Thesis (Ph. D.)--University of Washington, 2006. / Vita. Includes bibliographical references (p. 238-260).

Made available in DSpace on 2014-12-17T15:46:20Z (GMT). No. of bitstreams: 1 ErikaSM_DISSERT.pdf: 1440315 bytes, checksum: 5697be22f2bb929332541669d3861e07 (MD5) Previous issue date: 2010-03-29 / This paper presents the survey results: PROCEDURE FOR WORK IN HEALTH: an analysis of working conditions of social workers in hospitals. Analyzes the inclusion of social workers in work processes in healthcare, specifically in the public hospital, from the objective conditions of work, according to which materializes professional action. The aim is to understand them from the point of view of its relationship with users and other health professionals through the privatization of health, which prevents the Unified Health System (SUS), limiting the operation of the services and the guarantee of rights. The approach to the reality studied was through theoretical and methodological procedures based on the qualitative and quantitative research, focusing on documentary research, observation, semi-structured interview and the theoretical foundation. It is observed that the inclusion of social workers in this context arises from the demands derived from expressions of social issues, "raw material" of professional work, and the gaps resulting from contradictions in the process of rationalization / reorganization of the SUS, meaning that the needs the population are confronted with the content and form of organization of services. At the hospital, the professional actions are developed through the shift, space contradictory clash between the collective and individual, in which individual activities are prioritized and ad hoc unplanned and reduced to the solution of "problems" of users, through actions assistance in an emergency and bureaucratic. These findings emphasize the inadequacy of space and lack of minimum conditions of service to users, which undertakes the professional with regard to ethical and political principles of the profession, since it is the responsibility and duty of the social guarantee the secrecy and privacy of users what is revealed during the process of professional intervention. The professional social workers is permeated by the diversity of skills and competence; lack of planning activities, by incorporating the institutional discourse at the expense of professional goals, by knowing the Code of Professional Ethics, for small number of professionals, the increasing number informality; by poor working conditions and wages; by discouraging research and participation in social policy councils, as well as professional training / Este trabalho apresenta os resultados da pesquisa: PROCESSO DE TRABALHO EM SA?DE: uma an?lise das condi??es de trabalho dos assistentes sociais no ?mbito hospitalar. Analisa a inser??o dos assistentes sociais nos processos de trabalho em sa?de, especificamente no ?mbito p?blico hospitalar, a partir das condi??es objetivas de trabalho, segundo as quais se materializa a a??o profissional. O intuito ? entend?-las sob o ponto de vista da sua rela??o com os usu?rios e demais profissionais de sa?de, mediante a privatiza??o da sa?de, que inviabiliza o Sistema ?nico de Sa?de (SUS), limitando a operacionaliza??o dos servi?os e a garantia dos direitos. A aproxima??o com a realidade pesquisada se deu atrav?s de procedimentos te?rico-metodol?gicos fundamentados na pesquisa quali-quantitativa, privilegiando-se a pesquisa documental, a observa??o, a entrevista semi-estruturada e a fundamenta??o te?rica. Observa-se que a inser??o dos assistentes sociais neste contexto decorre das demandas derivadas das express?es da quest?o social, mat?ria-prima do trabalho profissional, e das lacunas decorrentes das contradi??es presentes no processo de racionaliza??o/reorganiza??o do SUS, significando que as necessidades da popula??o se confrontam com o conte?do e a forma de organiza??o dos servi?os. No ?mbito hospitalar, as a??es profissionais s?o desenvolvidas atrav?s do plant?o, espa?o contradit?rio de embate entre as pr?ticas coletivas e individualistas, pelas quais s?o priorizadas atividades individuais e pontuais, n?o-planejadas e reduzidas ? solu??o dos problemas dos usu?rios, atrav?s das a??es assistenciais, de car?ter emergencial e burocr?tico. ? not?ria a inadequa??o do espa?o f?sico e a falta de condi??es m?nimas de atendimento aos usu?rios, o que compromete o exerc?cio profissional no tocante aos princ?pios ?ticopol?ticos da profiss?o, visto que ? responsabilidade e dever do assistente social garantir o sigilo profissional e a privacidade dos usu?rios naquilo que for revelado durante o processo de interven??o profissional. O exerc?cio profissional dos assistentes sociais ? perpassado pela diversidade de compet?ncias e atribui??es; pela falta de planejamento das atividades; pela incorpora??o do discurso institucional em detrimento dos objetivos profissionais; pelo desconhecimento do C?digo de ?tica profissional, por reduzido n?mero de profissionais; pelo n?mero crescente de informalidade; pelas prec?rias condi??es de trabalho e sal?rio; pelo desest?mulo ? pesquisa e ? participa??o em conselhos de pol?ticas sociais, bem como de capacita??o profissional

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-11-06T20:51:19Z No. of bitstreams: 1 GiordanoBrunoSouzaDosSantos_DISSERT.pdf: 1163230 bytes, checksum: c540940aac53afc06ed541131cbea58d (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-11-20T21:47:52Z (GMT) No. of bitstreams: 1 GiordanoBrunoSouzaDosSantos_DISSERT.pdf: 1163230 bytes, checksum: c540940aac53afc06ed541131cbea58d (MD5) / Made available in DSpace on 2017-11-20T21:47:52Z (GMT). No. of bitstreams: 1 GiordanoBrunoSouzaDosSantos_DISSERT.pdf: 1163230 bytes, checksum: c540940aac53afc06ed541131cbea58d (MD5) Previous issue date: 2017-08-30 / A discuss?o acerca da identidade de g?nero, orienta??o sexual e especialmente no que tange ? aten??o ? sa?de de pessoas LGBT ainda ? negligenciada no projeto pedag?gico dos cursos da ?rea da sa?de, em geral, e da Medicina, em particular. Diante disso, a presente pesquisa teve como objetivo geral elaborar um componente curricular sobre aten??o ? sa?de da popula??o LGBT em um curso de gradua??o em Medicina. Para tanto, foi realizada uma pesquisa-a??o junto ao curso de Medicina da Escola Multicampi de Ci?ncias M?dicas da Universidade Federal do Rio Grande do Norte. A pesquisa compreendeu as seguintes etapas: a) fase explorat?ria; b) coloca??o dos problemas ou necessidades; c) teoriza??o; d) semin?rios; e) coleta de dados; f) plano de a??o; e g) divulga??o interna e externa. Como resultado desse estudo obteve-se a proposta de inclus?o de um componente curricular denominado ?Aten??o ? Sa?de da Popula??o LGBT?, com carga hor?ria de 45 horas, no projeto pedag?gico do curso de Medicina da institui??o-cen?rio desta pesquisa. Al?m disso, foi submetida e aprovada uma Oficina Pr?