Turismo activo: um produto do turismo e do desporto

As pessoas viajam cada vez mais em busca de novas experiências, novas vivências associadas a diversas práticas activas. O uso do desporto como uma mais-valia para o turismo tem vindo a aumentar desde a década de oitenta, aliado ao aparecimento de uma nova filosofia de gestão do conceito que combina “aventura”, ecoturismo e os aspectos culturais do destino turístico. O turismo activo constitui-se como uma forma de organização que enfatiza a actividade do próprio turista. O presente estudo decorre de um trabalho de campo realizado na Região Autónoma da Madeira cujo propósito passa por aferir a percepção que terá o turista activo (em geral) que procura as levadas, perfazendo estas, um dos mais fortes atractivos da região. Como instrumento de pesquisa, recorremos ao questionário, aplicado numa amostra de cento e cinquenta turistas. A entrega dos questionários aos turistas decorreu em vários locais, a saber: unidades hoteleiras; empresas de animação turística desportiva; guias de montanha, assim como in loco, nas próprias levadas, objecto de estudo. Os objectivos do trabalho incidem sobre um conjunto de itens, tais como caracterizar o perfil do turista activo das levadas; apreender que motivações afectam a escolha do destino Madeira; perceber se o turista, quando opta pelo destino Madeira, considera a prática de actividade física como um factor decisivo e identificar quais os atributos das levadas mais valorizados pelos turistas. Pretende-se também determinar aproximadamente o impacto económico dos turistas das levadas no desenvolvimento da economia e do turismo da Madeira. Após a análise de dados, constatamos que 51,6% dos inquiridos são do sexo feminino, 23,9% têm idades compreendidas entre os 50 e os 59 anos e 24,5% são de nacionalidade alemã. Relativamente aos gastos efectuados durante a estadia, 51,6% dos inquiridos afirmaram despender até cem euros/dia. No que diz respeito aos atributos que os turistas mais valorizam nas levadas/veredas, 72,5% referem o contacto com a natureza. À pergunta “concorda com o pagamento de uma quantia simbólica, para uma taxa ecológica em benefício da natureza?”, a esmagadora maioria, cerca de 80,6% dos inquiridos, respondeu afirmativamente.Após a análise cuidada dos resultados obtidos, podemos realçar, então, a existência de um segmento de mercado de turista activo das levadas, que contribui para o desenvolvimento da economia e do turismo da Madeira, como uma das conclusões retiradas do estudo. O real contributo desta comunicação no âmbito do turismo activo deriva do facto de se tratar de um trabalho pioneiro nesta área específica, além de permitir estabelecer um roteiro de análise da problemática.

Teste do desenho da figura humana: validação e aferição do sistema de Wechsler à população portuguesa “madeirense”

O desenho da figura humana é um tipo de desenho realizado espontaneamente pelas crianças de diferentes culturas. Este pode ser encarado como medida não verbal da maturidade conceptual da criança. Ao longo dos tempos, na tentativa de construir um instrumento mais eficaz, vários autores desenvolveram diferentes sistemas de avaliação do Teste do Desenho da Figura Humana (TDFH). Assim, o objectivo desta investigação consiste na aferição e validação do TDFH à população portuguesa madeirense, utilizando o sistema de avaliação de Solange Wechsler (2003). Este teste propõe a aplicação de dois desenhos, uma figura masculina e outra feminina, que são cotados independentemente ao longo de 18 itens e 17 itens subdivididos respectivamente. Neste estudo participaram 489 sujeitos, 50,3% do sexo masculino e 49,7% do sexo feminino, com idades compreendidas entre os 5 e os 13 anos de idade da Região Autónoma da Madeira no ano lectivo 2009/2010. Os resultados mostram diferenças significativas na forma de desenhar a figura humana, entre os sexos, as faixas etárias e os anos escolares. Assim, as raparigas apresentam valores superiores aos dos rapazes; à medida que a idade avança os valores obtidos aumentam; e por fim à medida que as crianças progridem na escolaridade os resultados são superiores. Verificou-se ainda que alunos de escolas públicas apresentam resultados mais elevados do que os alunos de escolas privadas, sendo que alunos de escolas rurais expressam valores superiores aos das escolas urbanas. Os dados do TDFH apresentaram correlações positivas significativas com os das Matrizes Progressivas Coloridas de Raven, bem como com as classificações de Português e Matemática. Ao nível da consistência interna, o instrumento apresenta alphas de Cronbach entre os 0,80 e os 0,924, o que lhe confere fiabilidade. Globalmente, o TDFH apresenta bons valores de validade mostrando ser uma boa medida desenvolvimental e conceptual.

