Satisfaçã dos Usuários e a qualidade da atenção primária à saúde no Rio Grande do Norte

O presente estudo tem por objetivo avaliar a satisfação dos usuários em relação à qualidade da Atenção Primária à Saúde no Rio Grande do Norte. Trata-se de Pesquisa Avaliativa observacional transversal, com abordagem quantitativa, a qual faz parte da Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ), da Universidade Federal do Rio Grande do Norte. Foram utilizados dados secundários de todas as entrevistas com usuários das equipes que participaram da Avaliação Externa do PMAQ no Estado do RN. A pesquisa foi realizada em 167 municípios do Estado do Rio Grande do Norte, na qual a população foi composta por 1.650 usuários. A amostra se deu por conveniência a partir dos seguintes critérios: usuários que estavam presentes na Unidade Básica de Saúde (UBS) para realizar qualquer tipo de procedimento e que consentisse em participar da avaliação. Foram excluídos os que tinham ido pela primeira vez na unidade e aqueles que não frequentaram há mais de 12 meses. A coleta dos dados foi realizada no período de setembro a novembro de 2013. Para tanto, foi elaborado um protocolo de pesquisa contendo as seguintes dimensões: organizacional, interpessoal e estrutural. Em relação à dimensão organizacional os resultados mostram que a marcação de consultas tem se configurado em empecilho ao acesso do usuário ao serviço de saúde, uma vez que se faz necessário para o atendimento, enfrentar filas, antes da abertura da unidade para pegar fichas. No tocante ao funcionamento da unidade, se destaca o fato dos usuários referirem que o horário de funcionamento da unidade atende à suas necessidades, apesar de funcionar 5 (cinco) dias por semana, a maioria das unidades permanece fechada no horário de almoço. Outro dado importante refere-se à coordenação do cuidado, cujos resultados apresentam diferenças maiores entre os usuários da região metropolitana e do interior do Estado em relação à Capital. Essa diferença se expressa principalmente em relação de marcação de consulta com outros profissionais especialistas. A dimensão interpessoal, no que diz respeito à categorias interação usuário-serviço-equipe e vínculo, demonstraram alguns avanços, contudo os melhores resultados foram observados em relação a satisfação com o cuidado, onde mais de 50% dos usuários se mostraram satisfeitos com o cuidado recebido nas unidades. Em contrapartida, o estudo mostrou que, na opinião de 56% dos usuários da capital, a falta de materiais e equipamentos influencia negativamente no cuidado. Por fim, o estudo contribuiu para reforçar a ideia de que a avaliação da satisfação dos usuários dos serviços de saúde pode ser uma ferramenta importante para subsidiar o processo de decisão compartilhada, de forma a se repensar as práticas profissionais, reorganizar o processo de trabalho desenvolvido, realocar recursos, readequar ações e redefinir objetivos que estejam coerentes com o projeto de saúde estabelecido

Avaliação da qualidade da atenção primária à saúde da criança no Rio Grande do Norte: visão das usuárias

The study aims to evaluate the quality of the work processes of the teams from the Family Health Strategy regarding the comprehensive health care for children, in the view of users in the state of Rio Grande do Norte. This is a cross-sectional observational evaluative research with quantitative approach. The primary data are part of the External Review from the Program of Improving Access and Quality of Primary Care (PMAQ) in 2012. 190 women were interviewed. The inclusion criteria was the presence in the clinic at the time of the survey, have attended the service in the last 12 months and be a mother or companion of a child up to two years old. A research protocol was developed in the dimensions of Growth and Development, Breastfeeding and nutrition, and health problems and its variables. The results revealed that mothers / companions who responded to the questionnaire 71% were aged between 18 and 35 years, 92.1% were literate, 96.3% had a monthly income and 62.6% received financial assistance from the government. As for the children, 39.4% were aged between 13 to 24 months. In promotion and prevention actions for children, 64.2% had consultation up to the 7th day of life, 91.1% underwent the screening test, 95.3% had a health handbook, 98.9% had a vaccine, 17.9% breastfed or breastfeed from 6 to 24 months. As for link and continuity of care, 86.8% of the children were accompanied by the same professional staff and 59.5% left with next consultation scheduled. In acute situations 42.4% of the children went to the health unit and 64% of these were attended. It is concluded that the actions involving prevention and health promotion of children in RN, are evaluated positively by the service users and meet the requirements of MS, as well as link and continuity of care. The weakness in access and reception of users is evident, indicating the need to adapt the service to the demand of health and planning actions to welcome all who seeks basic health unit-UBS

Um método para desenvolvimento de abordagens generativas com composição de linguagens específicas de domínio