-congresso sobre a mesma tem?tica a ser realizada no 55? Congresso Brasileiro de Educa??o M?dica. Sendo assim, pode-se concluir que a inclus?o da tem?tica objeto deste estudo ? de fundamental import?ncia para a forma??o do m?dico com perfil generalista, conforme as Diretrizes Curriculares Nacionais para os curso de gradua??o em Medicina vigente. / The discussion about gender identity, sexual orientation and especially about the health care of LGBT people is still neglected in the pedagogical project of the courses of health in general, and Medicine in particular. In view of this, the present research had as general objective to elaborate a curricular component on health care of the LGBT population in a graduation course in Medicine. For that, an action research was carried out next to the medical course of the Multicampi School of Medical Sciences of the Federal University of Rio Grande do Norte. The research comprised the following steps: a) exploratory phase; B) placement of problems or needs; C) theorizing; D) seminars; E) data collection; F) action plan; And g) internal and external disclosure. As a result of this study, a proposal was made for the inclusion of a curricular component called "Health Care of the LGBT Population", with a 45-hour workload, in the pedagogical project of the medical course of the institution-scenario of this research. In addition, a Pre-congress Workshop was submitted and approved on the same theme to be held at the 55th Brazilian Congress of Medical Education. Thus, it can be concluded that the inclusion of the subject matter of this study is of fundamental importance for the training of physicians with a generalist profile, according to the National Curricular Guidelines for undergraduate medical courses.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-12-12T19:15:39Z No. of bitstreams: 1 KisnaYasminAndradeAlves_TESE.pdf: 5272909 bytes, checksum: 857560ffd5b4df0df50bd99e31b2eb5b (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-12-14T18:22:11Z (GMT) No. of bitstreams: 1 KisnaYasminAndradeAlves_TESE.pdf: 5272909 bytes, checksum: 857560ffd5b4df0df50bd99e31b2eb5b (MD5) / Made available in DSpace on 2017-12-14T18:22:11Z (GMT). No. of bitstreams: 1 KisnaYasminAndradeAlves_TESE.pdf: 5272909 bytes, checksum: 857560ffd5b4df0df50bd99e31b2eb5b (MD5) Previous issue date: 2017-08-31 / A comunica??o escrita ? uma ferramenta que contribui com a redu??o de danos ao paciente, uma vez que possibilita a unifica??o dos registros da equipe multidisciplinar e a continuidade da assist?ncia. Diante disso, este estudo objetiva analisar a comunica??o escrita dos profissionais de sa?de em hospitais p?blicos do estado do Rio Grande do Norte, Brasil. Trata de um estudo transversal que se baseia nas recomenda??es da Organiza??o Mundial de Sa?de, quanto a constru??o ?Record review of current in-patients?. Seguiram-se as etapas: 1) constru??o da Scoping review; 2) sele??o e treinamento dos examinadores de registros; 3) testagem dos procedimentos de avalia??o do registro (estudo piloto); e 4) desenvolvimento da revis?o de registros. A coleta de dados nos prontu?rios ocorreu no per?odo de outubro a dezembro de 2016, em tr?s hospitais p?blicos de Natal, nos setores de enfermarias de cl?nica m?dica e cir?rgica. Foram inclu?dos na amostra os pacientes internados h? pelo menos 10 dias. Os dados foram organizados por meio de um pacote estat?stico e analisados de forma descritiva, por meio de frequ?ncia absoluta e relativa e Diagrama de Pareto. O estudo segue os preceitos ?ticos estabelecidos pela Resolu??o n? 466/2012, do Conselho Nacional de Sa?de. Os resultados destacaram que o conte?do da comunica??o escrita compreende os elementos comuns aos registros ? identifica??o do paciente e profissional, letras leg?veis, uso de siglas e abreviaturas padronizadas, aus?ncia de rasura e in?cio dos escritos com data e hora ? e elementos espec?ficos a cada categoria profissional. A partir da revis?o de prontu?rios evidenciou-se os principais dados em n?o conformidades: 1) identifica??o do paciente (cabe?alhos) - data de nascimento e filia??o na identifica??o do paciente; 2) evolu??es m?dicas - aspectos do exame f?sico, antecedentes pessoais e familiares, h?bitos e condi??es de moradia do paciente, intercorr?ncias, resultados laboratoriais e de imagem nas evolu??es m?dicas; 3) anota??es do t?cnico de enfermagem - h?bitos de vida, presen?a de alergia, identifica??o do acompanhante, uso de medicamento quanto ao tipo, condi??es gerais acerca da atitude, humor, locomo??o e colora??o da pele, estado nutricional e orienta??es ao paciente/acompanhante nas anota??es do t?cnico de enfermagem; 4) controles essenciais ? unidade de medida ap?s o sinal vital; 5) anota??es do enfermeiro - identifica??o do acompanhante, colora??o da pele, elimina??es quanto ? consist?ncia, odor e colora??o; orienta??o do paciente/acompanhante; aspectos sobre exame f?sico, h?bitos de vida e presen?a de alergias; 6) elementos comuns da comunica??o escrita ? letras leg?veis, in?cio dos registros com hora e uso de abreviaturas; e 7) identifica??o profissional ? categoria e n?mero no conselho de classe. Conclui-se que a comunica??o escrita dos profissionais de sa?de, nos tr?s hospitais analisados, apresenta n?o conformidades nos dados de identifica??o do paciente e profissional, nos registros admissional e di?rio tanto de m?dicos e como da equipe de enfermagem. Assim, a??es para a melhoria da comunica??o escrita dos profissionais nos hospitais analisados, como tamb?m contribuir com as discuss?es acerca dessa tem?tica s?o recomendadas para se efetivar a comunica??o e o cuidado seguro. / Written communication is a tool that contributes to reducing patient harm, since it allows the unification of multidisciplinary team records and continuity of care. As such, this study aims to analyze the written communication of health care professionals in public hospitals in Rio Grande do Norte state, Brazil. This is a cross-sectional study based on the recommendations