs with hearing loss in relation to health care. This is a cross-sectional, exploratory, descriptive study, conducted between April to July 2014, with a population composed of 21 health professionals, 17 students and 8 deaf users. For data collection, we used a structured questionnaire with open and closed questions applied to groups composed of health professionals (doctors, dentists, nurses and health workers) and students of medical schools, nursing, physical education, nutrition and social service. The professionals/students answered a semi-structured questionnaire with open and closed questions concerning the possible difficulties the care of the deaf and hearing impaired. Data collection with deaf users was conducted through filmed interview for the Brazilian Sign Language (Libras) could be interpreted as to the Portuguese by the researcher. With the latter it was conducted a survey of their reactions when looking for a care in the health service. Regarding the profile of identification of the subjects, it was analyzed by simple descriptive statistics (absolute and relative frequencies). The open questions were analyzed through the content analysis technique which allowed the categorization process preserving all the points raised in the discussion so that the lines were representative of the whole. When asked about the professionals and students attitude used to communicate with deaf patients possible the following categories emerged: the "writing", the "gestures" and the "third party assistance". With regard of the deaf, when asked about their experiences in seeking care in health, the elucidated categories were: "quality of care to the hearing impaired", "communication with the hearing impaired adequacy" and "dependence on third parties." The closed questions were measured and adapted to the 5 degrees of variation Likert Scale, which comprised three of these issues: degree of difficulty in communication to meet a patient with hearing loss (minimum to great difficulty); feeling of comfort while using sign language (minimum to severe discomfort); and knowledge of the Law 10.436, which provides for the Brazilian Sign Language (Libras) (low knowledge to entirely clear). The data collected with professionals and students revealed some misunderstanding and discomfort in health care for deaf patients, reality also evidenced in the opinion of the deaf participants. This study revealed problems in communication, resulting in negative consequences in serving this population. This diagnosis may be relevant to public policy development and curriculum guidelines essential to the training of health professionals, inclusion and improving assistance to deaf.

Fatores determinantes da near miss materna em uma unidade de terapia intensiva obstétrica: avaliação das competências profissionais da área médica

Objective: Evaluate the determinants of morbidity and mortality in an obstetric intensive care unit and professional medical skills of students/residents at a university hospital. Methods: observational cross - sectional with 492 pregnant/pue rperal women and 261 students/residents. Patients were admitted to the obstetric intensive care unit during a year, being informed about the proposals of the study and a questionnaire was applied. The analysis was performed using Microsoft Excel 2013 and G raphPad6. Chi - square tests were used to evaluate risk factors and student t test evaluates resident/students' skills concerning the cognitive test and the Mini - Cex. Results: the main risk factors to near miss were: non - white race (OR = 2.527; RR = 2.342) ; marital status(married women) (OR = 7.968; RR = 7.113) , schooling (primary) (OR = 3.177 ; RR = 2.829) , from country town (OR = 4.643 ; RR = 4.087), low income (OR = 7014 ; RR = 5.554) , gestational hypertensive disorders (OR = 16.35 ; RR = 13.27) , re alization of pre - natal (OR = 5.023 ; RR = 4.254) and C - section before labor(OR = 39.21 ; RR = 31.25). In cognitive/Mini - cex analysis were noted significant difference in the performance of students on the subject (3.75 ± 0.93, 4.03 ± 0.94 and 4.88 ± 0.35). We still observed the best performance of residents, when compared to graduation students (p < 0.01). Conclusions: the prevalence of near miss was associated with socioeconomic/clinics factors and care issues, revealing the importance of interventions to improve these indicators. In addition, we suggest a better curriculum insertion of this subject in the medical Course disciplines due the importance to avoid the near miss through of adequacy of medical education.

