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

Metodologia para medir a satisfa????o do usu??rio no Canad??: desfazendo mitos e redesenhando roteiros

Caderno composto de relat??rios de pesquisa, elaborados no ??mbito de uma rede de pesquisa formada por altos administradores p??blicos do Canad??, acad??micos e especialistas na ??rea de presta????o de servi??os p??blicos, sobre a avalia????o do cidad??o/usu??rio a respeito da qualidade dos servi??os p??blicos

Texto para discuss??o 42: experi??ncias internacionais voltadas para a satisfa????o dos usu??rios-cidad??os com os servi??os p??blicos

O levantamento de experi??ncias internacionais realizado objetiva apresentar um mapeamento preliminar de alternativas que possam oferecer subs??dios para o estabelecimento dos crit??rios, metodologias e os procedimentos a serem utilizados no Sistema Nacional de Avalia????o da Satisfa????o do Usu??rio dos Servi??os P??blicos. Visa tamb??m oferecer informa????es e conhecimentos que ap??iem as organiza????es p??blicas no desenvolvimento de uma estrat??gia ampla de orienta????o para o usu??rio-cidad??o

Programa de incentivo ?? produtividade e ?? qualidade total

A Ag??ncia da Receita Federal (ARF) Centro-Norte do Rio de Janeiro, a maior do Brasil, era conhecida, ao final de 1995, como ???ARF Inferno???. Os funcion??rios s?? atuavam a partir da cobran??a direta dos chefes de se????o. Estes ficavam sobrecarregados, executando tarefas que cabiam aos seus funcion??rios ??? e deixavam de gerenciar adequadamente suas se????es. A busca de solu????es come??ou pelo hor??rio de trabalho e de atendimento ao p??blico da ag??ncia, que foi mudado de 10:00 ??s 16:30 horas para de 07:00 ??s 19:00 horas, no sistema de turnos interpenetrantes, com hor??rio corrido de 6 horas. Este sistema ficava vinculado ao aumento de produtividade, efic??cia e qualidade do servi??o. Foi instalado um programa de controle eletr??nico do ponto, no qual cada funcion??rio digita sua senha secreta ao entrar e sair do trabalho. Em atendimentos como conta-corrente, foram criadas duplas de funcion??rios para dividir a responsabilidade pela produ????o. Constata-se acentuada satisfa????o da clientela. Os funcion??rios se tornaram mais produtivos, respons??veis e disciplinados e exibem orgulho e satisfa????o com o trabalho. A ag??ncia se tornou modelo para outras. Ocorreu um aprendizado no sentido de que ?? poss??vel fazer muito com poucos recursos, e de que as a????es de mudan??as devem ser adotadas com rapidez, para inibir as rea????es contr??rias e criar a predisposi????o favor??vel a uma transforma????o radical

Qualidade de vida em epilepsia e percepção de controle de crises

The individual affective-cognitive evaluations are important factors that control the way he feels the disease impact in his life. Then, the perception of seizure control is a more important factor to evaluate Quality of Life (QoL) than the illness characteristics, such as the severity, type, sickening period and seizure frequency. This study searched for the relationship among the subjective variables (perception of seizure control) and the illness characteristics to evaluate QoL. The sample consisted of 60 individuals with chronic epilepsy, aging 18 to 70 (M=37.05; SD=11.25), chosen at randon from the ambulatory of epilepsy - HC/UNICAMP, by the Questionnaire 65. The illness characteristics were not significant, except the seizures frequency, when associated to the impairment in QoL among controlled seizures and seizures with frequency higher than 10 per month (p=0.021). The perception of control was significantly associated to QoL (p=0.005).

Questionário de qualidade de vida na epilepsia: resultados preliminares

Seizures happen for brief periods of time, but the feelings of anxiety and helplessness, adaptation to the restrictions impose by the life-style and variety of other problems affect more the quality of life in epilepsy. This study proposes a protocol that regards the objectives of a quality of life assessment in health and is applied to a population that attends a university hospital. It contains 65 items and assesses the psychosocial performance, physical limitation, cognitive aspects, perception of control, self-concept, as well as perception of health and quality of life. The results of reliability and validity are discussed.

