Avaliação da qualidade da assistência prestada pelo serviço de atendimento móvel de urgência do Rio Grande do Norte

O objetivo dessa investigação foi avaliar a qualidade da assistência prestada pelo Serviço de Atendimento Móvel de Urgência do estado do Rio Grande do Norte (SAMU 192 RN), na visão dos profissionais de saúde. Trata-se de estudo descritivo, avaliativo com delineamento longitudinal e abordagem quantitativa, desenvolvido em quatro etapas: construção de perfil dos atendimentos do SAMU 192 RN; revisão integrativa para levantamento dos indicadores de avaliação da qualidade da assistência em serviços pré-hospitalares móveis de urgência; construção e validação de conteúdo do instrumento e definição dos indicadores de estrutura e processo; e aplicação do instrumento aos profissionais de saúde para avaliação da qualidade da assistência. A populaçãoe amostra foram compostas por todos os profissionais do SAMU 192 RN, atuantes no período do estudo. A coleta de dados foi realizada entre janeiro e dezembro/2012. Participaram do estudo: 11 enfermeiros, 24 médicos, 56 técnicos de enfermagem e 88 condutores, totalizando 179 profissionais. O estudo foi aprovado (Parecer nº 437/2010 e CAAE: 0025.0.294.051-10) pelo Comitê de Ética em Pesquisa do Hospital Universitário Onofre Lopes da Universidade Federal do Rio Grande do Norte. Os dados foram analisados por meio de estatística descritiva e inferencial, nesta foram utilizados os programas Microsoft-Excel XP e SPSS 20.0, com uso do índice Kappa (K) e Índice de Validade de Conteúdo (IVC), considerando K ≥0,61 e IVC>0,80. Além disso, foi considerando nível de significância estatística de ρ-valor < 0,05. Entre os 179 profissionais, 100,0% tinham menos de 5 anos de tempo de serviço, 55,9% tinham menos de 5 anos de experiência na área de urgência, 88,3% referiram trabalhar na instituição porque gosta, 55,3% possuiam outro vínculo de trabalho, 54,3% com jornada semanal de 30 a 40 horas, 98,9% participaram de treinamento, 83,2% valorizam o treinamento em serviço, 87,2% têm boa frequência de participação no treinamento e 96,6% sentem necessidade de realizar mais treinamentos. Com relação à categorização dos itens em indicadores de estrutura ou de processo, os juízes determinaram para estrutura: estado de conservação das ambulâncias; estrutura física geral do serviço; conforto dentro da ambulância; disponibilidade de recursos materiais; segurança para o usuário dentro da ambulância; segurança para o profissional; educação permanente; segurança demonstrada pela equipe profissional; remuneração do profissional e a satisfação profissional. E para processo: acesso ao serviço; acolhimento; humanização; atendimento realizado; tempo resposta; privacidade ao usuário; orientações sobre o atendimento; relacionamento entre o profissional e usuário; oportunidade do usuário realizar reclamações e articulação multiprofissional. O instrumento quando submetido à validação de conteúdo constatou-se que as contribuições dos juízes permitiram melhorar/otimizar o instrumento de avaliação da qualidade da assistência pré-hospitalar móvel de urgência, uma vez que os índices Kappa e IVC foram considerados bons e ótimos e o conteúdo foi validado. Na avaliação da qualidade da assistência, constatou-se que a qualidade da assistência prestada pelo SAMU 192 RN está prejudicada nas dimensões estrutura, com relação à estrutura física, segurança dos pontos de apoio descentralizados, o conforto e o estado de conservação das ambulâncias. Já com relação aos indicadores de processo, os profissionais avaliaram todos positivamente. A avaliação da qualidade da assistência contribui para a busca de soluções dos problemas detectados, permite novas perspectivas e colabora para a consolidação do serviço.

