Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-05-04T00:22:52Z No. of bitstreams: 1 LygiaMariaDeFigueiredoMelo_TESE.pdf: 1948122 bytes, checksum: 9bcf49eb54beb8b850005b34d139712c (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-05-06T20:18:53Z (GMT) No. of bitstreams: 1 LygiaMariaDeFigueiredoMelo_TESE.pdf: 1948122 bytes, checksum: 9bcf49eb54beb8b850005b34d139712c (MD5) / Made available in DSpace on 2016-05-06T20:18:53Z (GMT). No. of bitstreams: 1 LygiaMariaDeFigueiredoMelo_TESE.pdf: 1948122 bytes, checksum: 9bcf49eb54beb8b850005b34d139712c (MD5) Previous issue date: 2015-08-03 / Objetivou-se analisar o Apoio Institucional na Aten??o B?sica ofertado ?s equipes pelas gest?es municipais das capitais brasileiras que aderiram ao Programa de Melhoria do Acesso e da Qualidade da Aten??o B?sica (PMAQ-AB). Possuiu car?ter explorat?rio descritivo, com abordagens qualitativa e quantitativa para an?lise dos dados. A coleta de dados foi realizada no per?odo de fevereiro a outubro de 2014 com dois grupos amostrais, sendo o primeiro composto pelos respondentes do m?dulo II que correspondeu a 2941 equipes, das 23 capitais que aderiram ao Programa e o segundo por 22 gestores da Aten??o B?sica das capitais brasileiras que responderam ao m?dulo IV (on line). Na fase quantitativa as vari?veis foram analisadas atrav?s da estat?stica descritiva, com uso do Software IBM SPSS Statistics 20 e os resultados organizados e agrupados em tr?s dimens?es: caracter?sticas do Apoio Institucional; processo de trabalho do Apoiador Institucional e Apoio ?s equipes para administrar e planejar processos de trabalho. Na fase qualitativa, analisaram-se as diretrizes gerais para o Apoio Institucional no munic?pio, descritos pelo gestor municipal no formul?rio on line. Para organiza??o e categoriza??o dos dados qualitativos foi utilizado o Atlas ti.7.1, e como m?todo de interpreta??o, a an?lise de conte?do. A partir da concep??o do Apoio como ferramenta democratizante, procedeu-se a aproxima??o de conceitos do Apoio Paideia (Campos), das rela??es de poder (Foucault) e da an?lise institucional (Lourau). Elencou- se as seguintes categorias de an?lise: Categoria 1- Dimens?o administra??o e planejamento de processos de trabalho com as Subcategorias: Apoio ? organiza??o do processo de trabalho das equipes; Apoio ao planejamento, monitoramento e avalia??o; Apoio ?s a??es das equipes; Apoio ao fortalecimento das redes de aten??o ? sa?de e a??es intersetoriais e estrutura organizacional e administrativa do Apoio no munic?pio. Categoria 2- Dimens?o Pol?tica com as Subcategorias: Apoio aos processos participativos de gest?o e est?mulo ao controle social; Apoio a constru??o de rela??es democr?ticas, cooperativas e dial?gicas; Apoio ?s a??es vinculadas ao PMAQ; descri??o do Apoio Institucional utilizando a mesma reda??o dos documentos oficiais do MS. Categoria 3- Dimens?o Pedag?gica com a Subcategoria: processos de forma??o e qualifica??o de profissionais e gestores. Observou-se que o Apoio Institucional ? uma realidade no contexto da Aten??o B?sica no Brasil, por?m identificou-se que, tanto nas a??es apoiadas quanto nas diretrizes propostas pelas gest?es evidencia-se um tra?o normalizador e burocr?tico nesse processo. Houve avalia??o positiva pelas equipes do Apoiador Institucional, embora esses profissionais encontrem-se sobrecarregados no exerc?cio dessa fun??o pelo n?mero excessivo de equipes sob sua responsabilidade, evidenciando-se a necessidade de um dimensionamento que leve em considera??o o modo de operar a fun??o Apoio. Nas capitais brasileiras observaram-se fragilidades nas condi??es de gerir os processos para a institucionaliza??o do Apoio, inferindo-se que as gest?es e equipes de gest?o da Aten??o B?sica precisam ser apoiadas na condu??o desse processo. Prop?e-se, assim, o aprofundamento da tem?tica e que nos outros ciclos do PMAQ-AB haja adequa??o dos instrumentos utilizados na avalia??o externa, referente ? dimens?o Apoio Institucional, a fim de avan?ar na valoriza??o das singularidades do Apoio, principalmente, no tocante ? cogest?o enquanto processo coletivo e democr?tico. / It was aimed to analyze one of dimensions of the Basic Attention offered by in primary care team by the municipal administrations of Brazilian cities that have joined Access Improvement Programme and Quality of Primary Care (PMAQ-AB in portuguese). Owned descriptive exploratory, by qualitative and quantitative approaches to data analysis. Data collection took place between February-October 2014 by two sample groups, the first one consisting of respondents of module II corresponding to 2941 teams of 23 capitals that have joined the program and the second one by 22 managers of Primary Care Brazilian cities that responded to the module IV (on line). In quantitative phase variables were analyzed using descriptive statistics, using IBM SPSS Statistics Software 20 and organized and grouped results in three dimensions: characteristics of Institutional Support; Institutional Sketchpad the work process and support teams to manage and plan work processes. In qualitative phase, it was analyzed general guidelines for the Institutional Support in the municipal, as described by the municipal manager in online form. For organization and categorization of qualitative data was used Atlas ti.7.1, and as a method of interpretation, content analysis. From the conception of support as a democratizing tool, it was proceeded to approach concepts Support Paideia (Campos), power relations (Foucault) and institutional analysis (Lourau). It was defined following categories of analysis: Category 1 - Dimension administration and planning work processes by subcategories: Support for organization of work process of teams; Support planning, monitoring and evaluation; Support the actions of teams; Support for the strengthening of health care networks and intersectoral actions and organizational and administrative structure of support in the city. Category 2 - Dimension Policy by following subcategories: Support for participative process management and stimulation of social control; Support the building of democratic relations, cooperatives and dialogical; Support for actions related to PMAQ; description of Institutional Support using the same wording of official documents of health ministry. Category 3 - Pedagogical dimension formed by Subcategory: formation and training of professionals and managers. It was observed that Institutional Support is a reality in context of Primary Care in Brazil, but it was found that in both actions supported as the guidelines proposed by managements is evident in a normalizing and trace this process. There was a positive evaluation by teams Sketchpad Institutional, although these professionals find themselves overwhelmed when exercising that function by excessive number of teams under their responsibility, demonstrating the need for a design that takes into account how to operate the Support function. In Brazilian cities were observed weaknesses in a position to manage the processes for institutionalization of support, the conclusion was that managements and management teams in Primary Care need to be supported in conducting this process. It is proposed thus deepening the theme and when other PMAQ-AB cycles tooccur be made adequacy of instruments used in external evaluation concerning the importance Institutional Support in order to advance the appreciation of uniqueness of support, especially regard to co-management as a collective and democratic process.