Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-09T22:56:27Z No. of bitstreams: 1 WelytonParaibaDaSilvaSousa_DISSERT.pdf: 1036369 bytes, checksum: 95c8fca53673ba8680c8678d733342ed (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-10T23:40:24Z (GMT) No. of bitstreams: 1 WelytonParaibaDaSilvaSousa_DISSERT.pdf: 1036369 bytes, checksum: 95c8fca53673ba8680c8678d733342ed (MD5) / Made available in DSpace on 2016-03-10T23:40:24Z (GMT). No. of bitstreams: 1 WelytonParaibaDaSilvaSousa_DISSERT.pdf: 1036369 bytes, checksum: 95c8fca53673ba8680c8678d733342ed (MD5) Previous issue date: 2015-04-27 / A gesta??o, de forma geral, ? um evento importante na vida de uma mulher e provoca mudan?as f?sicas, fisiol?gicas e emocionais, constituindo uma experi?ncia repleta de sentimentos intensos. Por gravidez tardia, entende-se aquelas gesta??es que ocorrem na faixa et?ria de 35 anos ou mais. A ocorr?ncia desse tipo de gravidez vem aumentando no Brasil e no mundo, fatores como maior acesso aos recursos de controle da natalidade e a busca da estabilidade financeira tem explicado o adiamento da gesta??o. Processos importantes como a resili?ncia e o apoio social podem auxiliar, as gestantes tardias, de forma ben?fica na adapta??o ao processo gestacional. A resili?ncia caracteriza-se pela capacidade de um determinado sujeito ou grupo passar por uma situa??o adversa, conseguir super?-la e sair fortalecido, transformando-a em est?mulos para o seu desenvolvimento biopsicossocial. O apoio social ? um processo din?mico e complexo que envolve transa??es entre indiv?duos e as suas redes sociais, satisfazendo as necessidades sociais, promovendo e completando os recursos pessoais que possuem para enfrentarem novas exig?ncias. No intuito de levantar informa??es sobre esses construtos em gestantes tardias do munic?pio de Natal-RN, que se justifica a import?ncia dessa pesquisa, cujo objetivo geral foi avaliar os indicadores de resili?ncia e o apoio social em gestantes tardias do munic?pio de Natal (RN). Pesquisa descritiva e correlacional de corte transversal que foi realizada com 150 gestantes tardias. Os instrumentos utilizados foram: um Question?rio estruturado com informa??es sociodemogr?ficas e gestacionais, a Escala de Resili?ncia e a Escala de Apoio Social. Para analisar os dados foi utilizado um software de planilhamento eletr?nico (Excel e SPSS 21.0) que auxiliou na realiza??o de estat?sticas descritivas e inferenciais conforme a tipologia das vari?veis e os objetivos do estudo. Para as vari?veis nominais utilizou-se frequ?ncias relativas e para as cont?nuas correla??es de Pearson e coeficiente de determina??o, visto que a amostra teve uma distribui??o normal. O projeto cumpriu os aspectos ?ticos prescritos pela Resolu??o 466/12 do Conselho Nacional de Sa?de, tendo obtido parecer favor?vel (356.436/ 2013) do Comit? de ?tica em Pesquisa da UFRN. A maioria das gestantes apresentaram baixa renda e escolaridade, natural do Rio Grande do Norte, tinham em m?dia 37,49 (?2,577) anos de idade, eram cat?licas, viviam em uni?o est?vel, trabalhadoras do lar (?donas de casa?), multigestas e estavam no terceiro trimestre gestacional; al?m de baixo hist?rico de aborto, de n?o planejarem a gravidez, com m?dia de 4,22 (?2,506) consultas pr?-natais, de residirem em m?dia com 3,673 (?1,397) pessoas, terem feito uso de algum tipo anticoncepcional e de possu?rem indicadores elevados de resili?ncia e apoio social. As correla??es mantidas entre a resili?ncia, o apoio social e algumas das vari?veis sociodemogr?ficas e gestacionais foram consideradas baixas. Tais dados sinalizam que o fato da maior parte dessas gr?vidas se encontrarem num relacionamento est?vel, n?o terem tido hist?rico de aborto, fazerem parte de alguma religi?o, n?o serem m?es primigestas, possu?rem uma m?dia de idade suficiente para serem consideradas m?es experientes e ainda terem apresentado escores elevados na escala de apoio social, possivelmente, sejam os fatores que mais tenham contribu?do no desenvolvimento e na constru??o da resili?ncia nessas gestantes de 35 anos ou mais. Espera-se que as informa??es oriundas dessa pesquisa possam incrementar conhecimentos, a??es e melhorias na qualidade da assist?ncia ? sa?de das gestantes tardias e para uma maior compreens?o do fen?meno da gravidez em geral. / The gestation process, in general, is a very important event on a woman?s life and it brings phisical, phisiological and emotional changes, which by itself is an experience full of intense feelings. By late-aged pregnancy we mean those which occurs at the age of 35 or further. The occurance of this type of pregnancy is rising in Brasil and throughout the world, factors such as, better access to birth control resources and the search for financial stability explains the pregnancy delay. Important processes like resilience and social support can help late-aged pregnant women, in a benefical way, to adapt to the gestation process. Resilience is the capacity that a certain individual or group of individuals have to go through an adverse situation, be able to overcome it and become streghtened, transforming it in motivation for its biopsichosocial development. Social support is a complex and dinamic process that involves transactions between individuals and their social networks, meeting the social needs, promoting and complementing the personal resources that they have to face new demands. This research has the intention of raising information about the issues of late-aged pregnant women in the County of Natal- RN, the main objective was to evaluate the resilience indicators and the social support on late-aged pregnant women in the Natal-RN County. A transversal cut, correlational and descriptive research