A pessoa idosa com doença crônica não transmissível atendida em serviços de média complexidade na cidade de Natal/RN

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

Atenção à saúde mental na Estratégia Saúde da Família no Município de Parnamirim/RN: opinião dos profissionais, dos portadores de transtornos mentais e seus acompanhantes

This study aims to analyze and compare the opinion of professionals, managers and users about the mental health care in the Family Health Strategy (FHS). It is characterized as an Operations Research or Health System Research with a cross-sectional design and a descriptive quantitative nature. The study was developed from the application of the Opinion Measurement Scale allied to techniques of observation and structured interview in the city of Parnamirim / RN. The sample consists of 409 subjects, 209 professionals of the Family Health Strategy, 30 of the Oral Health Strategy, 19 of the Family Health Support Center, 24 directors of Basic Health Units, plus 68 users with mental disorders and 59 caregivers, respecting the ethical parameters of Resolution 196/96 of the National Health Council, trial registration number: CAAE 0003.0.051.000-11. Quantitative data were submitted to the Epi-info 3.5.2 for analysis. The network of mental health in Parnamirim involves the flow between the FHS, Psychosocial Care Centers, clinics and hospitals, having as main barriers the fragility of the referral and counter-referral system, of the municipal health conferences, of the FHS teams by the limitations in material and human resources as well as the population´s lack of acknowledge about the organization of the mental health network, issues that affect the integral attention. Even though the FHS professionals recognize the importance of their actions, they question their role in mental health care, experiencing difficulties in accessing psychiatric services (76.5%). Although most agree that the mentally ill is best treated in the family than in hospital (65.2%), the community health workers were the predominant category in the partial or total disagreement of this statement (40.8%), who is the professional in greater contact with the family. Nevertheless the caregivers miss the support of the FHS as the main focus of attention is on revenue control. The views of professionals, mental patients and caregivers converged in several statements, showing the main weaknesses to be focused by the mental health network of the city, as the perceptions that: (a) physical strength is needed to take care of mental patients for its tendency to aggression, requiring it to stay in the sanatorium for representing danger to society, (b) only a psychiatrist can help the person with emotional problems, (c) the user of alcohol and drugs does not necessarily develop mental illness, (d) the access barriers and doubts about the quality of psychiatric services, (e) caring of a mental health patient does not bring suffering to professionals. Therefore, the commitment to consensus building, monitoring and evaluation of the network are important mechanisms for an effective management system, reflecting in the importance of strengthening the health conferences and approximating different institutions. The results reinforce the importance of strengthening primary care through programs of continuing education focusing on the actions and functions of professionals in accordance with its competences and duties what contribute to the organization and response of mental health care, favoring user´s care and the promotion of family health

Influência do manejo do solo nas propriedades químicas e físicas em topossequência na bacia do rio Araguaia, Estado do Tocantins

A conversão do Cerrado nativo em áreas de exploração agrícola pode modificar os processos de decomposição e síntese da matéria orgânica do solo e, assim, na disponibilidade de nutrientes. Objetivou-se avaliar as propriedades químicas e físicas do solo em topossequência caracterizada por apresentar uso com pastagem cultivada com Brachiaria brizantha ao lado do Cerrado nativo, na camada de 0- 15 cm de profundidade. O estudo foi realizado no município de Colmeia, Estado do Tocantins. Foram determinados 10 pontos de coleta (cinco para Cerrado nativo e cinco para pasto) para cada posição do relevo (topo, encosta e pedimento); em cada ponto amostral, foram coletados solos em três profundidades (0-5, 5-10 e 10- 15 cm), totalizando 90 amostras. Foram realizadas as seguintes análises químicas e físicas: C orgânico, P, K+, Ca2+, Mg2+, H + Al, pH e granulometria. O C orgânico não apresentou diferença (p > 0,05) entre os valores encontrados no Cerrado nativo e pastagem e as posições do relevo avaliadas. A conversão de Cerrado nativo para uso agropecuário reduziu os teores de P. Os teores de K trocável não foram alterados pela retirada da cobertura vegetal original. Observou-se aumento dos teores de areia quando se passou da meia-encosta para o pedimento.