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-05-11T20:02:58Z No. of bitstreams: 1 LeonardoNunesMaiaPimentel_DISSERT.pdf: 1254095 bytes, checksum: a9efb1c54d07df68ac2b799a5135cc7e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-05-19T00:29:08Z (GMT) No. of bitstreams: 1 LeonardoNunesMaiaPimentel_DISSERT.pdf: 1254095 bytes, checksum: a9efb1c54d07df68ac2b799a5135cc7e (MD5) / Made available in DSpace on 2016-05-19T00:29:08Z (GMT). No. of bitstreams: 1 LeonardoNunesMaiaPimentel_DISSERT.pdf: 1254095 bytes, checksum: a9efb1c54d07df68ac2b799a5135cc7e (MD5) Previous issue date: 2015-07-27 / O objetivo desse estudo foi avaliar a influ?ncia de agentes remineralizantessobre a susceptibilidade do esmalte clareado ? pigmenta??o por caf? durante o clareamento de consult?rio. Noventa incisivos bovinos foram selecionados e divididos aleatoriamente em 5 grupos (n=10) em fun??o dos agentes remineralizantes: G1 sem pigmenta??o e sem agente remineralizante; G2, fl?or neutro; G3, Nano-P, G4, CPP-ACP e; G5 sem remineralizante. A solu??o pigmentante foi confeccionada com caf? sol?vel (Nescaf?) de acordo com as orienta??es do fabricante. As amostras foram imersas no caf?, em temperatura de 55?C, por 1 minuto/4x ao dia. Todos os grupos foram clareados com Per?xido de Hidrog?nio a 35%. As medidas de cor foram realizadas pelo espectrofot?metro Easyshade (VITA), pelo m?todo CIE Lab, antes e depois das 3 sess?es de clareamento. Os dados foram submetidos ? An?lise de Vari?ncia ANOVA a dois crit?rios para medidas pareadas e ao p?s-teste de Tukey para m?ltiplas compara??es (p<0,05). Os resultados mostraram haver diferen?as estatisticamente significantes entre as subst?ncias remineralizantes para os par?metros *L, *a, *b e ?E (p<0,0001). Os valores de L*, para o grupo G5, e os de *b, para os grupos G2 e G5, diferiram do grupo controle. Ap?s a 3? sess?o de clareamento, os grupos do Fluor (G2) e aquele sem agente remineralizante (G5) apresentaram valores de ?E inferiores ao grupo controle, n?o pigmentado. Concluiu-se que a apenas os agentes remineralizantes CPP-ACP e Nano-P foram capazes de reduzir a interfer?ncia do caf? na efic?cia clareadora do per?xido de hidrog?nio. / The aim of this study was to evaluate the influence of remineralizing agents on the susceptibility of enamel cleared by the coffee pigmentation during office bleaching. Fifty bovine incisors were selected and randomly assigned into 5 groups (n = 10) on the basis of remineralizing agents: G1 gel hydrogen peroxide to 35% (control group); G2, hydrogen peroxide gel and a 35% gel 2% neutral fluorine; G3, hydrogen peroxide gel and a 35% nanostructured calcium phosphate gel, G4, hydrogen peroxide gel and a 35% casein fosfopt?dia-phosphate and amorphous calcium folder; G5 hydrogen peroxide gel to 35% without mineralizing agent. All groups exception G1 (control group) were subjected to pigmentation soluble coffee according to the manufacturer's guidelines. The samples were immersed in coffee at temperature of 55? C, 1 time a day for 4 minutes. Color changes were performed by Easyshade spectrophotometer at CIE Lab method before and after 3 whitening sessions. Data were analyzed by analysis of variance ANOVA. The results showed statistically significant differences between the remineralizing substances for the parameters L *, a *, b * ?E (p <0.0001). The L * values for the group G5, and the b * for G2 and G5 groups differed from the control group. After the 3rd whitening session, Fluor's group (G2) and that without mineralizing agent (G5) showed ?E values less than the control group that did not undergo pigmentation. It was concluded that only the nanoclusters remineralizing agents Phosphopeptides Casein-Amorphous Calcium Phosphate and Calcium Amorphous phosphate were able to reduce the coffee interference whitening efficacy of hydrogen peroxide.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-05-11T20:02:58Z No. of bitstreams: 1 LiviaMariaRodriguesDePontesMedeiros_DISSERT.pdf: 871526 bytes, checksum: 4a86e499a00478383f9e73948a7fb595 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-05-19T00:34:44Z (GMT) No. of bitstreams: 1 LiviaMariaRodriguesDePontesMedeiros_DISSERT.pdf: 871526 bytes, checksum: 4a86e499a00478383f9e73948a7fb595 (MD5) / Made available in DSpace on 2016-05-19T00:34:44Z (GMT). No. of bitstreams: 1 LiviaMariaRodriguesDePontesMedeiros_DISSERT.pdf: 871526 bytes, checksum: 4a86e499a00478383f9e73948a7fb595 (MD5) Previous issue date: 2015-02-25 / A atual concep??o de sa?de envolve diversos fatores determinantes, dentre eles a educa??o. ? fundamental a organiza??o intersetorial para o atendimento ? sa?de de jovens e adultos. Nesse contexto foi institu?do o Programa Sa?de na Escola (PSE), que prev? uma articula??o cont?nua entre sa?de e educa??o auxiliando na efetiva??o do Sistema ?nico de Sa?de. Objetivo: Analisar o Programa Sa?de na Escola no munic?pio de Natal/RN, considerando a intersetorialidade das a??es na perspectiva da gest?o. Metodologia: O m?todo escolhido foi o estudo de caso, com abordagem qualitativa. A amostra foi do tipo intencional incluindo todos os componentes do Grupo de Trabalho Intersetorial Municipal de Natal-RN, formado por representantes da Secretaria Municipal de Educa??o, Secretaria Estadual de Educa??o e Secretaria Municipal de Sa?de. A t?cnica de coleta de dados foi a entrevista semi-estruturada. A an?lise dos dados foi realizada por meio da t?cnica de an?lise de conte?do. Para apresenta??o dos dados foram consideradas as seguintes categorias de an?lise: Significado da intersetorialidade; Planejamento das a??es; Forma??o continuada e permanente para a autonomia na promo??o da sa?de; Dificuldades e potencialidades para a operacionaliza??o das a??es. Resultados: Os resultados permitem identificar no PSE de Natal pr?ticas intersetoriais ainda incipientes. Os profissionais gestores, da sa?de e educa??o ainda n?o conseguem reconhecer o potencial da intersetorialidade. O planejamento ? realizado de forma setorializada e sem a participa??o ativa dos educandos e comunidade. O grupo gestor destaca como dificuldades ac?mulo de fun??es, desest?mulo por parte de alguns servidores do grupo gestor e a falta de compromisso de alguns profissionais, inadequa??o estrutural e dificuldade na continuidade das a??es do programa. Apesar da fragmenta??o existente, o grupo gestor do programa tem contribu?do com a qualifica??o profissional e o desenvolvimento das a??es de educa??o em sa?de junto aos educandos. Conclus?o: Conclui-se portanto, que a sa?de, a educa??o e a