Avaliação de sistemas de lagoas de estabilização em série no Rio Grande do Norte

Stabilization ponds are biological treatment systems in that stabilization of organic matter is performed by the bacterial oxidation and / or reduction of photosynthetic algae. This study aimed to monitor and evaluate the efficiency of stabilization ponds in the Rio Grande do Norte State. Collections were made of the treated effluent, made directly in the output boxes of facultative lagoons and maturation (M1 and M2) and raw sewage (EB) that arrived at the stations. The variables analyzed were: pH, temperature, dissolved oxygen, total suspended solids, chlorophyll "a", apparent color, total phosphorus, organic nitrogen, ammonia nitrogen, Kjeldahl nitrogen, turbidity, cyanobacteria density and concentrations of microcystin. Variance analysis (ANOVA one way) observing the premises using the Tukey test, so as to check differences between treatments. The evaluate the stations found to COD removals in the bands of 48,8% (Pipa) to 75,8% (Caiçara Rio do Vento) and 57,5% (Pipa) to 83,0% (Santo Antônio), respectively. The mean concentrations of cyanobacteria varied from LFs density of 62,545 cels.mL-1 (Pedro Velho Roça) cels.mL-1 to 2,669,048 (Ponta Negra), while the final effluent showed range between 9,072 Cels.mL- 1 (Pedro Velho Roça) to 1,899,981 cels.mL-1 (Macau – Ilha de Santana) and the average concentrations of microcystin the final effluent ranged from 0.02 μg.L-1 (Ponta Negra) to 0.15 μg.L-1 (Macau – Ilha de Santana) at the studied the stations.

Utilização de mapas conceituais como ferramenta de ensino para o desenvolvimento do raciocínio clínico no curso de medicina da Universidade Federal do Rio Grande do Norte

BACKGROUND: Among the wide range of skills displayed by a medical doctor is undoubtedly the need to use cohesive and well grounded clinical reasoning in order for medical care to be indeed effective. It is in this respect that conceptual maps emerge; these are a methodological innovation that allows a comprehensive, panoramic and associative outlook of theoretical content, making it more practical and applicable to the reality of clinical observation. Promoting learning, learning resources and a feedback system between professor and students, as well as assessing and monitoring the performance of students during their academic training, are the main features of this tool. OBJETIVE: Assess the use of conceptual maps as a teaching-learning tool in the training of undergraduate medical students at Universidade Federal do Rio Grande do Norte (UFRN). METHODOLOGY: Interventional, randomized, cross-sectional study conducted with students from the 3rd and 5th periods of the medical course at UFRN, during the second semester of 2014, totaling 86 participants, divided into two groups: GI (intervention – clinical case resolution with a conceptual map) and GII (control – clinical case resolution without a conceptual map) in each period. RESULTS: The use of conceptual maps to teach liver failure syndrome resulted in a statistically significant cognitive gain for G1 students from the 5th period (GI: 6.8±1.6 and 8.0±1.5, p = 0.024; GII: 7.2±2.1 and 8.0±1.7, p = 0.125, pre and post-intermediate means, respectively), a result not observed in the period 3rd (GI: 7.7±1.3 and 8.0±1.4, p = 0.501; GII: 6.7±1.8 and 7.8±1.8; p=0.068, pre and post-intermediate means, respectively). Students in the 3 rd period gave better responses to the first clinical case, with a larger number of suitable concepts and crosslinks, when they used conceptual maps (GI: 91.3±13.15 and GII: 64.84±22.84, p=0,002). Students in the 5th period exhibited better clinical reasoning and more complete responses using the tool (p=0,01). Most of the students were not aware of the tool (53.8% from the 3rd period and 65.3% from the 5th period). Among those who knew about conceptual maps, most (59.3%) had only used them during high school, 14.8% had never used them and only seven students (25.9%) used them during the medical course. Analysis of open responses, obtained in process assessment showed clear satisfaction and enthusiasm with learning about the new tool, and frequent suggestions to use it at other moments in the course. Assessment of learning profile, using the VARK questionnaire, showed that most students from both periods exhibited a multimodal style. CONCLUSION: Despite their scant knowledge regarding the tool, good acceptability and understanding was observed in the study participants. The conceptual maps allowed cognitive gains, better responses and clinical reasoning in teaching liver failure syndrome to 5th period students.