XpressTrades: aplicação Android para troca de itens

As pessoas que gostam de comprar videojogos e livros, ao final de algum tempo, verificam que têm muitos destes itens armazenados e que já não os utilizam. Se estas pessoas não tiverem o intuito de criar uma coleção desses itens, irão, provavelmente se desfazer deles, por exemplo deitando-os fora. Neste contexto, apresenta-se uma aplicação para dispositivos móveis que possuam o sistema operativo Android, designada de XpressTrades. Esta aplicação visa resolver o problema descrito acima, tornando as trocas de jogos e de livros mais fácil, ajudando os seus utilizadores a reutilizarem os seus itens e a os utilizarem como moeda de troca. Juntamente com esta aplicação foi desenvolvida uma Web API, utilizando a framework ASP.NET, a qual é utilizada pela aplicação para esta poder funcionar. Embora este projeto de mestrado se tenha focado no desenvolvimento de uma aplicação especificamente para a troca de jogos e de livros, a aplicação foi desenhada e desenvolvida de forma modular e está preparada para ser estendida à troca de qualquer tipo de itens. A aplicação XpressTrades reúne diversas particularidades que tornarão as trocas de itens mais rápidas e eficientes. Algumas delas são: a apresentação da lista de proprietários ordenados por distância em relação ao utilizador e a apresentação de uma lista de itens recomendados com base no histórico de visualizações de itens realizadas pelo utilizador, ou seja, com base nos seus interesses. Relativamente à metodologia utilizada no desenvolvimento deste projeto, dado que a ideia surgiu do autor deste trabalho, recorreu-se primeiramente a inquéritos para se averiguar se as pessoas realmente revelavam interesse neste projeto e investigou-se também a existência de aplicações semelhantes. Seguidamente, utilizou-se a técnica de brainstorming para gerar as ideias e criou-se protótipos de baixa fidelidade para testar a interface de utilizador. Na fase de implementação, seguiu-se o seguinte ciclo para cada funcionalidade: prototipagem, testes com os utilizadores e correções dos erros detetados nos testes.

A personalidade nos trabalhos em grupo no ensino superior

O Ensino Superior é um contexto fundamental no desenvolvimento pessoal, profissional e social do indivíduo, pois pretende que os indivíduos obtenham conhecimentos técnicos específicos na sua área de formação, e que ao mesmo tempo desenvolvam competências pessoais e sociais, fundamentais para ingressar no mundo do trabalho. Dessa forma, a metodologia dos trabalhos em grupo tem sido muito adotada pelas várias universidades, uma vez que tem sido apontada como sendo uma estratégia adequada para o desenvolvimento de competências ao nível da comunicação, resolução de conflitos e liderança, cada vez mais procuradas pela realidade profissional. A personalidade tem sido também muito considerada no que toca aos requisitos exigidos pelas entidades empregadoras, uma vez que as características da personalidade são determinantes no comportamento profissional de um indivíduo. Este fator tornar-se ainda mais importante quando estamos perante um trabalho em grupo, uma vez que o bom funcionamento do mesmo e a conquista de bons resultados, dependem da forma como os elementos do grupo conjugam cada uma das suas singularidades. Assim, este estudo longitudinal, enquadrado numa metodologia quantitativa, pretendeu analisar os traços de personalidade dos time-organizer dos grupos em dois momentos distintos, de forma a comparar as perceções nessas duas fases do trabalho. Foi utilizada uma amostra de 92 alunos do 1º Ciclo da Universidade da Madeira, sendo que 17 dos quais são time-organizer dos seus grupos. Os dados foram recolhidos a partir de um questionário, baseado no Big Five Inventory, versão abreviada de 10 itens (Rammstedt & John, 2006). No que se refere aos resultados obtidos, verificamos que o traço de personalidade Conscienciosidade foi o mais predominante nos time-organizer da amostra. No entanto, foi curioso verificar que as perceções, sobre a personalidade do time-organizer, alteraram-se no decorrer do trabalho. Por fim, constatou-se que houve divergências entre as perceções dos alunos time-organizer e dos restantes alunos.