sociedade t?m muitos desafios a enfrentar para a consolida??o da intersetorialidade e do Programa Sa?de na Escola, bem como a concretiza??o das diretrizes do Sistema ?nico de Sa?de em Natal/RN. / The current conception of health deals with several influential factors, having education among them. Intersectoral organization is essential for Young and adult healthcare services. In this context the Healthcare in School Program was created which foresees a continuous articulation between health and education aiding the effectuation of the Healthcare Single System. The objective of this research is analyze the Healthcare in School Program (HSP) in Natal city in Rio Grande do Norte State taking into consideration the Intersectoriality of actions from the standpoint of the management. The chosen method was the case study, with qualitative approach. The sample was of the intentional kind including all components of the Natal city Intersectorial work group, composed by representatives of the Municipal Education Bureau, the State Education Bureau and Healthcare Municipal Bureau. The collecting data technique was the semi-structured interview. The data analysis was performed through the analysis of contents technique. For Data Show the following analysis categories were considered: Meaning of Intersectoriality; Actions Planning; Permanent and ongoing training for autonomy regarding to Healthcare Promotion; Difficulties and Potentials for actions operationalization. The outcomes allow us to indentify in Natal HSP intersectoral practices not developed yet. The manager professionals of Healthcare and Education do not get to acknowledge the power of Intersectoriality yet. The lack of commitment of some professionals stands out, planning is performed in a sectorial basis and without active participation of learners and community, there is duties accumulation and discouragement group, structural inadequacy and difficulty on the ongoing of the program actions. Despite the existing fragmentation, the program has contributed to the professional qualification and development of education actions regarding to healthcare along with learners. Therefore we conclude that healthcare, education and society have lots of challenges to face in order to consolidate Intersectoriality and the Healthcare in School Program and the and the implementation of the guidelines of the Healthcare Single System in Natal city in the state of Rio Grande do Norte.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-06T22:12:33Z No. of bitstreams: 1 FrancileneAmorimXavier_DISSERT.pdf: 1480840 bytes, checksum: 39809f10fe620827a6bec3f1a6e3fcbf (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-09T00:38:10Z (GMT) No. of bitstreams: 1 FrancileneAmorimXavier_DISSERT.pdf: 1480840 bytes, checksum: 39809f10fe620827a6bec3f1a6e3fcbf (MD5) / Made available in DSpace on 2016-06-09T00:38:10Z (GMT). No. of bitstreams: 1 FrancileneAmorimXavier_DISSERT.pdf: 1480840 bytes, checksum: 39809f10fe620827a6bec3f1a6e3fcbf (MD5) Previous issue date: 2015-10-29 / A mortalidade materna e infantil no Brasil tem se constitu?do como um grave problema de sa?de p?blica, principalmente nas regi?es nordeste e norte. No Rio Grande do Norte, os atuais ?ndices de ?bitos de m?es e beb?s t?m preocupado n?o s? as autoridades de sa?de como ?rg?os da justi?a como o Minist?rio P?blico. Em 2011, o Minist?rio P?blico Estadual ? MPE criou um projeto chamado ?Nascer com Dignidade?, voltado para o acompanhamento da aten??o prestada no pr?-natal, parto e puerp?rio nos munic?pios. O objetivo desse estudo foi investigar como se d? a atua??o do MPE na aten??o materno infantil. O m?todo adotado para levantamento dos dados foi o estudo de caso mediante an?lise dos relat?rios das per?cias realizadas em quatro, das oito Unidades Regionais de Sa?de P?blica (URSAP). Foram selecionados 26 munic?pios e os resultados mostram fragilidades especialmente na aten??o pr?-natal, que podem resultar em complica??es no parto e p?s-parto como: equipes de sa?de da fam?lia incompletas (em 05 munic?pios), falta de acesso ou acesso dificultado a exames laboratoriais (em 16 munic?pios) e falta de vincula??o da gestante ao local do parto (em 26 munic?pios). Com base nessa realidade, o MPE tem adotado medidas relevantes como ajuizamento de A??es Civis P?blicas, celebra??o de Termos de Ajustamento de Conduta com os gestores municipais e realizado interven??es em unidades de sa?de e maternidades do Estado. Dessa forma, entende-se que a interven??o do Minist?rio P?blico ? de suma import?ncia para indicar as adequa??es necess?rias ao enfrentamento da mortalidade materna e infantil estadual (que ? em m?dia de 65/100.000 e 16/100.000 respectivamente) e responsabilizar as prefeituras pela qualidade na assist?ncia de sa?de prestada a seus mun?cipes; exigindo que se cumpram os princ?pios da universalidade e integralidade, com vistas a redu??o das iniquidades sociais. / Maternal and infant mortality have become a serious public health problem in Brazil, especially in northeasternand northern regions.In RioGrande do Norte, the high rates ofdeathsofmothersandbabies haveconcerned not onlythehealthauthorities andjusticeagenciessuch as the prosecution service. In 2011, State Public Ministry (MPE) has developed a proposition which was called ?Nascer com Dignidade?, focused on the monitoring ofcare givenin prenatal, childbirth andpost childbirthin the cities. The aim of thisstudy was toinvestigate how the intervention of MPE works in maternal and child care. The method adopted to survey data was the case study by analyzing the skills of the reports which were carried out in four of the eight Public Health Regional Units (URSAP).A total of 26municipalities were chosenand the results showfragilityparticularly inprenatal care which can result in complicationsin childbirthand postpartumlike:incomplete health family teams(in05cities), lack of access orinaccessibility to laboratory tests(16 cities) and lack of the pregnant woman'sattachment to thebirthing place(in26 cities). Based on this reality, MPE has adopted relevant attitudes as filing public civil suits, compliance of Conduct Adjustment Declaration in the municipal management and performing interventions in heath care centers and maternity clinics of the state. Thereforeit is known thatPublic Ministryis of paramount importanceto indicatethe necessaryadjustmentsto addressinfant and maternalmortalityin the state (mean of 65/100,000 and16/100,000respectively) and give the city hall the responsibility for the health care quality provided to their citizens. These factors demand theprinciples ofuniversality and integrality to be performed in order to reduce social inequities.