Serviços-escola de psicologia do Rio Grande do Norte: formação profissional e política pública de saúde em debate

The Psychology University Services is stablished normatively as an indispensable equipment to the recognition of the graduation courses of psychologists by the Brazilian Education Ministery. The Public Healthcare Policies (Universal Health System/SUS) constitutes itself as a input field of the professional category, but shows huge challenges in the formation of these professionals. The objective of this work is to analyse the functioning of the Psychology University Services (SEP) and the Superior Educational Institutions from Natal, understood as important formation devices to attend the actual demands of the psychologist's work on SUS. For this, it sought a) characterize the psychological practices developed in the SEP; b) relate the National Curricular Lines of Direction of the psychology courses to the skills and competences developed in the SEP to the performance on the public healthcare policies; c) mapping ways of including the SEP in the network designed by the healthcare policy. Interviews were performed with 13 academic supervisors, 8 field supervisors and technicians of superior level (TNC), along with 9 managers, being for of the Psychology University Services and 5 of the graduation programs. Questionnaires were also applied to 57 interns and 24 graduates. Besides that, two conversation circles were performed with the faculty and technician members from two of the Educational Institutions that were participating of the research, as well as a workshop with students and psychologists, promoted by the CRP 17. We observed that most part of the faculty members and managers know the DCN and comprehend that the formation is in process of change in what concerns to the extension of the formation to the performance of the psychologists in various contexts. However, most part of the TNC don't know about them. Moreover, the results point to the predominance of the assisting model based on the traditional clinic psychology, although the articulation with the public healthcare and social assistance networks can already be timidly visualized. Different modalities of practices in theses Psychology University Services were also detected, such as conversation groups, thematic workshops, organizational consultancies, team meetings with the interns and TNS in a daily basis, matriciament in mental health, therapeutic monitoring, among others. Yet, the SEP in Rio Grande do Norte are still isolated from the other courses that perform in the healthcare area and also from the services that compose the public healthcare and public policies.

Cuidado psicossocial em saúde mental: estudo em assentamentos rurais do Rio Grande do Norte

Dwellers of agrarian reform settlements have a life conditioned by poor living and work conditions, difficulties accessing health programs, social assistance and other public policies and by this exacerbating their psychosocial and environmental vulnerability, which has an impact on their mental health. This research investigates the availability of support by the health and social assistance staff, regarding the demands of common mental disorders and alcohol abuse of dwellers of nine settlements in Rio Grande do Norte. Fifty three experts from different professional categories were interviewed individually or in groups. The results indicate that the workers suffer from poor working conditions, attributes of patrimonial heritage and welfare, which still survives in Brazilian social policies and particularly at local administrations of the countryside. The staffs have little knowledge of the local conditions and of the mental health needs, which has a negative impact on the reception and offered care. The implemented health care still corresponds to the biomedical logic, characterized by ethnocentrism, technicality, biology, cure, individualism and specialization, with little participation of the dwellers and disregarding the traditional knowledge and practices of local health care and by this not achieving the expected results. The psychosocial attendance is not well coordinated, presenting problems with the follow-up and continuity of care. The psychosocial mental health care in rural context has to face the challenge of the reorganization of the health care networks, the establishment of primary health care close to the people’s everyday life, building intersectional practices considering a health multidetermination and health education connected to these specific contexts. Due to the lack of knowledge of the specifics of the life conditions of the dwellers and the fragmentation of the psychosocial health care network, these staffs do not abide and are not ready to face the mental health needs in order to interfere with these health iniquities.

Cuidado psicossocial em saúde mental: estudo em assentamentos rurais do Rio Grande do Norte

Dwellers of agrarian reform settlements have a life conditioned by poor living and work conditions, difficulties accessing health programs, social assistance and other public policies and by this exacerbating their psychosocial and environmental vulnerability, which has an impact on their mental health. This research investigates the availability of support by the health and social assistance staff, regarding the demands of common mental disorders and alcohol abuse of dwellers of nine settlements in Rio Grande do Norte. Fifty three experts from different professional categories were interviewed individually or in groups. The results indicate that the workers suffer from poor working conditions, attributes of patrimonial heritage and welfare, which still survives in Brazilian social policies and particularly at local administrations of the countryside. The staffs have little knowledge of the local conditions and of the mental health needs, which has a negative impact on the reception and offered care. The implemented health care still corresponds to the biomedical logic, characterized by ethnocentrism, technicality, biology, cure, individualism and specialization, with little participation of the dwellers and disregarding the traditional knowledge and practices of local health care and by this not achieving the expected results. The psychosocial attendance is not well coordinated, presenting problems with the follow-up and continuity of care. The psychosocial mental health care in rural context has to face the challenge of the reorganization of the health care networks, the establishment of primary health care close to the people’s everyday life, building intersectional practices considering a health multidetermination and health education connected to these specific contexts. Due to the lack of knowledge of the specifics of the life conditions of the dwellers and the fragmentation of the psychosocial health care network, these staffs do not abide and are not ready to face the mental health needs in order to interfere with these health iniquities.