Projeto em Áreas Consolidadas de Patrimônio Cultural: Propostas para a Construção de uma Metodologia de Ensino

Le thème du patrimoine culturel architectural et urbain continue d avoir une place importante dans le milieu technique et scientifique. Le concept s est élargi et aujourd hui comprend différentes procédures de projets d intervention. L importance accordée au thème amène à l inclusion de la matière de techniques rétrospectives et aux contenus qui en sont liés: conservation, restauration, restructuration et reconstruction d édifices et ensembles urbains, dans les parcours des cours d architecture et d urbanisme au Brésil établies par le Ministère de l Education Nationale (MEC) dans les années quatre-vingt-dix, postérieurement incorporés dans les directrices disciplinaires nationales. Nous partons des discussions théoriques et conceptuelles du Domaine du Patrimoine Culturel, ainsi que des principales théories pédagogiques d enseignements et d apprentissage articulées au projet. Dans ce contexte les objectifs principaux de cette thèse consistent à systématiser et à analyser les principales procédures méthodologiques contribuant pour la construction de méthodes d enseignement tournée vers des activités pratiques dans ce domaine. Pour cela, la recherche a été systématisée dans une approche à deux niveaux. En ce qui concerne le premier, basé sur des données secondaires, neuf cours d architecture et urbanisme ont étés identifiés entre institutions publiques d enseignement supérieur dont huit brésiliennes et une française, considérées représentatives en ce qui concerne les pratiques d enseignement de projet et de patrimoine culturel. Trente disciplines dédiées à la matière ont été également reconnues initialement, et postérieurement, cinq disciplines qui possèdent un emploi du temps dédié à la pratique de projet ont aussi été reconnues. Dans le deuxième cas, basée sur des données primaires, ont étés analysées les méthodologies et les stratégies d enseignement de projet basées sur les définitions des matières et des autres éléments des plans de travail avec des observations, des entrevues et des questionnaires en trois ateliers. Par rapport aux résultats nous avons constaté que toutes les écoles possèdent les contenus de la matière, mais peu d entre elles privilégient la relation du projet appliqué au patrimoine culturel. Nous avons constaté que les questions des projets dans ce contexte, même s elles sont considérées complexes, ont privilégié le listage et l analyse du site. L atelier qui intègre les fondements des théories de préservation, l histoire de l architecture et urbanisme et techniques anciennes et actuelles, est mis en valeur comme un modèle cohérent avec les propositions d intégration des connaissances théoriques et pratiques du projet appliqué à la discipline. Basé sur ces constatations il est possible de démontrer quatre étapes du projet appliqué au patrimoine culturel: 1ª) les fondements généraux qui concernent les bases théoriques sur la préservation, histoire et technique rétrospective, par exemple, l appropriation de lois et normes et la sensibilisation de l élève sur les questions de patrimoine culturel; 2ª) le contacte avec la réalité qui inclut l appropriation du problème à partir de ces acteurs, de ces échelles, de cette lecture de site et l analyse de l objet d étude; 3ª) le développement de la proposition qui inclut programmes (fonctions existantes et propositions), définitions du partit (types d intervention), conception (hypothèse et discussion) et définition de proposition; 4ª) la finalisation du projet qui consiste à développer la proposition avec sa représentation graphique et sa présentation finale. Nous concluons que le projet en Domaine du Patrimoine Culturel demande une attention spéciale et doit être présent dans les cursus considérant les principes généraux nécessaires à la formation de l élève. Le binôme projet / patrimoine signifie avoir dans le cursus universitaire les contenus et questions nécessaires les connaissances, les variables et possibilités existantes dans le projet appliqué au patrimoine culturel de façon à ce que ces connaissances soient incorporées dans l exercice de projet et n apparaissent pas comme un simple contenu théorique sans articulation avec la pratique. Naturellement ces conclusions n épuisent pas la réflexion sur la question. Nous espérons que les analyses faites contribuent à définir des méthodologies d enseignements capables d êtres vérifiées et testées dans la pratique en salle de cours, et puisse collaborer avec les nouvelles recherches surtout celles qui ont pour but des nouvelles théories pédagogiques d enseignement apprentissage du projet en Domaine du Patrimoine Culturel

