Aptidão física e psicológica relacionada à saúde de policiais militares da cidade de Natal

condições de saúde são questões que precisam ser investigadas na nossa sociedade. Diante da inexistência de estudos que abordem os aspectos psicológicos e físicos desses profissionais, tornou-se necessário e relevante esta investigação para a área de segurança pública num contexto multidisciplinar. O estudo objetivou verificar as características da aptidão física e psicológica relacionada à saúde de policiais militares do Batalhão de Atividades Policiais Especiais (BOPE), da Polícia Militar do Rio Grande do Norte. A amostra selecionada de forma aleatória foi composta de 64 militares de diferentes graduações, do sexo masculino com idade média de 26,2±2,6 anos. Foram utilizados como instrumentos de medida o Questionário de Saúde Geral de Goldberg para avaliar a saúde geral; uma balança digital da marca Techline®, e estadiômetro portátil da marca Sanny® para avaliar a massa corporal e a estatura; fita antropométrica metálica Sanny® para avaliar a perimetria (circunferência do braço contraído, circunferência da panturrilha); paquímetro Sanny® para avaliar os diâmetros ósseos (bi-epicondilar umeral e bi-epicodilar femural); adipômetro Harpender® para avaliar a espessura das dobras cutâneas; dinamômetro manual Jamar para avaliar a força de preensão manual; flexímetro Sanny®, fotocélulas CEFISE modelo Speed Test Fit e o YoYo Intermitent Recovery Test para avaliar o desempenho físico ( flexibilidade, agilidade, velocidade e endurance anaeróbica). Os participantes apresentaram valores elevados para risco de distúrbio ou mesmo a presença de distúrbio, no que se refere à saúde geral; o grupo estudado é classificado como mesoendomorfico, predominando características de endurance aeróbico e anaeróbico e força que foram relacionadas com os aspectos psicológicos. O perfil somatotípico meso-endomorfo parece interferir nos elevados riscos de distúrbios psicológicos advindos da atividade laboral exigida, apesar dos mesmos apresentarem um bom desempenho físico

Satisfação do paciente com a fisioterapia :tradução, adequação cultura e validação de um instrumento de medida

The measurement of patient satisfaction can provide information about the success of the care provider in reaching the values and meeting the expectations of the patient. The purpose of this study was to translate into the Portuguese language and to culturally customize to the Brazilian population the instrument to measure patient satisfaction with physical therapy elaborated by Goldstein et al. The study sample was made up of 279 patients who were undergoing physical therapy treatment at 39 different private clinics in a middle-sized town in northeastern Brazil. For the translation of the survey instrument, the back-translation technique was employed, in association with the bilingual method. The reliability and validity of the Brazilian version of the instrument were both assessed. Reliability analysis, carried out with the computation of Cronbach alpha coefficients, showed that the measures obtained with the instrument have a high degree of internal consistency. The aspects dealing with the patient therapist relationship are the most important predictors of satisfaction, followed by those dealing with courtesy, privacy, and practical aspects such as efficiency of the facility in the patient admissions process, setting up of appointments, and waiting time in waiting room. Items dealing with aspects such as location of the facility and availability of parking facilities may underestimate the reliability of the instrument. This study translated, culturally customized, and validated an instrument to measure patient satisfaction with physical therapy originally developed in English. By so doing, this study has made this instrument available to the Brazilian society, and it has rendered it a useful parameter that can be utilized in our country in the field of physical therapy

Candidíase vulvovaginal: sintomatologia, fatores de risco e colonização anal concomitante

Post-menarche patients with clinical signs of vulvovaginitis were analyzed in this study, whose aims were the following: identify the frequency of C. albicans and non C. albicans species and negative results, correlate the vaginal culture for yeast with risk factors and symptomatology; compare positive and negative results for yeast in the vaginal and anal cultures; compare the positive results for C. albicans with other results found in the vaginal and anal cultures; and compare concomitant positivity for C. albicans and non C. albicans in the vaginal and anal cultures. Sample selection occurred between May, 2003 and May, 2005, and included 99 patients from Natal, Brazil. The laboratory methods used consisted of CHROMagar Candida culture medium, thermotolerance test at 42-45°C and hypertonic NaCL, in addition to the classic methods of carbohydrate assimilation and fermentation. We used absolute numbers, percentages, means of central tendency, chi-squared test (χ2) with Yates correction, Fisher s exact test and odds ratio for statistical analysis. The most frequent species was C. albicans in 69% of the cases. The positivity for Candida spp showed an association with the use of tight-fitting intimate clothing and/or synthetics, allergic diseases and the occurrence of itching, leukorrhea and erythema. Anal colonization increased the likelihood of vaginal contamination by 2.8 and 4.9 times, respectively, for Candida spp and C. albicans. When compared to the other species, C. albicans-positive anal colonization increased by 3.7 times the likelihood of vaginal positivity. These data suggest likely vaginal contamination originating in the anus

