Suporte ao uso de álcool e drogas na atenção primária: um estudo com equipes de Natal/RN

National surveys indicate that 6.8 % of the brazilian population is dependent on alcohol and 1 % dependent on illicit drugs, representing a significant portion of the population affected by this issue . Primary Care becomes instrumental in expanding the coverage of this demand and in reducing unnecessary referrals for specialized care. This study aimed to investigate the responsiveness and institutional support of Primary Care Teams in relation to the demands of alcohol and drugs users. The research was conducted in a Family Health Unit in West Sanitary District of Natal City. With quantitative and qualitative nature, our study consisted of two stages. At first, we performed a mapping of alcohol and other drugs abusive use in a sample of the population assisted by Family Heath Teams, using sociodemographic questionnaire and ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). 406 questionnaires were completed. Of these questionnaires, 27.8% are men and 72.2% women, of which 56% are between 20 and 39 years-old, they are housewives, have a stable relationship and are consumers of tobacco (37.6%), marijuana (13%) and especially alcohol (57%). In second stage, two Conversation Circles with Family Health Teams and the referential Family Health Support Center were formed to discuss the data of the mapping realized in the previous phase. The circles, which had participation of 20 of the 37 professional teams from Family Health and 2 from Family Health Support Center, showed a lack of professional training in the subject; inability of the healthcare network in the user embracement; belief of professionals that nothing can be done when matter is alcohol and drugs; and referencing as the only care action performed by teams. Thus we point out the need to support an approach on issues of alcohol and drugs which consider gender issues, investing in Harm Reduction Policy as a possibility of working in this context for recognizing each user in their uniqueness and strategizing with them to promote health in a broad and contextualized way

Avaliação do programa de atenção à saúde do trabalhador: uma abordagem da atenção primária

The accelerated industrialization, coming with the Industrial Revolution, caused profound changes in the working world. These changes led to the households risks from work environment. Trying to assist comprehensively the health of workers, Brazil has a program of Health Care Workers in the Primary Care, and the Family Health Strategy is the main entrance for this system. The study sought to determine if the actions of the health care worker have been developed in primary care through the Family Health Strategy. This is a quantitative study with a methodological evaluation, focusing on normative assessment. The sample was formed by professionals from Team Family Health Strategy, in the municipalities of Pau dos Ferros, Caicó and Natal in Rio Grande do Norte state. The sample consists of 202 professionals (Doctors, Nurses, Assistant / Technician Nursing and Community Health Workers) in 52 Health Family Units from the 3 municipalities cited. The instrument used consists of a checklist, from Manual of Primary Care 5 - Family Health - Occupational Health, Ministry of Health. The data were analyzed describing the variables by its frequency and doing a classification of cities from the scores obtained by each. It was observed that the Family Health professionals know the program of health care worker, however do not know the Manual of Primary Care 5, which is a guidance tool. As a result of non-appropriation of the FHT professionals with worker health, these activities are not performed, mainly surveillance in occupational health and health education labor

Satisfaçã dos Usuários e a qualidade da atenção primária à saúde no Rio Grande do Norte