of the World Health Organization regarding the construction of a ?Record review of current in-patients?. It included the following stages: 1) performing a scoping review; 2) selecting and training record examiners; 3) testing record assessment procedures (pilot study); and 4) conducting the record review. Data were collected from medical records in the wards of the medical and surgical clinics in three public hospitals in the city of Natal, between October and December 2016. Patients hospitalized for at least 10 days were included in the sample. The data were organized in a statistical package and analyzed descriptively by absolute and relative frequency and a Pareto chart. The study complied with the ethical principles established by Resolution 466/2012 of the Brazilian National Health Council. The results highlight that written communication includes common elements ? information on the patient and medical professional, legible writing, the use of standardized acronyms and abbreviations, lack of erasures, and records initiated with the date and time ? and aspects that are specific to each professional category. The main nonconformities identified in the record review were: 1) patient identification (headers) ? date of birth and parents? names in the patient information; 2) progress notes ? aspects of the physical examination, personal and family history, patient?s habits and living conditions, complications, lab and imaging results; 3) notes by the nursing technician ? lifestyle habits, allergies, companion?s identification information, type of medication used, general health status in terms of behavior, mood, movement ability and skin color, nutritional status and guidance for the patient/companion; 4) essential controls ? unit of measurement after vital signs; 5) nurse?s notes - companion?s identification information, skin color, consistency, color and odor of urine/stools, guidance for the patient/companion, aspects of the physical examination, lifestyle habits and allergies; 6) common elements of written communication ? legible writing, records initiated with the date and time, use of abbreviations; and 7) medical professional?s information ? medical specialty and registration number. It was concluded that the written communication of health care professionals in the three hospitals studied exhibits nonconformities in the identification information of patients and professionals in both the admissions and daily records of doctors and nurses. Thus, action is recommended to improve the written communication of staff in the hospitals analyzed and contribute to discussions on the theme, in order to ensure effective communication and safe care.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-01-16T20:57:31Z No. of bitstreams: 1 NubiaMariaLimaDeSousa_DISSERT.pdf: 1759490 bytes, checksum: 500389ccad320affbe0f164fec1f33e9 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-01-23T11:11:51Z (GMT) No. of bitstreams: 1 NubiaMariaLimaDeSousa_DISSERT.pdf: 1759490 bytes, checksum: 500389ccad320affbe0f164fec1f33e9 (MD5) / Made available in DSpace on 2018-01-23T11:11:51Z (GMT). No. of bitstreams: 1 NubiaMariaLimaDeSousa_DISSERT.pdf: 1759490 bytes, checksum: 500389ccad320affbe0f164fec1f33e9 (MD5) Previous issue date: 2017-11-23 / A preceptoria em sa?de, em hospitais universit?rios, tornou-se uma pr?tica pedag?gica e muitos profissionais do servi?o foram inseridos como preceptores, por?m a maioria deles n?o teve forma??o em educa??o. Esse fato pode lev?-los a encontrar dificuldades em adotar estrat?gias de ensino-aprendizagem que aproximem o conhecimento cient?fico ? realidade pr?tica na forma??o de profissionais da ?rea da sa?de. O presente estudo objetivou analisar o conhecimento das metodologias de ensino pelos preceptores no processo ensino/aprendizagem de residentes multiprofissionais em sa?de. Trata-se de um estudo transversal, descritivo, com abordagem qualitativa, composto por 50 preceptores, que atuavam h? mais de um ano na resid?ncia multiprofissional em sa?de de um hospital-escola. A coleta de dados foi realizada de setembro a dezembro de 2016, por meio de um roteiro semiestruturado para caracteriza??o dos sujeitos do estudo e com a aplica??o da t?cnica de associa??o livre de palavras. Os dados foram analisados pelo software Ensemble de Programmes Permettant L?Analyse des Evocations (EVOC), vers?o 2000, e discutidos com base no referencial te?rico da Teoria do N?cleo Central. Teve aprova??o do Comit? de ?tica em Pesquisa, sob o n? 1.663.421/16. Os dados foram divididos em tr?s unidades tem?ticas: conhecimento dos preceptores sobre estrat?gias de ensino, sobre metodologia tradicional e metodologias ativas e suas respectivas categorias: elementos conceituais; uso te?rico pr?tico, aprofundamento do conte?do e aplicabilidade. Foram considerados como elementos do n?cleo central as palavras que tiveram menor ordem media de evoca??o (MOE), com par?metro de 2,0, 2,3 e 2,5 e maior frequ?ncia(F) com par?metro de 10. Na unidade tem?tica referente ? estrat?gia de ensino destacaram-se as palavras ?m?todo de ensino? (OME, 1,4- F29). ?din?mica? (OME 1,6 - F 13) e ?aulas? (OME 2,0 - F17). A metodologia tradicional foi representada por ?ensino arcaico? (OME 1,7 ? F 45) e ?centrado no professor? (OME 1,8 F 22). Para as metodologias ativas destacaram-se ?proatividade? (OME 1,7 ? F 23), ?construtivismo? (OME1, 9 F 61) e ?Feedback ?(OME 2,1 F10). O estudo apontou que os preceptores compreendem as estrat?gias de ensino com m?todos que favorecem o ensino aprendizado, evidenciando-se o conhecimento sobre as metodologias tradicionais como ?ensino arcaico? e ?metodologia conteudista?, e as metodologias ativas como ?proatividade?, ?construtivismo? e ?feedback?, embora a maioria aponte a n?o utiliza??o desta no ensino da resid?ncia multiprofissional em sa?de. Por fim, acredita-se que para a forma??o de profissionais na ?rea da sa?de deve haver um car?ter interdisciplinar, com uso de metodologias ativas que despertem no aluno o seu potencial cr?tico-reflexivo, tornando-o agente transformador no processo de cuidar dos sujeitos nos diferentes cen?rios de atua??o profissional proposto pelo Sistema ?nico de Sa?de. Como produto desse estudo, foi criada uma proposta para capacita??o dos preceptores da resid?ncia multiprofissional de sa?de, campo do estudo, em metodologias ativas de ensino. / Preceptory in health in university hospitals has become a pedagogical practice and many service professionals