Efeitos da subsolagem e da adubação verde nas propriedades físicas do solo em pomar de citros

O presente trabalho teve por objetivo avaliar o efeito da subsolagem e da adubação verde nas propriedades físicas de um Latossolo Vermelho distrófico típico, cultivado com citros (laranjeira Valência). Os tratamentos empregados foram: manejo mecânico das plantas invasoras com roçadora (Testemunha); subsolagem em um lado da planta na entrecopa; subsolagem nos dois lados da planta na entrecopa, e semeadura direta de Crotalaria spectabilis na entrecopa. As propriedades físicas do solo avaliadas foram: porosidade total, macroporosidade, microporosidade, densidade, resistência mecânica à penetração vertical e condutividade hidráulica. Na avaliação efetuada na safra 2001-2002, obtiveram-se os maiores valores de densidade do solo e resistência do solo à penetração vertical, e os menores valores de macroporos e condutividade hidráulica do solo nas entrecopas com e sem tráfego no pomar, em relação à região da copa, principalmente na camada de 0,0-0,2 m de profundidade. Os tratamentos aplicados não surtiram efeitos positivos significativos nas propriedades físicas do solo.

Acidez do solo e calagem em pomares de frutíferas tropicais

A produtividade agrícola nos trópicos é afetada, principalmente, pelos fatores ligados à acidez do solo (pH, saturação por bases, acidez potencial, disponibilidade de nutrientes). A calagem é uma prática bem conhecida para corrigir a acidez do solo em culturas anuais, ainda que não seja praticada com a regularidade necessária. Entretanto, em culturas perenes, a incorporação de corretivos é mais complexa, devido às características desse grupo de plantas e à carência de informações científicas sobre o assunto. em condições de acidez, a calagem promove a neutralização do Al3+, a elevação do pH e o fornecimento de Ca e Mg, possibilitando a proliferação de raízes, com reflexos positivos no crescimento da parte aérea das plantas. Contudo, devido à baixa solubilidade e à lenta movimentação do calcário ao longo do perfil do solo, há obrigatoriedade de se fazer distribuição uniforme e incorporação profunda, antecedendo a implantação do pomar, a fim de garantir o eficiente aproveitamento de água e de nutrientes contidos nessas camadas. A calagem deve ser considerada um investimento, pois seus benefícios perduram além de um ano ou de uma safra agrícola. Isso se deve ao efeito residual dos corretivos de acidez do solo, sendo o tempo de duração desse efeito dependente de vários fatores, entre os quais: condições edafoclimáticas, cultura, manejo da área e tipo de corretivo empregado. em geral, partículas maiores de calcário têm efeito residual mais prolongado, sendo empregadas na implantação dos pomares. No entanto, a relação entre o tamanho da partícula e o efeito residual tem sido pouco pesquisada, devido à necessidade de estudos de longa duração. em função das elevadas doses de adubos nitrogenados utilizadas nos pomares de altos rendimentos, a acidez do solo aumenta, como resultado do processo de nitrificação. em pomares já implantados, o procedimento atualmente utilizado pelos produtores é a incorporação superficial do calcário na área. As recomendações talvez fossem outras, caso houvesse maior subsídio da pesquisa, tendo em vista os diversos problemas fitossanitários que podem ocorrer, direta ou indiretamente da prática da incorporação do corretivo, tais como redução do sistema radicular, ferimento das raízes e consequente risco de infecções, com disseminação de pragas e doenças no pomar. O objetivo desta revisão é apresentar os principais resultados de pesquisas sobre o assunto, mostrando os efeitos da calagem sobre a fertilidade do solo, a nutrição e a produtividade de frutíferas de grande importância econômica para o Brasil, bem como discutir a duração do efeito residual dos corretivos e a dose mais ecônomica a ser aplicada nos pomares de frutas em implantação e em produção.