O presente estudo tem por objetivo avaliar a satisfação dos usuários em relação à qualidade da Atenção Primária à Saúde no Rio Grande do Norte. Trata-se de Pesquisa Avaliativa observacional transversal, com abordagem quantitativa, a qual faz parte da Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ), da Universidade Federal do Rio Grande do Norte. Foram utilizados dados secundários de todas as entrevistas com usuários das equipes que participaram da Avaliação Externa do PMAQ no Estado do RN. A pesquisa foi realizada em 167 municípios do Estado do Rio Grande do Norte, na qual a população foi composta por 1.650 usuários. A amostra se deu por conveniência a partir dos seguintes critérios: usuários que estavam presentes na Unidade Básica de Saúde (UBS) para realizar qualquer tipo de procedimento e que consentisse em participar da avaliação. Foram excluídos os que tinham ido pela primeira vez na unidade e aqueles que não frequentaram há mais de 12 meses. A coleta dos dados foi realizada no período de setembro a novembro de 2013. Para tanto, foi elaborado um protocolo de pesquisa contendo as seguintes dimensões: organizacional, interpessoal e estrutural. Em relação à dimensão organizacional os resultados mostram que a marcação de consultas tem se configurado em empecilho ao acesso do usuário ao serviço de saúde, uma vez que se faz necessário para o atendimento, enfrentar filas, antes da abertura da unidade para pegar fichas. No tocante ao funcionamento da unidade, se destaca o fato dos usuários referirem que o horário de funcionamento da unidade atende à suas necessidades, apesar de funcionar 5 (cinco) dias por semana, a maioria das unidades permanece fechada no horário de almoço. Outro dado importante refere-se à coordenação do cuidado, cujos resultados apresentam diferenças maiores entre os usuários da região metropolitana e do interior do Estado em relação à Capital. Essa diferença se expressa principalmente em relação de marcação de consulta com outros profissionais especialistas. A dimensão interpessoal, no que diz respeito à categorias interação usuário-serviço-equipe e vínculo, demonstraram alguns avanços, contudo os melhores resultados foram observados em relação a satisfação com o cuidado, onde mais de 50% dos usuários se mostraram satisfeitos com o cuidado recebido nas unidades. Em contrapartida, o estudo mostrou que, na opinião de 56% dos usuários da capital, a falta de materiais e equipamentos influencia negativamente no cuidado. Por fim, o estudo contribuiu para reforçar a ideia de que a avaliação da satisfação dos usuários dos serviços de saúde pode ser uma ferramenta importante para subsidiar o processo de decisão compartilhada, de forma a se repensar as práticas profissionais, reorganizar o processo de trabalho desenvolvido, realocar recursos, readequar ações e redefinir objetivos que estejam coerentes com o projeto de saúde estabelecido

Avaliação da qualidade da atenção primária à saúde da criança no Rio Grande do Norte: visão das usuárias

The study aims to evaluate the quality of the work processes of the teams from the Family Health Strategy regarding the comprehensive health care for children, in the view of users in the state of Rio Grande do Norte. This is a cross-sectional observational evaluative research with quantitative approach. The primary data are part of the External Review from the Program of Improving Access and Quality of Primary Care (PMAQ) in 2012. 190 women were interviewed. The inclusion criteria was the presence in the clinic at the time of the survey, have attended the service in the last 12 months and be a mother or companion of a child up to two years old. A research protocol was developed in the dimensions of Growth and Development, Breastfeeding and nutrition, and health problems and its variables. The results revealed that mothers / companions who responded to the questionnaire 71% were aged between 18 and 35 years, 92.1% were literate, 96.3% had a monthly income and 62.6% received financial assistance from the government. As for the children, 39.4% were aged between 13 to 24 months. In promotion and prevention actions for children, 64.2% had consultation up to the 7th day of life, 91.1% underwent the screening test, 95.3% had a health handbook, 98.9% had a vaccine, 17.9% breastfed or breastfeed from 6 to 24 months. As for link and continuity of care, 86.8% of the children were accompanied by the same professional staff and 59.5% left with next consultation scheduled. In acute situations 42.4% of the children went to the health unit and 64% of these were attended. It is concluded that the actions involving prevention and health promotion of children in RN, are evaluated positively by the service users and meet the requirements of MS, as well as link and continuity of care. The weakness in access and reception of users is evident, indicating the need to adapt the service to the demand of health and planning actions to welcome all who seeks basic health unit-UBS

Debates sobre educação feminina no século XIX: Nísia Floresta e Maria Amália Vaz de Carvalho

L'article discute la structure discoursive de deux oeuvres qui représentent des voix féminines en défense de l'éducation et du travail des femmes et qui ont eu quelque répercussion au Brésil au XIXe siècle : Opúsculo humanitário (1853), de la brésilienne Nísia Floresta (1809 ou 1810-1885), et Mulheres e crianças (1880), de la portugaise Maria Amália Vaz de Carvalho (1847-1921). Nous avons essayé d'identifier à qui les textes étaient adressés et comment ils justifiaient le droit d'auteur et l'érudition féminine à un moment où la traditionnelle interdiction du mot public et de la presse aux femmes commençait à être questionnée.

