Construção e evidências de validação de instrumentos de pesquisa para avaliação da assistência nos centros de atenção psicossocial

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

O atendimento do enfermeiro aos acidentados de trânsito terrestre

Considered the disease of the 20th century, the trauma is still the main cause of mortality in the age group of one to forty-four years old in World, and among several possible etiologies, the terrestrial transit accident has a strong impact on these statistics. The operational essentiality of nurses in the organization and integration of this scenario of care to the terrestrial transit casualties and the recognition that the moments after the trauma are decisive in the victim's prognosis, justify this study. Thus, it was sought to evaluate the nurses´care to casualties of land transit in this crucial process in a public hospital in urgent and emergency reference. This is an normative evaluative study with qualitative approach, carried out at the Hospital Monsenhor Walfredo Gurgel, located in the municipality of Natal/RN. Data collection occurred in May 2014, with approval of the Ethics Committee in Research (CAAE 27971114.9.0000.5537). The target population of the study were the nurses who work in Politrauma area of the hospital, following the inclusion criteria: agree to be part of the study voluntarily and act in the mentioned area and, as exclusion: allocated professionals in other areas (eventually acting in the area) and professionals on vacation and/or medical license. A semi-structured interview and non-participant observation was held to obtain data submitted subsequently to the technique of Content Analysis based on Bardin. The lack of specific training for trauma care was identified, whose severity can be mitigated with proper and skilled care. Therefore, the urgent need of the nurses' training for qualification of care to the victims of traffic accidents on land was evidenced

Características dos programas de residência médica em cardiologia do estado do Rio Grande do Norte

The present study had as goal to evaluate Rio Grande do Norte state’s medical residency programs (MRP) in Cardiology. It’s a descriptive study, including a documental analysis of the program’s accreditation processes (PAP) of cardiology’s medical residency in Rio Grande do Norte state in 2014 and the analysis of the resident’s perception about his professional education as a specialist in Cardiology. Beside the documental analysis of the PAPs, it was applied a semi-structured questionnaire with closed questions Likert style and open questions to all the current and former residents of the MRPs analyzed. Two MRPs in Cardiology were identified in Rio Grande do Norte state, one hosted in a public institution and the other in a private institution. The documental analysis showed a greater amount of preceptors with a good level of ownership on the public institution in comparison with the private one, as well as a bigger number of publications, participation in congresses and in book’s publications. The private institution presents a better Urgency’s infrastructure, with emergency room and cardiologic ICU. It IS clear that the residents are aware of how a good residency must work, as well as the strengths and fragilities of their own residences. Most of Onofre Lopes Universitary Hospital’s residents point out as a strength the organization, participation and quality of the preceptors, practice activities and scientific debates, great amount of patients and the visits and debates with the preceptors on the sickrooms. As the greatest fragilities, they emphasize the lack of a urgency service of their own and a specialized ICU. In Coração Hospital of Natal (HCor), it is listed as weak points the theoretic scheduling and the few ambulatory practices. As positive aspects, they report the preceptors, the agility on the execution of exams, a good number of serious patients and procedures. In both residences, it is seen a certain difficulty in accepting the important and mandatory items imposed by the rules of the Medical Residences’ National Committee, such as: biostatistics, bioethics, medical ethic, epidemiology and research methodology. Besides that, the residents recognize that both hospitals have a good infrastructure and technological support, especially in imaging methods. The evaluation of PRMCs identifies the strengths of each program and the aspects to be improved in both programs. It also allowed the observation of difficulties in accepting some regulations contained in the CNRM resolution by the resident, such as participation in activities such as biostatistics, epidemiology and research methodology as well as the improvement needs of specific technical training, such as in emergency care. Thus, our results make possible to develop strategies for continued improvement of PRMC in RN state. In addition, it enabled the preparation of the resident’s manual in cardiology, containing even a breakdown of resident evaluation system, which could serve as a model for other residency programs.