Avaliação da presença de osteopatia decorremte do diabetes tipo 1 em criança e adolecentes do Rio Grande do Norte

Diabetes Mellitus (DM) and osteoposes are chronic diseases with great socioeconomic consequences, mainly due to the late complications and consequent disabilities. The potential effects of DM on bone metabolism remain a very conroversial issue, and disagreement exists with regard to the clinical implications of diabetic osteopenia and the mechanism of its ocurrence. The issue is further complicated by the contribuicion of the especific factors, such as duration of disease an dthe degree of metabolic control. The objective of this study is to identify the osteopathy in children and adolescents with DM 1 assisted in the hospital of pediatrics, UFRN, through biochemical markers of bone and mineral metabolism and the extent of bone mineral density. The study was composed by 74 diabetics type 1 patients (DM1) of both gender and aged 6 to 20 yars. Normoglicêmic group was composed by 97 healthy subjects of both genders, which showed the same age range of DM1, in addition to same socioeconomic class. These individuals qere students from the networks of public education in the city of Natal-RN, randomly invited to paticipate in our study. Both groups DM1 and NG were divided intofour subgroups, according to the classification of tanner , T1, T2, T3, T4 for achieving a benchmark. Diabetic individuals showed up with a poor glycemic control. the group DN1 T4 showed an incresead value for total protein, albumin, urea and microalbumiuria are predictors of grumelura injury in DM1 patients . The total alkaline phosphatase activitywas kept on high levels for both groups because they are in a stature development age. For osteocalcin there were decreased levels for groups Dm1 T1, T2, and T3 when compared to their NG (s), suggesting that this decrease could be associated with reduction in the number and/or differentiation os osteoblasts thereby contributing to reducing bone formation. There were no changes in the activity of TRAP. The serum concentrations of total and ionized calcium, phosphorus and magnesium were included within the RV. It was observed that the BMD (Z- SCORE ) has always been within the RV for both groups, despite to DM1 T4. Taking all together, our results support the hypothesis that children and adolescents with type 1 DM present the risk in the long run to suffer a reduction in the bone mass, associated to poor glicemic control and disease duration. It could limit the bone growth and increase the probality of development of osteopenia, as well as other complications surch as retinopathy and renal failure

Análises espaciais na identificação das áreas de risco para a esquistossomose mansônica no município de Lauro de Freitas, Bahia, Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência do cultivar, do tipo de folha e do tempo de cultivo na medida indireta da clorofila (spad) em mudas de goiabeira

A análise foliar de nitrogênio, comumente empregada em laboratórios de rotina, é destrutiva e nem sempre rápida, obstante para a tomada de decisão. Objetivou-se com a pesquisa estudar as medidas SPAD, em mudas de goiabeira (Psidium guajava L.) cultivada em solução nutritiva completa, observando-se as diferenças entre cultivares, épocas de amostragem e tipos de folhas avaliadas. O delineamento foi inteiramente casualizado, com quatro repetições, em parcelas sub-subdivididas. Assim, foi utilizada como parcela as duas cultivares de goiabeira (Paluma e Século XXI), como subparcelas os tipos de folhas (+1, +2 e +3) e, cinco épocas de amostragem ao longo do período experimental (60, 75, 90, 105 e 120 dias, após o transplantio de mudas) Concluiu-se que a leitura SPAD em mudas de goiabeira é influenciada pela cultivar, tipo de folha e época de amostragem. O terceiro par de folhas mostrou-se mais adequado para avaliar o estado nutricional do nitrogênio nas mudas de goiabeira a partir da leitura SPAD. As cultivares de goiabeira apresentaram diferença na leitura SPAD apenas aos 60 e 90 dias após o transplantio, independentemente do tipo de folha.