Transição demográfica e a questão educacional: uma abordagem para o ensino médio do Rio Grande do Norte

Due to demographic transition process, the educational public sector politics formers encounter a highly specific demographic situation because, nowadays, despite the demographic transition, population is still growing because of the demographic inertia; however, due to steady decline in fertility, young population tends to decrease in next years. In this way, aiming to make high school widely accessible in the country, the issue of education quality is highlighted as well the importance of the physical structure of schools and their teaching equipments to confirm a favorable or not environment for developing educational processes. In this way, this work aims to relate the enrollment of students as school types with the demand of young people who will be able to attend high school on the Rio Grande do Norte state by the year of 2020, emphasizing teaching unities structural aspects, from a school profiling to the design of three prospective alternatives. So, from INEP's Scholar Census data and IBGE population's projections, this work is composed by four stages: i) literature review about research related subjects; ii) database design and build; iii) school profiling; and, iv) prospective alternatives creation. As results, three alternatives relate potential demand and enrollment using the built profiles and they are: i) “Alternative A” attends PEE's requirements related to demands but do not provide improvements in the school structural aspects; ii) “Alternative B” points into an increase of enrollment offering to the detriment of school's structural conditions which are offered to these students; iii) “Alternative C” propitiates a quantitative enrollment increasing combined with improvements on school's physical structure. These alternatives help to support decision making related to goals and realization of universal access with physical conditions which are necessary to a favorable environment to educational activity development.

Inclusão de alunos com deficiência no ensino superior: ações no contexto da Universidade Federal do Rio Grande do Norte

Aborda a educação inclusiva no âmbito da Universidade Federal do Rio Grande do Norte (UFRN), com vistas às ações estruturantes para alunos com deficiência, no período de 2001 a 2007. O seu objetivo principal é situar as ações que foram desenvolvidas por essa universidade e, ainda, as que estão em andamento e que privilegiam o acesso e a qualidade do ensino, particularmente, a esses alunos. Este estudo caracteriza-se também por uma abordagem qualitativa e exploratória, por meio do qual empregou-se a análise documental. Os primeiros resultados apontam para ações de diversas naturezas, tais como: criação de uma comissão para elaborar diretrizes gerais e propor ações acadêmicas para a educação especial; realização de Seminários de Educação Inclusiva; criação do ‘espaço inclusivo” na biblioteca central; adequação e construção de ambientes acessíveis; aprovação de projeto no Programa Incluir, dentre outras. Portanto, a partir dessas ações a UFRN demonstra ser fiel aos princípios que norteiam a construção de um sistema educacional democrático e inclusivo, ao buscar garantir a qualidade da oferta e do acesso aos seus cursos, respeitando a diversidade de todos os que nela ingressam

Infância e regimentos escolares no Rio Grande do Norte (1910-1920)

RODRIGUES, Marta Bezerra; MEDEIROS, Ana Luiza. Infância e regimentos escolares no Rio Grande do Norte (1910-1920). In: COLÓQUIO NACIONAL DA AFIRSE, SECÇÃO BRASILEIRA, 6., 2011, Teresina, 2011. Anais... Teresina: Universidade Federal do Piauí, 2011.

A criança [pobre] em escola católica na cidade paroquial de Jardim do Seridó (Rio Grande do Norte, 1943-1951)

ARAÚJO, M. M. A criança [pobre] em escola católica na cidade paroquial de Jadrdim do Seridó (Rio Grande do Norte, 1943-1951). Educação e Filosofia (UFU. Impresso), v. 23, n.46, p. 19-36, 2009