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-06T22:12:33Z No. of bitstreams: 1 IrapuanMedeirosDeLucena_DISSERT.pdf: 971053 bytes, checksum: dc09173a69f1980f9b3b6eb44ca70869 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-09T19:45:18Z (GMT) No. of bitstreams: 1 IrapuanMedeirosDeLucena_DISSERT.pdf: 971053 bytes, checksum: dc09173a69f1980f9b3b6eb44ca70869 (MD5) / Made available in DSpace on 2016-06-09T19:45:18Z (GMT). No. of bitstreams: 1 IrapuanMedeirosDeLucena_DISSERT.pdf: 971053 bytes, checksum: dc09173a69f1980f9b3b6eb44ca70869 (MD5) Previous issue date: 2015-08-18 / O crescimento da popula??o idosa ? um fen?meno mundial e, no Brasil, essa transforma??o est? acontecendo de forma bastante acelerada. Com o envelhecimento populacional atual, essa faixa et?ria emergente necessitar? de mais aten??o e cuidados ? sa?de. Uma das caracter?sticas do envelhecimento da popula??o ? o ac?mulo progressivo de incapacidades, o que a deixa mais vulner?vel a quedas. Este estudo foi desenvolvido com o prop?sito de conhecer o epis?dio quedas no ?mbito de uma popula??o idosa atendida em uma Unidade de Sa?de da Fam?lia. Trata-se de uma pesquisa de natureza transversal, com uma amostra constitu?da de 121 idosos. A pesquisa foi aprovada pelo Comit? de ?tica do HUOL, com parecer n? 816.022. Foi aplicado um question?rio junto aos participantes e os resultados foram analisados estatisticamente, sendo o teste de Qui-Quadrado e o Exato de Fisher utilizados para verificar a associa??o entre vari?veis. Para a an?lise multivariada, usou-se o m?todo da Regress?o Log?stica Binomial. Para ambos os testes, admitiu-se signific?ncia p<0,05 e IC de 95%. Os resultados demonstram que a maioria ? do sexo feminino, (76,9%); a faixa et?ria de pessoa idosa de 88,4% e 11,6% de sobrenvelhecida; com rela??o ao estado civil, 35,3% s?o casados e 29,4% vi?vos; 92,1% com renda familiar entre um e dois sal?rios m?nimos; e 91,8% moram com o c?njuge e/ou filhos. Com rela??o ? frequ?ncia das quedas, constatou-se que 61,2% dos idosos sofreram uma ou mais quedas em 2014. Como fatores associados, ficou evidente que 73,8% foram decorrentes de fatores extr?nsecos, 6,4% de fatores intr?nsecos e 21,4% de ambos os fatores. Como consequ?ncia da queda, constatou-se que 89,2% t?m medo de cair novamente, 37,3% manifestaram ansiedade e em 13,3% o andar foi afetado. No que diz respeito ? exposi??o aos fatores de riscos, os locais de maior preval?ncia foram: rua/avenida (31,0%), cal?ada (19,0%), sala (14,3%) e p?tio/quintal (10,7%). O estudo comprovou a associa??o estat?stica significativa entre o sexo feminino (p=0,001), entulhos/objetos no quintal (p=0,015) e mobili?rios que podem causar acidentes (p=0,005). Evidenciou-se entre os idosos pesquisados, que 72,7% receberam poucas informa??es sobre quedas, sendo um fator de risco para as quedas. Conclu?mos que existe uma elevada frequ?ncia de quedas em idosos pesquisados, constituindo um dado preocupante, visto que esse evento na popula??o idosa ? bastante grave, sendo necess?rio garantir-lhes um ambiente seguro em seu domic?lio e, sobretudo, fora deste. As informa??es prestadas pela equipe da Estrat?gia Sa?de da Fam?lia s?o importantes para evitar estas ocorr?ncias, refor?ando o desenvolvimento de atividades educativas em sa?de junto ? popula??o como forma de preven??o e redu??o da ocorr?ncia de quedas, melhorando, assim, a qualidade de vida dos idosos. / The growth of the elderly population is a global phenomenon and, in Brazil, this transformation is happening in a very rapid rhythm. With the current population aging, this emerging age group will need more health care and attention. One of the characteristics of the population aging is the progressive accumulation of disabilities, which makes it more vulnerable to falls. This study was developed with the purpose of knowing the episode falls in the scope of an elderly population treated at a Family Health Unit. It is a research with cross-sectional nature, and its sample was composed by 121 elderly. The research was approved by the Ethics Committee of HUOL, with Opinion n? 816.022. We applied a questionnaire to the participants, and the results were statistically analyzed by using Chi-square test and Fisher?s exact test to verify the association between variables. In order to perform a multivariate analysis, we used the method of the Binomial Logistic Regression. For both tests, we accepted significance p<0,05 and CI of 95%. The results prove that the majority belongs to the female gender (76,9%); the age group of elderly reaches 88,4% and 11,6% is over-aged; regarding the marital status, 35,3% are married and 29,4% widowed; 92,1% with family income between one and two minimum wages; and 91,8% live with their partners and/or children. Regarding the frequency of falls, we found that 61,2% of the surveyed elderly suffered one or more falls in 2014. As associated factors, it became clear that 73,8% were due to extrinsic factors, 6,4% to intrinsic factors and 21,4% to both factors. As a consequence of the fall, we found that 89,2% have fear of falling again, 37,3% showed anxiety and 13,3% had their ambulation affected. Concerning the exposure to the risk factors, the most prevalent places were: street/avenue (31,0%), pavement (19,0%), living room (14,3%) and courtyard/backyard (10,7%). The study has proven a statistically significant association among female gender (p=0,001), rubble/objects in the backyard (p=0,015) and furniture that may cause accidents (p=0,005). It was evident among the elderly people surveyed, 72.7% receive little information about falls, being a risk factor for falls. We conclude that there is a high frequency of falls in the surveyed elderly, thereby constituting a worrisome data because this event in the elderly population is a serious matter, which raises the need to ensure them a safe environment in their homes and, above all, outside them. The information provided by the Family Health Strategy team are important to avoid these occurrences, which reinforces the need for developing health education activities together with the population as a way to prevent and reduce the occurrence of falls, thereby improving the quality of life of elderly.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-07-06T20:41:26Z No. of bitstreams: 1 LigiaMorenoDeMoura_TESE.pdf: 1156965 bytes, checksum: 3136206e210f061e45cb5fd73eb2331b (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-07-08T18:43:39Z (GMT) No. of bitstreams: 1 LigiaMorenoDeMoura_TESE.pdf: 1156965 bytes, checksum: 3136206e210f061e45cb5fd73eb2331b (MD5) / Made available in DSpace on 2016-07-08T18:43:39Z (GMT). No. of bitstreams: 1 LigiaMorenoDeMoura_TESE.pdf: 1156965 bytes, checksum: 3136206e210f061e45cb5fd73eb2331b (MD5) Previous issue date: 2015-12-18 / A sociedade est? em constante mudan?a e a ci?ncia deve acompanhar tais transforma??es, de modo a entend?-las, analis?-las e propor solu??es para eventuais problemas que surjam. Dessa forma, no Brasil, a Pol?tica Nacional de Sa?de tamb?m vem se adequando aos atuais problemas, e dentre eles pretende-se reduzir mortalidade infantil. Por isso, vem desenvolvendo uma s?rie de pol?ticas para melhorar a qualidade da aten??o ? gestante, na perspectiva da integralidade. Uma aten??o pr?