Qualidade da assistência e o conhecimento sobre o direito à saúde das pessoas com úlcera venosa crônica

The study aimed to identify the quality of care and knowledge of health rights of people with chronic venous ulcers (VU) in Brasilian National Health Care System (SUS). It is a cross-sectional study, with quantitative approach, performed at the University Hospital Onofre Lopes (HUOL). The study was approved by the Ethics Committee of HUOL (CAAE nº 0148.0.051.000-10). The sample by accessibility was composed for 30 people with VU treated at the outpatient surgical clinic of HUOL. For data collection we used a structured questionnaire composed of two parts: sociodemographic characteristics and of health, of care and the clinical course of VU; and knowledge of people with VU about the rights of health. The results were processed using SPSS 15.0 and analyzed by descriptive statistics. Given the characterizations sociodemographic and health presented, we identified a clientele of users with VU predominantly female (76,7%), aged from 60 years (66,7%), married/ stable union (60,0%), low education level (83,3%), family income lower than a minimum wage (73,3%), unemployeds and with chronic diseases (53,3%), sleep greater than or equal to 6 hours (76,7%) and were not alcoholics or smokers (93,3%). In relation to clinical conditions, were shown the presence of one or more relapses of VU (73,3%), predominance of granulation tissue/epithelialization in the bed of VU (60,0%), exudate serosanguineous (43,3%), in quantity medium/large (60,0%), with no predominance of presence or absence of odor (50,0%), all patients with tissue loss in grade III / IV, no signs of infection (73,3%) and presence of intense pain (50,0%). In the last 30 days the main venue of achievement of dressing was the HUOL (100,0%), the main compression therapy used was the Unna boot (60,0%) and on inability to perform the dressing on the unit were the own patients who made the exchange at home (40,0%). The majority of respondents listed out more positive factors associated with quality of care (56,7%) were satisfied with the care of SUS (76,7%), claimed to have knowledge about their rights (70,0%), but at the same time did not know the meaning of the acronym SUS (90,0%) and classified their level of information as inappropriate (70,0%). We realize that people with VU identified as good the quality of care and demonstrated inadequate knowledge about their rights to health in the SUS, but showed interest in acquiring more information. The basic rights to entry in the SUS are constitutionally guaranteed and need to be disseminated in order to make them known to the population, so it can be implemented and ensured a greater resolution assistance in treating this type of injury

Estudo numérico de escoamento turbulento em padrão anular gás-líquido em dutos verticais

Multiphase flows in ducts can adopt several morphologies depending on the mass fluxes and the fluids properties. Annular flow is one of the most frequently encountered flow patterns in industrial applications. For gas liquid systems, it consists of a liquid film flowing adjacent to the wall and a gas core flowing in the center of the duct. This work presents a numerical study of this flow pattern in gas liquid systems in vertical ducts. For this, a solution algorithm was developed and implemented in FORTRAN 90 to numerically solve the governing transport equations. The mass and momentum conservation equations are solved simultaneously from the wall to the center of the duct, using the Finite Volumes Technique. Momentum conservation in the gas liquid interface is enforced using an equivalent effective viscosity, which also allows for the solution of both velocity fields in a single system of equations. In this way, the velocity distributions across the gas core and the liquid film are obtained iteratively, together with the global pressure gradient and the liquid film thickness. Convergence criteria are based upon satisfaction of mass balance within the liquid film and the gas core. For system closure, two different approaches are presented for the calculation of the radial turbulent viscosity distribution within the liquid film and the gas core. The first one combines a k- Ɛ one-equation model and a low Reynolds k-Ɛ model. The second one uses a low Reynolds k- Ɛ model to compute the eddy viscosity profile from the center of the duct right to the wall. Appropriate interfacial values for k e Ɛ are proposed, based on concepts and ideas previously used, with success, in stratified gas liquid flow. The proposed approaches are compared with an algebraic model found in the literature, specifically devised for annular gas liquid flow, using available experimental results. This also serves as a validation of the solution algorithm

A convivência familiar e comunitária é direito da criança e do adolescente e uma realidade a ser repensada pela escola