Atuação do enfermeiro na estratégia de atenção integrada às doenças prevalentes na infância

This study aimed to describe nurses' actions in the strategy of Integrated Management of Childhood Illness in the city of Natal, Rio Grande do Norte. This is a qualitative study with descriptive approach. The universe consisted of nurses from the Family Health Strategy, totaling 16 participants. For the research project was submitted for approval by the Ethics Committee of the Universidade Federal do Rio Grande do Norte, obtaining Opinion No. 187/2012. Data were obtained in two ways: a questionnaire survey to profile the training of nurses and an interview guided by a structured interview. Interviews were treated in the light of analysis of thematic category Bardin. The results showed the central thematic study "Integrated Management of Childhood Illness in the context of nursing activities" category and three analyzes: "Understanding the Integrated Management of Childhood Illness", "Difficulties invibializam use IMCI "and" Working conditions for nurses in the Integrated Management of Childhood Illness. " It is observed that nurses consider the Integrated Management of Childhood Illness useful, effective and important to keep sick children within the logic curative. However disregard the character of health promotion and disease prevention thereof. It was found that the participants still hold the attendance of crinaças within the biomedical model and that these same professionals are subjected to increasingly precarious working conditions and unhealthy due to lack of human and material resources. It was found that the interviewees do not follow the protocols of strategy because of barriers related to prescription medications by nurses, the medical, the lack of incentives, training and supervision by the municipal health and the Regional Nursing Council

Atuação do enfermeiro no acompanhamento do crescimento e desenvolvimento da criança

The nurses assistance in monitoring the growth and development of children has been characterized mostly a service based on the biological dimension of illness, when in reality, the actions should be combined in the reorientation of care model of the Family Health Strategy. Thus, the research aimed to examine the role of nurses in the growth and development of children. This is an exploratory and descriptive, qualitative approach. The project was approved by the Ethics Committee of the Universidade Federal do Rio Grande do Norte under Opinion No. 191/2012. Data collection was developed in the Health Units from the city of Natal, RN, Brazil. Survey participants were nurses who worked in the Family Health Strategy for at least two years and who performed the monitoring of child growth and development in the health unit selected. Data were collected through an in-depth interview, and seized material from speeches was treated as categorical thematic analysis proposed by Bardin. This process revealed three themes, which were analyzed in the light of Relief Models and Process Work in Health and Nursing and discussed based on the findings literary. The results elucidated that nurses consider their performance satisfactory as it has favored the accession of mothers of children under one year nursing visits, contributing to the reduction of morbidity and mortality due to prevalent diseases, as well as the establishment of a connection between the professionals and mothers. It was shown that despite having a promotion and prevention with the use of lightweight technologies, the nurses also emphasized the care of mothers in complaints and signs and symptoms of children, followed by referrals to professionals in the unit or to other sectors. Furthermore, we found that the process of working nurses face challenges regarding the organizational structure of services and social situation of the family. Given these statements, it is observed that despite the strong interference from hegemonic health model in the performance of nurses, it is found that these professionals have been investing in promotion and prevention to injuries to children in care, with a focus on family context. Thus, nurses are embarking on making the reorientation of health care through the use of relational technologies, which has contributed to solving the integral care to the pediatric population

Trajetos no labirinto: história de vida dos portadores de doenças oncológicas em uso de transfusões sanguíneas na cidade de Natal/RN

The studies paths in the maze: life story of individuals with oncological diseases into use of blood transfusion in Natal has the hemotherapy as a primordial procedure to review the relationship between users of oncological health and the due ramifications. The hemotherapy looks for supply the organic needs through blood transfusion, which acquires vital function to the ones that have cancer, because it might reestablish the functionality of the organism throughout the raising of blood components. The impact over the transfusion affects emotionally and physically the users life. Aiming to reflect on these impacts, this study tried, through narratives of lives, rescue their experience since their knowledge of the disease until the time of blood transfusion using. It s about an exploratory-descriptive study, where the qualitative approach uses the theoretical-methodological reference of the oral life history to analyze a colony consisting of five users of health diagnosed with cancer, with achievement of at least three blood transfusions, the clinic Núcleo de Hematologia e Hemoterapia - UFRN, in Natal-RN. The network, in turn, was composed by employees of both sexes, regardless of age, who voluntarily agreed to participate in the study. The data collection, with approval of the Ethics Committee in Research, Liga Norte Riograndense Contra o Cancer, on the number 001/001/2012, occurred through semi-structured interviews, recorded individually in the home context that was previously chosen by employees. The methodological procedure occurred with the transcription of the interviews and their transcreations, and analysis of reports by thematic content analysis. At the reading orientation and interpretation of the employees stories, were discussed three categories of analysis: the impact on psychological REVIEW; impact on socialization and group membership, the environment and the impact of blood transfusion on treatment. Based on the narrative of the life histories of employees, we conclude that the experiences and feelings, hope and sorrow, pain and faith, even when facing a disease like cancer, bring lots of teaching and learning to health professional that deposits humanization health and reinstate hemotherapy forms of clinical critical