-natal e puerperal de qualidade e humanizada ? fundamental para a sa?de materna e neonatal, bem como a aten??o ? sa?de bucal. Atualmente, a Pol?tica Nacional de Sa?de Bucal visa ? amplia??o da assist?ncia odontol?gica ?s gestantes. Sendo assim, as pol?ticas de promo??o da sa?de bucal e de aten??o ao pr?-natal devem estar integradas, entretanto, h? pouca ades?o das gestantes. Dessa forma, faz-se necess?rio verificar o conhecimento das gestantes relacionado ? sa?de bucal buscando estimar a qualidade dos cuidados odontol?gicos oferecidos durante o pr?-natal, sendo essencial para a Estrat?gia da Sa?de da Fam?lia dimensionar pessoal, planejar custos e garantir o padr?o de qualidade da assist?ncia. OBJETIVO: Este estudo objetivou validar instrumento de investiga??o sobre o conhecimento das gestantes sobre a sua sa?de bucal e do seu beb?. M?TODO: Trata-se de um estudo de valida??o, realizado com 93 gestantes em Unidades de Sa?de da Fam?lia e Cl?nicas privadas especializadas em Obstetr?cia, da cidade do Natal/RN. Foi autorizado pelo Comit? de ?tica do Hospital Universit?rio Onofre Lopes da Universidade Federal do Rio Grande do Norte sob o Parecer n?mero 421.163/13. Para que o instrumento fosse v?lido, confi?vel e sens?vel, sua constru??o seguiu as etapas: cria??o e redu??o dos itens (elabora??o do instrumento), validade de conte?do e teste do instrumento e valida??o das hip?teses. Depois de constru?do o instrumento, ele foi avaliado por dezenove expertises, que sugeriram modifica??es. Estas foram analisadas por um comit? de ju?zes. Logo foi criada uma nova vers?o do instrumento que consultou a popula??o-alvo. S? ent?o foi realizada a consist?ncia interna atrav?s da calibra??o intra e interexaminadores, e da aplica??o do teste-reteste. Depois foram validadas as hip?teses. Um banco de dados foi constru?do no Statistical Package for Social Sciences (SPSS?) na vers?o 22.0. Na valida??o de crit?rios, ap?s cria??o das hip?teses, esta associa??o foi verificada entre cada uma das quest?es espec?ficas para cada crit?rio estabelecido considerando n?vel de signific?ncia de 5%. A an?lise dos dados foi realizada atrav?s da descri??o das frequ?ncias absolutas e relativas das vari?veis concernentes ? caracteriza??o das quest?es relativas ao conhecimento sobre sa?de bucal das gestantes e beb?s. Para avaliar a consist?ncia interna e a reprodutividade do instrumento (teste-reteste) no processo de valida??o, foi utilizado o coeficiente alfa de Cronbach. Al?m disso, o teste do qui-quadrado foi utilizado para cruzar a vari?vel dependente com as vari?veis independentes as quais foram dicotomizadas. RESULTADOS: A an?lise da consist?ncia interna mostrou que as quest?es do instrumento apresentaram ?tima confiabilidade nas respostas (? de Cronbach?0,7). Na investiga??o da rela??o entre as vari?veis dependentes (conhecimento sobre sa?de bucal) e as vari?veis independentes (trimestre da gravidez, escolaridade, renda e mult?paras) verificou-se que nenhuma destas vari?veis independentes teve associa??o significativa. CONCLUS?O: O instrumento criado foi v?lido, tendo em vista que se mostrou consistente e com boa reprodutividade e pode ser usado para avaliar o conhecimento das gestantes sobre a sua sa?de bucal e a sa?de bucal do seu beb?. / INTRODUCTION: Humanized and quality prenatal and post-partum care is critical to maternal and newborn health, as well as oral health care. Currently, the National Oral Health Policy is aiming at expanding dental care for pregnant women. Thus, the promotion of oral health and attention to prenatal care policies should be integrated; however, there is still limited participation of pregnant women. Thus, it is necessary to verify the knowledge of pregnant women related to oral health, seeking to estimate the quality of dental care provided during prenatal care, being essential for the Family Health strategy to organize personnel, plan costs and to ensure the quality standard of care. OBJECTIVE: To develop and validate a research instrument on the knowledge of pregnant women about their oral health and of their baby. METHOD: This is a construction and validation study with 93 pregnant women in Family Health Units and specialized private clinics in Obstetrics, in the city of Natal / RN. It was authorized by the Onofre Lopes University Hospital Ethics Committee of the Universidade Federal do Rio Grande do Norte (UFRN) under the registration number 421.163/13. The construction of the instrument followed steps so that it was valid, reliable and sensitive: creation and reduction of the items (drafting of the instrument), content validity and testing of the instrument, and hypotheses validation. Once constructed, the instrument was evaluated by experts who suggested modifications. There was consultation with the target population about the new version of the created instrument, which had the instrument validation verified by internal consistency through intra and inter-calibration and test-retest. Next, the hypotheses were validated. A database was built in the Statistical Package for Social Sciences (SPSS), version 22.0. After creating the hypotheses, an association was found for validating the criteria between each of the specific issues for each established criteria, considering a 5% significance level. Data analysis was carried out by describing the absolute and relative frequencies of the variables pertaining to issues relating to their pregnancy knowledge about their oral health and their baby. The Kappa coefficient was used for the calibration process (Inter and Intra-examiner calibration) and Cronbach's alpha coefficient was used to analyze instrument reproducibility (test-retest). In addition, the chi-square test was used to cross the dependent variable with the (dichotomized) independent variables. RESULTS: The intra and inter agreement analysis presented a Kappa coefficient between 0.400 and 1.000. Internal consistency through the analysis showed that 90% of the instrument's questions showed great reliability in the answers (Cronbach ? ? 0.7). In the investigation of the relationship between the dependent variable (knowledge about oral health) and the independent variables (trimester of pregnancy, education, income and multiparous), it was found that none of these independent variables were significantly associated. All hypotheses had their Ho confirmed. CONCLUSION: The constructed instrument was validated, considering that it showed to be sensitive with good reliability and good accuracy, and therefore can be used to assess pregnant women?s knowledge about their oral health and the oral health of their baby.