Antecedentes do engajamento em boca a boca eletrônico positivo entre turistas

This study examined the influence of the tourism destination image as well as satisfaction and motivation in the intention of engaging in a positive electronic word of mouth (eWOM) by tourists through Facebook. In addition, it was also specifically expected to assess the sociodemographic profile and frequency of eWOM publications from those who answered the questions; it also assessed the adequacy of the manifested variables for composition of the following dimensions: Quality, Satisfaction, Image, Motivations and Positive Electronic Word of Mouth (eWOM). And finally, it analyzed a relational model where there are relationships between Quality, Satisfaction, Image and Motivations in the explanation of engagement in the Positive Electronic Word of Mouth (eWOM). With this aim it was conducted a study, based on a hypothetical-deductive logic, which was descriptive in relation to its goals. The analytical approach was quantitative (a survey). The sampling procedure was non-probabilistic, by the convenience method of sampling specifically, having the choice of the subject been made through the probabilistic systematic method, and using time as a factor of systematization in an attempt of making randomly the selection of the interviewed people. The study sample consisted of 355 tourists. The used instrument to collect information was the structured questionnaire whose answers were collected in the main points of entry, exit and rides of tourists on the Pipa’s Beach/RN. Data analysis was carried out using descriptive and multivariate statistics, mainly exploratory and confirmatory factor analysis and structural equation modeling. Among the main results, it was possible to confirm that the Motivations, Satisfaction and Image strongly affect the intention of engaging in positive electronic word of mouth (eWOM). Emphasis is given to the motivations, as they demonstrate bigger impact in explaining the dependent variable; they are followed by the satisfaction and the image. The latter, however, is inversely proportional. Among the motivations, the one with the highest percentage of variance were the social benefits sought by tourists; and presenting the same percentage appears the desire to help other tourists and to vent Positive Emotions. The manifested variables demonstrate to be fully acceptable to be taken as reflexes of their respective factors.

Revestimento decorativo monocamada pigmentado, com resíduo de vidro temperado, para aplicação em fachadas

Although efficient from a technical point of view, mortar layers that make up the traditional masonry coating (slurry mortar, plaster and plaster) have to be in contradiction with the new construction technologies and more efficient methods of consumption and work rationalization. From an environmental point of view, the recovery of waste into new composites for the building has been a growing strand of studies in the scientific community, may prove to be a cost-effective solution in some cases. Thus, this research proposes the development of a mortar Decorative Coating Monolayer (RDM), for use in facades, produced on site, incorporating tempered glass waste (RVT) in the cement matrix, as a partial substitute for aggregate. Therefore, we adopted the binder respect / aggregate of 1: 6 (by volume), consistency index 250mm ± 20, sand substitution levels of glass waste 20%, 50% and 80% and relative water / cement varied in many traits. Two additives were used, a polymer, styrene-butadiene-based, and other chemical, besides mineral and silica fume inorganic pigment in colors red, yellow and blue. Mechanical tests were carried out on fresh pasta and hardened, as well as for the applied coating on masonry, so as to demonstrate the feasibility of the material. In addition, it verified the adequacy of the RDM built environment by means of thermal tests. The results demonstrated the feasibility of the proposed RDM with significantly higher values when compared to norms, especially the dash-added replacement content of 20% and addition of pigment in red. Therefore, the study shows the scientific community as an incentive to the use of technological innovations in construction, increasing the range of alternatives available for housing production, with the proposition of a material that achieves the desired functionality and obtain environmental gain, and may be adopted on construction sites as an alternative industrialized mortars.

Aplicação e otimização de métodos eletroquímicos combinados para remoção e determinação de cromo hexavalente em efluentes simulados