that was done with 150 lateaged pregnant women. The tools that were used were: A form with sociodemographic and gestation info, the scale of resilience and social support. An eletronic spreadsheet sofware (Excel e SPSS 21.0) was used to analize data which helped on the statistics according to its variables and the objective of this work. For the nominal variables, relative frequencies were used and for continuous the Pearson correlation and determination coefficient were used, regarding that; the sample had a normal distribution. The project fulfilled the ethnic aspects prescribed by Resolution 466/12 of the National Health Council, with a favorable decision (356.436/ 2013) of the UFRN Ethics on Research Committee. Most of the pregnant women had a low money income and education level, born in the state of Rio Grande do Norte they had an average age of 37,49 (?2,577), catholic, married, house wives, they had more than one child and were on their third trimester of pregnancy; they also had a low past abortion rate, not having planned their pregnancy, with an average of 4,22 (?2,506) pre-natal appointments, residing with an average of 3,673 (?1,397) people, having used any sort of birth control device and having high indicators of resilience and social support. The correlations kept between resilience, social support and some of the social demographics and gestation variables were considered low. Such data points out the fact that most of these women were in a stable relationship; they hadn?t had a past of abortion, they were involved with some kind of religion, they were not first pregnancy mothers, had an age on which they are not considered inexperienced mothers and even had scored high on the social support scale, these may all possibly be the most contributing factors on development and resilience building on these 35 years or more mothers. We expect that the data and information from this research may add up knowledge, actions and improvements regarding late-aged pregnant women and the pregnancy phenomena in general.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-22T19:43:36Z No. of bitstreams: 1 AnaCarlaDosSantosGomes_TESE.pdf: 2045836 bytes, checksum: ff6c9c41b7e51898c5fe7a829858ce04 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-28T20:29:43Z (GMT) No. of bitstreams: 1 AnaCarlaDosSantosGomes_TESE.pdf: 2045836 bytes, checksum: ff6c9c41b7e51898c5fe7a829858ce04 (MD5) / Made available in DSpace on 2016-03-28T20:29:43Z (GMT). No. of bitstreams: 1 AnaCarlaDosSantosGomes_TESE.pdf: 2045836 bytes, checksum: ff6c9c41b7e51898c5fe7a829858ce04 (MD5) Previous issue date: 2015-03-06 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / O clima e a polui??o do ar, dentre outros, s?o fatores respons?veis pelo aumento da vulnerabilidade da sa?de das popula??es residentes nos grandes centros urbanos. Altera??es clim?ticas combinadas a altas concentra??es de poluentes atmosf?ricos est?o associadas a doen?as respirat?rias e cardiovasculares. Neste sentido, o objetivo principal da pesquisa ? modelar de diferentes formas a rela??o clima e sa?de, especificamente para a popula??o de crian?as e idosos residentes em S?o Paulo. Para tanto, foram utilizados dados de vari?veis meteorol?gicas, poluentes atmosf?ricos, interna??es e ?bitos por doen?as respirat?rias e cardiovasculares no per?odo de 11 anos (2000 a 2010). Por interm?dio de Modelos via equa??es de estima??o generalizadas, estimou-se o risco relativo. Com a regress?o din?mica, foi poss?vel prever o n?mero de ?bitos por meio das vari?veis atmosf?ricas e por meio do modelo beta-binomial-poisson estimouse o n?mero de ?bitos e foi poss?vel projetar cen?rios. Os resultados mostraram que o risco das interna??es por asma aumenta aproximadamente duas vezes para crian?as expostas ?s altas concentra??es do material particulado do que crian?as que n?o s?o expostas. O risco de morte por infarto agudo do mioc?rdio de idosos aumenta em 3%, 6%, 4% e 9% devido ?s concentra??es de CO, SO2, O3 e PM10, respectivamente. Com rela??o ? modelagem via regress?o din?mica, os resultados mostraram que os ?bitos por doen?as respirat?rias podem ser previstos de forma consistente. O modelo betabinomial-poisson conseguiu retratar o n?mero m?dio de ?bitos por insufici?ncia card?aca. Na regi?o de Santo Amaro o n?mero observado foi de 2,462 e o simulado de 2,508 na regi?o da S?, o observado foi de 4,308 e o simulado de 4,426 o que possibilitou a gera??o de cen?rios que possam servir como par?metro para a an?lise destinada ? tomada de decis?o. A partir dos resultados obtidos, ? poss?vel contribuir com metodologias que possam auxiliar a compreens?o da rela??o clima e sa?de fornecendo subs?dios aos gestores no planejamento de pol?ticas de sa?de p?blica e ambiental. / Climate and air pollution, among others, are responsible factors for increase of health vulnerability of the populations that live in urban centers. Climate changes combined with high concentrations of atmospheric pollutants are usually associated with respiratory and cardiovascular diseases. In this sense, the main objective of this research is to model in different ways the climate and health relation, specifically for the children and elderly population which live in S?o Paulo. Therefore, data of meteorological variables, air pollutants, hospitalizations and deaths from respiratory and cardiovascular diseases a in 11-year period (2000-2010) were used. By using modeling via generalized estimating equations, the relative risk was obtained. By dynamic regression, it was possible to predict the number of deaths through the atmospheric variables and the betabinomial-poisson model was able to estimate the number of deaths and simulate scenarios. The