were inserted as preceptors, but most of them did not have education training. Finding difficulties in adopting teaching-learning strategies that bring scientific knowledge closer to practical reality in the training of health professionals. This study aims to analyze the knowledge of teaching methodologies by preceptors (teachers) in the teaching/learning process of multiprofessional residents in health. It is a descriptive, cross-sectional study with a qualitative approach, composed with 50 preceptors who had been working for more than one year in the multiprofessional health residency of a school hospital. Data collection was carried out from September to December 2016, through a semistructured script to characterize the subjects of study and with the application of the word-free association technique. Data were analyzed by the Ensemble software of Permettant L'Analyse des Evocations (EVOC), version 2000, and discussed based on the theoretical framework of the Core Nucleus Theory. It was approved by the Research Ethics Committee under no. 1.663.421 / 16. Data were divided into three thematic units: knowledge of preceptors about teaching strategies, about traditional methodology and active methodologies and their respective categories: conceptual elements; practical theoretical use, deepening of content and applicability. The items with the lowest mean order of evocation (MOE), with a parameter by 2.0, 2.3 and 2.5 and higher frequency (F) with a parameter by 10, were considered with elements of the central nucleus. In the thematic unit referring to teaching strategy, the words stood out the words, such as "teaching method" (MOE, 1,4- F29). "Dynamic" (MOE 1.6 - F 13) and "lessons" (MOE 2.0 - F17). The traditional methodology was represented by "archaic teaching" (MOE 1.7 - F 45) and "teacher-centered" (MOE 1.8 F 22). For the active methodologies "proactivity" (MOE 1,7 - F 23), "constructivism" (MOE1, 9 F 61) and "feedback" (MOE 2.1 F10) stood out. The study pointed out that preceptors have understood the teaching strategies with methods that have favored learning teaching. Moreover, it has evidenced the knowledge about traditional methodologies, such as "archaic teaching" and "content methodology" and active methodologies, such as "proactivity", "constructivism" and "feedback", although most points out the non-use of this in the teaching of multiprofessional residency in health. Finally, it is believed that for the training of professionals in the area of health, there must be an interdisciplinary character, using active methodologies that awaken in the student his/her reflexive-critical potential, making him/her a transforming agent in the process of caring for the subjects in the different scenarios of professional activity proposed by Unified Health System. As a product of this study, a proposal was created to train the preceptors of the multiprofessional health residency, field of study, in active teaching methodologies.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-01-18T10:50:44Z No. of bitstreams: 1 FranciscoAssisVieiraLimaJunior_DISSERT.pdf: 656231 bytes, checksum: f6ccd153b3b8dcff92b89db4dc0c38d4 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-01-22T14:47:13Z (GMT) No. of bitstreams: 1 FranciscoAssisVieiraLimaJunior_DISSERT.pdf: 656231 bytes, checksum: f6ccd153b3b8dcff92b89db4dc0c38d4 (MD5) / Made available in DSpace on 2018-01-22T14:47:13Z (GMT). No. of bitstreams: 1 FranciscoAssisVieiraLimaJunior_DISSERT.pdf: 656231 bytes, checksum: f6ccd153b3b8dcff92b89db4dc0c38d4 (MD5) Previous issue date: 2017-11-20 / Introdu??o: apesar da cobertura midi?tica trazer a certeza de uma rela??o entre o V?rus da Zica e microcefalia em rec?m-nascidos, configurando um aumento no agrupamento das anomalias cong?nitas no Nordeste brasileiro, sugere-se que a incid?ncia de anomalia cong?nitas no Rio Grande do Norte n?o seja diferente quando comparada a sua distribui??o espacial antes e ap?s Zica, isso porque fatores como os ambientais, socioecon?micos e biol?gicos podem contribuir para a perman?ncia de uma alta incid?ncia no estado. Objetivo: analisar a distribui??o temporo-espacial das taxas de incid?ncia de anomalias cong?nitas no Rio Grande do Norte, antes e ap?s a epidemia v?rus da zica atrav?s de uma an?lise geoestat?stica e correla??o com os determinantes sociais em sa?de M?todos: trata-se de um estudo epidemiol?gico do tipo ecol?gico, retrospectivo que avaliou os casos notificados de anomalias cong?nitas no Rio Grande do Norte agrupando em dois bi?nios (2005-2006 e 2015-2016), configurando per?odos antes e ap?s a epidemia de zica atrav?s de uma an?lise espacial, cujos dados obtidos do DATASUS e da Secretaria Estadual de Sa?de, foram agrupados no SPSS 13.0 e analisados no Terraview vers?o 4.2.2. Resultados: a taxa de anomalias cong?nitas no per?odo pr?-Zica foi de 11,83 casos/1.000 nascidos vivos e no per?odo p?s-Zica aumentou para 14,24 casos/1.000 nascidos vivos, resultado do aumento dos casos notificados. Foi observada que a mesorregi?o Agreste Potiguar ? a que possui maior n?mero de casos notificados de Zica assim como ? a regi?o que concentra maior n?mero de casos de anomalias cong?nitas no per?odo estudado, estando correlacionada com regi?o com grandes dicotomias sociais. Conclus?es: o presente parece revelar que as anomalias cong?nitas sempre estiveram presentes no estado e nenhuma outra a??o foi suscitada com tamanha import?ncia como no per?odo Zica. Estrat?gias para minimizar os casos de anomalias cong?nitas atrav?s de a??es de planejamento familiar, controle da idade materna, programas de vacina??o, controle na venda de medicamentos abortivos, combate ao consumo de drogas, ?lcool e fumo podem facilmente ser desenvolvida e ganhar ades?o midi?tica, fato que nem sempre ? percebido, tendo a m?dia dado um enfoque ao aumento dos casos de notifica??o sem buscar entender o processo. / Introduction: although the media coverage provides certainty of a relationship between the Zika virus and microcephaly in newborns, which is an increase in the grouping of congenital anomalies in the Brazilian Northeast, it is suggested that the incidence of congenital anomaly in Rio Grande do Sul North isn?t different when compared to its spatial distribution before and after Zika, because factors such as environmental, socioeconomic and biological can contribute to the permanence of a high incidence in the state. The objective of the present study is to analyze the temporal-spatial