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

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-07-08T20:36:43Z No. of bitstreams: 1 LuciaMariaDeOliveiraSantos_DISSERT.pdf: 1117679 bytes, checksum: b534802cf25f161fce0c6edc89f67851 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-07-11T19:00:00Z (GMT) No. of bitstreams: 1 LuciaMariaDeOliveiraSantos_DISSERT.pdf: 1117679 bytes, checksum: b534802cf25f161fce0c6edc89f67851 (MD5) / Made available in DSpace on 2016-07-11T19:00:00Z (GMT). No. of bitstreams: 1 LuciaMariaDeOliveiraSantos_DISSERT.pdf: 1117679 bytes, checksum: b534802cf25f161fce0c6edc89f67851 (MD5) Previous issue date: 2015-05-25 / O L?pus Eritematoso Sist?mico (LES) ? uma doen?a autoimune cr?nica, rara, multissist?mica, com um padr?o muito heterog?neo de manifesta??es cl?nicas e sorol?gicas. O paciente, al?m de sofrer agravos f?sicos e no funcionamento fisiol?gico, tamb?m pode enfrentar uma s?rie de problemas psicossociais. Pesquisas apontam que o LES pode acarretar danos importantes no ?mbito psicol?gico, principalmente com presen?a de ansiedade e depress?o. O American College of Rheumatology (ACR), em 1999, prop?s a defini??o de 19 s?ndromes cl?nicas neuropsiqui?tricas atribu?das ao LES. A depress?o, portanto, encontra-se entre os transtornos de humor e ? uma das manifesta??es psiqui?tricas mais comuns nesse grupo, sendo encontrada com maior frequ?ncia nesses pacientes do que na popula??o em geral. Estudos tamb?m sugerem que o apoio social desempenha um papel importante no desenvolvimento de estrat?gias de enfrentamento, na gest?o do LES e na depress?o. Assim, este estudo tem como objetivo geral verificar a associa??o entre sintomas depressivos e apoio social percebido em pacientes com LES. Os objetivos espec?ficos voltaram-se ?: investigar a preval?ncia de sintomas depressivos; investigar o apoio social percebido e verificar se h? associa??o entre a depress?o, o apoio social e vari?veis sociodemogr?ficas. Utilizou-se um question?rio sociodemogr?fico, a Escala de Depress?o de Beck e a Escala de Apoio Social Percebido. A an?lise foi realizada atrav?s das estat?sticas descritiva e inferencial. A amostra final foi de 79 mulheres com LES, com uma m?dia de idade de 35,7 anos. Destas, 44 (55,7%) eram casadas. Apenas 6 (7,59%) haviam terminado o ensino superior e 32 (40,51%) ainda n?o finalizaram o ensino m?dio. Setenta e uma (89,87%) tinha renda abaixo de tr?s sal?rios m?nimos e 71 (89,87) praticavam alguma religi?o, sendo a cat?lica (67,71%) a mais mencionada pelas participantes. Do total da amostra, 37 (46,74%) j? haviam sido diagnosticadas h? mais de 7 anos, sendo que 25 (31,65%) tinham LES h? mais de 10 anos. Apenas 19 (24,05%) desenvolviam alguma atividade laboral. Quarenta e duas (53,17%) apresentaram n?veis de sintomas depressivos de leve a grave e 51 (64,46%) referiram n?veis de dor igual ou acima de 5. Encontrou-se associa??o significativa entre sintomas depressivos e dor (p=0,013) e sintomas depressivos e atividade laboral (p=0,02). Quando se verificou a percep??o de apoio social, os resultados mostraram n?veis altos pelas participantes do estudo. Atrav?s do teste de correla??o de Spearman, encontrou-se forte correla??o entre sintomas depressivos e apoio social (p= 0,000037) de modo que quanto maior a frequ?ncia de apoio menor os escores de depress?o. Esses achados s?o relevantes porque sintomas depressivos nos pacientes com LES t?m um car?ter multicausal e multifatorial e podem permanecer despercebidos, pois muitos deles se confundem com as manifesta??es da doen?a. Tal fato exige dos profissionais uma avalia??o cuidadosa, n?o apenas no ?mbito cl?nico, mas tamb?m considerando outros fatores de ordem psicossociais que podem estar atuando no surgimento ou mesmo agravamento dos sintomas. Esses resultados tamb?m corroboram com outros estudos, os quais n?o apenas confirmam o papel preditivo do apoio social nos aspectos f?sicos, mas tamb?m psicol?gicos. Nesse sentido, os profissionais de sa?de que atuam nesta ?rea, podem desenvolver a??es que fortale?am as dimens?es de apoio social, pautando-se em interven??es bem-sucedidas j? em curso ou, a partir da fala dos pacientes com LES, construir pr?ticas de cuidado que estejam de acordo com as necessidades, peculiaridades e disponibilidade desse grupo. / Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease, rare, multisystem, with a very heterogeneous clinical and serological manifestations standard. The patient, in addition to suffering injuries on his physical and physiological functioning, may also face a number of psychosocial problems. Research indicates that SLE can