results showed that the risk of hospitalizations due to asthma increases approximately twice for children exposed to high concentrations of particulate matter than children who are not exposed. The risk of death by acute myocardial infarction in elderly increase in 3%, 6%, 4% and 9% due to high concentrations CO, SO2, O3 and PM10, respectively. Regarding the dynamic regression modeling, the results showed that deaths by respiratory diseases can be predicted consistently. The beta-binomial-poisson model was able to reproduce an average number of deaths by heart insufficiency. In the region of Santo Amaro the observed number was 2.462 and the simulated was 2.508, in the S? region 4.308 were observed and 4.426 simulated, which allowed for the generation of scenarios that may be used as a parameter for decision. Making with these results, it is possible to contribute for methodologies that can improve the understanding of the relation between climate and health and proved support to managers in environmental planning and public health policies.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-22T19:46:18Z No. of bitstreams: 1 TalithaRodriguesRibeiroFernandesPessoa_TESE.pdf: 2252690 bytes, checksum: 448ef1d18273ec11fc29231aed6697d1 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-28T21:47:25Z (GMT) No. of bitstreams: 1 TalithaRodriguesRibeiroFernandesPessoa_TESE.pdf: 2252690 bytes, checksum: 448ef1d18273ec11fc29231aed6697d1 (MD5) / Made available in DSpace on 2016-03-28T21:47:25Z (GMT). No. of bitstreams: 1 TalithaRodriguesRibeiroFernandesPessoa_TESE.pdf: 2252690 bytes, checksum: 448ef1d18273ec11fc29231aed6697d1 (MD5) Previous issue date: 2015-03-05 / A necessidade da universaliza??o do acesso ? sa?de e a fal?ncia do modelo pedag?gico centrado na transmiss?o de conhecimento tem levado a mudan?as na forma??o de profissionais de sa?de. O objetivo deste estudo foi proporcionar uma nova alternativa para avalia??o de cursos de Odontologia por meio do desenvolvimento, valida??o e aplica??o de crit?rios com base nas Diretrizes Curriculares Nacionais (DCN). Para tanto, o estudo foi desenvolvido em tr?s etapas: desenvolvimento e valida??o de crit?rios de avalia??o de cursos de Odontologia com base nas DCN; estudo piloto para verifica??o da aplicabilidade dos crit?rios validados e avalia??o de cursos de Odontologia da regi?o nordeste. Na primeira etapa foi formulado modelo l?gico que permitiu a constru??o de uma matriz de crit?rios validada por meio da t?cnica de consenso Delfos modificado, apresentando as dimens?es: Perfil do egresso, Orienta??o do cuidado em sa?de, Integra??o ensino-servi?o e Abordagem pedag?gica. O estudo piloto foi realizado com cinco cursos de Odontologia, por meio de estudo documental dos Projetos Pedag?gicos dos Cursos (PPC), aplica??o do question?rio validado e entrevista com os coordenadores de curso. Os resultados do estudo piloto indicam a possibilidade de serem verificados, por meio dos crit?rios validados e utilizando-se diferentes propostas metodol?gicas, avan?os e limita??es curriculares frente ? proposta de reorienta??o da forma??o recomendada pelas DCN. A avalia??o de cursos de Odontologia da regi?o Nordeste foi realizada a partir da aplica??o do question?rio validado a coordenadores de 30 cursos, incluindo institui??es p?blicas e privadas. Os dados foram submetidos ? an?lise descritiva, sendo ainda testada a diferen?a entre m?dias e a correla??o entre a avalia??o dos coordenadores nas dimens?es e subdimens?es entre si, entre a avalia??o geral dos cursos e entre as vari?veis: categoria administrativa, tempo decorrido da ?ltima atualiza??o curricular, participa??o em programas de reorienta??o da forma??o de profissionais de sa?de, nota ENADE (Exame Nacional de Desempenho dos Estudantes) e CPC (Conceito Preliminar do Curso) do ano de 2013. Foi constatada correla??o positiva (p<0,01) entre as m?dias obtidas pela percep??o dos coordenadores na maior parte das dimens?es e entre estas e o desempenho geral do curso. N?o houve diferen?as significativas entre a percep??o dos coordenadores quanto ao desempenho dos cursos e a categoria administrativa (p?blico/privado). Essa diferen?a foi um pouco maior quando comparou-se as m?dias de desempenho 9 ao tempo decorrente da ?ltima atualiza??o curricular, obtendo melhor desempenho cursos com atualiza??o curricular mais recente, mesmo sem diferen?a significativa entre dimens?es. Obtiveram melhores m?dias de desempenho os cursos que n?o participam de programas de reorienta??o da forma??o profissional, com diferen?a significativa (p<0,05) para o escore geral e para todas as dimens?es, exceto a dimens?o Integra??o ensino-servi?o (p=0,064). N?o foi observada correla??o significativa entre a avalia??o dos coordenadores em todas as dimens?es e na avalia??o geral e as notas do ENADE e CPC 2013. O instrumento final proposto neste estudo representa alternativa diferenciada de avalia??o da forma??o, tanto de cirurgi?es-dentistas como de outros profissionais, considerando que as DCN preveem a forma??o com foco nas necessidades de sa?de da popula??o, integrada ao SUS e baseada na aprendizagem centrada no estudante. / The need for universal access to health and the failure of the pedagogical model centered on the transmission of knowledge has led to changes in the training of health professionals. The objective of this study was to provide a new alternative for evaluating dental students through the development, validation and application of evaluation criteria based on the National Curriculum Guidelines (DCN in Brazil). Therefore, the study was conducted in three phases: development and validation of evaluation criteria of Dentistry courses based on the DCN; a pilot study to