Trauma em idosos atendidos pelo serviço pré-hospitalar móvel

O The aim of this study was to characterize the occurrence of trauma in the elderly population served by the mobile pre-hospital service, in Natal, Rio Grande do Norte. This is a descriptive, transversal and quantitative approach and whose population consisted of 2,080 trauma victims. The sample, of systematic random type, consisted of 400 elderly people, aged from 60 years old, assisted by the Office of Mobile Emergency in Natal / RN, between January 2011 and December 2012. Data collection began after consent and assent of the institution of a Research Ethics Committee under No. 309 505. It was proceeded to documentary retrospective analysis of records of this service through a form of self-development, validated by expert judges considered reliable (α> 0.75) and valid (CVI = 0.97) in their clarity and relevance. Data were tabulated by the Statistical Package for Social Sciences, version 20.0. The results show that older victims have an average age of 74.19 years old, with a prevalence of female involvement by chronic diseases, especially hypertension, average usage of 2.2 routine medications with vital signs within normal limits. The trauma prevailed during the daytime, in the residence of the victims, north of the city and on weekends. Among the mechanisms of trauma were falls, traffic accidents and physical aggression, whose most common type was brain-cerebral trauma and the main consequences were suture wounds and closed fractures. Basic Support Units were as more driven to pre-hospital care (87.8%) and the main destination place consisted of a referral hospital for emergency of the state (57.5%). Among the most commonly performed procedures by nursing staff immobilization with rigid board and neck collar and the peripheral venipuncture, and the main component used for volume replacement to saline were highlighted. There was a significant relationship between the deaths and the mechanism of injury, mechanism of injury and procedures, except medication administration procedures carried out, except immobilization and unit for service. It is highlighted the prevalence of trauma in the elderly, poor follow-up Pre-Hospital Trauma Life Support protocol and the paucity of records and nursing procedures performed. There is need for a protocol of care specific to elderly trauma victims and education strategies for the prevention of such events

Razão e Fé: estudo do grupo de oração como prática complementar na promoção à saúde

The World Health Organization (WHO) has given special attention to therapeutic procedures other than those practiced in conventional therapy, including homeopathy, phytotherapy, spiritual therapies and prayers, making possible the transition from a mere medicalizating model to a holistic view of the human being. This trend, earmarked in 1978 at the Alma-Ata Conference, questions the ability of technological and specialized medicine to solve the health problems of humankind. In Brazil, the onset of the Brazilian unified health system in 1988, introduced changes in the population s health care model where, within the scope of basic care, emphasis has been given to the Family Health Program since 1994. In this scenery, there is a broad area of complementary practices used in promoting health and preventing and treating diseases to support an understanding of the habits and beliefs underpinning popular practices. The purpose of this study was to analyze the perception users participating in the Peace and Balance group of the Family Health Unit of Nova Cidade, in Natal, Rio Grande do Norte, started in 1999, have of the relationship between the experience of prayer and the changes that may have taken place in their lives after joining the group. It is a case study of descriptive nature and qualitative approach. The data were collected during focus group interviews between January and February 2007, using as tools a questionnaire to describe the research participants and a discussion outline. The theoretical support approached the following: religion and the evolution of thought; complementary health practices; and religion as a complementary health practice. Those interviewed reported, as results of such experience, a reduction in stress and depression, an increase in socialization and self-esteem, improved family interaction, comfort, safety, assurance, improved blood pressure levels and a decrease in the use of antihypertension medication and psychopharmacs. Although most professionals do not consider attention to the religious and spiritual aspects an effective therapeutical complement in health care, its understanding and practice may democratize knowledge and relationships, out of which they can learn how to make health production more effective, strengthening assurance and confidence, and developing and expanding soft technologies aimed at health care promotion and wholeness

Influência do cultivo da cana-de-açúcar e da mineralogia da fração argila nas propriedades físicas de latossolos vermelhos