Fatores de longevidade do programa Central do Cidadão no Rio Grande do Norte

The public management reform in Brazil, since 1995, provoked new experiences in public administration. Among the new models of public service the one-stop shopping has distinguished and was adopted at Rio Grande do Norte with the Citizens Center Program. The one-stop shopping assembles in the same place many public services with appropriate structure, enabled human resources and citizens focus processes. The goal of this research was understand how citizens focus processes help to explain Citizens Center Program s longevity. It was made a case study and the research tools were applied with Citizen Center Programs workers and citizen-users at South Unit of Citizen Center Program placed at Via Direta Mall, Natal. The major contributions for Citizen Center Program s longevity were imputed to Basic Operation Processes. The most spoken features in Citizen Center Program mentioned were quality, efficiency, celerity e personal appearance, what demonstrate concern and care with citizen-users. Worker s personal appearance, accommodation, celerity, politeness and attending capacity planning were high evaluated by citizen-users revealing the wisely choice of use a large quality concept and citizenship concept in public administration. Citizen-users also pointed the necessity of refine and enlarge the communication ways that form an essential mechanism to public citizen focus administration. Not ignoring the policy aspect citizen focus processes were noticed like especial management actions that make easier citizen s activities and public service access, what generate satisfaction to citizen-users. It s possible to conclude that the high level approving evaluation of Citizen Center Program consolidates it an especial public policy that serves citizen s necessities e create appropriate legitimacy conditions of the public policy making harder the choice of ending the policy even in more fragile moments strongly contributing for its longevity

Inserção de fornecedores locais como fonte de desempenhos em custos de transação e legitimidade: estudo de caso na cadeia produtiva do petróleo e gás do Rio Grande do Norte

The inclusion of local suppliers in production chains has considerable impact on its performance, but most notably in its main actors. The results of this process may be of different kinds and can be analyzed from economic or institutional approaches. This study aimed to verify the existence of different performances of Petrobras due to the inclusion of local suppliers in the oil and gas production chain in the state of Rio Grande do Norte, from the viewpoints of transaction costs and the Institutional Theory. In order to this, were made the characterization of the PROMINP, the description of its actions and results, the mapping of its institutional context of reference, and identification of results obtained by Petrobras in terms of transaction costs and legitimacy. The theoretical framework is based on authors dealing with industrial concentration, as like Marshall, Krugman, Porter and Schmitz, from the sociological perspective of neoinstitucional theory, as like DiMaggio and Powell and Scott and Meyer, and transaction costs, as like Williamson. This is a qualitative research, with data collection done by consulting secondary fonts and semi-structured interviews with nineteen actors of three groups, namely: actors involved in actions of the program, representatives of enterprises and representative of Petrobras. To analyze the content was used the Suchman s model (1995) for categories associated with strategies of legitimation and fourteen variables associated with the three variables assets specificity, bounded rationality and opportunism (Williamson, 1995, 1989) in the case of transaction costs. The results indicate that PROMINP has achieved its objectives by encouraging the increased participation of local companies in the oil and gas production chain, reflecting in the economic development of the state. The Redepetro/RN, fostered and built upon the interaction of the participants, is presented as a solution of continuity to the participation of enterprises in the chain, after the closure of the actions of the program. PROMINP demands responses to coercive, legislative and regulatory pressures of the organizational field, whose institutional context of reference is wide. From the point of view of legitimacy, through strategies to gain cognitive legitimacy and maintaining pragmatic legitimacy, Petrobras can manipulate the environment, ensuring the compliance of the constituents to their technical and institutional demands. Enterprises, in turn, respond to the demands through compliance with technical demands, mainly through the certification of processes, and cultural changes. There aren t clear gains related to the transaction costs, however, gains in legitimacy can be seen as a cumulative capital that can serve as a competitive differential that generates economic gains. In terms of theoretical findings, it was found that, due to its explanatory power for actions that are difficult to explain only in economic terms, Institutional Theory may be used as theoretical support concurrent with other theories. TCE model has limitations in explaining the program actions. In the case, it s emphasized that Petrobras doesn t seek only economic efficiency, but has in its mission the commitment to social development.