verify the applicability of the validated criteria and evaluation of the dentistry courses in the Northeast. In the first stage, a logical model was formulated, allowing for the construction of a criteria matrix, validated by a modified Delphi consensus technique. The validated matrix has the following dimensions: Profile of graduates, health care guidance, teaching and service integration, and pedagogical approach. The pilot study was conducted in five dental courses through a documentary study of the pedagogical project course (PPC), and application of validated questionnaires and interviews with course coordinators. The results of the pilot study indicate the possibility of being verified by means of validated criteria and using different methodological proposals, advances and curricular limitations facing the proposed reorientation of training recommended by DCN. The evaluation of Northeast Dentistry courses was carried out by applying a questionnaire validating a matrix of 30 course coordinators, including public and private institutions. The data were submitted to descriptive analysis, and also tested the difference between means and the correlation between the assessment of the coordinators in the dimensions and sub-dimensions with each other, among the general evaluation of courses and between the following variables: administrative category, time since last curriculum updating, participation in reorienting the training of health professionals programs, ENADE and CPC (Preliminary Concepts of the Course) scores in the year 2013. Positive correlation (p <0.01) was found between the means obtained by the perception of the coordinators in most dimensions, and also between them and the overall performance of the course. There were no significant differences between the coordinators? perception about course performance and the administrative category (public / private). This difference is slightly higher when the average performance is compared with respect to time due to the last curriculum update, getting better performance in courses with the latest updated curriculum, even with there not 11 being this significant difference between dimensions. Better averages of performance were obtained in courses that do not participate in reorientation programs of professional training, with a significant difference (p<0.05) for the overall score and for all dimensions except the dimensions of teaching-service Integration (p = 0.064). There was no significant correlation between the assessment of coordinators in all dimensions, in the overall assessment or ENADE and CPC scores in 2013. The final instrument proposed in this study is a different alternative assessment for health training of both dentists and other professionals, considering that the DCN providing for the training and graduation of professionals is focused on the health needs of the population, integrated with the SUS (the National Brazilian Health System) and based on student-centered learning.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-04-01T19:51:45Z No. of bitstreams: 1 CelesteMariaDeMenezesSouza_DISSERT.pdf: 828781 bytes, checksum: 9755e5418c5ee46cbd00b3d37d799061 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-07T21:48:25Z (GMT) No. of bitstreams: 1 CelesteMariaDeMenezesSouza_DISSERT.pdf: 828781 bytes, checksum: 9755e5418c5ee46cbd00b3d37d799061 (MD5) / Made available in DSpace on 2016-04-07T21:48:25Z (GMT). No. of bitstreams: 1 CelesteMariaDeMenezesSouza_DISSERT.pdf: 828781 bytes, checksum: 9755e5418c5ee46cbd00b3d37d799061 (MD5) Previous issue date: 2015-04-24 / Diagn?sticos imprecisos das vulvovaginites geram tratamentos inadequados que causam preju?zos ? sa?de das mulheres. Sendo assim, a pesquisa tem como objetivo: avaliar sistematicamente a efic?cia dos m?todos diagn?sticos das vulvovaginites infecciosas. Para tanto, adota como m?todo: realiza??o de um estudo de corte transversal com 200 mulheres no menacme com queixa de corrimento vaginal. Foi coletado material vaginal dessas mulheres para realiza??o dos seguintes exames: microbiol?gico a fresco e corado pelo Gram, citologia oncol?gica, teste das aminas e mensura??o do pH vaginal. Foi avaliada a efic?cia dos m?todos dispon?veis para diagn?stico do corrimento vaginal (sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo). Os dados foram inseridos em planilha do software Excel/Office 2010 com todas as vari?veis e, ap?s, exportados para o Graphpad Prism 6, para an?lise estat?stica. Resultados: na avalia??o da efic?cia dos m?todos, foram estudadas 200 pacientes, tendo como padr?o ouro o exame microbiol?gico corado pelo Gram, atrav?s do qual foram obtidos os seguintes resultados: exame a fresco para a candid?ase vaginal: sensibilidade = 31%, especificidade = 97%, valor preditivo positivo (VPP) = 54%, valor preditivo negativo (VPN) = 93%, acur?cia = 91%; exame a fresco para vaginose bacteriana: sensibilidade = 80%, especificidade = 95%, valor preditivo positivo (VPP) = 80%, valor preditivo negativo (VPN) = 95%, acur?cia = 92%; abordagem sindr?mica para vaginose bacteriana: sensibilidade = 95%, especificidade = 43%, valor preditivo positivo (VPP) = 30%, valor preditivo negativo (VPN) = 97%, Acur?cia = 54%; abordagem sindr?mica para a candid?ase vaginal: sensibilidade = 75%, especificidade = 91%, valor preditivo positivo (VPP) = 26%, valor preditivo negativo (VPN) = 98%, acur?cia = 90%; Papanicolau para a candid?ase vaginal: sensibilidade = 68%, especificidade = 98%, valor preditivo positivo (VPP) = 86%, valor preditivo negativo (VPN) = 96%, acur?cia = 96%; Papanicolau para vaginose bacteriana: sensibilidade = 75%, especificidade = 100%, valor preditivo positivo (VPP) = 100%, valor preditivo negativo (VPN) = 94%, acur?cia = 95%. Houve apenas um ?nico caso de tricomon?ase vaginal, diagnosticado pela citologia oncol?gica e exame a fresco, confirmado pelo Gram. A abordagem sindr?mica o deu como vaginose bacteriana. A partir desses dados e tendo ainda o suporte da literatura mundial, foi elaborado o Protocolo de diagn?stico e tratamento das Vulvovaginites da Maternidade Escola Janu?rio Cicco /UFRN. Desse estudo, restou como conclus?o: o Papanicolau e o exame a fresco demonstraram, respectivamente, baixa e muito baixa sensibilidade para a candid?ase vaginal; a abordagem sindr?mica apresentou muito baixa especificidade e acur?cia para a vaginose bacteriana, o que implica, na pr?tica cl?nica, um grande n?mero de pacientes n?o diagnosticadas ou tratadas de forma incorreta. / Inaccurate diagnosis of vulvovaginitis generates inadequate treatments that cause damages women's health. Objective: evaluate the effectiveness of methods when diagnosing vulvovaginitis. Method: a cross-sectional study was performed with 200 women who complained about vaginal discharge. Vaginal smear was collected for microbiological tests, considering the gram stain method as gold standard. The efficacy of the available methods for diagnosis of vaginal discharge was assessed (sensitivity, specificity, positive predictive value and negative predictive value). Data were inserted to Graphpad Prism 6, for statistical analysis. Results: the following results were obtained: wet mount for vaginal candidiasis: sensitivity = 31%; specificity = 97%; positive predictive value (PPV) = 54%; negative predictive value (NPV) =93%; accuracy = 91%. Wet mount for bacterial vaginosis: sensitivity = 80%; specificity =95%; positive predictive value (PPV) = 80%; negative predictive value (NPV) = 95%; accuracy = 92%. Syndromic approach for bacterial vaginosis: sensitivity = 95%; specificity=43%; positive predictive value (PPV) =30%; negative predictive value (NPV) = 97%; accuracy = 54%. Syndromic approach for vaginal candidiasis: sensitivity = 75%; specificity =91%; positive predictive value (PPV) = 26%; negative predictive value (NPV) = 98%; accuracy = 90%. Pap smear for vaginal candidiasis: sensitivity = 68%, specificity = 98%; positive predictive value (PPV) = 86%; negative predictive value (NPV) =96%; accuracy = 96%. Pap smear for bacterial vaginosis: sensitivity = 75%; specificity = 100%; positive predictive value (PPV) = 100%; negative predictive value (NPV) =94%; accuracy = 95%. There was only one case of vaginal trichomoniasis reported ? diagnosed by oncological cytology and wet mount ? confirmed by Gram. The syndromic approach diagnosed it as bacterial vaginosis. From the data generated and with support on world literature, the Maternidade Escola Janu?rio Cicco?s vulvovaginitis protocol was constructed. Conclusion: Pap smear and wet mount showed respectively low and very low sensitivity for vaginal candidiasis. Syndromic approach presented very low specificity and accuracy for bacterial vaginosis, which implies a large number of patients who are diagnosed or treated incorrectly.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-04-22T22:38:50Z No. of bitstreams: 1 AvohanneIsabelleCostaDeAraujo_DISSERT.pdf: 1407247 bytes, checksum: 131d9ceb89b6b524110bea91a63418e0 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-22T23:09:35Z (GMT) No. of bitstreams: 1 AvohanneIsabelleCostaDeAraujo_DISSERT.pdf: 1407247 bytes, checksum: 131d9ceb89b6b524110bea91a63418e0 (MD5) / Made available in DSpace on 2016-04-22T23:09:35Z (GMT). No. of bitstreams: 1 AvohanneIsabelleCostaDeAraujo_DISSERT.pdf: 1407247 bytes, checksum: 131d9ceb89b6b524110bea91a63418e0 (MD5) Previous issue date: 2015-07-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Esta pesquisa tem como problem?tica compreender de que maneira os saberes e a??es m?dico-sanit?rios moveram as transforma??es no espa?o p?blico da Cidade do Natal, no per?odo de 1850 a 1889, especificamente na sa?de p?blica. Para responder a este questionamento, faz-se necess?rio enfocar em tr?s aspectos: no exerc?cio m?dico e farmac?utico, na fiscaliza??o dos g?neros aliment?cios e no ordenamento urbano da Cidade do Natal. Neste sentido, foram utilizadas as seguintes fontes: Relat?rios dos Presidentes de Prov?ncia do Rio Grande do Norte, correspond?ncia ativa dos Presidentes de Prov?ncia do Rio Grande do Norte para a C?mara Municipal da Cidade do Natal; Atas das sess?es da institui??o camar?ria, C?digos de Posturas; documentos da Inspetoria da Sa?de P?blica, jornais (Correio Natalense, Liberdade e O Conservador) e as Legisla??es Imperiais (Constitui??o de 1824 e o Decreto da Junta Central de Higiene). Compondo a metodologia, para o tratamento e an?lise das fontes, foram utilizados: a leitura e transcri??o paleogr?fica, classifica??o das tem?ticas encontradas na documenta??o, cruzamento das informa??es obtidas na documenta??o, a historicidade e condi??es de produ??o das fontes hemerogr?ficas, produ??o de tabela e estudos comparativos relacionados a outras realidades provinciais do Imp?rio. / This research focuses on the effort to understand how medical and sanitizing knowledge along with taken measures were capable of carry out transformations in the public space the city of Natal in the period ranging from 1850 to 1889, as far as public health is concerned. In order to address this issue, three aspects will be taken into consideration: the medical and pharmacist practice, the inspection of foodstuff and urban planning of the city of Natal. In this sense, we use the following sources: Reports of Presidents of the Province of Rio Grande do Norte, active mail between the Presidents of the Province of Rio Grande do Norte and the Council of the city of Natal; minutes of the meetings held by Natal?s Council; stance codes; the documents of Public Health Inspection, newspapers (Correio Natalense, Liberdade and O Conservador) and the Imperial Laws (Constitution of 1824 and the Decree of the Central Departament of Hygiene). As a methodology for the treatment and analysis of the sources, we used paleographic reading and transcription, classification of the facts found in the documentation, crossing information obtained in the documentation with the historicity and conditions of production of the newspaper sources, table production and comparative studies related to other provincial scenarios in the Empire.