Bioecologia da ictiofauna marinha descartada pelo arrasto camaroeiro em praias da Bacia Potiguar, Brasil

The composition of ichthyofauna discarded by trawling shrimping, their reproductive status and feeding ecology were studied on the beaches of Basin Rio Grande do Norte, Brazil. Fish were collected monthly in the year of 2012. During biometrics, portions of the digestive tract and of gonads were removed, fixed in formalin 10% and Bouin, respectively, for be submitted to histological processing by the techniques of hematoxylin-eosin. Stomach content analyzes were performed using the methods of Frequency of Occurrence and Volumetric and was calculated the repletion index. Throughout the study period were recorded a total of 49 species. The fish assemblages differed between sections monitoring, with the highest abundance, biomass and indices of richness and diversity in sections B, D and C. Already the excerpt A, showed higher values for dominance and equitability. In the cluster analysis according to the faunal similarity was observed the formation of three groups: group I formed by excerpts B and D, group II by excerpt C and group III formed by excerpt A. The assessment of reproductive stage revealed that the fish assemblages discarded by trawling are composed mainly of juveniles. Regarding the feeding ecology, the species Larimus breviceps, Menticirrhus littoralis and Pomadasys corvinaeformis characterized as carnivorous with tendency to carcinofagia. Already Conodon nobilis characterized as carnivorous with tendency to piscivory, but all proved generalist-opportunistic with increase of feeding activity during drought. The dendrogram of grouping of the species developed based on the food items used shows the formation of four groups: Group I consists of species that feed mainly of "gastropod" and "sediment"; group II of "teleost fish"; the group III of "crustacea" and group IV of "echinodermata" and "bivalve". The anatomical and histological characteristics of the digestive tract were consistent with the dietary habits of the analyzed species. In this context, the Costa Branca of Rio Grande do Norte can be considered a feeding site and recruitment for juveniles, which, opportunistically, utilize resources associated with the background

Confiabilidade interobservador da escala do equilíbrio de Berg entre fisioterapeutas com extensa e escassa prática clínica

This study aimed at assessing the interobserver reliability of the Brazilian-Portuguese version of the Berg Balance Scale (BBS). The assessment was made by physiotherapists with extensive or little clinical experience in non-institutionalized elderly individuals. Participants comprised 12 elderly subjects (10 women and 2 men) with mean ages of 75.8 ± 8.4 years (range = 63-87) and 18 physiotherapists with varying clinical experience. Inter-examiner reliability obtained for each scale item yielded weighted kappa value > 0.75 in 11 of the 14 items (varying from 0.37 to 1.0). The intra-class correlation coefficient (ICC) for the total sum of BBS scores between the two groups of physiotherapists was 0.996 (95% confidence interval, 0.987 0.999) with a Cronbach alpha coefficient of 0.996. We found no difference between the rater groups when we compared the sum score means obtained with the student s T-test (p = 0.86). Although some items had low reliability values, in general our results suggest that the Brazilian Version of the BBS showed good levels of interrater reliability and agreement when used by physiotherapists with different clinical practice levels and without previous training on non-institutionalized elderly patients. We concluded that the BBS can be useful as an important evaluation instrument on a protocol for Rehabilitation clinics. It may be used by various health professionals, as: Physicians, Physical therapists, Physical educators, Occupational therapists, Nurses and Phonoaudiologists, so confirming the interdisciplinary character of this study

Desenpenho funcional, carga alostática e biomarcadores do estresse em idosos residentes na comunidade

Conselho Nacional de Desenvolvimento Científico e Tecnológico

A propaganda de medicamentos voltados à clínica obstétrica e/ou ginecológica e sua influência sobre a prescrição

INTRODUCTION: Drug advertisement stimulates self-medication and irrational use of medicines, especially when it starts to interfere in the prescription. Monitoring advertisements, as well as the observation of its influence on health professionals, prescriptions become necessary because of this public health problem. OBJECTIVE: The aim of this work was to analyze drug advertisements directed to gynecologists and/or obstetricians doctors relating them to the current legislation as well as its influence on prescription. METHODOLOGY: The sample was composed of drug advertisements divulged to the gynecologists and / or obstetricians doctors and was analyzed according to RDC96/2008. To evaluate the influence of advertisement on prescription, a questionnaire was administered to gynecologists / obstetricians doctors and prescriptions of a public maternity were also evaluated. RESULTS AND CONCLUSION: Concerning the advertisements analyzed, 48% complied fully with current legislation and 52% of the advertisements analyzed were in accordance to the RDC No. 96/2008 in most of the items evaluated. The doctors interviewed are used to receive the visits of propagandists, even in the public service, receiving gifts offered by the industry and believe that medicine advertisement tries to influence prescribing. Many of them use the material provided by the propagandist as a source for their prescription, although they present a critical view about them information. The use of trade name / mark on the prescription is a common practice among the doctors interviewed, even in the public service, suggesting there is an influence of medicine advertisement on the prescription