Trabalho e saúde: análise da relação entre condições de trabalho e motivação no emprego e suas interfaces com a saúde dos profissionais nos hospitais públicos

Health results from the interaction of biological, social, economic, political and cultural factors. Under this perspective, we aim to analyze the relationship among working in public emergency hospitals and the health-sickness of the professionals who work there. We are based in a quantitative and qualitative research, in which 240 health professionals (doctors, nurses, social workers, psychologists, dentists, nutritionists, audiologists, physiotherapists and occupational therapists) answered a survey. All of them recognize the importance of work to guarantee favorable conditions to good health. However, they highlight its physical and mental wear effects on workers like stress, absence of a healthy life-style, high blood pressure, musculoskeletal, gastrointestinal and sleep disorders. It becomes urgent to face this reality, to enhance professionals' health and, consequently, the quality of user’s assistance, since the illness of health workers is strongly correlated with the existing health model in society.

Transplantes de córneas no estado do Rio Grande do Norte: aspectos epidemiológicos e clínicos

This study aimed to characterize in a clinical and epidemiological way the patients who are on a waiting list for transplantation and the patients transplanted with corneal tissue in a corneal transplants reference service in the state of Rio Grande do Norte. It is an epidemiological study of a quantitative approach, with cross-sectional, descriptive and analytical cut including all patients on the waiting list for transplantation (population A) and the patients already transplanted with a corneal tissue (population B) in a reference service. In population A, there was a census conducted of patients on the waiting list for corneal transplantation (n=62 patients). In population B, the sample was non-probabilistic and corresponded to all corneal transplants performed in the service in the period from 2010 to 2014 (n=258). This study is approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, in Opinion 876 177 and CAAE 37533014.8.0000.5537. Data were collected in full in the period from January to April 2015, by two instruments built to systematize the necessary data collection. After being coded and tabulated, data were analyzed using the Statistical Package for Social Sciences software, version 20.0. The definition of variables and their distribution patterns were presented as frequencies and measures of central tendency while, for multivariate analysis, the effect of magnitude measures were applied (prevalence ratio) and measures of association (chi-square test or Fisher's exact test) for a 0.05 significance level. The results are shown in two scientific articles coming from the field survey data. It was found that the epidemiological profile of patients on the waiting list (n=62) showed a prevalence of individuals aged over 50 years old, female (54.84%) and residents of the middle region of East Rio Grande do Norte (66.13%). The clinical profile of patients with corneal transplantation (n=258) was characterized by being male (51.16%) with an average age of 49.33 years old and 57.75% were coming from East Rio Grande do Norte. The average time on the waiting list was 172.63 days in elective transplants and 9.03 days in urgent transplants. Keratoconus was the main indicator condition to perform the transplant. For patients on the waiting list, the variable “type of disorder of the cornea” showed statistically significant association with gender and age. For patients with corneal transplants, the variable "type of disorder of the cornea" was associated with the variables gender, age, previous surgery, failure of previous graft, classification of the eye and glaucoma. By characterizing the clinical and epidemiological profile of corneal transplants, it is possible to question the reality, pointing about the care that should be offered and develop targeted interventions to collective and individual needs intrinsic to patients who need this surgery as a treatment option.

Saberes e perspectivas dos docentes em torno do currículo de uma escola pública rural do RN