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 2016-05-10T19:56:09Z No. of bitstreams: 1 IsabelLopesDosSantosKeppler_DISSERT.pdf: 7572059 bytes, checksum: 0d17b1df8321e185697905d0dabeca8d (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-05-11T22:38:25Z (GMT) No. of bitstreams: 1 IsabelLopesDosSantosKeppler_DISSERT.pdf: 7572059 bytes, checksum: 0d17b1df8321e185697905d0dabeca8d (MD5) / Made available in DSpace on 2016-05-11T22:38:25Z (GMT). No. of bitstreams: 1 IsabelLopesDosSantosKeppler_DISSERT.pdf: 7572059 bytes, checksum: 0d17b1df8321e185697905d0dabeca8d (MD5) Previous issue date: 2015-08-28 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) / O campo da Sa?de do Trabalhador n?o est? presente, ou aparece de forma limitada na forma??o do Psic?logo. No entanto observa-se de um lado, como fruto da expans?o dos cursos de Psicologia, a oferta cada vez maior de profissionais para atuar n?o s? na ?rea do Trabalho como em diversas outras. De outro, uma demanda (das empresas, do Estado e mesmo dos trabalhadores, nos sindicatos) para que as ?reas psi respondam aos impactos do trabalho (e da aus?ncia, no caso do desemprego) na sa?de mental. O campo da Sa?de do Trabalhador se consolida como pol?tica p?blica no Brasil a partir da Constitui??o Federal de 1988, e em 2002, os Centros de Refer?ncia em Sa?de do Trabalhador (CEREST) torna-se a principal pol?tica, considerado ?polo irradiador?. O psic?logo atua nessas unidades de refer?ncia desde a sua forma??o e compreende-se a import?ncia de investigar a sua atua??o. O presente trabalho ? um estudo sobre a articula??o entre a atua??o dos psic?logos nos CERESTs e o campo te?rico-pol?tico da Sa?de do Trabalhador. Para tanto, foi realizado um question?rio on line com psic?logos que atuam nos CERESTs, em que obteve-se 48 respostas. A an?lise ? dividida em quatro t?picos: (1) dados e perfil do psic?logo, (2) atividades do psic?logo no CEREST, (3) cen?rio do servi?o e da pol?tica e (4) estrat?gias de a??o. O estudo apresentou limites presentes desde a forma??o ? pr?tica cotidiana, e permitiu compreender as dificuldades em efetivar as propostas em Sa?de do Trabalhador diante das condi??es impostas por um modelo de Estado neoliberal, mais do que relacionadas ao compromisso ou n?o do profissional. Al?m de identificar tais limites, tamb?m aponta estrat?gias de a??o para uma atua??o mais alinhada com o campo, algumas propostas pelos profissionais. / The field of Worker ?s Health is not present, or appears briefly, in the academic education of the Brazilian psychologist. However, it is observed on the one hand, as a result of the expansion of Psychology courses, the increasing supply of professionals that act not only in the Occupational field as in many others. On the other hand, a demand (from companies, the State and even from workers in unions) that psifields respond to the impacts of work (and the absence of it, in the case of unemployment) on mental health. The field of Worker ?s Health was introduced as public policy in Brazil with the Federal Constitution of 1988, and in 2002, the Worker ?s Health Reference Centres (CEREST in Portuguese) become the core policy, considered "dissemination poles". The psychologist acts in those reference units since their formation and we understand the importance of investigating its performance. This work is a study about the work of psychologists in CERESTs and the theoretical-political field of Worker ?s Health. Thus, an online questionnaire was made with psychologists working in CERESTs, where we obtained 48 replies. The analysis is divide into four topics: (1) data and profile of the psychologist, (2) activities of the psychologist in CEREST, (3) service and policy scenario and (4) action strategies. The study showed the limits present, from the academic education to everyday practice, and made possible to understand the difficulties in putting in practice the proposals on Worker ?s Health given the conditions imposed by a neoliberal agenda, rather than related to the commitment or not from the professional. In addition to identifying such limits, also points out action strategies for a performance more aligned with the field, some proposed by the professionals themselves.