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-08-10T00:00:18Z No. of bitstreams: 1 MatheusFigueiredoNogueira_TESE.pdf: 4719783 bytes, checksum: f8e02f38460b71c10b2013161eae4784 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-08-15T23:34:03Z (GMT) No. of bitstreams: 1 MatheusFigueiredoNogueira_TESE.pdf: 4719783 bytes, checksum: f8e02f38460b71c10b2013161eae4784 (MD5) / Made available in DSpace on 2016-08-15T23:34:03Z (GMT). No. of bitstreams: 1 MatheusFigueiredoNogueira_TESE.pdf: 4719783 bytes, checksum: f8e02f38460b71c10b2013161eae4784 (MD5) Previous issue date: 2016-02-29 / O acelerado crescimento da popula??o idosa ? uma realidade mundial, configurando-se um dos maiores desafios para a sa?de p?blica contempor?nea. Considerando o envelhecimento um fen?meno multidimensional e a amplia??o da expectativa de vida, p?e-se em evid?ncia a necessidade de investigar se o prolongamento da longevidade est? acompanhado de n?veis satisfat?rios de qualidade de vida (QV). Objetivou-se neste estudo avaliar a QV facetada e global de idosos da microrregi?o do Curimata? ocidental paraibano, explicada por suas condi??es de vida e sa?de. Consta de um estudo observacional transversal com desenho quantitativo realizado com 444 idosos de cinco munic?pios: Barra de Santa Rosa, Cuit?, Nova Floresta, Rem?gio e Sossego. Para obten??o das informa??es, foram utilizados os seguintes instrumentos: I) Question?rio para coleta de dados pr?-idoso, para as caracter?sticas sociodemogr?ficas, cl?nicas e comportamentais; e II) Question?rio WHOQOL-Old, para mensura??o e avalia??o da QV. Os dados foram processados no software IBM-SPSS Statistics 20.0 por meio dos testes ANOVA (one-way), t-Student, Mann-Whitney, Kruskal-Wallis e correla??o de Pearson, sendo p-valores<0,05 aceitos como estatisticamente significativos. Os resultados apontam uma boa QV global (ETT=65,69%), com melhor avalia??o por idosos do sexo masculino, com idade entre 60 e 74 anos, casados, morando com c?njuge e filhos, sem cuidador, praticantes de exerc?cios f?sicos, com at? um problema de sa?de diante de um aspecto de multimorbidade e com muito boa e/ou boa avalia??o das necessidades b?sicas. O estresse autorreferido apresentou uma correla??o significativa negativa diante da QV global, onde quanto maior a percep??o do estresse, pior a avalia??o da QV. Na avalia??o facetada da QV, o Funcionamento Sens?rio apresentou o melhor desempenho (ETF=68,86%) e a Participa??o Social (PSO) o pior (ETF=60,37%). No modelo de regress?o linear m?ltipla, a PSO isoladamente ? respons?vel por 51,8% (R2=0,518) de explica??o da QV global. Na intercorrela??o entre as facetas do WHOQOL-Old, apenas Morte e Morrer n?o revelou signific?ncia. A harmonia evidenciada entre as facetas suscita a necessidade de assegurar uma aten??o integral ? sa?de do idoso, em especial na compreens?o da participa??o social como elemento intr?nseco ? QV e que demanda a rediscuss?o e reconstru??o de a??es individuais e coletivas, familiares e comunit?rias, pol?ticas e governamentais. Logo, garantir um envelhecimento ativo, saud?vel, participativo e com QV ? o grande desafio. / The fast growth of the elderly population is a reality throughout the world and has become one of the greatest challenges for contemporary public health. When considering the increased life expectancy and the aging as a multidimensional phenomenon, one should highlight the need to investigate if the increase of longevity is associated with satisfactory levels of Quality of Life (QOL). This study has the objective of assessing the QOL of elderly people from the Para?ba?s Western Curimata? microregion, explained by its health and living conditions. This is a cross-sectional and observational study with quantitative design held with 444 elderly people from five cities: Barra de Santa Rosa, Cuit?, Nova Floresta, Rem?gio e Sossego. In order to obtain information, the following instruments were used: I) Questionnaire for collection data related to the elderly population, for sociodemographic, clinical and behavioral characteristics; and II) WHOQOL-Old questionnaire, with a view to measuring and assessing QOL. Data were processed on the IBM-SPSS Statistics 20.0 software by means of the ANOVA (one-way), Student?s t, Mann-Whitney, Kruskal-Wallis and Pearson?s correlation tests, with p-values<0,05 accepted as being statistically significant. The results indicate a good global QOL (ETT=65,69%), with better assessment by elderly men, aged between 60 and 74 years, married, living with partner and children, without caregiver, physical activity practitioners, with up to one health problem before an aspect of multimorbidity and with very good and/or good assessment of basic needs. The self-reported stress showed a negative significant correlation before the global QOL, where the greater the perception of stress, the worse the assessment of QOL. In the faceted assessment of QOL, the Sensory Operation showed the best performance (ETF= 68,86%) and the Social Participation (SP) the worst (ETF=60,37%). In the multiple linear regression model, SP is singly responsible for 51,8% (R2=0,518) of explanation of the global QOL. In the intercorrelation among the WHOQOL-Old facets, only Death and Dying did not reveal significance. The harmony highlighted among the facets raises the need to ensure a comprehensive health care for the elderly population, especially in understanding the social participation as an intrinsic part of the QOL and that it requires the re-discussion and reconstruction of individual and collective, family and community, political and government actions. Hence, guaranteeing an active, healthy and participatory aging, with QOL, is the major challenge.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-02-15T13:29:42Z No. of bitstreams: 1 IsabelleFerreiraDaSilvaSouza_DISSERT.pdf: 1093593 bytes, checksum: 6543fb71b96f298c1fd5e5c38088482e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-02-20T20:36:23Z (GMT) No. of bitstreams: 1 IsabelleFerreiraDaSilvaSouza_DISSERT.pdf: 1093593 bytes, checksum: 6543fb71b96f298c1fd5e5c38088482e (MD5) / Made available in DSpace on 2018-02-20T20:36:23Z (GMT). No. of bitstreams: 1 IsabelleFerreiraDaSilvaSouza_DISSERT.pdf: 1093593 bytes, checksum: 6543fb71b96f298c1fd5e5c38088482e (MD5) Previous issue date: 2017-12-01 / Introdu??o: Embora a literatura afirme existir rela??o entre o excesso de peso e a osteoartrite de joelhos, a rela??o entre a doen?a e o consumo alimentar, ainda n?o est? esclarecido. Objetivo: Avaliar a ingest?o habitual de energia e nutrientes de idosas comunit?rias com e sem dor nos joelhos. Metodologia: Trata-se de um estudo transversal, com idosas sintom?ticas (n=49) e assintom?ticas (n=51) quanto ? dor nos joelhos. A ingest?o alimentar foi determinada pela m?dia de 2 dias do Recordat?rio de 24 horas. As dietas foram analisadas no Dietbox?. A necessidade energ?tica individual foi estimada atrav?s de f?rmulas e o consumo de calorias totais foi analisado considerando o intervalo de 97 a 103% do gasto energ?tico. A adequa??o dos macronutrientes foi verificada de acordo com os Acceptable Macronutrient Distribution Ranges. A ingest?o m?dia de ?cidos graxos, colesterol e fibra, foi analisada de acordo com os valores propostos pela IV Diretriz Brasileira sobre Dislipidemias. A inadequa??o dos micronutrientes foi estimada pelo m?todo da Estimated Average Requirement como ponto de corte e o consumo h?drico foi avaliado a partir da recomenda??o do Guia Alimentar para a Popula??o Brasileira. Para an?lise dos dados, foi utilizado