Este trabajo tiene como objetivo analizar los saberes y las perspectivas docentes en torno al currículum de una escuela pública rural de Enseñanza Fundamental del Río Grande do Norte considerando, sobre todo, los debates sobre la Educación en el Campo en Souza (2006, 2007), Arroyo, Caldart y Molina (2004) y Fernandes (2002, 2004). La propuesta surge como alternativa para la elaboración de proposiciones curriculares para mejorar la calidad de la enseñanza en esas escuelas, según las características específicas de la educación escolar en contexto rural, en la expectativa de que esta sea un elemento para el desarrollo local y global de las comunidades rurales. La fundamentación teórica para responder a la investigación, se respalda en las consideraciones sobre los saberes docentes teniendo en cuenta las lecturas de Gauthier (1998), Tardif (2011), Pimenta (2009), Paulo Freire (1996), Nóvoa (2007, 2008) y las referencias sobre el currículum crítico y postcrítico discutidas en Giroux (1997), Silva (1999), Moreira (2008), Moreira y Candau (2003, 2010), Sacristán (2000) e Sacristán e Gómez (1998). La referencia empírica se constituye de una escuela pública de una comunidad rural en el municipio de São José de Mipibu-RN. Los sujetos sociales de la investigación son cuatro profesores(as) que trabajan en los años iniciales de la Enseñanza Fundamental. Se recurrió a la investigación etnográfica fundamentada en los estudios de Lüdke y André (1986), Sandín Estebán (2010) y Gil (2007), una vez que el análisis del cotidiano escolar, bajo el mirar etnográfico, a través de los procedimientos de la observación participante y de la entrevista semiestructurada, permite el contacto directo del investigador con el ambiente en estudio, registra el no documentado, y percibe la institución escolar como espacio cultural, caracterizando varios grados de acomodación, contestación y resistencia inmersos en una pluralidad de lenguajes y objetivos conflictivos. Las observaciones hechas en la clase y las enseñanzas de los profesores y profesoras permiten comprender que los saberes y perspectivas docentes, a partir de las experiencias del profesorado, lanzan expectativas socioprofesionales sobre la docencia e intensifican el papel fundamental del docente en la construcción de los saberes, de las prácticas y concepciones del mundo rural, de la escuela rural y de la función social de esta. Los hallazgos de la investigación con los profesores sobre el contexto rural apuntan para la necesidad en problematizar verdades socialmente construidas, bajo la orientación de una racionalidad que reconozca el espacio rural como productor de la existencia. A partir de los análisis construidos, se pudo reconocer la necesidad de una política de formación conceptual específica para el profesorado de las escuelas rurales, anclada en el concepto históricocultural del rural. También se reitera la urgencia permanente y continuada en revisar los procesos de formación, vividos en la escuela, que contemplen las peculiaridades de la enseñanza rural, en una visión contrahegemónica del urbanocentrismo, a partir de un análisis crítico sobre el marco legal de la Educación del Campo.

Toothache and social and economic conditions among adolescents in Northeastern Brazil

O objetivo deste estudo foi relacionar dor de dente com condição socioeconômica, acesso aos serviços de saúde bucal e estilo de vida em adolescentes do município de Sobral, Ceará, desenvolvido com delineamento transversal analítico, com amostra composta por 688 indivíduos. A prevalência de dor de dente no grupo pesquisado foi de 31,8%. Para avaliar a relação entre as variáveis independentes e a dor de dente, realizou-se teste de associação pelo qui-quadrado, estimando-se a razão de prevalências por meio da regressão de Poisson. Os fatores que mais demonstraram relação com a dor de dente foram severidade da cárie, motivo do atendimento odontológico relacionado com urgência, frequência ao dentista e recebimento de escova na escola. Observou-se que a alta prevalência de dor de dente em adolescentes está diretamente relacionada às condições de acesso, assim como às características das ações desenvolvidas pelos serviços de saúde. Assim como há necessidade da implantação de serviços vinculados à promoção de saúde, pautados pela equidade e integralidade, é necessária a implantação de serviços de urgência que não simplesmente intervenham na dor de forma mutiladora, mas a encarem como mecanismo de estímulo ao desenvolvimento de procedimentos de prevenção das doenças bucais.

Estudo da Acessibilidade Organizacional aos Serviços de Saúde Bucal de um Município de Pequeno Porte do Nordeste Brasileiro

Objective: This study aimed to evaluate the accessibility to oral health services in Santa Cruz (RN), focusing on the organizational aspect which is characterized by variables like delay in getting consultation, waiting lines, difficulty scheduling appointments, lack of material, among others. Material and Methods: For such purpose, questionnaires were addressed to 194 users’ houses based on census tract. Results: It has been found that 12.9% of the population has never gone to the dentist’s office, and that the service demand has not been affected by users’ individual and socioeconomic characteristics, except for gender. Data have revealed that 36.1% of users went to the dentist’s in less than a year. In addition, the youngest users are among those who seek the dentist’s office more frequently (p<0.05). 63.3% of the interviewees have reported they find some kind of difficulty when seek for dental care, and 43.2% of users have waited three weeks or more for assistance. It is also noteworthy that 7.4% of the interviewees have been finding difficulties in getting access to urgency care, and that long wait for the consultation is the most frequently cited matter. Conclusion: It could be verified that accessibility to oral health services in the municipality of Santa Cruz (RN) has been hampered by factors related to public policies organization, especially with regards to the work process.

