O trabalho em equipe na atenção primária à saúde: situação de Portugal e do Brasil

Introdução: Na Atenção Primária à Saúde, nos contextos internacional e nacional, o trabalho em equipe tem sido reconhecido como estratégia decisiva para a organização de processos que visam à integralidade do cuidado, além de possibilitar melhorias na satisfação dos usuários com os serviços de saúde. Neste sentido, o objetivo, deste estudo, é analisar o trabalho em equipe na Atenção Primária à Saúde. Método: Trata-se de uma pesquisa em banco de dados secundários. Realizou-se três estudos: a) O trabalho em equipe na Atenção Primária à Saúde, em Portugal, pesquisa avaliativa, de natureza qualitativa, tipo estudo de caso descritivo, que representou um recorte dos resultados derivados da pesquisa integrada ao projeto “Implantação das Unidades de Saúde Familiar em Portugal”, que teve como procedimentos entrevistas semiestruturadas, roteiro de coleta de informações (check list) e análise documental. Foi realizada a estratégia de triangulação dos dados com análise de conteúdo; b) trabalho em equipe, acesso e qualidade na Atenção Primária à Saúde, no Brasil, estudo transversal, de abordagem quantitativa, realizado a partir dos dados obtidos da “Pesquisa de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica”, no Brasil, em 2013. Amostra composta de 17202 profissionais e 65391 usuários. Utilizou-se entrevista estruturada, com análise estatística realizada pelas frequências absolutas e relativas das variáveis através do programa Statistical Package for Social Sciences. c) satisfação dos usuários com o trabalho em equipe na Atenção Primária à Saúde, no Brasil, estudo transversal, de abordagem quantitativa, realizado a partir dos dados obtidos da “Pesquisa de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica”, no Brasil, em 2013. Amostra composta de 65391 usuários. Realizou-se análise estatística das frequências absolutas e relativas das variáveis através do programa Statistical Package for Social Sciences. Utilizou-se, ainda, o Teste X2 , com nível de significância de 5%; análise de regressão logística múltipla. O modelo final foi ajustado pelo teste de Hosmer/Lemeshow, o qual indicou um ajuste de 66%. Resultados: Sobre o trabalho em equipe na Atenção Primária à Saúde, em Portugal, destacou-se a formação das equipes de forma voluntária, por meio de afinidades pessoais, a existência de “carteira básica de serviços”, juntamente com x intervenções de vigilância, promoção da saúde e prevenção de doença, cuidados em situação de doença aguda, acompanhamento clínico de doença crônica e de patologia múltipla, cuidados domiciliares, interligação e colaboração em rede com outros serviços (cuidados hospitalares), sistemas informatizados nas unidades de saúde. Os dados revelaram dificuldades quanto ao atendimento domiciliar. No Brasil, foi destaque o processo de trabalho, com avanços relacionados a realização de planejamento e programação das ações e o apoio da gestão. Existência de território definido e de prontuários familiares. É destaque a agenda compartilhada e pactuada entre os profissionais. As equipes realizam acolhimento e reuniões, cujos temas, discutidos, giram em torno do processo de trabalho e planejamento. Os desafios, enfrentados, estão relacionados ao agendamento dos usuários; ao número de pessoas sob a responsabilidade das equipes; à existência de população descoberta nas áreas adscritas à Unidade de Saúde; à incipiência na ação intersetorial e ao pouco envolvimento da comunidade pelas equipes. Quanto aos fatores associados à satisfação do usuário foi marcante: a faixa etária; a escolaridade; a raça; se a falta de material prejudica o atendimento e se a equipe consegue marcar consulta para outros profissionais. Conclusões: Constatou-se o trabalho em equipe como elemento central no processo de mudança na Atenção Primária à Saúde, tanto no contexto de Portugal quanto no do Brasil, o qual ampliou o acesso e a qualidade na oferta de serviços de saúde e obteve, ainda, o reconhecimento social, mesmo que, em ambas as realidades, não tenha avançado na coordenação do cuidado e no estímulo à participação social. Os fatores, associados com a satisfação do usuário, estão relacionados diretamente ao cuidado prestado e refletem a expectativa, por parte do usuário, de resolução concreta de suas necessidades.