o software Statistical Package for the Social Sciences (SPSS) vers?o 20.0. Resultados: A m?dia de idade foi de 67(?8,0) anos para o grupo assintom?tico e 67(?9,0) anos para o sintom?tico. Quanto ao consumo de energia, macronutrientes, ?cidos graxos, colesterol, fibra e ?gua, observam-se diferen?as entre os grupos, que n?o se mostraram estatisticamente significativas. A ingest?o de energia foi inadequada em 96,1% das assintom?ticas e em 93,9% das sintom?ticas. Tamb?m n?o foram observadas diferen?as estatisticamente significativas entre as idosas quanto ao consumo alimentar dos micronutrientes, exceto para o consumo habitual do mineral zinco (p valor = 0,033), o grupo sintom?tico teve um consumo m?dio de zinco inferior ao grupo assintom?tico. Nos grupos, as maiores inadequa??es (> 50%) foram para vitaminas A, D, E e ?cido f?lico e magn?sio e c?lcio. As menores inadequa??es foram para vitamina C e piridoxina (valores entre 21,6% e 22,4%). Destaca-se a ingest?o inadequada da vitamina D (100% das avaliadas). Conclus?o: Entre os grupos, foram observadas elevadas preval?ncias de inadequa??o para ingest?o cal?rica, consumo dos ?cidos graxos saturados, colesterol, fibra, ingest?o h?drica, macros e micronutrientes. Contudo, n?o foram observadas diferen?as estatisticamente significativas no consumo alimentar dos nutrientes, com exce??o do mineral zinco, pois as idosas sintom?ticas tiveram um consumo m?dio de zinco inferior ao grupo assintom?tico. / Introduction: Although the literature states that there is a relationship between overweight and knee osteoarthritis, the relationship between disease and food consumption is still unclear. Objective: To evaluate the habitual intake of energy and nutrients of community aged women with and without pain in the knees. Methodology: This is a cross-sectional study with symptomatic elderly women (n = 49) and asymptomatic women (n = 51) for knee pain. Food intake was determined by the 2-day mean of the 24-hour Reminder. The diets were analyzed in Dietbox?. The individual energy requirement was estimated using formulas and total calorie consumption was analyzed considering the range of 97 to 103% of energy expenditure. Macronutrient suitability was checked according to the Acceptable Macronutrient Distribution Ranges. The mean intake of fatty acids, cholesterol and fiber was analyzed according to the values proposed by the IV Brazilian Directive on Dyslipidemias. The micronutrient inadequacy was estimated by the Estimated Average Requirement method as the cutoff point and the water consumption was evaluated based on the recommendation of the Food Guide for the Brazilian Population. Statistical Package for the Social Sciences (SPSS) software version 20.0 was used to analyze the data. Results: The mean age was 67 (? 8.0) years for the asymptomatic group and 67 (? 9.0) years for the symptomatic group. As for the energy consumption, macronutrients, fatty acids, cholesterol, fiber and water, there were differences between the groups, which were not statistically significant. The energy intake was inadequate in 96.1% of the asymptomatic ones and in 93.9% of the symptomatic ones. There were also no statistically significant differences among the elderly women regarding the dietary intake of micronutrients, except for the usual consumption of zinc mineral (p value = 0.033), the symptomatic group had an average zinc intake lower than the asymptomatic group. In the groups, the greatest inadequacies (> 50%) were for vitamins A, D, E and folic acid and magnesium and calcium. The lowest inadequacies were for vitamin C and pyridoxine (values between 21.6% and 22.4%). Inadequate intake of vitamin D (100% of the evaluated ones) is highlighted. Conclusion: Among the groups, high prevalence of inadequacy for caloric intake, saturated fatty acid consumption, cholesterol, fiber, water intake, macros and micronutrients were observed. However, no statistically significant differences were observed in food intake of the nutrients, except for the zinc mineral, since the symptomatic elderly had an average zinc consumption lower than the asymptomatic group.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-12T20:18:44Z No. of bitstreams: 1 LayanneCristiniMartinSousa_DISSERT.pdf: 1742028 bytes, checksum: 9edd9252e78cba594579c04e160087da (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-16T19:49:44Z (GMT) No. of bitstreams: 1 LayanneCristiniMartinSousa_DISSERT.pdf: 1742028 bytes, checksum: 9edd9252e78cba594579c04e160087da (MD5) / Made available in DSpace on 2018-03-16T19:49:44Z (GMT). No. of bitstreams: 1 LayanneCristiniMartinSousa_DISSERT.pdf: 1742028 bytes, checksum: 9edd9252e78cba594579c04e160087da (MD5) Previous issue date: 2017-12-20 / A Vigil?ncia em Sa?de ? caracterizada como um conjunto articulado de a??es com foco na promo??o da sa?de e preven??o de doen?as, sob a ?tica da integralidade do cuidado. O objetivo deste estudo foi analisar a Vigil?ncia em Sa?de sob a perspectiva de seus trabalhadores, utilizando uma abordagem qualitativa. Foram entrevistados 28 profissionais lotados no n?vel central da Vigil?ncia em Sa?de, dos quais 12 da secretaria de sa?de de Natal e 16 da secretaria de sa?de do Rio Grande do Norte. As entrevistas semi-estruturadas foram realizadas entre novembro e dezembro de 2016. O material produzido foi analisado a luz do referencial te?rico de Bardin, utilizando a t?cnica de An?lise de Conte?do. Emergiram da an?lise quatro categorias tem?ticas: concep??o sobre Vigil?ncia em Sa?de; articula??o intr?nseca e extr?nseca ? Vigil?ncia em Sa?de; potencialidades e desafios. Os resultados mostraram que os trabalhadores t?m uma concep??o ampliada sobre a Vigil?ncia em Sa?de, entretanto a vis?o tecnicista ainda se encontra presente. As a??es desenvolvidas por eles apresentam-se fragmentadas, tanto entre as vigil?ncias como entre estas e os servi?os de sa?de, deixando evidente a desarticula??o entre os processos cotidianos. Os trabalhadores demonstraram satisfa??o e comprometimento no exerc?cio de suas fun??es, configurando-se como potencialidades, no entanto se traduzem em caracter?sticas conflitantes diante do cen?rio de dificuldades e limita??es relatado por eles. Apontaram como desafios a serem superados: maiores investimentos no setor; valoriza??o dos profissionais e maior suporte e apoio por parte da gest?o. Observa-se, portanto, a necessidade de se imprimir novos avan?os na Vigil?ncia em Sa?de, que perpasse, necessariamente, pela redefini??o do modelo de aten??o, e que adote o planejamento coletivo de forma genu?na, a ressignifica??o de processos de trabalho e de forma??o profissional al?m de uma gest?o participativa com controle social, objetivando a efetividade de suas a??es e a integralidade do cuidado. / Health Surveillance is characterized as an articulated set of actions focused on health promotion and disease prevention, from the point of view of integral care. The objective of this study is to analyze the Health Surveillance from the perspective of its workers using a