The software systems development with domain-specific languages has become increasingly common. Domain-specific languages (DSLs) provide increased of the domain expressiveness, raising the abstraction level by facilitating the generation of models or low-level source code, thus increasing the productivity of systems development. Consequently, methods for the development of software product lines and software system families have also proposed the adoption of domain-specific languages. Recent studies have investigated the limitations of feature model expressiveness and proposing the use of DSLs as a complement or substitute for feature model. However, in complex projects, a single DSL is often insufficient to represent the different views and perspectives of development, being necessary to work with multiple DSLs. In order to address new challenges in this context, such as the management of consistency between DSLs, and the need to methods and tools that support the development with multiple DSLs, over the past years, several approaches have been proposed for the development of generative approaches. However, none of them considers matters relating to the composition of DSLs. Thus, with the aim to address this problem, the main objectives of this dissertation are: (i) to investigate the adoption of the integrated use of feature models and DSLs during the domain and application engineering of the development of generative approaches; (ii) to propose a method for the development of generative approaches with composition DSLs; and (iii) to investigate and evaluate the usage of modern technology based on models driven engineering to implement strategies of integration between feature models and composition of DSLs

Inundações urbanas no semiarido nordestino: o caso da cidade de Pau dos Ferros - RN

The Apodi river basin, particularly within the snippet that crosses Pau dos Ferros - RN city, place anthropogenic actions that interfere in the dynamic environment by modifying the local landscape. The reflection of these actions can be seen in the floods that occur in rainy periods (February to may) virtually every year in the city. It is important to stress that the project of integration of the waters of the San Francisco basin with the northern basin of Northeastern will perennial the main channel of the river basin, and generate greater impacts in the region. This work sought to define a methodology able to delimit areas susceptible to flooding in cities of semiarid Northeast based on the Pau dos Ferros RN city. The dissertation is divided into two chapters and introduction. The introduction presents a theoretical frame based on discussion of the concept of risk, their main characteristics and subdivisions; floods; geotecnologies; Apodi River basin; municipal data Pau dos Ferros RN and design integration of Francisco basin with the northern basins Northeast. The first chapter evaluates the urban expansion process between 1987 and 2008, delimiting the flood areas and analyzes the relationship between urban growth and retention areas. The second chapter identifies the flood risk areas in the Pau dos Ferros city. The methodology used was based on tools of geographic information system GIS from software SPRING/INPE 5.1, as well as bibliographical, satellite images, aerial photographs and field activities. The results obtained enabled view the rapid expansion of the urban area of Pau dos Ferros, which has doubled in a period of 22 years. The population density checks with greater intensity in South-central portion of the city, in flood areas and not flood (Cap. 01). It was noted also that some neighborhoods along the River Apodi are susceptible to more instances of flooding ranging from minimum to maximum, while in neighborhoods near the Riacho Cajazeiras floods occur to a lesser extent because of altimetry higher and lower water volume. (Cap. 02). It is expected that this work will help in the preparation of flood risk municipal map subsidising managers in implementing public policies targeted to the softening of urban flood-related issues in Pau dos Ferros RN and serve as a model for mapping of other cities with similar characteristics analyzed in this work

Intoxicação aguda por metano arsonato ácido monossódico em bovinos

O presente trabalho estudou a intoxicação acidental por arsênico em um lote de 24 vacas Girolando, as quais tiveram acesso a pasto pulverizado com herbicida à base de metano arsonato ácido monossódico (MSMA). Os bovinos apresentaram apatia, anorexia e diarreia profusa. Foram necropsiados na fazenda dois animais de 14 que morreram. Os principais achados macroscópicos foram úlceras abomasais e congestão renal. No exame microscópico, as principais lesões observadas foram abomasite e omasite necro-hemorrágica multifocal acentuada e, nos rins, necrose tubular difusa. As concentrações médias de arsênico em vacas com sinais clínicos foram 1,19±0,40, 10,52±2,16 e 76,06±48,37ppm no sangue, leite e fezes, respectivamente. Os níveis de arsênico encontrados em dois animais necropsiados foram 25,58 e 23,85ppm em fígado, e 28,71 e 35,94ppm em rins, respectivamente. No feto de uma vaca necropsiada, os níveis de arsênico mensurados no fígado e rim foram 9,0 e 8,92ppm, respectivamente. A concentração de arsênico no capim do piquete pulverizado foi 111,58ppm. No Brasil, o uso MSMA na composição de pesticidas e herbicidas é permitido somente para uso agrícola, mas não pecuário. A utilização desse ou de outros produtos à base de arsênico na pecuária pode causar altos índices de mortalidade no rebanho, além de diminuição da produção e contaminação de produtos de origem animal.

Clinical correlates of social adjustment in patients with obsessive-compulsive disorder