Uma leitura atual do bairro da Ribeira em Natal/RN a partir dos dois circuitos da economia urbana

The present study aims to analyze the spatial organization of the Ribeira district in Natal/ RN from the two circuits of the urban economy. For its realization, was used the bibliographical, documentary and field research. From the information collected in the field research and of secondary data was elaborated the maps, tables, graphics, frames and photographic collections. In the analysis of the results identified the presence of two circuits of the urban economy in the said neighborhood, thus as the predominance of the upper circuit compared to the lower circuit between the surveyed establishments, well as the role that each of the circuits represents to their spatial organization. Some variables such as technology, organization, information, publicity and consumption were important to establish the main differences between the circuits.

Dinâmicas de reprodução do comércio e os novos papéis urbanos de pequenas cidades norte-rio-grandenses: um olhar a partir das redes associativistas de supermercados

The work presented here aims to make an analysis of the socio-spatial dynamics of associative supermarket chains and their importance in redefining the roles of small urban North Rio Grande cities. The theoretical approach gives priority to business as a city constituent whose understanding allows us to seize the new socio-spatial dynamics of small towns in the face of globalization and which caused changes in the scope of its commercial forms. In this sense, we understand that trade, as an essentially urban activity has a very specific characteristic, with respect to its ability to transform the content and meaning of places. Another important factor in the construction work was the context of changes in the capitalist production system with the advent of flexible production and the determinations of the economic globalization process that brought new ways of organizing trade. The empirical analysis of the research includes two associative supermarket chains, the “Rede 10” and the “Rede Seridó”, bringing together basic elements for understanding the genesis and evolution of this new organizational model of trade in small towns of the state, as well as allowed -In understand the main changes in this segment of commercial activity. The methodology we used literature in books and periodicals, collected mainly secondary data collection with the SEBRAE and the ABRAS and was still a field research where interviews were conducted forwarded along to the associative network managers to supermarkets, owners of associated facilities and with consumers of the surveyed networks .Finally, we conclude that the formation and expansion of associative supermarket chains in the context of small cities potiguares is essentially in a survival alternative traditional small traders, that sharing the associative principles albeit somewhat rigidly guided by the training cooperation networks can not only stay in the market , but to impose as a new agent in the capital of the reproduction process. Thus, the associative supermarket chains in the search for new spaces, particularly within small towns end up promoting new momentum in these cities providing different flows and interconnections with different places, giving new content and urban roles. By taking not only the condition of the place of living, but also the place to reproduce the capital, small towns offer their population better able to make purchases, thus avoiding the mandatory population shifts to other urban centers in order to meet their consumption needs.

Dinâmica de expansão urbana de Ceará-Mirim-RN: aspectos locais e metropolitanos?

This study aims to understand the growth dynamics of Ceará-Mirim city considering the aspects that define its current urban sprawl. We chose to use as methodological approach the concept of space as a product and producer of social relations and the same constitutes by objects and actions that relate in a dialectical process over time. As a research tool, it took place bibliographical study that features the historical aspects of use and occupation, in order to evidence the regional ground agents that explain its current urban setting. Then, it was collected a secondary data of economic analysis activities from municipality and their impact on local social structure. Between these aspects, the sugar economy, even in decline, had appeared as defining the boundaries of urban growth. At the regional scale, other factors were discussed in a way of urban influence processes forming the Greater Natal (RMNatal), and Ceará-Mirim appears integrating into this scale in a very low level according to Metropolis Observatory (2012). However, we have pointed out that in recent years, especially in growth vector of BR 406, settled metropolitan scope equipment. These objects have been associating in a real estate sector's reasoning while the possible "metropolization" have been promoting as investments in the city's expansion area.