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-05-10T22:03:48Z No. of bitstreams: 1 LauraCostaDePaivaMendonca_DISSERT.pdf: 1593958 bytes, checksum: 31bc653999d87cdb7466374218770a2a (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-05-16T22:11:05Z (GMT) No. of bitstreams: 1 LauraCostaDePaivaMendonca_DISSERT.pdf: 1593958 bytes, checksum: 31bc653999d87cdb7466374218770a2a (MD5) / Made available in DSpace on 2016-05-16T22:11:05Z (GMT). No. of bitstreams: 1 LauraCostaDePaivaMendonca_DISSERT.pdf: 1593958 bytes, checksum: 31bc653999d87cdb7466374218770a2a (MD5) Previous issue date: 2015-08-31 / Esta disserta??o apresenta o Estado da Arte realizado das produ??es em sa?de do PPGSS/UFRN no per?odo de 2000 e 2014 e, buscou apreender os desafios e ac?mulos da pesquisa em sa?de e da p?s-gradua??o. A p?s-gradua??o em Servi?o Social vem se tornando ao longo dos anos um importante espa?o tanto para a universidade quanto para a categoria profissional que o curso representa, de modo a auxiliar cotidianamente na forma??o e atua??o profissional bem como na elabora??o e (re)estrutura??o de pol?ticas sociais. O programa de p?s-gradua??o em Servi?o Social (PPGSS) da Universidade Federal do Rio Grande do Norte vem se fortalecendo em quatorze anos de exist?ncia (2000-2014), sendo frequente a inser??o de alunos de outras ?reas, agregando ao programa o car?ter de integra??o com os demais campos do saber, contribuindo assim para estudos com maior rigor te?rico e expressiva reflex?o cr?tica, caracter?sticas intr?nsecas ao Servi?o Social, discutindo temas de relev?ncia social que perpassam os mais variados campos de atua??o do Assistente Social e demais profiss?es que atuam em conjunto com este, como por exemplo, a Sa?de. O prop?sito foi analisar as disserta??es em sa?de nos quatorze anos de exist?ncia do referido programa de p?s-gradua??o. Assim, a exposi??o do conte?do baseou-se nos indicadores utilizados para a an?lise da coleta de dados, como: os temas e motiva??o; o e o contexto econ?mico, pol?tico e social que os perpassam; as perspectivas te?rico-metodol?gicas que s?o recorrentes pelos mestrandos ao construir um debate te?rico que aprofunda o conceito de cada perspectiva utilizada. Para al?m de problematizar sobre a sa?de, tema de significativa relev?ncia por interagir diretamente com todos os demais campos da vida dos sujeitos, e, portanto, com o conjunto das pol?ticas sociais, buscou-se analisar o contexto da p?s-gradua??o de modo geral e tamb?m como vem se estruturando o PPGSS/UFRN, considerando quais desafios precisam ser enfrentados e quais as alternativas de crescimento podem ser indicadas a partir deste estudo. A t?cnica do Estado da Arte se mostrou fundamental para investigar o objeto de estudo, categorizando-o para melhor abordagem e compreens?o, o que nos permitiu apreender com maior riqueza de detalhes o objeto desta pesquisa. / This dissertation is working foundation the State of the Art done with the productions in health PPGSS / UFRN and sought to seize the challenges and accumulations of health research and graduate. The State of the Art technique investigates the object of study, categorizing it to best approach and understanding, allowing us to grasp with greater detail the object of this research. The Social Work graduate has become over the years an important place both for the university and for the professional category that the course is in order to routinely assist in the training and professional work as well in the design and (re) structuring social policies. The graduate program in Social Work (PPGSS) of the Federal University of Rio Grande do Norte has been strengthened in fifteen years of existence (2000-2015), with frequent inclusion of students from other areas, adding to the character program integration with other fields of knowledge, thereby contributing to studies with larger theoretical rigor and expressive critical reflection, intrinsic characteristics of Social Services, discussing issues of social relevance that underlie the most varied fields of activity of the social worker and other professions working together with this, such as health. The purpose was to analyze the health dissertations in fourteen years of existence of the postgraduate program (2000-2014), given that the year 2015 is still in progress and data would not be complete. Thus, exposure of the content was based on indicators from the analysis of data collection, as most discussed topics and the economic, political and social context that permeates as well as the theoretical and methodological perspectives that are most used by masters to build a theoretical debate that deepens the concept of each perspective used. Apart from questioning on health, the subject of significant relevance to interact directly with all other fields of life of the subjects, and thus with the set of social policies, we sought to analyze the postgraduate context in general and Also as has been structuring the PPGSS / UFRN, considering what challenges need to be addressed and what growth alternatives can be shown from this study. As a result, there is a predominance of studies that bring the historical and dialectical materialism of Marx as a theoretical and methodological fundamentals and also that the nature of bibliographical research has been gaining attention in the social sciences

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 2016-05-11T20:53:49Z No. of bitstreams: 1 CesimarSeverianoDoNascimento_DISSERT.pdf: 3438359 bytes, checksum: 8b85af0725080eee571cc3c80442c05b (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-05-19T21:38:24Z (GMT) No. of bitstreams: 1 CesimarSeverianoDoNascimento_DISSERT.pdf: 3438359 bytes, checksum: 8b85af0725080eee571cc3c80442c05b (MD5) / Made available in DSpace on 2016-05-19T21:38:24Z (GMT). No. of bitstreams: 1 CesimarSeverianoDoNascimento_DISSERT.pdf: 3438359 bytes, checksum: 8b85af0725080eee571cc3c80442c05b (MD5) Previous issue date: 2015-08-18 / O presente estudo teve como objetivo analisar os Programas de Resid?ncias M?dica (PRM) em Cardiologia do Estado do Rio Grande do Norte, identificando quais os programas credenciados para funcionamento no Estado. Trata-se de estudo transversal, descritivo, incluindo a an?lise documental dos processos de credenciamento dos programas (PCP) de resid?ncia m?dica em cardiologia vigentes no Estado do Rio Grande do Norte (RN) no ano de 2014 e a an?lise da percep??o do residente sobre a sua forma??o como especialista em cardiologia. Al?m da an?lise documental dos PCPs, foi aplicado um question?rio