990 resultados para Ciclismo Adaptado


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We believe that the dissatisfaction arising from the lack of belief in the possibilities of change in the workplace, which cause difficulties to achieve professional results in the professional psychological distress that currently fits into the context of mental health. This is a qualitative, descriptive and representational research aiming to discover how the professional nurses represent the very psychological distress from work in the hospital environment. Aided and supported by specific objectives of identifying factors that generates this suffering and strategies for defense and confronting these professionals in the hospital. 22 nurses participated in this research, officials of the University Hospital Onofre Lopes, located in the city of Natal / RN, with length of service in the institution more than one year and less than five, and they accepted, by signing the Term of Free and Informed Consent, participate in the study. We use plurimethodological approach: a questionnaire, a semi-structured interview and the design-story with a theme adapted from Trinca with the support of the Theory of Social Representations and that nurses do in their psychological distress of the Central Core. We reviewed the data from the results generated by the ALCESTE software, based on hierarchical categorization downward, leading seven classes used as categories: Work process: completeness vs. incompleteness; labor contradiction of the nurse; qualitative aspects of interpersonal relationships; hospital surveillance: Challenges, muteness and neglect; Expectations, conflicts and feelings in the work process; Leisure: the other side of the work process, and Suffering generating aspects of in the work process. We consider the analysis of quarters generated by the program, which SLQ houses in the central core of the representations; the SRQ and the DLQ the intermediaries elements and the DRQ the peripheral elements that nurses do in their psychological distress. We analytically adequate results in the three belonging dimensions of social representations: the Subjectivity, the Intersubjectivity and Trans-subjectivity. We infer that the interpersonal relationship, the extra work, the deviation in the role of nurse show themself as the factors responsible for psychological distress of it. In that sense, the central core of SR of this profession is based on the level of trans-subjectivity and understood as a Social Representation controversy

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The objective of this work - which is characterized analyze the search for symptomatic tuberculosis in practice and perspective of the Community Health Agent (ACS) in the districts of Natal. Methods: This is a cross-sectional study. The study population was 646 professionals, and conducted a probabilistic random sampling, stratified by districts. The data were collected from one instrument to collect data based on Primary Care Assesment Toll (PCAT) and analyzed by descriptive statistics. The sample consisted of ACS was 87% female. Among the study participants 58% completed high school and 120 months of exercise training (95% CI 111.9 to 129.5) on average. 90% were USF. The average follow-up of cases found were 2 cases of TB since the beginning of the career of the ACS and the last three years the average is presented in a case accompanied. The ACS received satisfactory ratings on the bond of trust with the user, so as access to homes in the community. The ACS reported for denying the fear of being positive result was the biggest reason for not performing the sputum. All units have a professional that responds to the Tuberculosis Control Program. Regarding the structural capacity of primary care settings for the diagnosis of TB, we observed satisfactory levels in different districts of pots for sputum collection, however, a point that deserves attention from managers is lack of materials for packaging sputum. Fear of positive result was one of the reasons for the refusal of sputum collection, followed by alcoholism. With regard to TB suspects, all responded that ACS always suspect when the user has TB coughs, but in all districts were noticed at low delivery of requests for applications for smear. BSR in TB control, is characterized in practice as a complex action goes beyond technical expertise and contact with the family that breaks with the Cartesian. The BSR is part of the ACS can perform them from the daily visits. We conclude that the ACS is difficult to achieve. This practice should not be the privilege of this actor, but the entire team of primary care. We must rethink the practices of TB care, seeing the health surveillance while aegis of the working process of primary care teams for early diagnosis and thereby reduce TB in communities

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Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.

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Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