Estudo da Acessibilidade Organizacional aos Serviços de Saúde Bucal de um Município de Pequeno Porte do Nordeste Brasileiro

Objective: This study aimed to evaluate the accessibility to oral health services in Santa Cruz (RN), focusing on the organizational aspect which is characterized by variables like delay in getting consultation, waiting lines, difficulty scheduling appointments, lack of material, among others. Material and Methods: For such purpose, questionnaires were addressed to 194 users’ houses based on census tract. Results: It has been found that 12.9% of the population has never gone to the dentist’s office, and that the service demand has not been affected by users’ individual and socioeconomic characteristics, except for gender. Data have revealed that 36.1% of users went to the dentist’s in less than a year. In addition, the youngest users are among those who seek the dentist’s office more frequently (p<0.05). 63.3% of the interviewees have reported they find some kind of difficulty when seek for dental care, and 43.2% of users have waited three weeks or more for assistance. It is also noteworthy that 7.4% of the interviewees have been finding difficulties in getting access to urgency care, and that long wait for the consultation is the most frequently cited matter. Conclusion: It could be verified that accessibility to oral health services in the municipality of Santa Cruz (RN) has been hampered by factors related to public policies organization, especially with regards to the work process.

Estratégia de capacitação pedagógica do residente: uma perspectiva para melhoria do ensino na Universidade Federal do Rio Grande do Norte

Studies have shown that resident informally plays the role of teacher. It is estimated that up to 25% of the residents of the time is devoted to teaching, mainly contributing as a facilitator, however, almost the entire medical residency programs in Brazil did not offer teacher training during residency education. This paper aims to introduce educational content initiation to teaching as part of the training of resident physician inserted in residency program of the University Hospital Onofre Lopes (HUOL). It is an exploratory, descriptive and prospective study in HUOL the Federal University of Rio Grande do Norte. Three steps were developed: preparation and planning of a pedagogic course, associated with a motivating technical content (basic and advanced life support); second stage, testing of pedagogical model for medical students; and finally, replication to residents. The interventions were made two practice stations life support with performance evaluation in practical activity through OSPE (Objective Structured Practical Examination). The techniques presented teachings were one-minute preceptor and feedback. Data collection was conducted through a structured evaluation form during the life support stations and at the end of the course, and analyzed using descriptive statistics. The results showed that the feedback and one minute preceptor were considered important for teaching and learning for more than 85% of participants. The feedback from evaluators practices stations added information about the performance and were held appreciatively way, according to 100% of the participants. Positive aspects highlighted by the participants were related to educational content, especially the participants of the first intervention. The time of the lectures of motivating technical content was the most repeated negative. Based on the good acceptance of pedagogical contents, this pioneer teacher training strategy was included in the formal residency program in Cardiology of our institution. It is considered therefore that the educational training model with motivating technical content was feasible and had a good evaluation and acceptance by most participants in both interventions. Thus, we believe that the educational content can be inserted in the formal curriculum of medical residency of other programs at HUOL through the training model developed in this study.

Estratégia de capacitação pedagógica do residente: uma perspectiva para melhoria do ensino na Universidade Federal do Rio Grande do Norte

Studies have shown that resident informally plays the role of teacher. It is estimated that up to 25% of the residents of the time is devoted to teaching, mainly contributing as a facilitator, however, almost the entire medical residency programs in Brazil did not offer teacher training during residency education. This paper aims to introduce educational content initiation to teaching as part of the training of resident physician inserted in residency program of the University Hospital Onofre Lopes (HUOL). It is an exploratory, descriptive and prospective study in HUOL the Federal University of Rio Grande do Norte. Three steps were developed: preparation and planning of a pedagogic course, associated with a motivating technical content (basic and advanced life support); second stage, testing of pedagogical model for medical students; and finally, replication to residents. The interventions were made two practice stations life support with performance evaluation in practical activity through OSPE (Objective Structured Practical Examination). The techniques presented teachings were one-minute preceptor and feedback. Data collection was conducted through a structured evaluation form during the life support stations and at the end of the course, and analyzed using descriptive statistics. The results showed that the feedback and one minute preceptor were considered important for teaching and learning for more than 85% of participants. The feedback from evaluators practices stations added information about the performance and were held appreciatively way, according to 100% of the participants. Positive aspects highlighted by the participants were related to educational content, especially the participants of the first intervention. The time of the lectures of motivating technical content was the most repeated negative. Based on the good acceptance of pedagogical contents, this pioneer teacher training strategy was included in the formal residency program in Cardiology of our institution. It is considered therefore that the educational training model with motivating technical content was feasible and had a good evaluation and acceptance by most participants in both interventions. Thus, we believe that the educational content can be inserted in the formal curriculum of medical residency of other programs at HUOL through the training model developed in this study.