Hexavalent chromium is a heavy metal present in various industrial effluents, and depending on its concentration may cause irreparable damage to the environment and to humans. Facing this surrounding context, this study aimed on the application of electrochemical methods to determine and remove the hexavalent chromium (Cr6+) in simulated wastewater. To determine was applied to cathodic stripping voltammetry (CSV) using ultra trace graphite electrodes ultra trace (work), Ag/AgCl (reference) and platinum (counter electrode), the samples were complexed with 1,5- diphenylcarbazide and then subjected to analysis. The removal of Cr6+ was applied electrocoagulation process (EC) using Fe and Al electrodes. The variables that constituted the factorial design 24, applied to optimizing the EC process, were: current density (5 and 10 mA.cm-2), temperature (25 and 60 ºC), concentration (50 and 100 ppm) and agitation rate (400 and 600 RPM). Through the preliminary test it was possible the adequacy of applying the CSV for determining of Cr6+, removed during the EC process. The Fe and Al electrodes as anodes sacrifice showed satisfactory results in the EC process, however Fe favored complete removal in 30 min, whereas with Al occurred at 240 min. In the application of factorial design 24 and analysis of Response Surface Methodology was possible to optimize the EC process for removal of Cr6+ in H2SO4 solution (0.5 mol.L-1), in which the temperature, with positive effect, was the variable that presented higher statistical significance compared with other variables and interactions, while in optimizing the EC process for removal of Cr6+ in NaCl solution (0.1 mol.L-1) the current density, with positive effect, and concentration, with a negative effect were the variables that had greater statistical significance with greater statistical significance compared with other variables and interactions. The utilization of electrolytes supports NaCl and Na2SO4 showed no significant differences, however NaCl resulted in rapid improvement in Cr6+ removal kinetics and increasing the NaCl concentration provided an increase in conductivity of the solution, resulting in lower energy consumption. The wear of the electrodes evaluated in all the process of EC showed that the Al in H2SO4 solution (0.5 mol.L-1), undergoes during the process of anodization CE, then the experimental mass loss is less than the theoretical mass loss, however, the Fe in the same medium showed a loss of mass greater experimental estimated theoretically. This fact is due to a spontaneous reaction of Fe with H2SO4, and when the reaction medium was the NaCl and Na2SO4 loss experimental mass approached the theoretical mass loss. Furthermore, it was observed the energy consumption of all processes involved in this study had a low operating cost, thus enabling the application of the EC process for treating industrial effluents. The results were satisfactory, it was achieved complete removal of Cr6+ in all processes used in this study.

Dual path: a concept to improve the esthetic replacemente of missing anterior teeth with removable partial denture

The dual path of insertion concept for removable partial denture (RPD) design may be used in esthetically demanding situations. When compared to conventional RPDs, the main advantage of this design is the minimal use of clasps. This clinical report describes the treatment of a patient with an anterior maxillary edentulous area using a dual path RPD. The diagnostic cast was surveyed to ensure the adequacy of the undercuts on the mesial surfaces of the anterior abutments, where rigid minor connectors were placed. Inverted V-shaped canine cingulum rest seats were prepared to provide resistance to tooth movement during function. The dual path RPD concept allows excellent esthetic results, minimizes tooth preparation, and reduces the tendency toward plaque accumulation in a Kennedy class IV partially edentulous arch.

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.

Etnobotânica e percepção ambiental de pescadores e coletoras tradicionais submetidos à escassez de recursos vegetais silvestres

In our first chapter was recorded the perception of fishermen and gatherers of Patané about the absence of local forests, was collected a list of species considered locally as strategic use, the ethnoknowledge associated with those, and identify which of these plants are already perceived as scarce in the region. In the second chapter, was studied all species of plants known by the community, the associated knowledge and the various uses. Were used individual interviews, formal and semi-structured, that have been consecutively applied to sampled respondents not probabilistically by snowball. Were collected socioeconomic data of informants. A adequacy test was performed. Guided tours were conducted to gather photographs and samples witnesses of plants, all identified by the usual methods of botany. Excerpts of the interviews on perceptions appear by looking for consensual information. Some data were presented by descriptive statistics. Were mounted two lists of plants, one with the strategic use and one with all the species listed in the study. It was shown that knowledge about plants remains resilient despite the forest resources now no longer be available.