Registro da informação sobre nascidos vivos no nordeste: uma avaliação da evolução do SINASC entre 2000 e 2010

Os nascimentos ocorridos em uma população consistem em informação de grande valia para diversos estudos e planejamento de políticas públicas. O Sistema de informações sobre Nascidos Vivos (SINASC) representa uma promissora fonte de informação sobre o tema, uma vez que coleta continuamente e no âmbito municipal, dados sobre nascimentos. Tendo em vista a necessidade de avaliação contínua do SINASC e o panorama do declínio da fecundidade no Nordeste, objetivou-se avaliar a qualidade das informações provenientes do SINASC para o Nordeste, estados e microrregiões, nos anos 2000 e 2010, utilizando o Censo Demográfico como informação de referência, avaliando a cobertura do SINASC e identificando níveis e padrões de fecundidade. Pretendeu-se ainda verificar a relação entre os níveis de fecundidade, o grau de cobertura do SINASC e as condições socioeconômicas das microrregiões sintetizadas pelo Índice Social de Desenvolvimento Municipal (ISDM), utilizando-se a análise de cluster, associada à análise de variância (ANOVA) e o teste de Tukey. Por último, analisou-se a incompletude no preenchimento dos campos da Declaração de Nascido Vivo (DNV). De acordo com os resultados, observou-se que houve ampliação da qualidade das informações do SINASC no período estudado, resultando em uma maior aproximação das TFTs oriundas das duas fontes de dados consideradas no estudo. Maranhão e Paraíba foram os estados com maiores ganhos em cobertura das TFTs no período, e os estados do Rio Grande do Norte e Sergipe revelaram um grau de cobertura ligeiramente inferior em 2010 frente aos resultados de 2000, bem como ainda persistem várias microrregiões com TFTs oriundas do SINASC bem abaixo daquelas estimadas pelo Censo. Na verificação da associação entre o ISDM, TFTs e cobertura, a análise de cluster resultou em três agrupamentos, GrISDM A com melhores coberturas, ISDM e mais baixas TFT; GrISDM B , intermediário e GrISDM C com piores coberturas, ISDM e TFT mais altas. Notou-se a evolução das condições socioeconômicas no Nordeste, tendo o GrISDM A passado de 8% do total de microrregiões em 2000 para 37% em 2010. Reiterou-se ainda que quanto melhores as condições socioeconômicas de uma população, menores são as TFTs e melhores as coberturas do SINASC. A análise de variância apontou interações significativas entre o ano estudado versus ISDM (p-valor < 0,016) e o ano versus fonte de informação (p-valor < 0,020), e o teste Tukey apontou que não houve similaridade entre as médias das TFT das fontes Censo versus SINASC no período, fato que aponta para a captação ainda deficiente do SINASC nas microrregiões. O resultado da análise de variância da cobertura do SINASC em relação ao Censo apresentou uma interação significativa entre as variáveis UF versus Ano (p-valor < 0,0001), causada pelos estados que apresentaram queda de cobertura entre 2000 e 2010. Quanto à incompletude dos itens da DNV, evidenciou-se uma melhor coleta no período, embora alguns itens ainda careçam de atenção, como o apgar no 1º e 5º minuto e ocupação da mãe, sendo esta a que apresenta maiores percentuais de informações ignoradas. Destaca-se a possibilidade de preenchimento inconsistente nas variáveis referentes ao histórico de gestações anteriores, com o uso da informação zero inserida no lugar da informação ignorado . Concluiu-se que o SINASC é uma importante base de dados sobre nascimentos e que dispõe de dados confiáveis para o acompanhamento dos nascimentos e de seu panorama epidemiológico no Nordeste brasileiro, embora para alguns estados, assim como para algumas microrregiões, ainda faz-se necessária a ampliação da cobertura do Sistema. As informações constantes na DNV podem servir como embasamento para diversos estudos sobre as condições epidemiológicas dos nascituros e das suas mães, e dos indicadores baseados as informações dos nascimentos