Os usos do território e a economia solidária no Rio Grande do Norte

The solidary economy as the organization of production, alternative to the capitalist economy provides new forms of organization and social behavior, that, in the sight of geography, it is shown by the different territory uses. The territory assume new meanings that, influenced by the Solidary Economy movement, tries to reach for new ways of acting that differ from social order already stablished. However, the different uses show themselves in a more complex and contradictory way, given that, in solidary undertakings, different corporative agents start to act, the State being a last resource on this process. Given this reality, our goal on the present paper is to analyze the different uses of the territory from the rural economic solidary undertakings and the relationship it establishes to the different agents involved on the socio-territorial dynamics on Rio Grande do Norte. Starting from a study that contemplates the territorial organization forms and contents of the analyzed phenomena, the methodology utilized for this research is based on a bibliographic review, with authors from the geography and areas related to the Solidary Economy, besides the use of secondary data, acquired from official offices such as SIES and IBGE, from the documented research, SENAES and field interviews conducted with local solidary undertakings. The results obtained in the study reveal the complexity of the agricultural use of the territory by Solidary Economy on the RN, while a resource of intensified use, from the state actions and important economical agents, and regulating the use while shelter, that marginalize solidary workers, making them subdued to the hegemonic logic. Therefore, we can infer that the solidary economy, despite its image of new form of organization between agricultural workers, given the expressivity of the rural solidary undertakings presented on RN, it hasn’t shown a full social development as an instrument of reproduction and emancipation of the associates. Nevertheless, the undertakings articulated in nets excel, even when considering its punctual and residual form. The given contradictions show that it is necessary to fortify the building of the solidary economy as being horizontal and popular based for it to have strength to surpass the regulative actions of the capitalist state and ownership created by the Capital.

Avaliação dos efeitos tóxicos in vitro e in vivo do extrato hidroetanólico dos frutos de Genipa americana L. (Rubiaceae) em camundongos Swiss

The therapeutic use of medicinal plants has contributed since antiquity in a beneficial way for health. However, many species lacks of scientific evidence which provide basis for their use in therapeutic practice. In this context is the Genipa americana L. species (Rubiaceae), popularly known as jenipapo and used to treat syfilis, ulcer and hemorrhagic disturbs. It's also used against bruising, as tonic and as aphrodisiac. Due this species lacks toxicological studies, the aim of this study was to evaluate the toxicity in vivo (acute and sub-chronic toxicity) and in vitro (cytotoxicity) of the hydroethanolic extract from G. americana fruits. The hydroethanolic extract of G. americana fruits was prepared by maceration. A preliminary phytochemical analysis was performed to assess the presence of secondary metabolites in the extract. The cytotoxicity study of the extract (0.1, 1.0, 10, 100 and 1000 mg / 100 ul) were performed against normal cells (3T3) and tumor (786-0, HepG2 and B16), analyzed by the MTT assay. To evaluate the acute (single dose of 2000 mg / Kg) and subchronic (100, 500 and 1000 mg / kg for 30 days) toxicity Swiss mice of both sexes were used. At the end of the experiment, blood samples and organs were collected for analysis. Data between groups were compared by t test or ANOVA with Dunnett's post-test with 5% significance level. The phytochemical study of the extracts mainly indicated the presence of iridoids. Results for cytotoxicity tests showed up to 70% inhibition of B16 cell line at a dose of 1000 mg / 100 ul, and up to 29% inhibition of 786-0 at a dose of 10 ug / 100 ul. The extract did not cause death in 3T3 and HepG2 cells. During the in vivo assays, there were no animal deaths. Analysis of blood samples revealed that the animals submitted to the evaluation of acute toxicity had changes in AST and ALT, and that the animals evaluated for subchronic toxicity showed changes in the relative wet weight of the kidney and plasma urea concentration. No differences were observed between groups on histopathological evaluation of the collected organs. Despite the changes found in the in vivo toxicity tests, using the criteria described by the OECD Guidelines, it is suggested that the hydroethanolic extract of the fruits of the G. americana is classified as low toxicity. The cytotoxicity of the extract suggests that they have potential against melanoma cell lines (B16).