Mapas de zonas de risco de epidemias e zoneamento agroclimático para o Cancro Cítrico no Estado de São Paulo

O cancro cítrico, causado pela bactéria Xanthomonas axonopodis pv. citri Valterin et alii 1995, é uma doença conhecida mundialmente e sempre constituiu séria ameaça para a citricultura brasileira. O objetivo do presente trabalho foi analisar as condições climáticas do Estado de São Paulo e desenvolver mapas de zonas de maior risco de epidemias de cancro cítrico. Foram utilizados dados meteorológicos referentes aos anos de 2002 a 2005, os quais foram baseados no modelo de previsão desenvolvido por Campbell & Madden (4) e Hau & Kranz (10). A freqüência dos dados foi horária e quando alguma estação apresentava falha, esses eram extrapolados da estação mais próxima. Foram contabilizados os índices de favorabilidade e posteriormente calculadas as porcentagens de dias favoráveis à ocorrência da doença no período de um ano. A partir destas informações, foram gerados os mapas temáticos do Estado de São Paulo, com a distribuição espacial da porcentagem de dias favoráveis à ocorrência de cancro cítrico. A região Noroeste do Estado foi a que apresentou a maior porcentagem de dias favoráveis à ocorrência de cancro cítrico.

Avaliação multidimensional de pessoas idosas atendidas por equipes de saúde da família em Natal-RN: uma análise demográfica e epidemiológica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Efeito do ácido alfa-lipóico sobre biomarcadores de estresse oxidativo, inflamação e fatores de risco cardiovascular em hipertensos

Alpha-lipoic acid (ALA) is a potent antioxidant with favourable anti-inflammatory, metabolic and endothelial effects, and has been widely investigated due to its potential against cardiovascular risk factors. This study aimed to evaluate the effect of oral ALA supplementation on oxidative stress biomarkers, inflammation and cardiovascular risk factors in patients with hypertension. This is a double-blind placebo-controlled randomized clinical trial, where the intervention was evaluated prospectively comparing results in both groups. The sample consisted of 64 hypertensive patients who were randomly distributed into ALA group (n = 32), receiving 600 mg / day ALA for twelve weeks and control group (n = 32), receiving placebo for the same period. The following parameters were evaluated before and after intervention: lipid peroxidation, content of reduced glutathione (GSH), enzymatic activities of glutathione peroxidase (GPx) and superoxide dismustase, ultrasensitive C-reactive protein (hs-CRP), triglycerides, total cholesterol and fractions, fasting glucose and anthropometric indicators. There was a statistically significant reduction (p <0.05) in serum concentrations of total cholesterol, very low density lipoprotein (VLDL), high density lipoprotein (HDL), triglycerides and blood glucose. There was a reduction in body weight and waist, abdominal and hip circumferences in the group that received ALA. In addition, there was a statistically significant increase (p <0.05) in the contents of reduced glutathione (GSH) and glutathione peroxidase (GPx) in the group receiving ALA. Oral administration of ALA appears to be a valuable adjuvant therapy, which may contribute to decrease the damage caused by oxidative stress and other risk factors associated with the atherosclerotic process

O direito à saúde: a medida do dever do estado de fornecer Medicamentos de dispensação excepcional à sociedade sob a ótica do desenvolvimento

It is a fact that the fundamental rights of citizens are being recognized and guaranteed by the state over time, regardless of the belief that if these rights has always been part of the heritage of subjective individuals, or whether they will be aggregated during the course of human history. In that, emerged the rights of freedom of men and, subsequently, the rights to create a situation of equality between the humans, the so-called social rights. In turn, as these rights known as social, to be implemented, need a positive action by the state, more precisely by the state power whose function is to manage public money and create policies for implementation of fundamental rights. Given this, pay attention to the right to health, was created the Programa de Medicamentos de Dispensação Excepcional, which aims to provide high-cost medicines to citizens Brazilian carriers of serious diseases, such as Alzheimer's and Mal Hepatitis C. Also on the program, it provides a way which will be mandatory that the drugs will be offered in such situations, and does not include a means of updating the list predicted able to monitor the progress of medicine that have been in the interest of the program. Given that, at present it is necessary to mention the recognition of another fundamental right: the right to development, which is the right of access to positive actions being implemented by the State, which are nothing more than public policy, gender which the Programa de Medicamentos de Dispensação Excepcional is kind. Thus, through the search in legislation and doctrine in relation to the theme, this work has the aim to examine the extent of the state to provide exceptional dispensing of medicines. Specifically, if the State in attention to the right to development and the implementation of the right to health, can really list exhaustively the drugs to be provided by the State, and what are the elements guiding this choice and how to control the same