Função compras no setor público: fatores preponderantes para o alcance da celeridade dos pregões eletrônicos da Base Aérea de Natal

This study discusses the issue of deadlines in the purchasing process within the Federal Public Administration. Your main goal is to analyze the main factors that influenced, mainly in the implementation of sub-phases of electronic trading in BANT, in 2014, as service to the principle of celerity. The research is descriptive since they were identified and analyzed the factors that influenced in terms of purchases, through direct observation and interviews. Based on the theoretical framework, the purchasing function, four dimensions of analysis were established: "Legislation and procurement processes", "Structure and Organization of the purchasing department", "purchasing systems" and "Human Resources of the purchasing department." Analysis showed that, unlike what happens in the private sector, the public procurement sector has not reached a strategic status within organizations, which brings harmful consequences to the speed of the purchases. It was found that there is a need for greater involvement of the purchasing department staff and criers in the formulation of the organization's purchasing strategies and that these purchases elements present, about their attitudes, a hybrid profile, proactive regarding specifications of the items, but reactive in relation to the need to urgently purchase, due to the lack of a better plan, which overloads the work of the sector. The observation of these strategic aspects of the procurement function in BANT influenced the finding that the lack of staff and expertise in investments plus the lack of rigor and formality of legislation, among other factors, contributed mainly to the lack of speed of processes.

Construção de um classificador automático de severidade de bugs para sistemas open source

Software bug analysis is one of the most important activities in Software Quality. The rapid and correct implementation of the necessary repair influence both developers, who must leave the fully functioning software, and users, who need to perform their daily tasks. In this context, if there is an incorrect classification of bugs, there may be unwanted situations. One of the main factors to be assigned bugs in the act of its initial report is severity, which lives up to the urgency of correcting that problem. In this scenario, we identified in datasets with data extracted from five open source systems (Apache, Eclipse, Kernel, Mozilla and Open Office), that there is an irregular distribution of bugs with respect to existing severities, which is an early sign of misclassification. In the dataset analyzed, exists a rate of about 85% bugs being ranked with normal severity. Therefore, this classification rate can have a negative influence on software development context, where the misclassified bug can be allocated to a developer with little experience to solve it and thus the correction of the same may take longer, or even generate a incorrect implementation. Several studies in the literature have disregarded the normal bugs, working only with the portion of bugs considered severe or not severe initially. This work aimed to investigate this portion of the data, with the purpose of identifying whether the normal severity reflects the real impact and urgency, to investigate if there are bugs (initially classified as normal) that could be classified with other severity, and to assess if there are impacts for developers in this context. For this, an automatic classifier was developed, which was based on three algorithms (Näive Bayes, Max Ent and Winnow) to assess if normal severity is correct for the bugs categorized initially with this severity. The algorithms presented accuracy of about 80%, and showed that between 21% and 36% of the bugs should have been classified differently (depending on the algorithm), which represents somewhere between 70,000 and 130,000 bugs of the dataset.