Avaliação dos efeitos tóxicos in vitro e in vivo do extrato hidroetanólico dos frutos de Genipa americana L. (Rubiaceae) em camundongos Swiss

The therapeutic use of medicinal plants has contributed since antiquity in a beneficial way for health. However, many species lacks of scientific evidence which provide basis for their use in therapeutic practice. In this context is the Genipa americana L. species (Rubiaceae), popularly known as jenipapo and used to treat syfilis, ulcer and hemorrhagic disturbs. It's also used against bruising, as tonic and as aphrodisiac. Due this species lacks toxicological studies, the aim of this study was to evaluate the toxicity in vivo (acute and sub-chronic toxicity) and in vitro (cytotoxicity) of the hydroethanolic extract from G. americana fruits. The hydroethanolic extract of G. americana fruits was prepared by maceration. A preliminary phytochemical analysis was performed to assess the presence of secondary metabolites in the extract. The cytotoxicity study of the extract (0.1, 1.0, 10, 100 and 1000 mg / 100 ul) were performed against normal cells (3T3) and tumor (786-0, HepG2 and B16), analyzed by the MTT assay. To evaluate the acute (single dose of 2000 mg / Kg) and subchronic (100, 500 and 1000 mg / kg for 30 days) toxicity Swiss mice of both sexes were used. At the end of the experiment, blood samples and organs were collected for analysis. Data between groups were compared by t test or ANOVA with Dunnett's post-test with 5% significance level. The phytochemical study of the extracts mainly indicated the presence of iridoids. Results for cytotoxicity tests showed up to 70% inhibition of B16 cell line at a dose of 1000 mg / 100 ul, and up to 29% inhibition of 786-0 at a dose of 10 ug / 100 ul. The extract did not cause death in 3T3 and HepG2 cells. During the in vivo assays, there were no animal deaths. Analysis of blood samples revealed that the animals submitted to the evaluation of acute toxicity had changes in AST and ALT, and that the animals evaluated for subchronic toxicity showed changes in the relative wet weight of the kidney and plasma urea concentration. No differences were observed between groups on histopathological evaluation of the collected organs. Despite the changes found in the in vivo toxicity tests, using the criteria described by the OECD Guidelines, it is suggested that the hydroethanolic extract of the fruits of the G. americana is classified as low toxicity. The cytotoxicity of the extract suggests that they have potential against melanoma cell lines (B16).

Capacidades estatais para implementação de políticas públicas em ambientes federativos: o caso do Programa Bolsa Família

This thesis aims to understand the extent to which state capacities of state governments explain the effectiveness of the implementation of Programa Bolsa Família (PBF) in the Northeast, adopting the implementation of the theory as the main theoretical lens and more specifically the concept of state capacity. Methodologically is a study of public policy evaluation, and categorized as a process of evaluation study or implementation. Given the specificity of the object is classified as a multi case study research covering the states of Sergipe, Rio Grande do Norte and Bahia. In addition to using secondary data, the study used semi-structured interviews with members of Intersectoral Committees responsible for the actions of PBF and the Cadastro Único at the state level, composed of representatives of the areas of the state government of Social Welfare, Education and Health. the main findings related to technical and administrative capacities and policies were found: infrastructure with weakness in human resources, technological and financial resources; intra-governmental coordination with boundaries between PBF and Unified Social Assistance System , and the actions of conditionality of health and Health Unic System Basic Attention; intergovernmental coordination carried out mostly by the distance limitations of displacement and incipient regional decentralization of actions; based monitoring in the municipalities of lower performance and from the parameters placed by the federal government and political capacities; representative political system is hardly accessed by instances of program management; minor social participation and low articulation with related issues advice to PBF; audit control by any outside agencies. The thesis concludes that depending on the capabilities found implementing weaknesses are not unique to the program's actions, but from the very institutional capacity of the systems in which it operates that are the Unified Social Assistance System, the Health Unic System and the Educational System. In other words limitations of their own state capacities of the state governments and the municipal governments of each territory, such as quantitative insufficiency and qualification of human resources, financial and institutional resources, lack instance promoting decentralization (Intergovernmental and intra-governmental) as well the weakness or absence of a network of local social services are also factors that explain the program management performance and state capabilities of arrangements formed by states and municipalities in the PBF, only to partially deal with the complexity of joints involving Implementation of the program with regard to inter and intra-governmental action.