A medida cautelar na ação direta de inconstitucionalidade: uma abordagem pela perspectiva do princípio do acesso à justiça

The present study deals with the caution measure in the direct action of inconstitutionality. The treatment given to the approach is through the principle of access to justice. For this, a construction of the juridical content in the principle of access to justice is proposed, without losing the focus of its characteristic as a metajuridical principle, which is presented in the constitutional field as a fundamental right, generator of a new universality, destined to guarantee the prevalence of an adequate juridical tutelage. Some challenges of the concretizing hermeutics are still shown to give way to principle of access to justice, dealing with certain limitations and proposals. The direct action of inconstitutionality in face of the dissertation, begins to focus on the presentation of the tutelage of urgency, differentiating it from the other brief tutelage and elevating it to the condition of instrument which is indispensable to the principle of access to justice. In the most specific field of the abstract control of constitutionality, the characteristics of the objective process are defined, their sources, amongst which the regimental norms of the Federal Supreme Court and their role in the new constitutional reality. Finally, the caution measure in the direct action of inconstitutionality is presented by the perspective of principle of access to justice, identifying some points: the interpretations of the principle of the natural judge to adapt him to the aspect of continuous and temporarily adequate juridical account, especially when concerned to emergency; the analysis of facts in the direct action; the bonding objective effects and the erga omnes; the effect over the factual and normative plan; the effect of the caution measure over other processes and over the prescriptional course; the polemic of the possibility of caution measure in direct action of inconstitutionality through omission

Os conflitos de competência normativa do estado regulador brasileiro no setor administrado pela ANP

The dissertation has by objective describe the administrative activity of regulation exercised by independent regulatory agencies, observing that this activity was already done before this structures creation, however, after a really deep administrative reform that had as objective built a Public Administration with more efficiency, it passed to be done with some own peculiarities of these new structures of regulation. The work gave especial attention to what concern the conflicts of normative competency that really often happen between ANP (Agência Nacional do Petróleo, Gás Natural e Biocombustíveis) and the legislatives organs of the Republic Federative of Brazil, because energetic area has unbelievable mater to any country, and the fact of some juridical norm be against the law and be accepted is very dangerous, it affronts the constitutional principle of the legality e may put in risk the democratic Estate of law, them, regulatory dogmatic must be scientifically knows, and developed, thought and especially there are so many doctrinaires divergences about regulation constitutionality. As a theorist point, the investigation got the Logical nocontradiction principle, according Hans Kelsen and Lourival Vilanova thought, doing a philosophical reflection about the system of positive law, in which there are many antinomies, or conflicts of norms, what include the conflicts of the administrative acts expedited by ANP and the legislation of the brazilian regulatory Estate. For a better understanding and exemplify some perplexities treated by the doctrinaire angle, this work did a lucubration about a possibility of a normative conflict between a ANP resolution and the municipal legislation in a specific case, also, brought several jurisprudences for the brazilians courts of justice, that confirm the empiric existence of normative conflicts among ANP s administrative norms and federal legislation. Finally, concludes observing that the regulation is not a legislative competency delegation to regulatory agencies, is just a new exercise of the administrative function, it is a technical specialization of the public administration, that using this know-how can acting with more efficiency, however the normative power of regulatory agencies must respect the empire of law, so in this terms, the dissertation suggests the ponderation of the constitutionals principles of efficiency and legality how form to harmonizing the democratic legitimate inherent to legal norm supremacy, with the perspective of an efficient economic and institutional development