O tema sobre a convivência familiar e comunitária como um direito de crianças e adolescentes, à primeira vista, se mostra bastante abstrato e ocupando ao mesmo tempo um lugar-comum. A sociedade aceita facilmente o fato de que toda criança tem direito a nascer e crescer em um lar saudável, protegido e seguro. Entretanto, muitas são as crianças que enfrentam situações de extrema vulnerabilidade pessoal e social, tendo que se afastar de suas famílias de origem para viver em situação de abrigamento, como medida protetiva. Este artigo tem como objetivo principal, a partir do que está preconizado no Plano Nacional de Promoção, Proteção e Defesa do Direito de Crianças e Adolescentes à Convivência Familiar e Comunitária e em leis anteriores (Constituição Federal Brasileira de 1988 e na Lei n. 8069/90 - Estatuto da Criança e do Adolescente), apresentar uma análise sobre os desafios e transformações que serão imprescindíveis para que esse direito seja efetivado, abordando os principais aspectos que envolvem as responsabilidades das políticas sociais brasileiras, com ênfase na educação pública.

A intervenção do poder judiciário no acesso a medicamentos no Rio Grande do Norte: uma análise sob a ótica das políticas nacionais de medicamento e de assistência farmacêutica

The present study aimed to evaluate the inclusion of the principles of the National Medicines Policy - PNM and the Pharmaceutical assistance - PNAF in the prosecution of lawsuits involving medicines. To fulfill this necessity , data collection was performed on the website by the Tribunal Rio Grande do Norte - TJ RN ( Rio Grande do Norte Court) , in 2012 . It was obtained 115 judgments, which were analyzed in order to generate Monitoring Indicators from lawsuits and conduct content analysis proposed by Bardin (2006). The results showed that : a) 100 % of the decisions were favorable to the author , b) 76 % of decisions were requests by the trade name of the drug , c) only one drug (eculizumabe) had not granted by ANVISA , d) 36 % of drugs were present in the list of standard medicines in SUS , 16 % of primary care block and 20 % of specialized component , e) 76 % of the decisions presented the request of at least 01 non-standard medicine. With regard to decentralization of PNM and PNAF we observed a commitment to this principle at judicial decisions, to see that municipalities and states are often forced to buy medicines of responsibility from another federal entity or other tertiary units as CACONs and UNACONS. The content analysis revealed that the argument from the judges used when you utter their decisions was that the right to health is recognized by Brazilian law as a fundamental right and should be guaranteed by the State for all its citizens. So, health is more than budgetary constraints of federal entities, which are severally liable for lawsuits , regardless the medication requested belongs or not to a particular block of a pharmaceutical assistance funding. Given these data, it is observed that there are gaps in the judgment when it comes to the insertion of the words and principles of PNM and PNAF, creating then the need for greater dialogue between the executive and judicial, so that they may consider relevant the effectiveness and application of such principles to minimize the negative consequences of the phenomenon of health judicialisation. Keywords: Judicialisation, Medicines, Public Policy, Pharmaceutical Care

As estruturas sociais e econômicas do Império Romano do Ocidente e o estabelecimento do reino dos visigodos nas Galliae Aquitania e Narbonensis

In the year 376 of the Common Era, a tribe of Germanic warriors known as Tervingi , of Gothic extraction, crossed the Hister (Danube) river due south, entering the Roman Empire. They fled the Huns, a nomadic group that came plundering their way from the East. It did not take long for a conflict between the Roman imperial authorities and the refugees to begin. Peace was reached in 382 and, henceforth, the Tervingi would be officially foederati (allies) of the Romans, gaining the right to remain an autonomous tribe inside the borders of the Empire. For the next thirteen years the Tervingi warriors fought beside the Roman imperial armies in every major conflict. Nevertheless, after the death of the emperor Theodosius I in 395, their relations deteriorated severely. In theory, the Tervingi remained Roman allies; in practice, they begun to extort monies and other assets from the emperors Honorius and Arcadius. The sack of Rome by the Tervingi king Alaric in 410 was both the culmination and the point of inflection of this state of affairs. During the 410s the Tervingi warriors would fought again beside the Roman Imperial armies and be rewarded with a piece of land in the southwestern portion of the Gallic diocese. Dubbed Visigoths , they would remain trusted Roman allies throughout the next decades, consolidating their own kingdom in the process. This dissertation deals not only with the institution of the Visigothic kingdom in the southwestern portion of the Galliae but also with the social and economic conditions that hindered the Roman ability to defend their territory by themselves, hence opening opportunities for foederati like the Tervingi to carve out a piece of it for themselves.