distribution of the incidence rates of congenital anomalies in Rio Grande do Norte, before and after the epidemic virus Zika through a geostatistical analysis and correlation with the social determinants in health. Methods: this is an ecological that evaluated the reported cases of congenital anomalies in Rio Grande do Norte before and after the Zika epidemy through a spatial analysis, whose data were grouped in SPSS 13.0 and analyzed in Terraview version 4.2.2. Results: the rate of congenital anomalies in the pre-Zika period was 11.83 cases / 1.000 live births and in the post Zika period it increased to 14.24 cases/1.000 live births, a result of the increase in reported cases. It was visualized that the Agreste Potiguar mesoregion is the one with the highest number of reported cases of Zika, as it is the region that concentrates the largest number of cases of congenital anomalies in the period studied, being correlated with the region with great social dichotomies. Conclusion: the present study revealed that congenital anomalies were always present in the state and no other action was raised with such importance as in the Zika period. Strategies to minimize cases of congenital anomalies through family planning actions, maternal age control, vaccination programs, control in the sale of abortive drugs, drug, alcohol and tobacco use can easily be developed and gain media adherence, fact which is not always perceived, the media having given a focus to the increase of the cases of notification without seeking to understand the process.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-01-18T10:54:05Z No. of bitstreams: 1 RosaSaDeOliveiraNeta_DISSERT.pdf: 1235288 bytes, checksum: c4877a052f6760b030f1c09c2b988a2b (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-01-23T11:39:19Z (GMT) No. of bitstreams: 1 RosaSaDeOliveiraNeta_DISSERT.pdf: 1235288 bytes, checksum: c4877a052f6760b030f1c09c2b988a2b (MD5) / Made available in DSpace on 2018-01-23T11:39:19Z (GMT). No. of bitstreams: 1 RosaSaDeOliveiraNeta_DISSERT.pdf: 1235288 bytes, checksum: c4877a052f6760b030f1c09c2b988a2b (MD5) Previous issue date: 2017-12-01 / Introdu??o: Uma das altera??es corporais t?picas do envelhecimento ? a perda da massa e da fun??o do muscular (sarcopenia), que contribui para a limita??o funcional assim como a obesidade que tamb?m ? um dos fatores de risco relacionados ao desenvolvimento de doen?as que limitam a funcionalidade. Objetivo: Avaliar a rela??o entre a capacidade funcional, a sarcopenia e o estado nutricional de idosas da comunidade. M?todos: Estudo observacional anal?tico de car?ter transversal realizado com 100 idosas acima de 60 anos que frequentaram a cl?nica-escola de fisioterapia da Faculdade de Ci?ncias da Sa?de do Trairi (FACISA-UFRN). Para a coleta de dados, aplicou-se um question?rio, contendo informa??es de identifica??o, dados socioecon?micos, pr?tica de atividade f?sica, dados antropom?tricos e de composi??o corporal atrav?s da aplica??o da bioimped?ncia e dados de funcionalidade atrav?s do teste de caminhada de seis minutos. Resultados: A m?dia de idade da amostra foi de 67?8,0 anos, A maioria das idosas n?o praticava atividade f?sica (59%), possu?am pelo menos o ensino fundamental (38%), recebiam at? dois sal?rios m?nimos (48%) e eram obesas. As taxas de preval?ncia quanto ? presen?a de sarcopenia foram: obesidade sarcop?nica (5%), sarcopenia (14%), obesidade (63%) e normais (18%). Idosas ativas, que estudaram mais que o ensino fundamental at? o ensino m?dio, com renda entre dois e quatro sal?rios, e n?o obesas tiveram melhor desempenho no teste de caminhada que as demais. N?o houve diferen?as estatisticamente significativas no teste de caminhada de acordo com a renda ou IMC (p>0,05). As idosas n?o obesas e n?o sarcop?nicas caminharam mais no teste de funcionalidade que as demais (p=0,021). Conclus?es: As idosas com baixa escolaridade, sedent?rias e com baixo n?vel socioecon?mico apresentaram piores desempenhos no teste de caminhada. A obesidade classificada apenas pelo IMC n?o mostrou signific?ncia quando comparada ao teste de caminhada, j? as outras formas de mensura??o da obesidade foram significantes. A obesidade, sarcopenia e obesidade sarcop?nica foram prevalentes nas idosas e tiveram rela??o com os piores desempenhos f?sicos, gerando novas demandas para os sistemas de sa?de e seguridade social. / Introduction: One of the typical body changes of aging is the loss of muscle mass and function (sarcopenia), which contributes to functional limitation as well as obesity, which is also one of the risk factors related to the development of diseases that limit functionality. Objective: To evaluate the relationship between functional capacity, sarcopenia and the nutritional status of the elderly in the community. Methods: Cross-sectional observational study performed with 100 elderly women over 60 years of age attending the physical therapy clinic of the Faculty of Health Sciences of Trairi (FACISA-UFRN). To collect data, a questionnaire containing identification information, socioeconomic data, physical activity practice, anthropometric data and body composition were applied. waist circumference, waist-height ratio, and muscle mass measured by bioimpedance) and functional data (six-minute walk test). Results: The mean age of the sample was 67 ? 8.0 years. Most of the elderly women did not practice physical activity (59%), had at least elementary school (38%), received up to two minimum wages (48%), and were obese. Prevalence rates for sarcopenia were: sarcopenia (5%), sarcopenia (14%), obesity (63%) and normal (18%). Active elderly, who studied more than elementary school through high school, with income between two and four salaries, and not obese had better performance in the walking test than the others. There were no statistically significant differences in the walk test according to income (p> 0.05). Non-obese and non-sarcopenic women walked more on the functional test than the others (p = 0.021). Conclusions: The elderly with low education, sedentary and with low socioeconomic level presented worse performance in the walking test. Obesity classified only by BMI showed no significance when compared to the walking test, while other forms of obesity measurement were significant. Obesity, sarcopenia and sarcopenic obesity were prevalent in the elderly and related to the worst physical performance, generating new demands for the health and social security systems.