As atuais técnicas de manejo da cultura da cana-de-açúcar utilizam um vigoroso revolvimento do solo por ocasião do plantio, com o uso de arados, grades pesadas e subsoladores. O objetivo deste trabalho foi avaliar o grau de modificação de algumas propriedades físicas de um Latossolo Vermelho caulinítico (LVd) e de um Latossolo Vermelho caulinítico-oxídico (LVdf) cultivados com cana-de-açúcar e sob mata nativa no município de Jaboticabal (SP), além de comparar as propriedades físicas encontradas em ambos os Latossolos. O delineamento experimental utilizado foi o inteiramente casualizado, em esquema de parcelas subdivididas 4 x 3 (manejos e camadas), com quatro repetições. Também foi realizada a análise conjunta entre as propriedades físicas dos Latossolos. Os sistemas de uso foram: cana planta (CP), cana soca de segundo ano (C2), cana soca de quarto ano (C4) e mata nativa (MN). Avaliaram-se a densidade do solo (Ds), a sua porosidade e o diâmetro médio ponderado (DMP) nas camadas de 00,10, 0,10-0,20 e 0,20-0,30 m. Os efeitos dos sistemas de uso e manejo sobre os atributos físicos, nas diferentes camadas, foram verificados a partir da análise de variância; quando significativas, as médias foram comparadas pelo teste de Tukey a 5 %. A MN do LVdf apresentou maior macroporosidade e menor microporosidade em relação à das áreas cultivadas, mas, para porosidade total e Ds, a MN apresentou diferença apenas para C2 e C4. O tempo de cultivo da cana-de-açúcar proporcionou o aumento da Ds e diminuição da macroporosidade em ambos os Latossolos. Entretanto, o maior teor de óxido de Fe no LVdf proporcionou maior porosidade total e menor Ds, e sua macroporosidade permaneceu acima de 0,10 m³ m-3 em todos os manejos e camadas. Os sistemas de uso do solo com cana-de-açúcar reduziram a estabilidade de agregados, em relação à mata nativa.

Doenças sem doentes: Ocorrência de Distúrbios Osteomusculares Relacionados ao Trabalho DORT nos operadores de caixa de um banco

The changes incurred in the financial system with the introduction of new technologies and new forms of administration of banks has caused impact on the health of workers. These changes, which passed in the process of work, generate a combined share of the risk factors that result in numerous injuries and illnesses among banks, notably between the operators of banks tellers. The Work-Related Musculoskeletal Disordes - WRMD represent a group of occupational diseases always present among these workers. Because of its high incidence and the amount of financial resour envolved to manage the problem has been the object of constant study. This paper aims to analyze the bank teller activity; search the occurrence of WRMD in the activity, identifying the factors determining the occurrence of WRMD in the activity and determine the real number of touchs on a keyboard made by the operator and propose solutions that influence the reduction of illness in the workplace of the bank teller. Methodological tools of ergonomics are used to provide a broad knowledge of aspects of work that have been studied and influential in the generation of occupational diseases studied. It was found that activity put workers to serious risk of occupational diseases. As the main contributory factors and determinants for this illness: the requirements and control the numbers daily endorsements; evaluation system based on performance targets for productivity; management system at time of service to customers; work with stressful factors (broken box); excess of time worked; furniture of workstations with ergonomic inadequacies and policy for the prevention of occupational diseases inefficient. They have also noted cases of illness for DORT workers without fulfilling the legal requirement of the issuance of the communication of labour accident and without the removal of the employee of the workplace

Uso de diferentes formas físicas e quantidades de ração pré-inicial para frangos de corte

The objective of this work was to evaluate the effect of the physical form and quantity of pre-starter diet on the broiler chicks performance. In the first trial, 684 day old males were distributed in a randomized design of three treatments with six replicates of 38 birds. The physical forms of pre-starter diets tested were: mash diet; crumb diet and pellet diet. Another was conducted with 912 day old male distributed in a randomized design of three treatments with eight replicates of 38 birds. The treatments consisted in feeding the broiler chickens with 150 g/bird; 200 g/bird and 250 g/bird. After that, all the birds were fed with the same feed program. In the first week and at 21 days old the birds fed with mash pre-starter diet had body weight gain lower than those fed crumbed and pelleted diets. The variables studied were not affected by the quantity of diets. In conclusion, the physical form of pre-starter diet was important for initial performance and the quantity of pre-starter tip to 150 g/bird did not improve the development of broiler chicks.