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The demographic and epidemiological transition process caused by a declining in birth rates and in mortality, also changes occurred in morbidity and mortality is represented by the increasing of the aging population and the raising of chronic diseases. These diseases are characterized by multiple etiologies, risk factors, long latency period, a prolonged evolution, non-infectious origin and it has association with functional impairment and disability. Thus, elderly with chronic non-communicable disease has priority because they belong to a vulnerable group to get affection of comorbidities in aging, with increased demand and spending on health services. This study is aimed to analyse the understanding of elderly people with chronic non comunicable disease in the medium complexity service as a contribution to the improvement of health care in the city of Natal / RN. This is a descriptive and exploratory study with a quantitative approach, carried out at the Specialized Center for Elderly Health Care and at the Pescadores Hospital. The population was composed of 4,180 persons with a sample of 124 elderly aged above 60 years, attended in these medium complexity services. The instrument, a structured form, adapted from a questionnaire for monitoring risk and protective factors for chronic disease of the Ministry of Health. To collect data was was used the interview form containing demographic data, habits, health status and health care services. The results were processed using the Statistical Package for Social Science, version 18.0, analyzed by simple statistics. It was found that most seniors were female, predominantly between 70 and 74 years old, married, with a brown skin tone and Catholic religion, more than half had incomplete basic education, family income between one to two minimum wages and living with their families. Regarding the interviewers lifestyle, 94.4%, of them ate chicken and 97.6%, fruits, it was observed a reduction in smoking, alcoholism habits and physical activity according to the increasing age, 58.1 and 18.5% had insomnia18,5 % used sleeping pills. The elderly (51.6%) reported using services in times of sickness, seeking primary care at first (30.6%), 52% did not receive referral and was looking for free demand (38.7%). The most reported morbidity was hypertension, followed by musculoskeletal disorders. Regarding the difficulties in seeking health services, the delay in treatment and the waiting line were the most cited by the elderly. Almost all of them reported no activities to promote health in these services and those who received individual counseling on chronic diseases. Almost always, the health professionals who care of them, were mostly doctors followed by nurses. Based on the results presented, it is considered that the health services of medium complexity must undergone a more continuous dialogue with other attention level and focus on actions of health promotion and prevention. It is also recommended the necessity for qualified professionals to delivery health care to elderly and the implementation of protocols by a multidisciplinary health team, intending to provide better and continous care for the elderly with chronic diseases. The healthcare professionals who served them, were mostly physicians, followed by nurses. Through the results presented, it is considered that the medium complexity healthcare services need to perform a more continuous dialogue with the other levels of attention focusing attention to the health promotion and prevention actions. It is also recommended the necessity for qualified professionals to delivery healthcare for the elderly, in addition, a protocol implementation for the multidisciplinary health care team, to provide better care, and also the care continuity to elderly with chronic diseases

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The attention with safety of the patients is important in the quality of the nursing and health care. In the pre-hospital care, such care is essential on site with the purpose of avoiding possible consequences to the individual, ensuring a fast and appropriate care, with improvement of the morbidity and reduction of the mortality. This medical attention is equally associated with the significant risks of adverse events and serious mistakes, which can be reduced with the awareness of the professionals, organization and quality management. It is a descriptive, transversal research, of quantitative approach, with the objective of identifying the risks for the safety of the patient during the mobile pre-hospital care under the view of the nurses, in a city of the Brazilian Northeast. The sample was formed by 23 nurses. The inclusion criteria: to have at least two years of experience and accept to participate on the research. The data collection was done in two steps, first photo collection, through the adapted method of photographic analysis, and the second with the application of questionnaire, divide in two parts: socio-professional data and digital photo punctuation instrument of the patient s safety. The majority of the nurses had an average working time in the mobile pre-hospital care of six years and six months, in the age group of 38 to 53 years old (69,56%) and with Lato sensu specialization (73,91%), being (29,41%) emergency and (29,41%) in intensive care. The (74%) have the Advance Cardiac Life Support (ACLS) and (100%) have the Pre-Hospital Trauma Life Support (PHTLS); (91, 30%) know the thematic safety of the patient. On the pictures it was observed a bigger variability of the categories (risks) where 44% of variance emerged on the first picture of the research. The pictures 4 and 9 with the average below 5 were classified as very insecure, while pictures 7 and 3 with an average above 7, very secure. On the results of risks observed for the patient s safety in the mobile pre-hospital care five categories emerged: organization and packaging of the equipment and materials, routines and specificities in the mobile pre-hospital care, risks on the management of medications, for traumas and infections. Starting from the analysis of these risks, it was proposed ten steps for the safety in the mobile pre-hospital care: 1- Identify the patient; 2- Safety related to prevention of infection; 3- Safety in the management of medications; 4- Safety and standardization of the packaging of equipment and materials; 5- Attention to the specificities of the mobile pre-hospital care; 6- Incentive and value the participation of the patient and family; 7- Promote the communication with the central of regulation; 8- Prevention of traumas and falls; 9- Protect the skin from additional injuries; 10- Understand the benefit of all the equipment in the ambulance. The multiple risks and their emerged combinations on the research indicate a variety of actions to be developed and stimulated, like the use of steps for the patient s safety in the mobile pre-hospital care which contributes with the aid and management of risks, reduction of mistakes, disabilities and death