Prevalência e fatores de risco de leptospirose bovina no Estado do Maranhão

Foram investigados a prevalência e os fatores de risco da leptospirose bovina no Estado do Maranhão. O Estado foi dividido em quatro circuitos amostrais com base em parâmetros de produção distintos que variam conforme os diferentes sistemas de produção, as práticas de manejo, a finalidade de exploração, o tamanho médio dos rebanhos e os sistemas de comercialização. Objetivou-se estudar as características epidemiológicas da leptospirose bovina no Estado do Maranhão, de modo a determinar a prevalência em bovinos e em rebanhos, detectar as sorovariedades de Leptospira spp. presentes, identificar os fatores de risco eventualmente associados à leptospirose em bovinos e diferenciar os circuitos pecuários entre si no que se refere à prevalência de leptospirose. A pesquisa foi realizada em 136 propriedades rurais pertencentes ao circuito I, no qual 841 fêmeas bovinas com idade igual ou superior a 24 meses foram analisadas; 238 do circuito II, com 2.582 fêmeas analisadas; 122 do circuito III, com 869 fêmeas analisadas; e 77 do circuito IV, com 540 fêmeas analisadas; no total, 573 propriedades e 4.832 fêmeas foram estudadas. A presença de anticorpos contra Leptospira spp. foi verificada pela técnica de soroaglutinação microscópica (SAM). Das 4.832 fêmeas bovinas analisadas, 1.904 (35,94%; IC 95% = 33,01% - 38,98%) foram reagentes. Das 573 propriedades analisadas, 380 (64,81%; IC 95% = 61,10% - 68,35%) foram consideradas positivas. As sorovariedades Hardjo e Wolffi foram as mais frequentes em todo o Estado. O circuito III foi o que apresentou menor prevalência de leptospirose em todas as comparações. As variáveis identificadas como fatores de risco de leptospirose foram: presença de equinos (p = 0,000), presença de capivaras (p = 0,034) e rebanhos bovinos com 32 ou mais fêmeas adultas (p = 0,002).

A mediação como instrumento concretizador do direito fundamental à saúde: uma alternativa à judicialização de conflitos Natal 2013

In Brazil, the 1946 Constitution enshrined the right to health, having it defined as the possession of the best state of health that the individual can achieve. Already the Federal Constitution of 1988 lifted that right to the status of fundamental social right, which transcends the effectiveness and cure of the disease is based on the joint liability of public entities for the provision of a quality service, efficient and prioritize human dignity and comprehensive evaluation of patients. According to the World Health Organization, the definition of health, first characterized as the mere absence of disease, has become recognized as the need to search for preventive mechanisms to ensure the welfare and dignity of the population. Garantista this context, the growing seem lawsuits that deal with the implementation of public policies, especially in the area of the right to health, the omission of which the Government can result in the risk of death. Hence the concern of law professionals about whether or not the intervention of the judiciary in cases that deal with providing material benefits of health care. It claims to break the principle of separation of powers, disobedience to the principle of equality and the impossibility of judicial intervention in the formulation of public policy to try and exclude the liability of public entities. In contrast, the judiciary has repeatedly guardianships granted injunctions or merit determining the supply of materials indicated by the medical benefits that accompany the treatment of patients who resort to a remedy. In this context, mediation, object of study and resolution presented in this work, is presented as an instrument conciliator between the reserve clause and the right to financially possible existential minimum, as it seeks to serve all through rationalization of health services , avoidance of negativistic influence of the pharmaceutical industry, with prioritizing the welfare of the individual and the quality of relationships. This is alternative way to judicialization that in addition to encouraging and developing active citizen participation in public policy formulation also allows the manager to public knowledge of community needs. It is in this sense that affirms and defends the right to health is no longer the mere provision of medical care and prescription drugs, but a dialogue conscious existential minimum to guarantee a dignified life

Modelo de avaliação de risco : São o crescimento e a estequiometria dos girinos afetados pelo efeito interativo entre a presença do predador e da densidade de coespecíficos?

Many prey organisms change their phenotype to reduce the predation risk. However, such changes are associated with trade-offs, and can have negative effects on prey growth or reproduction. Understand how preys assess the predation risk is essential to evaluate the adaptive value of predator-induced phenotypic and its ecological consequences. In this study, we performed a mesocosm experiment to test: i) if growth and stoichiometry of Lithobates catesbeianus tadpoles is altered in response to giant water bug presence (Belostoma spp.); ii) if these responses depend on tadpoles density in environment. Here, we show that tadpoles growth and stoichiometry are not changed by predator presence, neither in low nor in high densities. Our results suggest that tadpoles exposed to predation risk regulate their physiology to preserve the elemental stoichiometric homeostase of their body and excretion. Further, point out to need for future studies that elucidate under what conditions growth and stoichiometry are changed in response to predation risk