Diversidade de cefalópodes e o seu papel no nicho trófico de seus principais predadores nos Arquipélagos de Fernando de Noronha e São Pedro e São Paulo

This study aims, to characterize the diversity of cephalopods by analyzing the stomach contents of fishes caught in the islands of St. Peter and St. Paul (ASPSP) and Fernando de Noronha (AFN). Also, verify the participation of cephalopods in the diet of their main predators. A total of 723 stomachs were collected, from 8 species of fish, caught by the fishery, 471 stomachs were from ASPSP and 252 were from the AFN. It was recorded the occurrence of food items (fish, cephalopods and crustaceans) and the cephalopods were identified to the lowest taxa possible, according to specialized literature. The Ommastrephidae family represented 84.46% of occurrence in the ASPSP and 63.48% in the AFN, confirming the importance of this family in the area studied and also in the diet of their predators. Among the species with greatest occurrence Ornitoteuthis antillarum was the most representative in both regions. This species had an average mantle length of 54.25 mm, thus demonstrating that the majority of this population is in the juvenile stage of development. The smallest species found was Argonauta nodosa with a mantle length of 4.06 mm and the largest was Ommastrephes bartrami, with 223.33 mm. In the AFN, the species richness (d) was 2.318, the diversity index (H ') was 1.454 and the measure of evenness (J) was 0.585. In the ASPSP, the species richness (d) was 2.66, the Shannon diversity index (H ') was 1.013 and the measure of evenness (J) was 0.373. AFN has a greater cephalopod diversity than ASPSP, confirming the pattern suggested by the Theory of Island Biogeography. Among the occurrence of prey items for all predators, the cephalopods are secondary preys. The most important cephalopod species in the diet of Thunnus albacares and Acantocybium solandri was Ornithoteuthis antillarum. These predators have different niche width the diet of Thunnus albacares is more specialized, but they have an overlap of 84.684% in the trophic niche, suggesting that in the ASPSP these two species may use similar niches

Ações de detecção precoce do câncer de mama realizadas por profissionais da estratégia saúde da família

This study is an exploratory descriptive study with a quantitative approach. The objective was to identify the actions for the early detection of breast cancer conducted by the health professionals of the Family Health Strategy in the Trairi region of the State of Rio Grande do Norte, Brazil. The research was conducted in nine municipalities of the region. Data were collected by means of a questionnaire with 52 Family Health Strategy professionals, 30 nurses and 22 physicians, that work in the region. Analysis was conducted using descriptive statistics. The results were organized and discussed in three areas: Knowledge about the early detection of breast cancer; Actions for early detection detection of breast cancer, and Difficulties experienced in the screening actions for breast cancer. The results indicate that these professionals (100%) have knowledge of the signs and symptoms of breast cancer and that the majority (96,2%) conduct screening actions in accordance with the recommendations of the Ministry of Health. However, a considerable number (55,8%) of these professionals encounters difficulties while conducting the screening procedures in his work setting. The difficulties varied from those of a personal nature to those of access to the procedure, such as the unavailability of sufficient quotas of screening exams. We conclude that the majority of health professionals execute the screening actions for breast cancer in their work settings according to the recommendations of the Ministry of Health, even though they encounter difficulties in the conclusion of the mammography and ultrasound exams, essential procedures in the early detection of breast cancer. We understand that these professionals demonstrate knowledge of secondary prevention even though they do not execute all the actions necessary for early detection primarily because they are impeded by the blockage of access to exam quotas. We conclude that, in spite of the difficulties experienced, the procedures for the early detection of breast cancer are being executed by the majority of the Family Health Strategy professionals in the Trairí region, specifically the clinical examination of the breast, orientation of breast self examination, requests for mammography and ultra sound examinations. Measures are needed that can mediate the difficulties, that will permit the realization of secondary prevention procedures with the population at risk in the region. We suggest training and actualization courses on the complete screening process that includes a wide discussion of the new legislation that provides the mammography exam for women over 40 years. We believe that the acquisition of such a work perspective for the early detection of breast cancer, along with knowledge of health vigilance and of breast cancer, will enhance integral health care of women that constitutes an aim of the nurse and the family health team

Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária

People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconized in the scientific literature, interfering with wound healing and quality of life of affected. In this sense, the construction of a assistance protocol specific to people with venous ulcers (VU) can help professionals of the Family Health Strategy both in patient assessment as and in establishment of quality assistance. Thus, this study aimed to analyse the validity of a multiprofessional assistance protocol for people with venous ulcers in primary care by health professionals using Delphi technique. This is a quantitative study, the methodological type conducted in two steps: first step related to integrative literature review to subsidize the development of the protocol, then these aspects were organized and proposed to the judges of the study through the Delphi technique. The study was initiated after approval by the Research Ethics Committee. The first step was performed between August and September 2012, in the virtual library of health, in the page of the Coordination of Improvement of Higher Education Personnel, of Municipal Health Secretariat and international guidelines of associations and in the subsequent step carried out between September 2012 to January 2013, was performed search by Lattes platform of the National Council of Technological and Scientific Development, in order to identify health professionals in Brazil who act as judges of the instrument and then, via online, the form was submitted to them.The sample for the second step was 51 judges in the first round and 35 for the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach Kappa and CVI established were: request / realization / test results, demographic data, medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion location/ edema and pain treatment. After removal of items which have not obtained Kappa or CVI index established, it was found achieving optimal levels of these index for the categories. In the next step was the ressubmissão of protocol to judges through the Delphi technique in it was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2 phase and the other three categories remained the same Kappa and IVC of the previous phase. As for the average of evaluation requirements of the protocol was found that the scores assigned by the judges were higher in the second phase in nine of the 10 items, remaining the same in only one of the items indicating validity of the instrument before the consensus of the judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The formulation of this assistance protocol valid and reproducible will enable a reorganization and redesign of assistance, with standardization of actions and continuity of care for persons with venous ulcers in primary health care

Evidências de validação de um protocolo para assistência às pessoas com úlceras venosas em serviços de alta complexidade

Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs . After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa ≥ 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity

Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente em unidades de terapia intensiva

The reports of adverse events date from 1990 up to the present day. Conceptually, these adverse events are unintentional injuries unrelated to the underlying disease, causing measurable lesions in patients, extending the period of hospitalization, or leading to death. These issues require discussions with regard to patient safety, improved quality of service, and preventing medical errors. In the Intensive Care Units, this concern is greater because these are sectors of intensive care to individuals with hemodynamic changes and imminent risk of death. Therefore, it is essential to conduct evaluation processes to investigate aspects of quality of nursing care and patient safety in these spaces. For that reason, we aimed to propose the Evaluation protocol of nursing care and patient safety in Intensive Care Units. For its achievement, we needed to: 1) analyze the evolution of the patient safety concept used in scientific productions, under Rodgers evolutionary concept; 2) identify the necessary items to build the evaluation protocol of nursing care and patient safety in the Intensive Care Unit, from the available evidence in literature; 3) construct an instrument for content validation of the evaluation protocol of nursing care and patient safety in the Intensive Care Unit; and 4) describe and evaluate the appropriateness of the content for an evaluation protocol of nursing care and patient safety in the Intensive Care Unit. This is a methodological study for the content validation of the abovementioned protocol. To meet the first three specific objectives, we used the integrative literature review in Theses Database of the Coordination for the Improvement of Higher Education Personnel and the portal of the Collaborating Centre for Quality of Care and Patient Safety. The fourth specific objective happened through the participation of judges, located from the Lattes curricula, in the content validation process developed in two stages: Delphi 1 and Delphi 2. As instrument, we used the electronic form of Google docs. We present in tables the answers from the evaluation instruments by Delphi consensus and Content Validity Index (CVI) of the entire protocol. We summarized the results in articles entitled Analysis of the patient safety concept: Rodgers evolutionary concept ; Scientific evidence regarding patient safety in the Intensive Care Unit ; Technological device for the content validation process: experience report ; and Evaluation protocol of nursing care and patient safety in Intensive Care Units. The Embodied Opinion of the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, No. 461,246, under CAAE 19586813.2.0000.5537, approved the study. Thus, we conclude the protocol valid in its content, constituting an important tool for evaluating the quality of nursing care and patient safety in Intensive Care Units