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A presente pesquisa objetivou estudar as relações entre os fatores intervenientes para a satisfação no processo de compras baseadas na Internet e sua influência na fidelidade online (e-loyalty), na visão dos consumidores de varejo virtual. Para tanto, foi utilizado como instrumento de coleta de dados um questionário baseado em fatores de qualidade e fidelidade oriundos dos serviços convencionais, que foi adaptado para a realidade dos serviços digitais. A pesquisa caracteriza-se como exploratória, de natureza quantiqualitativa. A análise quantitativa descreveu e testou a relação de variáveis de qualidade do site e de preço dos produtos do site com as variáveis de satisfação. Neste caso, foram utilizadas técnicas estatísticas como distribuição de freqüência, médias e desvio-padrão e correlação de postos de Spearman. Já na abordagem qualitativa, foi empregada a análise de conteúdo para uma questão aberta relacionada com a identificação dos fatores que levam a fidelidade digital. A pesquisa de campo foi feita com uma amostra de 44 alunos de pós-graduação em nível de Especialização da Universidade Federal do Rio Grande do Norte. Os resultados da análise quantitativa evidenciaram que a qualidade está ligada à satisfação dos clientes em vários fatores, mas o preço não influencia muito na satisfação. Na análise qualitativa, a segurança do website e os preços oferecidos são fatores que potencialmente fidelizam os clientes digitais, segundo a perspectiva dos entrevistados. O fator segurança e confiança no website foi considerado o mais crítico para a fidelidade dos clientes que compram pela Internet

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This thesis deals with the quality dimensions and factors affecting citizens satisfaction in the participatory budgeting process in a major city of Brazil. Participatory budgeting was introduced as a usual practice in many Brazilian cities since the 1990s. It is adapted a model proposed by Johnson et al. (2001) of customer satisfaction and loyalty antecedent factors with constructs related to governance also included, to evaluate the quality perception and satisfaction rates by citizens representatives in the participatory budgeting process. It is conducted a survey with a sample of 84 citizens representatives of the seven city regions of Natal, the capital of a Northeastern State of Brazil. It is applied descriptive and multiple regression statistical analysis. The main findings related to quality and governance constructs are that the quality factors are the main factors affecting satisfaction but also the tax construct is significative to satisfaction. More regarding it was found that for different perspective of the satisfaction there are different set of factors affecting it

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This study presents an investigation of the influence of Corporate Social Responsibility (CSR) in customer s satisfaction and loyalty through a study with car s buyers, besides that, it aims to contribute to conceptual models of satisfaction and loyalty analysis by applying the model of Johnson et al. (2001), adapted for the introduction of variables of CSR and conscious consumption, in a car dealership in Natal / RN. The methodology has a descriptive quantitative approach and for the analysis results were applied statistical methods of simple and multiple linear regression analysis, descriptive analysis and exploratory analysis. The field research provided 90 valid forms. The results show that CSR affects the image of the company studied and is also one of the elements of the compound of satisfaction and loyalty. This study concludes that CSR should be considered in the strategic and marketing actions of firms

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The jangadas (brazilian fishing rafts) are rudimentary artisanal vessels intrinsic to the Northeast of Brazil. The fishery with jangadas is highly representative in the State of Rio Grande do Norte, and source of income for many families in addition to being a strong cultural icon. Is still alive despite the difficulties, bringing the history and customs of the fishermen and their people. However, is in process of extinction due to factors such as the low profitability of the activity, tourism and urbanization. From the understanding of activity involving their context and circumstances, based on identified problems regarding the conditions of use of jangadas as the unpredictability, the risk of accidents, poor working conditions, hygiene and housing, this dissertation aims to: analyzing the design of the jangada on the beach of Ponta Negra and its relationship with the activity in relation to health, safety, productivity and environment, and from such assessments, together with the results achieved during the workshops of the project, proposing a cart to move the raft, adapted to the local fisherman activity studied. To perform analysis of jangadeira activity, we used a methodology based on ergonomic work analysis - AET (WISNER, 1987; GUÈRIN, 2001; VIDAL, 2008, SALDANHA, 2004 and Carvalho, 2005). For data collection were used observational and interaction methods as a conversational action, verbalizations, photographs and video. It is emphasized that the search for solutions appropriate to the jangadeira activity was possible through the collaboration of several people, not just an informational level and understanding during the work activity, but effectively contributing to the making decisions

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The jangadeiros in the work activity are exposed to diverse and constant variability, which are extremely important to know in order to understand this activity and the risks they are exposed. The current study aims to analyze the work activity raftsmen of Ponta Negra beach in Natal, focusing on handling and quality of the fish sold by them to propose through the social construction recommendations for improving its product. To achieve this purpose was used a methodology inspired by the ergonomic work analysis using techniques observational and interactional. He was also made an assessment of fish sold by jangadeiros Ponta Negra, this evaluation was a sensory evaluation using the method "Torry Research" adapted by Vieira (2004) in order to assess the level of quality fish. In general it was observed that the fish originated from the fishing that rafts in Ponta Negra, have a good degree of freshness. But it was found that some ways of handling and storage can be improved