Oportunidades de melhoria ergonômica das exigências físicas da atividade jangadeira em Ponta Negra Natal-RN

The fishing is an activity with rafts marked by unpredictability, poor tools, physical stress, awkward postures, risk of accidents and incidents, which contribute to insecurity in the context of activity. This study aimed to contribute to reducing of physical effort and the biomechanical impacts in jangadeiro activity of artisanal fishing using jangadas on the beach of Ponta Negra, Natal-RN. To achieve this purpose the methodology of the Work Ergonomic Analysis - WEA became a reference using techniques such as observational and interactional observation notes, photographs, videos, action conversational and listening verbalizations. The resulting activity in health jangadeiro, discussed in this research were: static postural assessment, flexibility of movement of shoulder flexion-extension, flexibility of the hamstrings and lower back, grip and musculoskeletal pain. It was found from observations, interactions and activity analysis, that in carrying out fishing rafts are frequent awkward postures associated with demand for power and many are already feeling the jangadeiros reflections of years of life dedicated to this work. These have already adopted some measures to manage the activity, such as job rotation during the expedition of capture. Therefore, there is a need to expand these measures of activity management, as well as design and capabilities of the raft, seeking positive changes in the activity and consequently the quality of life jangadeiro

Uso de técnicas de otimização baseadas em derivadas como suporte do planejamento operacional de redes de distribuição de energia elétrica

The usual programs for load flow calculation were in general developped aiming the simulation of electric energy transmission, subtransmission and distribution systems. However, the mathematical methods and algorithms used by the formulations were based, in majority, just on the characteristics of the transmittion systems, which were the main concern focus of engineers and researchers. Though, the physical characteristics of these systems are quite different from the distribution ones. In the transmission systems, the voltage levels are high and the lines are generally very long. These aspects contribute the capacitive and inductive effects that appear in the system to have a considerable influence in the values of the interest quantities, reason why they should be taken into consideration. Still in the transmission systems, the loads have a macro nature, as for example, cities, neiborhoods, or big industries. These loads are, generally, practically balanced, what reduces the necessity of utilization of three-phase methodology for the load flow calculation. Distribution systems, on the other hand, present different characteristics: the voltage levels are small in comparison to the transmission ones. This almost annul the capacitive effects of the lines. The loads are, in this case, transformers, in whose secondaries are connected small consumers, in a sort of times, mono-phase ones, so that the probability of finding an unbalanced circuit is high. This way, the utilization of three-phase methodologies assumes an important dimension. Besides, equipments like voltage regulators, that use simultaneously the concepts of phase and line voltage in their functioning, need a three-phase methodology, in order to allow the simulation of their real behavior. For the exposed reasons, initially was developped, in the scope of this work, a method for three-phase load flow calculation in order to simulate the steady-state behaviour of distribution systems. Aiming to achieve this goal, the Power Summation Algorithm was used, as a base for developing the three phase method. This algorithm was already widely tested and approved by researchers and engineers in the simulation of radial electric energy distribution systems, mainly for single-phase representation. By our formulation, lines are modeled in three-phase circuits, considering the magnetic coupling between the phases; but the earth effect is considered through the Carson reduction. It s important to point out that, in spite of the loads being normally connected to the transformer s secondaries, was considered the hypothesis of existence of star or delta loads connected to the primary circuit. To perform the simulation of voltage regulators, a new model was utilized, allowing the simulation of various types of configurations, according to their real functioning. Finally, was considered the possibility of representation of switches with current measuring in various points of the feeder. The loads are adjusted during the iteractive process, in order to match the current in each switch, converging to the measured value specified by the input data. In a second stage of the work, sensibility parameters were derived taking as base the described load flow, with the objective of suporting further optimization processes. This parameters are found by calculating of the partial derivatives of a variable in respect to another, in general, voltages, losses and reactive powers. After describing the calculation of the sensibility parameters, the Gradient Method was presented, using these parameters to optimize an objective function, that will be defined for each type of study. The first one refers to the reduction of technical losses in a medium voltage feeder, through the installation of capacitor banks; the second one refers to the problem of correction of voltage profile, through the instalation of capacitor banks or voltage regulators. In case of the losses reduction will be considered, as objective function, the sum of the losses in all the parts of the system. To the correction of the voltage profile, the objective function will be the sum of the square voltage deviations in each node, in respect to the rated voltage. In the end of the work, results of application of the described methods in some feeders are presented, aiming to give insight about their performance and acuity