semiestruturado, com perguntas fechadas, do tipo Likert, e abertas a todos os residentes e egressos dos PRM analisados. Foram identificados dois PRM em Cardiologia no Estado do RN, sendo um programa sediado em institui??o p?blica e outro em institui??o privada. A an?lise documental mostrou uma maior quantidade de preceptores com um maior titularidade na institui??o p?blica em rela??o a privada, assim como uma maior produ??o acad?mica, como publica??es em revistas indexadas, publica??o de livros, cap?tulos de livros e participa??o em congressos. A institui??o privada apresenta uma melhor infraestrutura de urg?ncias, com pronto socorro e Unidade de Terapia Intensiva (UTI) cardiol?gica. Percebe-se que os residentes t?m consci?ncia de como deve funcionar uma boa resid?ncia, assim como as fortalezas e fragilidades das resid?ncias que participam. A maioria dos residentes do Hospital Universit?rio Onofre Lopes (HUOL) destaca como fortalezas a organiza??o, participa??o e qualidade dos preceptores, atividades pr?ticas e discuss?es cient?ficas, grande quantidade de pacientes e as visitas e discuss?es com preceptores nas enfermarias. Citam como maiores fragilidades a falta de servi?os de urg?ncia pr?prio, bem como UTI especializada. No Hospital do Cora??o de Natal (HCor), observa-se como ponto fraco a programa??o te?rica e poucas pr?ticas ambulatoriais. Como vantagens, citam os preceptores, agilidade na realiza??o dos exames, um bom n?mero de pacientes graves e de procedimentos. Observa-se, nas duas resid?ncias, uma certa dificuldade de aceita??o em itens importantes e obrigat?rios de acordo com as normas da Comiss?o Nacional de Resid?ncias M?dicas (CNRM), como: a bioestat?stica, bio?tica, ?tica m?dica, epidemiologia e metodologia da pesquisa. Al?m disso, os residentes reconhecem que ambos os hospitais t?m uma boa infraestrutura e suporte tecnol?gico, em especial aos m?todos de imagens. A avalia??o dos PRMCs possibilitou identificar as fortalezas de cada programa e os aspectos a serem aprimorados nos mesmo. Permitiu tamb?m a observa??o de dificuldades na aceita??o de algumas normativas contidas na resolu??o da CNRM pelo residente, como a participa??o em atividades como a bioestat?stica, epidemiologia e metodologia da pesquisa, bem como a necessidades de melhoria da forma??o t?cnica espec?fica, como na urg?ncia e emerg?ncia. Desta forma, nossos resultados possibilitar?o elaborar estrat?gias para aprimoramento continuado dos PRMC do estado. Ademais, possibilitou a elabora??o do manual do residente em cardiologia, contendo, inclusive, o detalhamento do sistema de avalia??o do residente, que poder? servir de modelo para outros programas de resid?ncia m?dica. / The present study had as goal to evaluate Rio Grande do Norte state?s medical residency programs (MRP) in Cardiology. It?s a descriptive study, including a documental analysis of the program?s accreditation processes (PAP) of cardiology?s medical residency in Rio Grande do Norte state in 2014 and the analysis of the resident?s perception about his professional education as a specialist in Cardiology. Beside the documental analysis of the PAPs, it was applied a semi-structured questionnaire with closed questions Likert style and open questions to all the current and former residents of the MRPs analyzed. Two MRPs in Cardiology were identified in Rio Grande do Norte state, one hosted in a public institution and the other in a private institution. The documental analysis showed a greater amount of preceptors with a good level of ownership on the public institution in comparison with the private one, as well as a bigger number of publications, participation in congresses and in book?s publications. The private institution presents a better Urgency?s infrastructure, with emergency room and cardiologic ICU. It IS clear that the residents are aware of how a good residency must work, as well as the strengths and fragilities of their own residences. Most of Onofre Lopes Universitary Hospital?s residents point out as a strength the organization, participation and quality of the preceptors, practice activities and scientific debates, great amount of patients and the visits and debates with the preceptors on the sickrooms. As the greatest fragilities, they emphasize the lack of a urgency service of their own and a specialized ICU. In Cora??o Hospital of Natal (HCor), it is listed as weak points the theoretic scheduling and the few ambulatory practices. As positive aspects, they report the preceptors, the agility on the execution of exams, a good number of serious patients and procedures. In both residences, it is seen a certain difficulty in accepting the important and mandatory items imposed by the rules of the Medical Residences? National Committee, such as: biostatistics, bioethics, medical ethic, epidemiology and research methodology. Besides that, the residents recognize that both hospitals have a good infrastructure and technological support, especially in imaging methods. The evaluation of PRMCs identifies the strengths of each program and the aspects to be improved in both programs. It also allowed the observation of difficulties in accepting some regulations contained in the CNRM resolution by the resident, such as participation in activities such as biostatistics, epidemiology and research methodology as well as the improvement needs of specific technical training, such as in emergency care. Thus, our results make possible to develop strategies for continued improvement of PRMC in RN state. In addition, it enabled the preparation of the resident?s manual in cardiology, containing even a breakdown of resident evaluation system, which could serve as a model for other residency programs.