Um novo índice de qualidade das águas para proteção da vida aquática aplicado ao Rio Atibaia, região de Campinas/Paulínia-SP

In this paper a water quality index is developed to subsidize management actions in the Atibaia River for upon protection of aquatic organisms. This index is composed of two measurable environmental parameters normaly, ammonia and dissolved oxygen, the latter representing the contribution of organic matter. Concentrations of these two variables were normalized on a scale from 0 to 100 and translated into statements of quality (excellent, good, regular, bad and very bad). The index was applied to three monitoring points in the Atibaia River and compared to other indices used by the State of São Paulo Environmental Agency (CETESB). The results showed that the degradation in this watershed follows the urban population density. The developed index is more restricted than the other ones routinely used to infer water quality.

Uso de perfis cromatográficos de voláteis de cafés arábicas torrados para a diferenciação das amostras segundo o sabor, o aroma e a qualidade global da bebida

In this work, the volatile chromatographic profiles of roasted Arabica coffees, previously analyzed for their sensorial attributes, were explored by principal component analysis. The volatile extraction technique used was the solid phase microextraction. The correlation optimized warping algorithm was used to align the gas chromatographic profiles. Fifty four compounds were found to be related to the sensorial attributes investigated. The volatiles pyrrole, 1-methyl-pyrrole, cyclopentanone, dihydro-2-methyl-3-furanone, furfural, 2-ethyl-5-methyl-pyrazine, 2-etenyl-n-methyl-pyrazine, 5-methyl-2-propionyl-furan compounds were important for the differentiation of coffee beverage according to the flavour, cleanliness and overall quality. Two figures of merit, sensitivity and specificity (or selectivity), were used to interpret the sensory attributes studied.

Influência do processo de secagem na qualidade do cogumelo shiitake

Edible mushroom are highly perishable foods. Drying is an alternative to provide safe storage. In this work, the effects of some drying parameters on the quality of Shiitake mushroom were investigated: geometry of the raw material (whole and sliced), drying temperature (50 °C and 70 ºC) and final moisture content (5% and 15% wb). Experimental kinetics of drying was built and color and texture analyses were done in fresh and in rehydrated dried product. The effect of parameters was evaluated by analysis of variance and test of multiple comparisons. Drying kinetics showed that drying happened in falling-rate period and sliced mushroom dried at 70 ºC required lesser drying time than other treatments. Mushroom dried at 70 ºC showed less darkening. Drying time affected mushroom quality, evaluated by great hardness, gummosis and darkening.

Proposta metodológica utilizando ferramentas de qualidade na avaliação do processo de pulverização

The present work aimed to create a methodology to evaluate the pulverization process with the use of quality tools. It was listed the primary factors, secondary factors, tertiary factors and, with the check list tool support, the list was elaborated. It was evaluated the factors labor, agriculture machine, material and method of 32 pulverization process before pesticide application, in that each factor received a punctuation, having as total sum of 750 points. The medium punctuation to the factors labor, agriculture machine, material and method was 78; 211; 49; 20 and 94 points, respectively. The sum of the factors points for the 32 processes, the minimum value found was 230 and maximum was 620 points. With the proposed methodology, can be identify which common causes of the processes can affect its result.

Qualidade da classificação do tomate de mesa em unidades de beneficiamento

Quality evaluation of classification was done in two fresh market tomatoes packing house, using electronically and mechanical equipments in two harvest periods, summer and winter seasons. The main goal of this work was to evaluate size and color grading conformity with the standards proposed by the Brazilian Program for Horticulture Modernization and size grading obtainded with the one established by the packer. The cultivar studied was Carmen. The results showed that there was no grade conformity with the fresh tomato quality standards proposed by the Brazilian Program for Horticulture Modernization. The grade conformity obtained when compared with the one programmed by the packer, was only for large sizes, in both equipments. The electronically equipment has presented better performance, over the mechanical, considering grading quality and fruits post-harvest quality. However, the electronically equipment must be constantly monitored to achieve efficiency and investment return. On the other side, for mechanical equipment it will be necessary to review the actual system of size grading, in order to follow the fresh tomato quality standards.