Capacidades estatais para implementação de políticas públicas em ambientes federativos: o caso do Programa Bolsa Família

This thesis aims to understand the extent to which state capacities of state governments explain the effectiveness of the implementation of Programa Bolsa Família (PBF) in the Northeast, adopting the implementation of the theory as the main theoretical lens and more specifically the concept of state capacity. Methodologically is a study of public policy evaluation, and categorized as a process of evaluation study or implementation. Given the specificity of the object is classified as a multi case study research covering the states of Sergipe, Rio Grande do Norte and Bahia. In addition to using secondary data, the study used semi-structured interviews with members of Intersectoral Committees responsible for the actions of PBF and the Cadastro Único at the state level, composed of representatives of the areas of the state government of Social Welfare, Education and Health. the main findings related to technical and administrative capacities and policies were found: infrastructure with weakness in human resources, technological and financial resources; intra-governmental coordination with boundaries between PBF and Unified Social Assistance System , and the actions of conditionality of health and Health Unic System Basic Attention; intergovernmental coordination carried out mostly by the distance limitations of displacement and incipient regional decentralization of actions; based monitoring in the municipalities of lower performance and from the parameters placed by the federal government and political capacities; representative political system is hardly accessed by instances of program management; minor social participation and low articulation with related issues advice to PBF; audit control by any outside agencies. The thesis concludes that depending on the capabilities found implementing weaknesses are not unique to the program's actions, but from the very institutional capacity of the systems in which it operates that are the Unified Social Assistance System, the Health Unic System and the Educational System. In other words limitations of their own state capacities of the state governments and the municipal governments of each territory, such as quantitative insufficiency and qualification of human resources, financial and institutional resources, lack instance promoting decentralization (Intergovernmental and intra-governmental) as well the weakness or absence of a network of local social services are also factors that explain the program management performance and state capabilities of arrangements formed by states and municipalities in the PBF, only to partially deal with the complexity of joints involving Implementation of the program with regard to inter and intra-governmental action.

Aids em idosos no Brasil no período de 2000 a 2012: uma análise de série temporal e dos fatores contextuais associados

The characteristics profile of individuals who develop AIDS in Brazil has changed over time. Among these modifications, a worrying finding is the increased incidence of AIDS in the elderly across the country. But, however, is not yet clear whether the increase in AIDS cases is sufficient to produce a change in the trend of measures in recent years in the Brazilian states, and this increase has an effect from the socioeconomic and demographic indicators. In this sense, the objective of this study is to analyze the AIDS incidence rates among the elderly in Brazil and its effect on socioeconomic and demographic inequalities in the period 2000 to 2012. This is an ecological time-series study to meet behavior of the time series of the incidence rates of AIDS in the elderly from 2000 to 2012. the rates were calculated using the secondary data from Diseases Information System Notification and the Brazilian Institute of Geography and Statistics. Data were analyzed statistically to know the trends in incidence rates, by polynomial regression model and joinpoint log-linear regression model, but also the simple linear regression analysis to find the relationship of trends with variables socioeconomic and demographic. SPSS 20.0® and Joinpoint 4.1.1 programs were used. All tests were carried out considering a significance of 5%. After the analysis, in Brazil were reported 62,052 new cases of AIDS in the elderly from 2000 to 2012. During this period, a significant increase was found for males, both aged 50-59 years (APPC: 3.46 %, p <0.001), such as above 59 years (AAPC: 4.38%; p <0.001). For females, the increase was significant and has the largest increments in the time series, when compared to males in both age groups (AAPC: 4.62%, p <0.001 and AAPC: 6.53%; p <0.001) respectively. The largest increases are observed in women and in the states of North and Northeast. In the Southeast Region is observed stabilization of rates throughout the series. The reason of trends between the sexes had a significant reduction, but also an approach in both age groups of the study, reaching a ratio of 1.7 males for every female in the youngest age group. The trends were related to illiteracy rates, with increasing social inequality and the lowest human development in the Brazilian states. We conclude that in Brazil the incidence of AIDS in the elderly follows an increasing trend in individuals over 50 years. Noteworthy are the highest rates of study in women and in the states of North and Northeast. In this sense, the country needs to enhance policies towards older people with STD / AIDS, training health professionals and developing effective measures for the prevention and early diagnosis of infected people, especially in places with limited resources and high social inequality. In the long term, it is developing new studies to understand whether the measures taken were effective in reducing the trends identified in this study.