Percepções de maturidade em gerenciamento de projetos à luz da nova gestão pública: uma investigação com gestores das secretarias estaduais do Rio Grande do Norte

This study aimed to measure the perception of maturity project management of state boards of Rio Grande do Norte by the perception of its managers. Argues that project management has been highlighted as a critical factor for the success of any organization, because the projects are directly related to the set of activities that result in organizational innovation as products, services and processes and the improvement of project management is directly aligned with the main pillars of the New Public Management. Methodologically, this is a quantitative research of a descriptive nature in which 161 forms were applied with coordinators and subcoordinators of state departments of Rio Grande do Norte, culminating in a sampling error of less than 6% to 95% confidence according to the procedures finite sampling. The process of tabulation and analysis was done using the package Statistical Package for Social Sciences - SPSS 18.0 and worked with techniques such as mean, standard deviation, frequency distributions, cluster analysis and factor analysis. The results indicate that the levels of maturity in project management in state departments of Rio Grande do Norte is below the national average and that behavioral skills are the main problem for improving management in these departments. It was possible to detect the existence of two groups of different perceptions about the management of projects, indicating, according to the managers, there are islands of excellence in project management in some sectors of the state departments. It was also observed that there are eight factors that affect maturity in project management: Planning and Control , Development of Management Skills , Project Management Environment , Acceptance of the Subject Project Management , Stimulus to Performance , Project Evaluation and Learning , Project Management Office and Visibility of Project Managers . It concludes that the project management in state departments of Rio Grande do Norte has no satisfactory levels of maturity in project management, affecting the levels of efficiency and effectiveness of the state apparatus, which shows that some of the assumptions that guide the New Public Management are not getting the levels of excellence nailed by this management model

Autoavaliação institucional na dimensão do SINAES comunicação com a sociedade : estudo de múltiplos casos em instituições de ensino superior do Rio Grande do Norte

This study is about the institutional self-evaluation in Dimension 4, "Communication with Society", from the National System of Higher Education Evaluation SINAES, mandatory for all universities in Brazil. A multiple cases study was conducted with three institutions from Rio Grande do Norte, and the goal was to know how this evaluation is made, describing the concept for the evaluation of communication proposed by them, identifying controllers or emancipator aspects, categorizing methodological procedures and discussing the difficulties reported in the communication evaluation process. Coordinators of the institutions Evaluating Committees were interviewed and data categorized by means of qualitative content analysis. It was noted characteristics of the current controller, emancipator and hybrid designs in the three institutions for evaluation of communication, revealing the lack of a theoretical corpus that transits in accordance with the systemic perspective and epistemology of complexity from SINAES. It was found that the most frequently reported difficulties in the evaluation processes of communication are in the preparation stage, especially in the definition of indicators and tools and awareness work. The weakness in planning makes their own activities in the sector of communication become targets of assessment, forming goals poorly related with broader organizational goals. It was also concluded that the technical evaluation cannot override the issues associated with the broader issue of the complexity surrounding the assessment paradigm proposed by SINAES because contradictions and imperfections are part of the evaluation process and several references are current in the literature to support this view. Finally, it is said that objectives such as transparency and behavioral changes can rely on methodologies and techniques for research on the question of the construction of meaning

Modelo de decisão multicritério para seleções interciclo das universidades novas: estudo na Universidade Federal do Rio Grande do Norte

The discussions wherein develop proposals for university reform in Brazil include, among other things, the conception of the university titled "New University", whose structural origin comes from the bill of higher education reform and unification of the foundations of education European upper (Bologna process). At its core, the Bologna process has imposed a series of transformations, among which, the promotion of mobility, as a stimulus to interinstitutional cooperation to enable an better and bigger qualification of the students. Nevertheless, what we see is that this point is one of the main points made flawed by Brazilian institutions that have adopted this model of higher education. An example is the Bachelor of Science and Technology - BC&T, Federal University of Rio Grande do Norte - UFRN, where there are problems of the internal order, represented by the problem of the reusing of the disciplines, such also of external order, in cases of transfers interinstitutional. Because of this, and knowing that this is a typical problem in which multiple criteria are involved, the aim of this study is to propose a multicriteria model for selection of interciclo of the BC&T of the UFRN which addresses the issue of mobility. For this, this study was of exploratory and study case nature, use as tools of data collection, the bibliographic and documentary research, as well as semi-structured interviews. For the elaboration of the model, were used the five phases most commonly used in the modeling of problems in operational research in a sample of 91 students of BC&T. As a result, we obtained a model that addresses the issue of internal and external mobility of the school and that, moreover, was also more robust and fair than the current model of BC&T and also what is used in other courses of the UFRN, taking into consideration the expected results by the decision makers