Determinação em tempo real da magnitude de danos físicos por impacto em linhas de beneficiamento e em condições de laboratório e seus efeitos na qualidade de tomate

Tomatoes are one of the most important vegetable crops grown in Brazil and are among the crops that have one of the highest post-harvest losses indexes in the country. The present work aimed at evaluating impact damage observed in packing lines of fresh tomatoes as well as to determine, under laboratory conditions, quality alterations of tomato fruits submitted to impact damage in different surface types. Critical points evaluation was accomplished using an instrumented sphere. Critical transference points found showed variations in acceleration levels from 30 to 129 G (m s-2). Tests carried out under laboratory conditions showed that padded surfaces reduced up to 31% impact damage. Incidence of severe internal physical damage was evaluated by a subjective scale and increased by 79% on hard surfaces for the highest fall drop. On the other hand, it was observed an effective reduction in physical damage on fruits when padded surfaces were used. When a 10-cm drop was performed, the maximum reduction measured was 10% for hard surfaces and 5% for previously padded surfaces. For quality parameters, it was observed for high drops on hard surfaces, highest values for weight loss, total acidity, lower values for vitamin C and Soluble Solids.

Avaliação de linhas de beneficiamento e impactos de queda na qualidade de caqui Rama Forte

Excessive and inadequate handling of fruits and vegetables provides high incidences of physical damage, consequently, post harvest losses. The main goal of this work was to evaluate the impact magnitude in persimmon packing lines, Rama Forte, and to determine, at the laboratory, its impact limits. For evaluating the critical points it was used an instrumented sphere of 76 mm of diameter (Technmark, Inc, Lansing, USA), which registered the impact magnitude in seven distinctive impact lines located in four packing houses. For determining physical damages, tests were carried out at the laboratory, where fruit drop was related to impact magnitude, physical damage incidence and fruit post harvest losses. At the packing lines, the values found varied from 21 to 87 G on the transfer points and the majority of registered impacts (over 94%) were down 50G. Drops from 20 cm caused an increase in weight losses after six days of storage at room temperature. Drops from 20 and 30 cm caused skin darkness (low L values), associated to a decrease in color intensity (chroma). Impact drop did not affect pulp fruit chemical features.

Avaliação da qualidade de vida em pacientes idosos um ano após o tratamento cirúrgico de fraturas transtrocanterianas do fêmur

OBJECTIVE: Evaluate the impact that trochanteric hip fractures produce on life quality of elderly patients, treated surgically, during one year of monitoring. METHODS: Were selected 73 elderly with transtrochanteric femur fracture, aged equal or over than 65 years and of both sexes. All participants underwent a standardized questionnaire which obtained information on lifestyle habits, functionality, physical activity, ambulation and cognitive state. Were excluded patients who died, not walking, with neurological diseases and pathological fractures. RESULTS: The average age was 80.17 ± 7.2 years and 75% was female. When comparing the summation of activities of daily living (p = 0.04) and instrumental daily living (p = 0.004) obtained before and after fracture, the patients become more dependent after fracture. Activities of daily living that worsened after fracture were bathing (p = 0.04), toileting (p = 0.02) and dressing (p = 0.04). All instrumental activities of daily living showed a significant difference, with functional dependence after fracture, increased need for walking aid (p = 0.00002), aged (p = 0.01) and not doing housework (p = 0.01). The low score on the test Minimental was associated with a greater dependence to perform activities of daily living before (p = 0.00002) and after (p = 0.01) fracture. CONCLUSION: After a year, activities of daily living that depended on the lower limbs worsened significantly, all instrumental activities of daily living were significantly worse in more than 50% of patients and more than half of patients who walked without support lost this ability.

Unidade Haugh como medida da qualidade de ovos de galinha armazenados sob refrigeração

Alterations in physical, chemical and functional characteristics of egg proteins occur during storage. These changes depend on the storage conditions, mainly duration, temperature and relative humidity. This study examined the fresh egg Haugh unit score and the storage egg Haugh unit score, at room temperature (25°C) and under refrigeration conditions (8°C), during 7, 14 and 21 days of storage. Haugh units and albumin height decreased considerably during storage at room temperature. At 8°C, there was no significant difference in the Haugh unit for different periods of storage, but their values were smaller as compared to fresh eggs. The weight of the eggs was not affected by both storage and temperature. For both temperatures, pH was positively correlated with Haugh units and negatively with the albumin height.