Análise das LER/DORT notificadas no Rio Grande do Norte de 2010 a 2014

The increasing prevalence of Repetitive Strain Injury / Work-Related Musculoskeletal Disorders (RSI / MSDs) has been explained by changes in the work that has been characterized by setting goals and productivity. This fact does not take into account the psycho-physiological characteristics of workers who become ill as a result of professional activities engaged in and also the adverse conditions in which his work was done. This study aimed to analyze the RSI / MSDs reported in the state of Rio Grande do Norte, Brazil, 2010-2014 compared to the profile of the population, epidemiological aspects and features of these diseases. It is a descriptive epidemiological cross-sectional study using secondary data obtained in the Notifiable Diseases Information System (SINAN) in May 2015 was used as the area covered by the Rio Grande do Norte. Data were collected regarding the grievances of work-related RSI / MSDs, assigned by the Worker's Health Reference Center (CEREST) of the State Health Department. Data were processed with the help of Microsoft Excel® 2013 and presented in tables in absolute frequency (n) and relative frequency (%). The results showed a total of 403 notifications of RSI / MSDs, where the vast majority 72% (290) was recorded in Natal. Regarding the profile of notified employees, 88.59% (357) have aged between 25 and 54 years, 62.78% (253) were female, and in relation to education, 31.51% (127) had high school complete. The most affected occupations were seamstresses (the clothing industry) with 24.97% (97), followed by masons, construction with 3.23% (13) and cashiers with 2.99% (12). About the work situation, 75.93% (306) had a formal contract, however, were sent to Communications Occupational accidents (CAT) only 67% (270) of the cases. Regarding the signs and symptoms, pain and limitation of movement were the most mentioned respectively with 98.01% (395) and 95.04% (383) of notifications. Notifications, 94.29% (380) showed exposure to repetitive movements in their workplace. The most frequent specific diagnoses were synovitis and tenosynovitis (CID F 65), with 30.02% (121) of notifications, followed by back pain (CID F 54) to 19.35% (78) and shoulder injuries (ICD M 75) with 15.88% (64). They were away from work 81.64% (329) of workers reported with RSI / MSDs. Evolution more prevalent among cases was temporary disability with 75.68% (305). It was concluded that the SINAN is a database of potential to characterize the profile of RSI / MSDs, requiring, however, an improvement in the coverage of records and data quality. In addition, this study reflects the need to implement protection strategies to workers by companies, signaling promotion, prevention and rehabilitation aimed at reducing these injuries and the improvement of occupational health indicators in Rio Grande do Norte.

Sexualidade e saúde mental: construindo sentidos entre pessoas usuárias de um CAPS