Etnobotânica e percepção ambiental de pescadores e coletoras tradicionais submetidos à escassez de recursos vegetais silvestres

In our first chapter was recorded the perception of fishermen and gatherers of Patané about the absence of local forests, was collected a list of species considered locally as strategic use, the ethnoknowledge associated with those, and identify which of these plants are already perceived as scarce in the region. In the second chapter, was studied all species of plants known by the community, the associated knowledge and the various uses. Were used individual interviews, formal and semi-structured, that have been consecutively applied to sampled respondents not probabilistically by snowball. Were collected socioeconomic data of informants. A adequacy test was performed. Guided tours were conducted to gather photographs and samples witnesses of plants, all identified by the usual methods of botany. Excerpts of the interviews on perceptions appear by looking for consensual information. Some data were presented by descriptive statistics. Were mounted two lists of plants, one with the strategic use and one with all the species listed in the study. It was shown that knowledge about plants remains resilient despite the forest resources now no longer be available.

Efeitos da internacionalização no desvio da estrutura de capital alvo e na velocidade de ajuste

This dissertation investigates the effects of internationalization in two gaps related to the capital structure that have not been discussed by the Brazilian literature yet. To this, were developed two independent sections. The first examined what the effects of internationalization on the deviation from the target capital structure. The second examined what the effects of internationalization on speed of adjustment (SOA) of the capital structure. It used data from Brazil, multinational and domestic companies, from 2006 to 2014. The results of the first analysis indicate that internationalization helps reduce the difference between the target and the current debt. That is, to the extent that the level of internationalization increases; whether only export or a combination of export, assets and employees abroad, the gap between the current structure and the target structure decreases. This reduction is given as a function of internationalization as a consequence of the upstream effect of the upstream-downstream hypothesis. Thus, as the Market Timing theory, it can be seen as an opportunity for adjustment of the capital structure, and with the reduction of deviation, there is also a reduction in the cost of capital of the firm. The result of the second analysis indicates that internationalization is able to significantly increase the speed adjustment, ensuring for the multinational a faster adjustment of its capital structure. Exports increase the SOA in 9 to 23%. And when also kept active assets and employees abroad the increase is 8 to 20%. In terms of time, while domestic company takes more than three years to reduce half of the deviation that has, while multinacional companies take on average one and a half year to reduce the same proportion of the deviation. The validity of the upstream-downstream hypothesis for the effect of internationalization in SOA was confirmed by comparing the results for US companies. Thus, the phenomenon of internationalization increases SOA when companies are from less stable markets, such as Brazil; and it has a less significcative effect when companies are derived from more stable markets, because they already have a high speed of adjustmennt. In addition, the adequacy analysis of the estimators also showed the model pooled OLS (Ordinary Least Squares) presents the highest quality in predicting the SOA than the system GMM (Generalized Method of Moments). For future studies it is suggested to analyze the effect of international event, by itself, and to validate the hypothesis using samples of different markets and the use of other estimators.

Smoking and dietary inadequacy among Inuvialuit women of child bearing age in the Northwest Territories, Canada

Objective. The prevalence of smoking in Aboriginal Canadians is higher than non-Aboriginal Canadians, a behavior that also tends to alter dietary patterns. Compared with the general Canadian population, maternal smoking rates are almost twice as high. The aim of this study was to compare dietary adequacy of Inuvialuit women of childbearing age comparing smokers versus non-smokers. Research methods & procedures. A cross-sectional study, where participants completed a culturally specific quantitative food frequency questionnaire. Non-parametric analysis was used to compare mean nutrient intake, dietary inadequacy and differences in nutrient density among smokers and non-smokers. Multiple logistic regression analyses were performed for key nutrients inadequacy and smoking status. Data was collected from three communities in the Beaufort Delta region of the Northwest Territories, Canada from randomly selected Inuvialuit women of childbearing age (19-44 years). Results: Of 92 participants, 75% reported being smokers. There were no significant differences in age, BMI, marital status, education, number of people in household working and/or number of self employed, and physical activity between smokers and non-smokers. Non-parametric analysis showed no differences in nutrient intake between smokers and non-smokers. Logistic regression however revealed there was a positive association between smoking and inadequacies of vitamin C (OR = 2.91, 95% CI, 1.17-5.25), iron (OR = 3.16, 95% CI, 1.27-5.90), and zinc (OR = 2.78, 95% CI, 1.12-4.94). A high percentage of women (>60%), regardless of smoking status, did not meet the dietary recommendations for fiber, vitamin D, E and potassium. Conclusions: This study provides evidence of inadequate dietary intake among Inuvialuit of childbearing age regardless of smoking behavior.