Made available in DSpace on 2014-12-17T14:46:43Z (GMT). No. of bitstreams: 1 ThiagoEAA_DISSERT.pdf: 585302 bytes, checksum: 7f11f2b4dc83522d81e56e5c1d64397f (MD5) Previous issue date: 2010-05-26 / The ongoing transformations in brazilian society, arising from technical and organizational changes in the working world, are making, with much emphasis, heated debates resurge related to themes and issues that refer to the relationship between work, skills and education. Thus, this study is inserted in the link between education and work, pointing to the work as an educational principle according to Antonio Gramsci. This paper aims to discuss the interfaces between education and work in the everyday health care teams and learn about the activities developed by health teams related to the learning processes in and with the work to analyze the opportunities and challenges of transforming spaces of health work in an environment of lifelong learning. This is a descriptive, exploratory with a qualitative approach case study developed from semi-structured interviews with the health staff professionals of the Unidade de Terapia Intensiva da Casa de Sa?de Dix-Sept Rosado in Mossor? / RN , who answered open questions about the relationship between education and work. The interviews were conducted during the month of January 2010, the same being recorded, transcribed and analyzed, culminating in the production of new knowledge on the subject. It is understood that work and education activities are eminently human, therefore only the human being works and educates. Given the statements of participants, it is noticed that all work processes in health are learning moments. This happens through new demands imposed by the everyday of the services, by interaction with a multidisciplinary team, participation in educational activities and individual study. It was noticed that the institution in this case does not promote study courses related to Intensive Care and that there are obstacles to the realization of educational activities on and with the work, such as: excessive workload, inability to release staff to participate in events, low pay, which leads the worker to have more than one employment, rejection of new knowledge by some workers and lack of physical infrastructure and incentives for the activities. The daily situations must be transformed in learning, selfanalyzing the problems of practice and valuing the work process itself in its intrinsic context. We conclude that dealing with the web of relationships between educational processes and production processes of health services, unraveling the intricacies of the world of work and education requirements in this sector are increasingly on the agenda of Sistema ?nico de Sa?de workers and managers. The continuing consideration of this issue becomes an essential condition for the proper discharge of their responsibilities. We consider that bringing the education to everyday life is the result of recognition of the educational potential of the work situation / As transforma??es em curso na sociedade brasileira, decorrentes das mudan?as t?cnicoorganizacionais no mundo do trabalho, est?o fazendo ressurgir, com muita ?nfase, acalorados debates relativos a temas e problemas que remetem ?s rela??es entre trabalho, qualifica??o e educa??o. Diante disso, este estudo encontra-se inserido no ?mbito da articula??o entre educa??o e trabalho, apontando para o trabalho como princ?pio educativo na perspectiva de Antonio Gramsci. Este trabalho tem por objetivos discutir as interfaces entre educa??o e trabalho no cotidiano de equipes de sa?de e conhecer as atividades desenvolvidas por equipes de sa?de relacionadas com os processos de aprendizagem no e com o trabalho para analisar as possibilidades e os desafios de transformar os espa?os de trabalho em sa?de em ambientes de aprendizado permanente. Trata-se de um estudo de caso de car?ter descritivo, explorat?rio, de abordagem qualitativa e desenvolvido a partir de entrevistas semi-estruturadas com os profissionais da equipe de sa?de da Unidade de Terapia Intensiva da Casa de Sa?de Dix-Sept Rosado em Mossor?/RN, os quais responderam quest?es abertas sobre a articula??o entre educa??o e trabalho. As entrevistas foram realizadas durante o m?s de janeiro de 2010, sendo as mesmas gravadas, transcritas e analisadas, culminando com a produ??o de novos conhecimentos sobre o tema. Entende-se que trabalho e educa??o s?o atividades eminentemente humanas; logo, somente o ser humano trabalha e educa. Diante das falas dos participantes da pesquisa, conclui-se que todos os processos de trabalho em sa?de s?o momentos de aprendizado. Este acontece por meio de novas demandas impostas pelo cotidiano dos servi?os, pela intera??o com a equipe multiprofissional, pela participa??o em atividades educativas e estudo individual. Percebeu-se que a institui??o em estudo n?o promove cursos relacionados ? Terapia Intensiva e que existem entraves ? realiza??o de atividades educativas no e com o trabalho, tais como: excesso de carga hor?ria de trabalho, impossibilidade de libera??o do funcion?rio para participa??o em eventos, m? remunera??o, o que leva o trabalhador a ter mais de um v?nculo empregat?cio, rejei??o ? aquisi??o de novos conhecimentos por parte de alguns trabalhadores e falta de estrutura f?sica e incentivos para realiza??o de atividades. Deve-se transformar as situa??es di?rias em aprendizagem, analisando reflexivamente os problemas da pr?tica e valorizando o pr?prio processo de trabalho no seu contexto intr?nseco. Conclui-se que lidar com a teia de rela??es entre os processos educacionais e os processos de produ??o de servi?os de sa?de, desvendando os meandros do mundo do trabalho e da educa??o nesse setor s?o exig?ncias a cada dia mais presentes na agenda dos trabalhadores e gestores do Sistema ?nico de Sa?de. A an?lise permanente dessa problem?tica torna-se um exerc?cio indispens?vel para o bom desempenho de suas responsabilidades. Considera-se que aproximar a educa??o da vida cotidiana ? fruto do reconhecimento do potencial educativo da situa??o de trabalho