When expressed by mental health services users, sexuality is typically denied by professionals, viewed as another symptom or as if these people are not capable of practicing it. Once Brazilian health professionals haven’t shown lots of investment in this theme, and few are the studies in this field, it is necessary the attention to be focused on researches involving this public. Therefore, the main goal of this study was understand the meanings of sexuality of the mental health services users, which were negotiated in sexuality workshops. The secondary goals were: a) understand the meanings of themes about sexuality brought by users through their experiences of everyday life; b) to evaluate the facilitating experience of the workshops on sexuality at CAPS. Thus, 10 workshops on sexuality were held, with an average of an hour and twenty minutes each, distributed from December 2014 and April 2015. There were 43 participants, 29 women and 14 men. The meetings had the following central themes: sexuality; sexuality and mental health; myths, beliefs and sexual taboos; gender identity; sexual orientation; sexual and reproductive rights; safe sex; and STD/AIDS. The data collection was through audio-recording of these meetings. Later, was made the transcript of the workshops, a careful reading of these transcripts and then its analysis. It was identified categories to analyze the interfaces that permeate the focus of the study. Initially, the categories relating to mental health and sexuality: meanings about sexuality; gender issues; gender and religion; sexual rights, STD/AIDS prevention and attention or denial of sexuality at CAPS. Later, those relating to the workshops facilitating process: challenges in facilitating the workshops; and the perception of the participants. A variety of meanings about sexuality could be noticed in the users’ statements, relating it more with affection and respect than with intercourse. The gender issues that emerged during the workshops were related to marital relationship, sexism, domestic violence, psychological violence and male and female roles in society. Moreover, were also revealed some situations that associated gender differences with religious issues, such as the submission of women and homosexuality. It was also noticed some experiences of the participants involving worrying situations of family violence, suicidal ideation and chemical castration, were often mismanaged or ignored by the service professionals. With regard to the facilitation of the workshops, it was possible to legitimize it as places where users were able to talk openly about the suggested themes and highlight its importance to the study site. Besides, it’s possible to list a few challenges of its facilitation in a mental health service, which was in general positively evaluated by the participants. Thus, the research highlights the need for sexuality theme discussion in mental health services, in order to understand, discuss and inform the users. Also, it’s important to problematize the stigma created in the theme relation with the users, the professionals and the society, working its specificities and avoiding a pathological bias.

Proposta de arquitetura de plataforma de apoio a terapias a crianças com PHDA

A Perturbação da Hiperatividade e Défice de Atenção (PHDA) é uma perturbação que afeta cerca de 5% das crianças a nível mundial. O seu tratamento baseia-se na medicação e exercícios comportamentais para a criança, os quais podem acarretar efeitos secundários indesejados ou ser demasiado exigentes, respetivamente. Neste contexto, o objetivo do trabalho abordado neste documento foi o desenvolvimento de uma plataforma de apoio à terapia da PHDA, incluindo o desenvolvimento de serious games para crianças com idades entre os 6 e os 12 anos baseados em exercícios comportamentais, com uma abordagem mais lúdica, no intuito de aumentar o fator motivação na execução dos exercícios. A plataforma foi designada não para substituir a terapia tradicional, mas sim complementá-la, permitindo a um clínico manter os seus utentes sobre supervisão entre consultas de rotina. Desta forma, é pretendido a elaboração de um estudo sobre a fiabilidade dos serious games como forma de providenciar aos utentes um melhor controlo sobre os seus sintomas, não recorrendo apenas à terapia tradicional. Os primeiros resultados, obtidos com uma pequena amostra, demonstram uma melhora significativa nas competências das crianças e evidenciam a eficácia e robustez da plataforma em si.

As unidades de alojamento de 5 estrelas no concelho de lisboa - a evolução e comparação dos preços on-line em duas épocas distintas