A manifestação da vontade da criança na disputa judicial da guarda: escuta psicanalítica/

Currently, in custody disputes, the child has the right to be heard and to have its opinion considered, according to its age and maturity. The psychologist/psychoanalyst who works in the Family Court is required to produce a Report with the purpose of helping the Court´s decision. The present research aims to discuss and to find guiding principles for the hearing of the declaration of the child´s will in a custody dispute by its parents, from a psychoanalytical perspective. The case of a nine year old girl that affirmed in Court the desire of living with the mother and seeing the father only once a year is the starting point of this theoretical research over the psychoanalytic fundaments of the hearing of the case, how it appeared in that experience and how it was reflected in the report. Throughout this work, the peculiarities of psychoanalysis as a way of understanding the subject and the conditions that must be observed so that a sctrictu sensu analytic hearing is possible are studied. Then we present a reflection of the case, in the light of the theories studied, verifying that we could observe in the experience: i) the assumption of a subject of the unconscious, divided and desire full that constitutes itself from the oedipic structuration, that leads to the difference between speech and speak; ii) the concept of the child as having a sexuality of its own; iii) a hearing based on the ethic principles of psychoanalysis and the analysts'' formation. In the final considerations, we state that the institutional demand of a meaning for the case is a great difficulty for the analyst since he works from a place of 'not-knowing"

Compreendendo como as crianças significam o direito de brincar

This research aimed to understand how children mean the right to play. For that, assumes that the children composed a social category generational, with children experiencing their own skills, the result of the mediated relationship with the social and its transformative capacity. Adding to that, they are subject of duties with competence to means your own condition. After a long history of repression and an intense political struggle, the Doctrine of Integral Protection is inaugurated in Brazil and the Citizen (1889), which regulates the fundamental rights of all children and adolescents. Among these rights is the right to play. However, it is sufficient to provide by law, it is necessary to break with the diminishment of the play activity, still present in our society, watching it as a structuring activity of the subject and ensuring the enforcement of this right. Considering the child as the central focus of research, the research was conducted in a public school education. The subjects were six children of six years old, enrolled in 1st year of elementary school. The procedures employed for constituting the corpus of the research were: observation of children at school meetings and dialogue, monitoring of play resources such as drawings, cartoons and representative images of child rights. Also, the parents were interviewed with the goal to enlarge the understanding the context of the child. With the thematic content analysis, we raise two areas: play and children's rights. The results showed that children, however don‟t have a systematized knowledge about child rights , they understand that any elements are important for the children and your development, being the play the most recurrent, followed by education and family. The right to play configure as a necessity of the child, that even if she does not understand conceptually as a right, she feels the importance of living of the play activity

O aborto provocado como uma possibilidade na existência da mulher: reflexões fenomenológico-existenciais

Abortion is a very controversial and stigmatized subject, target of many criticism and discussions, mainly regarding to the legal, bioethical and religious aspects involved. In Brazil, abortion is considered a serious public health problem, being the major cause of maternal death due to its criminalization. The woman who causes an abortion is not up looked by society, since motherhood, culturally and historically, was imposed as a destination. Our main goal is to understand, from the existential-phenomenological perspective, the unique experience of the woman who induced the abortion This study is an offshoot of a larger study from USP in partnership with UFRN. Our participants were women who checked in on a maternity hospital in Natal with a miscarriage diagnosis and, among them, those who reported having induced abortion. Altogether, five women were interviewed. The used method was a phenomenological hermeneutics. The research revealed that the experience of abortion is a possibility that permeates women s life, being understood as a choice. This choice pervaded by much suffering, once it goes against everything that women are culturally taught and meant to be. The feeling more surfacing in this experiment, confirming the literature review, was blame. Abortion was also shown as an experience of helplessness and loneliness, due to lack of support from family and the partner. It was also revealed that abortion was made, mainly, by the desire of going along with future projects, including the prosecute of motherhood in the therms of what they consider ideal to a son s arrival, meaning, a family formation grounded on a stable relationship. Regarding the care provided by health professionals to these women, there is the need of restructuring the operating logic of SUS, so that women have the right to health in a integrate manner. This experience also made women reconsider the meanings they had towards abortion, and their life projects

Movimentos sociais e organização popular em Natal-RN: enquanto morar for privilégio...