Perceived risk of death in older primary care patients

There is a large gap between life expectancy and healthy life years at age 65. To reduce this gap, it is necessary that people with medical concerns perceived at higher risk of adverse outcomes are readily identified and treated. The same goes for the need to implement prevention plans. The main objectives of this study are to, in a first step, (a) estimate the percentage of medical concerns, (b) identify factors associated with this concern; in a second step, (c) estimate the perceived risk of death, and (d) evaluate the ability of medical concerns to predict this risk. Results show that the existence and severity of medical concerns are crucial in the prediction of perceived risk of death. Early identification of severity of medical concerns and the availability and adequacy of informal caregiving should allow healthcare professionals to promptly initiate an appropriate assessment and treatment of older patients.

The Psychometric Properties of the Developmental Reading Assessment

ABSTRACT The purpose of this study was to examine the technical adequacy of the Developmental Reading Assessment (Beaver & Carter, 2004). Internal consistency analysis, factor analysis, and linear regression analyses were used to test whether the DRA is a statistically reliable measuring of reading comprehension for Grades 7 and 8 students. Correlational analyses, decision consistency analyses, and a focus group of experienced Intermediate (Grades 7 and 8) teachers examined whether there is evidence that the results from the DRA provide valid interpretations regarding students’ reading skills and comprehension. Results indicated that, as currently scored, internal consistency is low and skewness of distribution is high. Factor analyses did not replicate those cited by the DRA developers to prove construct validity. Two-way contingency analyses determined that decision consistency did not vary greatly between the DRA, EQAO, scores and report card marks. Views expressed during the focus group echoed many of the challenges to validity found in the statistical analysis. The teachers found that the DRA was somewhat useful, as there were limited alternative reading assessments available for the classroom, but did not endorse it strongly. The study found little evidence that the DRA provides valid interpretations regarding Intermediate students’ reading skills. Indicated changes to the structure and administration procedures of the DRA may ameliorate some of these issues.

Educación superior y competencias para el empleo. El punto de vista de los empresarios

La relevancia del conocimiento como input del proceso productivo ha aumentado la complejidad de la contratación en el mercado de trabajo cualificado. Como consecuencia de ello, se ha generado un proceso de reflexión sobre la adecuación de la acreditación universitaria a las necesidades del mercado de trabajo. Académicos, gerentes y expertos en el mercado de trabajadores altamente cualificados han tenido parte en esta reflexión durante mucho tiempo. Este trabajo tiene como objetivo la identificación de las competencias profesionales con mayor relevancia en la empleabilidad de los graduados en Economía y Empresa. El análisis se basa en una investigación cualitativa que toma como fuentes de información las opiniones de los empleadores. La información para el estudio ha sido obtenida mediante entrevistas en profundidad y la realización de un grupo de discusión. En este proceso han participado empresarios, responsables del servicio de prácticas de la Universidad de Barcelona, expertos y responsables de empresa de colocación, representantes de organizaciones empresariales y profesores universitarios. La atención se centra en la percepción que los entrevistados tienen del requerimiento de conocimientos, habilidades y actitudes, en el grado en que los desarrollan y en los cambios que se necesitarían para lograr una mejor correspondencia entre las competencias adquiridas por los graduados y las requeridas por el mercado de trabajo. A partir de la clasificación de las competencias profesionales (proyecto Tuning), el estudio pone de relieve la importancia otorgada por los empleadores a de las competencias genéricas. No obstante, se observan diferencias valorativas según la tipología de empresas. Asimismo, se evidencian déficits en algunos aspectos relevantes, como la formación práctica y la capacidad de iniciativa, de análisis o de organización. Por último, de las opiniones recogidas también se constata la necesidad de aproximar la universidad al sistema productivo, al menos en el campo económico-empresarial.