Lazer e urbanização: a dinâmica do setor de serviços no litoral de Parnamirim e Nísia Floresta - RN

The research here undertaken analyzes the process of urbanization on the coast of Panamirim - RN and Nísia Floresta - RN, arising from leisure, the main leisure expression was considered the second residence and coastal tourism. The leisure promoted the growth of businesses and public and private services to meet consumer demand in that area, which initially occurred with users of second home, and which also gradually begin to occupy the coastline of these municipalities in 1980 and more recently with the development of tourism in the 1990s until now. To undertake such an analysis, we did the georeferencing about the trade and also public and private services of that coast, characterizing them; evaluated the extent to which services deployed in this area meets the demands of tourists and users of second residence; it was also identified how the centrality of Natal interferes in the expansion of services in these locations. The spatial area of research includes the coastal municipalities of Parnamirim and Nísia Floresta, considering the limits of the census of the Instituto Brasileiro de Geografia e Estatística- IBGE, and about the time frame, it was considered the 1990s to the present day. The methodology consists of: 1. survey and reading of the literature related to the researched topic, serving as the theoretical analysis in the construction of the object studied; 2. collection and organization of secondary data by the IBGE and tourism sectors of the State of Rio Grande do Norte, Natal and main municipalities of the research; 3. Questionnaires and / or interviews with the traders, service providers, tourists, users of second homes, local residents, and government. The analysis of such data collected allowed the preparation of graphs, maps and tables that illustrate the results obtained in the research field, basing so the study. The relevance of the study is shown by the extensive survey data involving agents of the research, including tourists, users of second homes and, above all, the data for the service sector that did not exist in the analyzed area. The study results identified in the area analyzed the emergence of three new centers, arising from the urbanization process from leisure, one of them located in the municipality of Nísia Foresta Beach in Barra de Tabatinga, and two in Parnamirim, more specifically in locality Pium and Beach Pirangi do Norte. It was further observed that, being located in tourist areas, the main feature of these new centers is seasonality

Trombectomia na angioplastia primária em ponte de safena

O emprego da trombectomia na angioplastia primária demonstra bons resultados clínicos e angiográficos imediatos, por meio de redução da embolização distal e do fenômeno do no-reflow e otimização da perfusão miocárdica. Essa técnica, principalmente usada em artérias coronárias, em raras oportunidades é descrita quando empregada em pontes de safena aortocoronarianas. Relatamos o caso de um paciente de 67 anos com infarto agudo do miocárdio relacionado a oclusão de ponte de safena e submetido a trombectomia com bons resultados.

Implicações tectônicas na hidrologia do aqüífero Barreiras e sistema lacustre do Bonfim, Nísia Floresta-RN

This MSc dissertation presents the results of a research carried out in a 500 km2 area in the Nísia Floresta county. The main goal of the research was to evaluate fault influence on hidrology features of aquifers and lakes, mainly in the Barreiras Group and in the Bonfim lake cluster respectively. The Precambrian crystalline basement is made of Caicó Complex rocks. They are capped by cretaceous sedimentary rocks and by cenozoic sedimentary rocks. Only the latter outcrop in the study area, wheareas the former are described in boreholes. Faults cut across all stratigraphic units and their main trends are NW, NE and E-W, which have been generated by E-W compression. Subordinate N-S trending faults also take place and have been generated by N-S oriented compression. Fault controlled hydrologic features are observed throughout the study area. There are sudden changes in saturated thicknesses of the Barreiras Aquifer due to vertical displacement of the Barreiras Group. The most important underground water source of the Bonfim Lake is related to abrupt thickness changes of the aquifer. In addition, the main faults control the underground drainage network and, probably, change in direction of equipotential surfaces seen on the potenciometric map. Regarding the surface hydrologic features, faults also control river and stream channels, as well as lake origin and shapes. The Bonfim Lake, in particular, has its peculiar shape, which follows NW and NE lineaments, and origin related to faulting and probably underground carstics processes

Aspectos Morfo-Dinâmicos daComplexo Lagunar Nísia Floresta-Papeba-Guaraíras, Região Costeira Sul Oriental Do RN