Made available in DSpace on 2014-12-17T14:46:49Z (GMT). No. of bitstreams: 1 VivianneRCS_DISSERT.pdf: 1496250 bytes, checksum: f09db27c037244a4e229920d59aea10a (MD5) Previous issue date: 2011-11-24 / Leprosy is an ancient disease that still stands as a public health problem worldwide, especially in the considered developing countries. Of these, Brazil still has large areas of endemicity. The disease remains high among those younger than 15 years old. In this group, the national index achieves 0.6 every 10 000 inhabitants and reaches 2 in the North and Midwest of Brazil. Therefore, the plan of the Ministry of Health is to prioritize the fight against disease in critical areas, providing early diagnosis and timely treatment, especially for patients under 15 years old. This research aimed to: identify the knowledge of students from three schools of basic education in Parnamirim/RN about the risk of getting ill in leprosy; conduct them health education on this topic. An exploratory-descriptive study with quantitative and qualitative nature. Data collection consists of two steps: questionnaire and health education on leprosy. The study was approved by the Research Ethics Committee (REC) of UFRN through the opinion n? 204/2009. Quantitative data obtained were organized, categorized, typed and submitted to the Microsoft Office - Excel for quantitative analysis with simple percentage. Qualitative data were subjected to a content analysis according to Bardin. The sample consisted of 164 students of basic education, most of which is: 1st year of high school, from 11 to 15 years, in the afternoon shift, female gender, skin color white and residents in the municipality of Parnamirim/RN. Still, each student living with four people curiously did not respond in relation to occupation of the father. But the same answered their mother as a housewife and a family income of one to less than four minimum wages. There have been significant results compared the performance of health education in leprosy. Initially, students possessed little knowledge about leprosy. Subsequent to health education, most knew the answer about the disease, transmission, cause, where to get help in case of suspicion of leprosy and the need for the people who lives with leprosy patients to also seek for help, the understanding about if it is treatable or not. Content analysis has established the following themes: axis I, what I do not know about leprosy: cure, fear and prejudice. Axis II, what I know about leprosy, we identified: cure, effectiveness of health education and social exclusion in the past. It is considered the scope of the proposed objectives by matching the effectiveness of health education on leprosy in basic education in Parnamirim/RN; emphasizes, therefore, the importance of understanding the knowledge of public school students. It is expected of them to detect early cases of leprosy in their communities; encourage adherence to treatment as quickly as possible; prevent disability; reduce the stigma surrounding the disease. / A hansen?ase ? uma doen?a milenar que ainda figura como um problema de sa?de p?blica no mundo, principalmente nos pa?ses considerados em desenvolvimento. Dentre estes, o Brasil ainda apresenta ?reas de grande endemicidade. A doen?a se mant?m alta entre os menores de 15 anos. Nesse grupo, o ?ndice nacional alcan?a 0,6 a cada 10 mil habitantes e chega a 2 nas Regi?es Norte e Centro-Oeste. Por isso, o plano do Minist?rio da Sa?de consiste em priorizar o combate ? doen?a nas ?reas cr?ticas, oferecendo diagn?stico precoce e tratamento oportuno, especialmente aos pacientes com menos de 15 anos. Esta pesquisa teve como objetivos: identificar o conhecimento dos estudantes de tr?s escolas da educa??o b?sica de Parnamirim/RN sobre o risco de adoecer em hansen?ase; realizar educa??o em sa?de sobre o tema para esses estudantes. Estudo do tipo explorat?rio descritivo e de natureza quantiqualitativa. A coleta dos dados comp?s-se de duas etapas: question?rio e educa??o em sa?de sobre hansen?ase. O estudo foi aprovado pelo Comit? de ?tica em Pesquisa (CEP) da UFRN por meio do Parecer de n.? 204/2009. Os dados quantitativos obtidos foram organizados, categorizados, digitados e submetidos ao programa Microsoft Office Excel para an?lise quantitativa com percentagem simples. Os dados qualitativos foram submetidos ? an?lise de conte?do de acordo com Bardin. Entrevistaram-se 164 alunos da educa??o b?sica, sendo que a maioria era: do 1? ano do ensino m?dio, com 11 at? 15 anos, do turno vespertino, do sexo feminino, de cor da pele branca, residentes no Munic?pio de Parnamirim/RN. E, ainda, cada estudante convivendo com quatro pessoas, curiosamente n?o responderam em rela??o ? profiss?o do pai, mas da m?e como dona de casa, e renda familiar de 1 a menos de 4 sal?rios m?nimos. Observaram-se resultados significativos em compara??o ? realiza??o da educa??o em sa?de em hansen?ase. Inicialmente, os alunos detinham pouco conhecimento a respeito da hansen?ase. Posteriormente ? educa??o em sa?de, a maioria soube responder sobre a doen?a, a transmiss?o, a causa, onde procurar ajuda em caso de suspeita de hansen?ase e da necessidade das pessoas que convivem com o doente de hansen?ase tamb?m procurarem ajuda, al?m da compreens?o de que a doen?a tem cura ou n?o. Na an?lise de conte?do estabeleceram-se os seguintes eixos tem?ticos: no eixo I, o que n?o sei sobre hansen?ase: cura, medo e preconceito. No eixo II, o que sei sobre hansen?ase, identificaram-se: cura, efetividade da educa??o em sa?de e exclus?o social no passado. Considera-se o alcance dos objetivos propostos ao corresponder ? efetividade da educa??o em sa?de em hansen?ase na educa??o b?sica de Parnamirim/RN; enfatiza-se, assim, a import?ncia da apreens?o do conhecimento dos estudantes das escolas p?blicas. Espera-se dos mesmos detectar precocemente casos de hansen?ase em suas comunidades; estimular a ades?o ao tratamento o mais r?pido poss?vel; prevenir incapacidades; minimizar o estigma em torno da doen?a.