qualitative approach. A total of 28 central-level Health Surveillance professionals were interviewed, of which 12 of the Secretariat of health of Natal and 16 of the Department of health of Rio Grande do Norte. The semi-structured interviews were carried out between November and December 2016. The material produced was analyzed using the Content Analysis technique in light of the theoretical reference of Bardin. Four thematic categories emerged: conception of Surveillance in Health; intrinsic and extrinsic articulation of Health Surveillance; Health Surveillance?s potential; and, conversely, it?s challenges. The results showed that the workers have an expanded concept of Health Surveillance, although the technician?s view is still present. Consequently, their actions developed a fragmented result, both between surveillance and health services, leaving clear the disarticulation between the everyday processes. The workers demonstrated satisfaction and commitment in the performance of their duties, configuring itself as potential, however result in conflicting characteristics before the backdrop of difficulties and limitations reported by them. Pointed as challenges to be overcome: greater investment in the sector; recovery of professionals and greater support on the part of management. There is therefore the need to print new advances in health surveillance, which circulates, necessarily, by redefining the model of attention, and to adopt the collective planning of genuine form, the ressignification of work processes and training Professional plus a participatory management with social control, aiming at the effectiveness of its actions and the completeness of the care.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-12T20:18:44Z No. of bitstreams: 1 YriuLourencoRodrigues_DISSERT.pdf: 2562345 bytes, checksum: 91fc4e0062ca0529e47b9cfb3eaa735a (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-16T19:57:58Z (GMT) No. of bitstreams: 1 YriuLourencoRodrigues_DISSERT.pdf: 2562345 bytes, checksum: 91fc4e0062ca0529e47b9cfb3eaa735a (MD5) / Made available in DSpace on 2018-03-16T19:57:58Z (GMT). No. of bitstreams: 1 YriuLourencoRodrigues_DISSERT.pdf: 2562345 bytes, checksum: 91fc4e0062ca0529e47b9cfb3eaa735a (MD5) Previous issue date: 2017-09-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / O presente estudo teve por objetivo investigar o comportamento biomec?nico de diferentes dimens?es de pr?teses temporomandibulares personalizadas, por meio do M?todo de Elementos Finitos. A partir de uma tomografia computadorizada, um modelo computacional 3D da mand?bula foi gerado. Este modelo foi replicado e suas c?pias submetidas a tr?s diferentes ressec??es progressivas, as quais foram reabilitadas com pr?teses temporomandibulares personalizadas, gerando assim tr?s modelos experimentais (Modelo Incisura Mandibular ? MIM, Modelo Linha Oclusal ? MLO e Modelo 3? Molar ? M3M) mais a mand?bula intacta (Modelo Controle ? MC). Com base nas geometrias geradas foram criados quatros modelos de elementos finitos, com prop?sito de mimetizar uma condi??o cl?nica. Os modelos foram considerados isotr?picos, homog?neos e linearmente el?sticos. Por meio de um software de simula??o computacional foram simuladas as a??es das principais for?as musculares que atuam sobre a mand?bula, e realizada uma an?lise da distribui??o de tens?es e deforma??o no osso adjacente ? pr?tese, c?ndilo oposto ? pr?tese, pr?tese personalizada e parafusos de fixa??o. Foi poss?vel observar que houve um aumento dos valores do equivalente de von Mises nos ossos adjacentes e nos c?ndilos opostos, ap?s a instala??o das pr?teses. Entretanto estes valores permaneceram semelhantes entre os modelos. As concentra??es de tens?es nos ossos adjacentes e nas pr?teses se apresentaram na regi?o em torno dos parafusos, e estes ?ltimos apresentaram os maiores picos de tens?o que variaram de 836 MPa a 13010 MPa. J? na an?lise da distribui??o de deforma??es foi poss?vel observar que n?o houve concentra??o de deforma??es nos c?ndilos opostos. Entretanto o MIM apresentou os maiores picos de deforma??o no osso adjacente e na pr?tese, enquanto que o M3M apresentou o maior nos parafusos, chegando a 9770 ??. O aumento das dimens?es das pr?teses personalizadas levou ao aumento dos picos de tens?o e deforma??o a valores cr?ticos nos ossos adjacentes ?s pr?teses e parafusos de fixa??o, que pode comprometer a estabilidade e fun??o das pr?teses, em todos os modelos experimentais. O aumento no n?mero de parafusos poder? conferir uma adequada estabilidade e distribui??o de tens?o para os modelos, sobretudo com o aumento das dimens?es das pr?teses temporomandibulares; necessitando assim de mais que tr?s parafusos de fixa??o. / The present study aimed to investigate the biomechanical influence of different dimensions of custom temporomandibular prostheses by means of the Finite Element Method. Frist, a 3D computational model of the mandible was generated using computerized tomography. This model was replicated and its copies were then submitted to three different progressive resections, which were rehabilitated with custom temporomandibular prostheses, thus generating three experimental models (Mandibular Notch Model ? MIM, Occlusal Line Model ? MLO and 3rd Molar Model ? M3M) plus the intact mandible (Control Model ? MC). Based on the generated geometries, four models of finite elements were created, aiming to mimic a clinical condition. The models were considered isotropic, homogeneous and linearly elastic. Using virtual simulation software, the actions of the main muscular forces acting on the mandible were reproduced, and analyses of the stress and strain distribution on the adjacent bones of the prosthesis, opposite condyle to the prosthesis, personalized prosthesis, and on fixation screws were performed. It was possible to observe that there was an increase in von Mises equivalent values in the adjacent bones and in the opposing condyles after installation of the prostheses. However, these values remained similar between the models. Stress concentrations in adjacent bones and prostheses occurred in the region around the screws, and the latter had the highest stress peaks ranging from 836 MPa to 13010 MPa. In the strain distribution analysis, it was possible to observe that there was no concentration of strain in the opposing condyles. However, the MIM showed the highest strain peaks in the adjacent bone and prosthesis, whereas the M3M presented the highest strain on the screws, reaching 9770 ??. Increasing the dimensions of the customized prostheses led to an increase of the stress peaks and strain at critical values in the bones adjacent to the prostheses and fixation screws which, can compromise the stability and function of the prostheses in all the experimental models. Increasing the number of screws could give adequate stability and stress distribution to the models, especially with the increase of the dimensions of the temporomandibular prosthesis, then requiring more than three fixing screws.