This dissertation presents the results of research developed in the Nísia Floresta-Papeba-Guaraíras Lagoon Complex, located on the south coast of the Rio Grande do Norte State. The main objectives of this dissertation were the stratrigraphic characterization, in detail scale, of the and the coastal dynamics study of the lagoonal deposits sedimentation, as well as the morpho-dynamic analysis of the area. Therefore, an interdisciplinary methodology was adopted, in which all sedimentological, morpho-tectonic and geomorphological data were integrated. Vibracore up to 4m in length were carried out in the lagoons. The referred lagoon complex made of a system of three lagoons that interact through two artificial channels, named Boqueirão and Surubajá. The Guaraíras lagoon, the largest one in the system, corresponds to the estuary zone of the Trairi and Jacu rivers. The sedimentary load brought by these rivers is strongly reworked by tide currents, forming an important net-work of channels and sandy bars inside this lagoon and close to its channel connection with the sea. The stratigraphic units of the area are Cenozoic in age, and are represented by sedimentary rocks of the Barreiras Formation (sandstones, mudstones and conglomerates) and by rocks beach, as well as by siliciclastics sediments related with the fluvial dynamics of tide plain (clay and sandy bars), and coast (sand dunes and beaches). Among the recognized geomorphologic aspects, there are the elements associated with continental enviroments (drainage basins of the Trairi, Baldum and Jacu rivers, coastal tableland supported by the Barreiras Formation), and transitional environments (lagoon complex, dune fields, cliffs, tidal channels and beach rocks lines). The morphotectonic analysis indicates that fauts affect Barreiras Formation sedimentary rocks, with two sets of main lineaments: SW-NE and SE-NW. The anomalies in the drainage net are directly associated with these fault/fracture system, which control and subdivede the low courses of the Trairi and Jacu rivers, at least a tail of their flowing principal courses. The Nísia Floresta, Papeba and Guaraíras lagoons present strong morphological control according to the lineament directions. Taking into account the lagoonal deposits, the sedimentological analyses reflect a sediment distribution related to the interaction of the fluvial and sea processes that act in the study area. The correlated deposits show textural mainly microclastic characteristics of shallow waters, and of currents of low to moderate energy.In general, the Nísia Floresta-Papeba-Guaraíras lagoon Complex, constitutes a very intrinsec group, that undewent important changes in historical times that are reflected in the currents clays. Inaddition to the natural processes that act in this system, we should take into account the antrohopic intervention, which have increased in the past years

Mapeamento da zona costeria protegida por arenitos de praia (Beachrocks) em Nísia Floresta - RN

The goal of this work comprises the detailed mapping of the coastal zone of the south coast of the State of Rio Grande do Norte. The emphasis of the study is the units of beachrocks and the features of the physical environment associated. The mapping of the beachrocks and of the adjacent coastal features is justified, among other aspects, by the fact that the beachrocks constitute an important protection agent against the sea erosion. By one side, they dissipate the energy of the sea waves and make possible the imprisonment of sediments in the foreshore. The beachrocks in the studied area are constituted of discontinuous strips, parallel to the coast line presenting emerged in some places, even in the highest tides, entirely submerged or partially buried by coastal sediments. These sandstones compose the landscape of big part of the coast and they are responsible for the partial dissipation of the energy of the waves on the studied coast. The methodology used in this work consisted of different techniques were used, as the use of aerial pictures of small format (FAPEFs), acquisition of data of system of global positioning (GPS) and later elaboration of thematic maps and of digital models of soil (MDTs). The results obtained in the mapping of the use and occupation of the soil, demonstrate the existence of strong human pressure in the coastal area (built lots and no built), occupying about 54,74% of built areas. This problem has been taking to degradation risks due to the inconsequent expansion of divisions into lots and tourist enterprises. The MDT came as an excellent resource, as visual as functional, being possible to visualize several angles and to act in three dimensions the relief of the area in study, as well as to identify the present features in the coastal area. By the importance of the bodies of beachrocks as a protection agent against the coastal erosion, faces were delimited in the sandstones based in geometric criteria, classifying them in, central face, outside face, inside face, break and undermiming. These last two associates to the erosion and washout in the base of these bodies. Field data indicate clearly that the most important process in the fracturing of the bodies is associated with mechanisms related to the gravity, being the joints formed by processes of gravitational sliding. Finally, the mapping of the coastal zone starting from aerial pictures of small format it made possible the identification of the elements that compose the beach strip, for accomplishing with larger detailed level and by presenting a better monitoring of the dynamics of the coastal zone