To the extent that the expansion of cities is increasingly pushing and segregating the working class to outlying areas, devoid of services and infrastructure, the urban space is also important as a space in the class struggle, and in this direction, the this study aims to analyze the political organization of urban social movements and popular organizations existing in Natal-RN, nowadays, in their process of struggle for social rights, with emphasis on the right to the city. With this dimension, we appropriate the contributions of historical and dialectical materialism because we believe that this benchmark enables the understanding of the processes of collective organization and a critical perspective of totality, going beyond its immediate appearance. For production data conducted literature, documentary and field, through semi-structured interviews recorded with (the) mapped leaders of organizations in our survey, as well as advisory bodies to the movements studied. The results of the study allowed us to characterize the action of the political movements in urban Christmas struggle for recognition and guarantee of the right to the city and seize the advances and obstacles in the process of intervention of social movements and popular organizations existing in Natal, highlighting dilemmas and contradictions underlie the processes of organization and mobilization in the contemporary period. Thus, we conclude that the Natal territory, as in contemporary Brazil, the urban and political action movements that show the public scene and intertwine necessarily relate to historical trend that has been performing since the 1990s, when the country entered a period marked by a new bourgeois offensive

The Rechtslehre doctrine and Kant's philosophy of history

The text is divided in two phases. In the first phase, consisting of three parts, the main concepts of Kant's Doctrine of Right are considered in a comprehensive approach related to: the issue of the relations between natural right and positive right, problem closely connected to that of the relations between natural state and civil state, private right and public right; to the doctrine of property and its connection with political right. on treating the right in its several types, we intend to appoint the practical reasoning as a background of the Doctrine. In the second phase, concerning its last section, the consideration on the presence of the practical reasoning into the right is placed before some specificities of Kant's phylosophy of history, with the intent of establishing the possible relation between Rechtslehre and that philosophy.

Protozoários de vida livre em ambientes aquáticos do RN: ocorrência, caracterização e importância para a educação básica

Water is considered an essential right to life, besides being a determinant of economic development and social welfare, represented by both the quantity available, and the quality. In semi-arid Northeast, droughts occurring on a regular basis combined with human activities, aggravate the situation regarding the conservation of water resources in this area. To alleviate this condition is common to construction of artificial reservoirs, such as reservoirs and dams. As in natural aquatic environments, these reservoirs are potential sites for the proliferation, growth and development of diverse biological communities, whether of animals, plants and microorganisms. Research on the composition and ecology of these communities, especially microbial, are still restricted. One of the least studied groups in these environments are free-living protozoa, which over time have been neglected and after discoveries about its various functions in the aquatic ecosystem are beginning to receive more attention from scholars. They are, in quantitative terms, the most important consumers of microorganisms (mainly bacteria and algae) in aquatic environments, and therefore control the abundance of these. They may therefore influence the structure of the aquatic food chain in terms of species composition, abundance, biomass and biodiversity. Despite the recognition of the importance of protozoa in the final of the trophic transfer in aquatic environments, there are few data and, in general, are still precarious knowledge of them. Given the importance of protozoa in aquatic environments and the paucity of research on this group, especially in the state of Rio Grande do Norte, the present study aimed at identifying the genus and species of free-living protozoa that are present in the Armando Ribeiro Gonçalves Dam as well as to relate the occurrence and dynamics of the trophic conditions in the environment in which they are inserted, in order to support the hypothesis that species that are in these environments can serve to indicate the water quality. We observed the presence of 65 taxa of free-living protozoa, of which 29 were identified at the species level. There was a similarity space in taxonomic composition of protozoa, suggesting a possible regulation of this type of community for limnological variables other than those studied in this work (chlorophyll a, pH, temperature). Although it was aimed to analyze the conceptions of teachers and students from nearby towns Dam Armando Ribeiro Gonçalves, on issues relating to water quality and the role of protozoa. For this, we applied questionnaires with teachers and pupils of public schools of San Rafael and Itajá. It was concluded that teachers and students recognize the multi-dam Armando Ribeiro Gonçalves, although unaware of important aspects of the dynamics and ecology of this environment. Conceptions of teachers and students are matched at various times, especially with regard to waterborne diseases. In an attempt to identify possible misconceptions about the knowledge of the protozoa, assuming that these organisms have neglected their ecological role, and are seen as only, disease, a study was done with teachers and students, following a particular methodology that allowed look so clear and precise results. It was clear that knowledge about the free-living protozoa is still quite limited. The alternative conceptions that were found show a direct relation of protozoans and diseases. From the data obtained by these studies, we planned a series of science communication activities, environmental education and health education in schools close to study environments in order to promote a didactic transposition of accumulated knowledge about these organisms, favoring continuing education of teachers and the increase of information to the local community through the knowledge of biodiversity and ecology of these organisms. Moreover, the results found in this study and reflections on it that led to propose the elaboration of a book Readers with an emphasis on the group of freeliving protozoa in the populations for use in public schools in the region where it was developed the semiarid work