A utilização da internet para efetuar reservas on-line de alojamento no setor hoteleiro, tem um peso cada vez maior no conjunto das reservas efetuadas. É por isso, necessário que sejam elaborados estudos que permitam perceber a evolução dos preços oferecidos ao cliente, ao longo do tempo, nos diversos sites de reserva on-line e no site do próprio hotel, para que quer os clientes quer os gestores possuam informação rigorosa que lhes permita tomar decisões e elaborar estratégias eficazes. Nesta investigação, apresentar-se-á a evolução dos preços médios dos hotéis em estudo, obtida a partir da consulta de um conjunto de sites de reserva on-line que previamente se definiram e do site institucional, consulta efetuada ao longo dos dois períodos de doze dias que antecederam a época festiva da Páscoa e uma época não festiva. A investigação empírica efetuada, neste trabalho, foi realizada com base num estudo de caso exploratório, tendo como objeto de estudo os hotéis de 5 estrelas do concelho de Lisboa, tendo em conta os dados secundários disponíveis. O recurso ao estudo de caso permitiu delimitar de modo preciso o contexto desta investigação. A opção pelo tipo de pesquisa exploratória teve em conta o facto de se conhecer pouca bibliografia científica disponível sobre a temática em estudo. Os resultados obtidos permitiram perceber qual foi a evolução dos preços ao longo do período de consulta para a época festiva da Páscoa e para a época não festiva, possibilitando depois fazer a comparação da evolução dos preços entre as duas épocas. Da análise dos dados pôde ainda perceber-se se havia concertação entre os vários meios de reserva consultados, ou seja, entre os sites de reserve on-line considerados e o site institucional. Tomando por base os hotéis que durante os períodos de consulta foram esgotando pode, ainda, observar-se o comportamento dos preços médios em relação à variação da oferta disponível.

Impact of the invasive macroalgae Asparagopsis armata - an ecotoxicological assessment

Os Oceanos representam o maior sistema de suporte de vida sendo a uma grande fonte de riqueza, oportunidade e abundância. No entanto, a humanidade tem levado este ecossistema ao seu limite com crescentes níveis de poluição e outras pressões antropogénicas. A introdução de espécies não-nativas é reconhecida como uma das maiores ameaças à biodiversidade e a segunda maior causa de extinção das espécies. A macroalga vermelha Asparagopsis armata é uma espécie invasora originária da Austrália e que atualmente apresenta uma ampla distribuição em todo o globo devido à sua estratégia oportunista, ausência de predadores e altas taxas de crescimento. Uma questão emergente está relacionada com a capacidade destas espécies invasoras produzirem grandes quantidades de metabolitos halogenados potencialmente tóxicos. Esta característica pode representar um perigo adicional para o equilíbrio ecológico da comunidade invadida. O presente trabalho teve como objetivo avaliar o potencial ecotoxicológico dos exsudatos de A. armata usando um gastrópode, Gibbula umbilicalis, como organismo modelo. A macroalga recolhida na costa de Peniche (Portugal) foi colocada em tanques no laboratório, durante 12 h, sendo depois o meio recolhido e filtrado para ensaios posteriores com os exsudatos da alga. No ensaio agudo, observou-se a mortalidade de G. umbilicalis que foi exposta a crescentes diluições do exsudato durante 96 h. Adicionalmente, os gastrópodes foram expostos a concentrações não letais do exsudato e analisou-se as respostas bioquímicas recorrendo a biomarcadores relacionados com destoxificação, defesas antioxidantes, danos oxidativos, danos neurotóxicos e metabolismo energético. Os resultados revelaram que os exsudatos de A. armata afetaram significativamente a sobrevivência dos organismos expostos com uma CL50 96h de 5.03% de exsudato da alga. A exposição aos exsudatos da alga também resultou em efeitos bioquímicos e metabólicos ao nível subcelular com resultados significativos na inibição da glutationa-S-transferase (GST), perda de integridade do ADN e níveis crescentes de atividade da lactato desidrogenase (LDH), dando uma indicação dos mecanismos de toxicidade desta alga marinha. Os níveis mais elevados de danos no ADN ocorreram quando a GST apresentou os níveis mais baixos de atividade e esta mesma atividade aumentou quando os danos no ADN diminuíram, em simultâneo com o aumento dos níveis de atividade da LDH, indicando que as necessidades energéticas aumentam devido à necessidade de sintetizar mais enzima. Conclui-se que a A. armata tem capacidade de libertar substâncias tóxicas que podem ter potenciais impactos no ambiente envolvente. Adicionalmente, as respostas bioquímicas estudadas em G. umbilicalis têm potencial para serem usadas como sinais de aviso na determinação dos efeitos provocados pelos compostos libertados por esta macroalga vermelha.