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

BODY DYSMORPHIC DISORDER IN PATIENTS WITH OBSESSIVE-COMPULSIVE DISORDER: PREVALENCE and CLINICAL CORRELATES

Background The prevalence, sociodemographic aspects, and clinical features of body dysmorphic disorder (BDD) in patients with obsessivecompulsive disorder (OCD) have been previously addressed in primarily relatively small samples. Methods We performed a cross-sectional demographic and clinical assessment of 901 OCD patients participating in the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. We used the Structured Clinical Interview for DSM-IV Axis I Disorders; Yale-Brown Obsessive-Compulsive Scale; Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS); Brown Assessment of Beliefs Scale; Clinical Global Impression Scale; and Beck Depression and Anxiety Inventories. Results The lifetime prevalence of BDD was 12.1%. The individuals with comorbid BDD (OCD-BDD; n = 109) were younger than were those without it. In addition, the proportions of single and unemployed patients were greater in the OCD-BDD group. This group of patients also showed higher rates of suicidal behaviors; mood, anxiety, and eating disorders; hypochondriasis; skin picking; Tourette syndrome; and symptoms of the sexual/religious, aggressive, and miscellaneous dimensions. Furthermore, OCD-BDD patients had an earlier onset of OC symptoms; greater severity of OCD, depression, and anxiety symptoms; and poorer insight. After logistic regression, the following features were associated with OCD-BDD: current age; age at OCD onset; severity of the miscellaneous DY-BOCS dimension; severity of depressive symptoms; and comorbid social phobia, dysthymia, anorexia nervosa, bulimia nervosa, and skin picking. Conclusions Because OCD patients might not inform clinicians about concerns regarding their appearance, it is essential to investigate symptoms of BDD, especially in young patients with early onset and comorbid social anxiety, chronic depression, skin picking, or eating disorders. Depression and Anxiety 29: 966-975, 2012. (C) 2012 Wiley Periodicals, Inc.

Equine poisoning by coffee husk (Coffea arabica L.)

Background: In Brazil, coffee (Coffea arabica) husks are reused in several ways due to their abundance, including as stall bedding. However, field veterinarians have reported that horses become intoxicated after ingesting the coffee husks that are used as bedding. The objective of this study was to evaluate whether coffee husk consumption causes intoxication in horses.Results: Six horses fed coast cross hay ad libitum were given access to coffee husks and excitability, restlessness, involuntary muscle tremors, chewing movements and constant tremors of the lips and tongue, excessive sweating and increased respiration and heart rates were the most evident clinical signs. Caffeine levels were measured in the plasma and urine of these horses on two occasions: immediately before the coffee husks were made available to the animals (T0) and at the time of the clinical presentation of intoxication, 56 h after the animals started to consume the husks (T56). The concentrations of caffeine in the plasma (p < 0.001) and urine (p < 0.001) of these animals were significantly greater at T56 than at T0.Conclusions: It was concluded that consumption of coffee husks was toxic to horses due to the high levels of caffeine present in their composition. Therefore, coffee husks pose a risk when used as bedding or as feed for horses.

Sequencing and expression analysis of hepcidin mRNA in donkey (Equus asinus) liver

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A nonsense mutation in the tyrosinase gene causes albinism in water buffalo

Background: Oculocutaneous albinism (OCA) is an autosomal recessive hereditary pigmentation disorder affecting humans and several other animal species. Oculocutaneous albinism was studied in a herd of Murrah buffalo to determine the clinical presentation and genetic basis of albinism in this species.Results: Clinical examinations and pedigree analysis were performed in an affected herd, and wild-type and OCA tyrosinase mRNA sequences were obtained. The main clinical findings were photophobia and a lack of pigmentation of the hair, skin, horns, hooves, mucosa, and iris. The results of segregation analysis suggest that this disease is acquired through recessive inheritance. In the OCA buffalo, a single-base substitution was detected at nucleotide 1,431 (G to A), which leads to the conversion of tryptophan into a stop codon at residue 477.Conclusion: This premature stop codon produces an inactive protein, which is responsible for the OCA buffalo phenotype. These findings will be useful for future studies of albinism in buffalo and as a possible model to study diseases caused by a premature stop codon.

Direct and transdentinal antibacterial activity of chlorhexidine

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Ultra-structure and histochemistry of digestive cells of Podisus nigrispinus (Hemiptera: Pentatomidae) fed with prey reared on bt-cotton

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The upgraded DO detector

The DO experiment enjoyed a very successful data-collection run at the Fermilab Tevatron collider between 1992 and 1996. Since then, the detector has been upgraded to take advantage of improvements to the Tevatron and to enhance its physics capabilities. We describe the new elements of the detector, including the silicon microstrip tracker, central fiber tracker, solenoidal magnet, preshower detectors, forward muon detector, and forward proton detector. The uranium/liquid -argon calorimeters and central muon detector, remaining from Run 1, are discussed briefly. We also present the associated electronics, triggering, and data acquisition systems, along with the design and implementation of software specific to DO. (c) 2006 Elsevier B.V. All rights reserved.

Combination of Tevatron Searches for the Standard Model Higgs Boson in the W+W- Decay Mode

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Combined Tevatron upper limit on gg -> H -> W+W- and constraints on the Higgs boson mass in fourth-generation fermion models

We combine results from searches by the CDF and D0 collaborations for a standard model Higgs boson (H) in the process gg -> H -> W+W- in p (p) over bar collisions at the Fermilab Tevatron Collider at root s = 1.96 TeV. With 4.8 fb(-1) of integrated luminosity analyzed at CDF and 5.4 fb(-1) at D0, the 95% confidence level upper limit on sigma(gg -> H) x B(H -> W+W-) is 1.75 pb at m(H) = 120 GeV, 0.38 pb at m(H) = 165 GeV, and 0.83 pb at m(H) = 200 GeV. Assuming the presence of a fourth sequential generation of fermions with large masses, we exclude at the 95% confidence level a standard-model-like Higgs boson with a mass between 131 and 204 GeV.