Effects of temperature on lung and blood gases in the South American rattlesnake Crotalus durissus terrificus

The effects of temperature on lung and blood gases were measured in the South American rattlesnake (Crotalus durissus terrificus). Arterial blood and lung gas samples were obtained from chronically cannulated animals at 15, 25, and 35 degrees C. As expected for reptiles, arterial pH fell with increased temperature (0.018 U degrees C-1 between 15 and 25 degrees C and 0.011 U degrees C-1 between 25 and 35 degrees C) while lung gas PCO2 rose from 5.8 mmHg at 15 degrees C to 13.2 mmHg at 35 degrees C. Concurrently, lung gas PO2 declined from 132 mmHg at 15 degrees C to 120 mmHg at 35 degrees C, and arterial PO2 increased from 33 to 76 mmHg in that temperature range. Arterial haemoglobin O-2 saturation rose from 0.53 at 15 degrees C to 0.83 at 25 degrees C but became slightly reduced (0.77) with a further elevation of temperature to 35 degrees C. Arterial haemoglobin concentration increased from 1.96 to 2.53 mM between 15 and 35 degrees C, consistent with higher demands on oxygen delivery to tissues at elevated temperatures. Moreover, the substantial increase of haemoglobin O-2 saturation between 15 and 25 degrees C conforms to the idea that reduction of the central vascular right-to-left shunt (pulmonary bypass of systemic venous return) is associated with high metabolic demands. (C) 1998 Elsevier B.V. All rights reserved.

1968-2008: O Veja Way of Life

O artigo aborda, segundo a nossa hipótese, o Jornalismo espetacular, marcado pelo entretenimento, utilizado pela revista Veja para noticiar os episódios do movimento estudantil - principal movimento engajado na luta da ditadura - já em 1968. Foram feitos pesquisa bibliográfica e estudo comparativo da abordagem de edições de 1998 e de 2008. Durante as comemorações deste ano ímpar, a nossa conclusão é a de que Veja agrega, cada vez mais, elementos sensacionalistas com o intuito de denegrir a imagem do movimento estudantil, corroborando, assim, com a indústria cultural e a sociedade do espetáculo que visam a produzir uma juventude democrática, ou seja, que almeja o sucesso econômico por meio do direito de consumir e da manutenção do sistema político vigente.

Morfologia do figado da paca (Cuniculus Paca, Linnaeus 1766)

The elements related to the morphology of the liver of paca (Cuniculus paca), the second largest rodent of the Brazilian fauna, were observed; this species present zootechnical potential. Eight animals from the animals sector of Faculdade de Ciencias Agrarias e Veterinarias - Campus of Jaboticabal - UNESP, which is duly certified by IBAMA as an experimental breeding institute, were used. Through a dissection procedure, it was found that the liver of the paca is located in the cranial portion of the abdomen, immediately after the diaphragm, to which it is connected by the triangular, coronary, and falciform ligaments, having its bigger part located right to the medium plan. The liver of this rodent presents the following lobation: right lateral lobe, right medial lobe, quadrate lobe, left medial lobe, and left lateral lobe, besides the caudate lobe formed by the papillary process of caudate lobe and the caudate process of caudate lobe. Gallbladder is located between the quadrate and right medial lobes. Fragments of this organ were collected, fixed, and histologically prepared, being the samples analyzed through light microscopy. It was microscopically observed that intralobular connective tissue is scarce, basically it consists polyhedral hepatocytes organized into cords interposed between sinusoids and the portal triads are found in the lobe, consisting of the portal vein, hepatic artery, and biliary duct.

Social Panorama of Latin America 2002-2003

Includes bibliography