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The objective of this Thesis is to investigate the strategic alignment between market end operations in the retail supermarket sector applying the concept product profiling by Hill (1993). To the developing was utilized a methodology of the cases study had were a evolvement if the action research into on of the RedeMais supermarkets. Through the interview, discussion and direct action became possible collect information necessary to direction this work, absorbing and understanding the methodology and thought form, action and management. This work contribute to development the create of the model adapted of the manufactory to service, the product matrix of the Hill, in which serve a tool to uncover the origins of misalignment that occur over time and to illustrate the phenomenon to executives gone support to decision

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Foi desenvolvido um modelo bioeconômico para o cálculo do desempenho, dos custos e das receitas para obtenção de valores econômicos de características de interesse econômico em sistemas de produção de gado de corte no Brasil. As informações de desempenho e de parâmetros biológicos e econômicos foram obtidas em uma propriedade de gado Nelore que realiza ciclo completo com venda de reprodutores. O modelo é determinístico e estático e foram usadas planilhas Excel para a realização dos cálculos. Com base nas informações originais, foram simulados dois sistemas de produção, um fazendo o ciclo completo com venda de reprodutores (CcoR) e o outro, de cria (Cc). Foram calculados os custos e as receitas para esses dois sistemas e, a partir disto, foram obtidos seus lucros anuais. Para o cálculo dos valores econômicos foram escolhidas as características peso à desmama (PD), peso adulto da vaca (PAV), taxa de prenhez (TP) e taxa de desmama (TD), que são de interesse nos dois sistemas de produção. Para avaliar o impacto das mudanças no desempenho das características sobre o lucro anual do sistema de produção, os valores iniciais das características foram aumentados em 1%. Esse aumento resultou em mudanças positivas no lucro, observando-se que a TD foi a característica que apresentou maior impacto nos dois sistemas. Para o CcoR, os valores econômicos para PD, PAV, TP e TD foram, respectivamente, R$ 0,40/kg, R$ 0,09/kg, R$ 3,20/1% e R$ 10,15/1%. Para Cc, estes valores foram, respectivamente, de R$ 1,31/kg, R$ 0,09/kg, R$ 2,41/1% e R$ 3,36/1%. O modelo foi capaz de reproduzir satisfatoriamente o sistema de produção de gado de corte estudado e pode ser adaptado para outras circunstâncias de produção.

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Ensuring the dependability requirements is essential for the industrial applications since faults may cause failures whose consequences result in economic losses, environmental damage or hurting people. Therefore, faced from the relevance of topic, this thesis proposes a methodology for the dependability evaluation of industrial wireless networks (WirelessHART, ISA100.11a, WIA-PA) on early design phase. However, the proposal can be easily adapted to maintenance and expansion stages of network. The proposal uses graph theory and fault tree formalism to create automatically an analytical model from a given wireless industrial network topology, where the dependability can be evaluated. The evaluation metrics supported are the reliability, availability, MTTF (mean time to failure), importance measures of devices, redundancy aspects and common cause failures. It must be emphasized that the proposal is independent of any tool to evaluate quantitatively the target metrics. However, due to validation issues it was used a tool widely accepted on academy for this purpose (SHARPE). In addition, an algorithm to generate the minimal cut sets, originally applied on graph theory, was adapted to fault tree formalism to guarantee the scalability of methodology in wireless industrial network environments (< 100 devices). Finally, the proposed methodology was validate from typical scenarios found in industrial environments, as star, line, cluster and mesh topologies. It was also evaluated scenarios with common cause failures and best practices to guide the design of an industrial wireless network. For guarantee scalability requirements, it was analyzed the performance of methodology in different scenarios where the results shown the applicability of proposal for networks typically found in industrial environments

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The lubricants found in the market are of mineral or synthetic origin and harm to humans and the environment, mainly due to their improper discard. Therefore industries are seeking to develop products that cause less environmental impact, so to decrease mainly, operator aggression the Cutting Fluids became an emulsion of oil / water or water / oil. However, the emulsion was not considered the most suitable solution for environmental question, therefore the search for biodegradable lubricants and which no are toxic continues and so vegetable oils are seen, again, as a basis for the production of lubricants. The biggest problem with these oils is their oxidative instability that is intensified when working at high temperatures. The process transesterification decreases the oxidation, however changes some physical and chemical properties. Therefore soybean oil after the transesterification process was subjected to tests of density, dynamic viscosity, kinematic viscosity which is calculated from two parameters mentioned, flash point and acidity. Besides the physico-chemical test the soybean oil was subjected to a dynamic test in a tribometer adapted from a table vise, whose induced wear was the adhesive and ultimately was used as cutting fluid in a process of turning in two different materials, steel 1045 and cast iron. This latter test presented results below the mineral cutting fluid which it was compared in all tests, already in other experiments the result was satisfactory and other experiments not, so that chemical additives can be added to the oil analyzed to try equate all parameters and so formulate a biolubrificante not toxic to apply in machining processes of metalworking industry