Made available in DSpace on 2014-12-17T14:46:52Z (GMT). No. of bitstreams: 1 DeborahKRR_DISSERT.pdf: 2051904 bytes, checksum: 77b58bf6f5ba60a2334606e0fc1eaf95 (MD5) Previous issue date: 2011-12-08 / The Brazilian Psychiatric Reform based on the desinstitucionalization of the assistance, translated to the emphasis on community/territorial treatment and in the social inclusion of the mental suffering, promoted advances in the psychiatric restructuring. In the Rio Grande do Norte (RN), we can enumerate as advances of the Brazilian Psychiatric Reform the expansion of the mental health care chain and the implementation of some strategies that, together, aims to further the psychosocial attention of the individual with psych suffering and to reduce the indices of psychiatrics readmissions in the state. In the current Brazilian‟s mental health situation we were interesting in answered the following question: what the impact of the substitutes services‟ extension in the revolving door phenomenon? This search aims to analyze the revolving door phenomenon occurrences based on the news strategies of mental health care in the Rio Grande do Norte. This is a descriptive-exploratory study with a qualitative approach, oriented by the theoretical framework of critical-dialectical approach about the Brazilian Psychiatric Reform and using the thematic oral history as method of information collects. The search was realized on the Hospital Jo?o Machado (HJM), estate reference in psychiatric treatment, and the participants was 20 professionals that work on it. The collection of information had started after the approval of the UFRN Research Ethics Committee with the opinion number 216/2011 and CAAE number 0021.0.051.000-11 and was realized using the direct observation and semi-structured interview. The study‟s results were categorized in two categories and five subcategories of analysis. CATEGORY 1) Current situation of the mental health care chain in the RN, with the subcategories: 1.1 Impact of the new services of mental health care in the revolving door phenomenon in the RN; 1.2 Implications of the new services of mental health care in assisting user to the HJM; 1.3 Issues the permeate the mental health care chain in the RN. CATEORY 2) Main causes of the revolving door phenomenon in HJM, with the categories: 2.1 Family problems; 2.2 Lack of assistance after discharge from psychiatric hospital. In summary, we conclude that the extension of the mental health care chain contributed for the reduction of the psychiatrics re-hospitalization‟s indices in RN. However, we realized that territorial services of mental health care are not the only responsible for the revolving door phenomenon. Factors as family problems and the disarticulation of the assistance after the discharge from hospital influence on the perpetuation of hospitalizations and re-hospitalizations in the local scenario. To study the revolving door phenomenon that occur in the psychiatrics‟ assistance considering the news strategies of mental health care allowed us to approach the advances and challenges brought by the RPb and by the desinstitucionatization in the state, indicating the need for further discussions and problem-solving strategies of psychosocial care. / A Reforma Psiqui?trica brasileira pautada sobre o ide?rio de desinstitucionaliza??o da assist?ncia, traduzido na ?nfase no tratamento de base comunit?ria/territorial e na inclus?o social do sofredor ps?quico, promoveu avan?os significativos na reestrutura??o da psiquiatria. No cen?rio do Estado do Rio Grande do Norte (RN), podemos enumerar como avan?os da Reforma Psiqui?trica brasileira a expans?o da rede de aten??o ? sa?de mental e a implementa??o de estrat?gias que, em conjunto, visam favorecer a aten??o psicossocial do indiv?duo em sofrimento ps?quico e reduzir os ?ndices de reinterna??es psiqui?tricas no Estado. Diante do panorama atual da sa?de mental no Brasil nos empenhamos em responder ao seguinte questionamento: qual o impacto da amplia??o dos dispositivos substitutivos no fen?meno da porta girat?ria na realidade da aten??o ? sa?de mental do Rio Grande do Norte? Assim, o presente estudo teve como objetivo analisar a ocorr?ncia do fen?meno da porta girat?ria ? luz das novas estrat?gias de aten??o ? sa?de mental no RN. Trata-se de uma pesquisa qualitativa do tipo explorat?rio-descritiva, norteada por um arcabou?o te?rico de enfoque cr?tico-dial?tico sobre a Reforma Psiqui?trica brasileira e tendo a hist?ria oral tem?tica como m?todo de coleta de informa??es. O cen?rio da pesquisa foi o Hospital Jo?o Machado (HJM), refer?ncia para o atendimento em psiquiatria no Estado do Rio Grande do Norte e os sujeitos da pesquisa foram 20 profissionais da institui??o. A coleta das informa??es foi iniciada ap?s a libera??o do Comit? de ?tica em Pesquisa da UFRN atrav?s do parecer no 216/2011 e CAAE no 0021.0.051.000-11 e realizada mediante a utiliza??o de observa??o direta e de entrevista semi-estruturada. A operacionaliza??o das informa??es suscitou o surgimento de duas categorias e cinco subcategorias de an?lise. CATEGORIA 1) A atualidade da Rede de Aten??o ? Sa?de Mental no RN, com as subcategorias: 1.1 Impacto da rede de sa?de mental no fen?meno da porta girat?ria no RN; 1.2 Implica??es dos novos servi?os de sa?de mental na assist?ncia aos usu?rios do HJM; 1.3 Problem?ticas que permeiam a rede de sa?de mental do RN. CATEGORIA 2) Principais causas da porta girat?ria no RN, com as subcategorias: 2.1 Problem?tica familiar e 2.2 desassist?ncia p?s-alta. Em s?ntese, conclu?mos que a amplia??o da rede sa?de mental contribuiu para a redu??o das reinterna??es psiqui?tricas no RN. No entanto, vimos que os dispositivos territoriais de sa?de mental n?o s?o os ?nicos respons?veis pela perpetua??o do fen?meno da porta girat?ria. Fatores como a problem?tica familiar e a desarticula??o de assist?ncia p?s-alta influenciam nas interna??es e reinterna??es psiqui?tricas na realidade estadual. Estudar a porta girat?ria da assist?ncia psiqui?trica e as novas estrat?gias de aten??o ? sa?de mental nos permitiu a aproxima??o com os avan?os e desafios trazidos pela Reforma Psiqui?trica brasileira e pela desinstitucionaliza??o no ?mbito estadual, apontando para a necessidade de novas discuss?es e estrat?gias de resolubilidade da aten??o psicossocial.