Múltiplos fluxos ópticos e o processamento atentivo da informação visual

The environment in which we live in, we constantly deal with a huge amount of dynamic information, thus, attention is an indispensable cognitive resource that allows an effective selection of stimuli for our survival. From this, investigating how we process our encouragement in movements and how the attention spreads into a space to serve more than one stimuli simultanously is something very important. The behavioural urgence hipothesis suggests that the encouragement in a movement of approaching shows a certain priority in the process related to objects which are in a movement away, but there are researches that point out that it might not happen in an attentive phase, but instead as a priorization of motor response. There are also many controversies found in researches about attentive focalization, in which some studies suggest that the focus of attention would work in a similar manner to a zoom lens, while some searches indicate that the focus of attention could be shared to answer some stimuli in non contiguous regions. This study tried to investigate through two experiments the effect of attentive priorization by encouragement in movements and how the attention is spread with distractors stimuli. The first experiment investigated if the amount of moving flows really influenced in the process of information. The results indicate an effect of priorization of the flows guided in relation to aleatory ones and also from the unique flow due to dual flow. The second experiment investigated how the distribution of attention is in a space with the use of flows as an exogenous cue. The results indicate that the focus of attention works as the one suggested in the zoom lens model.

As escolas polivalentes do Triângulo Mineiro e Alto Paranaíba (MG): sondagem vocacional no projeto desenvolvimentista civil-militar (1965–1976)

This study has as object eight state vocational schools located in Araguari, Araxá, Frutal, Ituiutaba, Monte Carmelo, Patos de Minas, Uberaba and Uberlândia, in Minas Gerais. The period analyzed comprises the years from 1965 to 1976, from the signature of the Agreement 512-11-610-042 beteween the Ministry of Education and Culture (MEC) and the American Agency for International Development (USAID), which started a series of other agreements, and actions ending up with the creation of the Expansion and Improvement of High Schools Program (Programa de Expansão e Melhoria do Ensino Médio - PREMEM) and, from this, the Vocational Schools. The upper limit of the study, 1976, was the year when these agreements, known as MEC/USAID agreements ceased. The Vocational Schools were characterized as vocation probing schools, directing the professional formation of the population in general, which would happen a posteriori, turning it shorter and more effective, since the labor market would demand, urgently, capable professionals for an expanding economy. The project of Vocational Schools had a national scope, and foresaw, for its unfolding, the complete substitution of State Schools for the new model, called “multi-curricula”. The theme Vocational schools was the object of my Master’s degree study, when I focused the State School Guiomar de Freitas Costa, in Uberlândia. That study raised questionings and concerns that resulted in the central problem of the thesis presented here: understanding the measure in which such schools integrated the country’s development project – mostly in the first half of the military rule – and to understand its structure, functionality and efficacyThe development of the study presented here, demanded the use of several sources: 1) specialized literature about the topics presented, i.e., the situation of national education in a temporal analysis, the political, economical and social context, research methodologies, the theory of human capital, vocational teaching, pedagogical trends and practices, agreements MEC-USAID and PREMEM; 2) national, state and county laws related to the discussion: laws of national education directives and basis, decrees and reports stating about the program of technical cooperation between Brazil and the United States of America, the Program of Expansion and Improvement of Teaching (PREMEM), formation of professors, establishment of Vocational Schools and educational planning; 3) documentation of school archives: books of minutes of Collegiate and of faculty and staff, registrar books with final scores, enrolment, visits of inspector, accounting books, punch clock records, student, professor and staff occurrences, inventory, class schedules, school year calendar, school rules, class reports, payment rolls, bills of sales, exchanged mail, personal documentation of professional personnel, documents of land acquisition, blueprints, manuals of PREMEM, didactic materials/resources used in classes, books available in the school library, structured evaluations for follow-up of school processes, pictures of events, texts prepared for special dates, and news from the official newspaper and, finally, 4) national and local press reports, especially from Folha de São Paulo, Correio de Araxá, Correio de Uberlândia and Lavoura e Comércio (Uberaba). The proposition of Vocational schools was conciliate theoretical and practical formation through an active education permeated by technological resources. The contact with knowledge and several practical activities under professional supervision, the student would identify the knowledge area that would interest him the most and his aptitude. This formation in primary school would make way for the vocation studies in high school, which became mandatory by the law 5.692/71, that reformed school education from the previous levels of elementary, middle high and high school. However, the multi-curricula proposal that would be spread to the other public schools in the country ended up succumbing to the model already established. From its ephemeral existence, maybe the Vocational Schools have not reached the more general goals in political, economic and social aspects; however, this study demonstrated that, for the people that, directly or indirectly, had contact with such schools, a legacy of vocational and quality teaching was made, so much so, that forty years after the end of that proposal, they are still remembered.