cause significant damage to the psychological realm, especially with the presence of anxiety and depression. In 1999, the American College of Rheumatology (ACR), proposed the establishment of 19 neuropsychiatric clinical syndromes attributed to SLE. Depression lies between mood disorders and is one of the most common psychiatric manifestations in this group, being found more frequently in these patients than in the general population. Studies also suggest that social support plays an important role in the development of coping strategies, in SLE management and depression. This study has as main objective verify the association between depressive symptoms and perceived social support in patients with SLE. The specific objectives turned to: investigte the prevalence of depressive symptoms; investigate the perceived social support and verify if there is an association between depression, social support and sociodemographic variables. We used a sociodemographic questionnaire, the Beck Depression Scale, and the Perceived Social Support Scale. The analysis was performed through descriptive and inferential statistics. The final sample could count with 79 SLE women, with an average age of 35.7 years. 44 (55.7%) of the participants were married. Only 6 (7.59%) had completed higher education and 32 (40.51%) have not finished high school. Seventy-one (89.87%) had an income below three minimum salaries and 71 (89.87) practiced a religion, and the Catholic (67.71%) was the most mentioned by them. Of the total sample, 37 (46.74%) had been diagnosed SLE more than 7 years before, and 25 (31.65%) had the disease for more than 10 years. Only 19 (24.05%) had some work activity. Forty-two of them (53.17%) had depressive symptoms levels from mild to severe, and 51 (64.46%) reported pain levels of 5, or above. The study found a significant association between depressive symptoms and pain (p = 0.013) and depressive symptoms and work activity (p = 0.02). When we examined the perception of social support, the results showed high levels among participants. Using the Spearman correlation test we found a strong correlation between depressive symptoms and social support (p= 0,000037). It means that the higher the frequency of support, the lower the score of depression. These findings are relevant because depressive symptoms in patients with SLE have a multicausal and multifactorial character and may remain unnoticed, since many of them are confused with the manifestations of the disease. This fact requires a careful assessment from professionals, not only in the clinical setting, but also considering other psychosocial reasons, that may be influencing the emergence or worsening of symptoms. These results also corroborate other studies, which not only confirm the predictive role of social support in the physical wellbeing, but also in the psychological.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-07-08T20:36:43Z No. of bitstreams: 1 MauricioCiriloDaCostaNeto_DISSERT.pdf: 2292457 bytes, checksum: 86e692523220efb4495247b7548e98f4 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-07-11T19:08:47Z (GMT) No. of bitstreams: 1 MauricioCiriloDaCostaNeto_DISSERT.pdf: 2292457 bytes, checksum: 86e692523220efb4495247b7548e98f4 (MD5) / Made available in DSpace on 2016-07-11T19:08:47Z (GMT). No. of bitstreams: 1 MauricioCiriloDaCostaNeto_DISSERT.pdf: 2292457 bytes, checksum: 86e692523220efb4495247b7548e98f4 (MD5) Previous issue date: 2016-02-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Moradores de assentamentos de reforma agr?ria t?m uma vida marcada por condi??es de vida e trabalho prec?rias, que aliadas ?s barreiras no acesso ?s pol?ticas e programas de sa?de e assist?ncia social, agravam as situa??es de vulnerabilidade psicossocial e ambiental que impactam na sa?de mental. Essa pesquisa objetiva caracterizar as ofertas de cuidado desenvolvidas pelas equipes de sa?de e assist?ncia social referente ?s demandas de transtornos mentais comuns e uso problem?tico de ?lcool de moradores de 9 assentamentos do Rio Grande do Norte. Foram entrevistados 53 profissionais de forma individual ou em grupo de diferentes categorias profissionais. Resultados indicam que os trabalhadores vivenciam condi??es prec?rias de trabalho, tra?os da heran?a patrimonial e assistencialista que ainda persiste no campo das pol?ticas sociais brasileiras e em especial nas gest?es locais no interior do pa?s. As equipes t?m pouco conhecimento do territ?rio e das necessidades de sa?de mental, o que impacta no acolhimento e cuidado ofertado. O cuidado implementado ainda corresponde ? l?gica biom?dica, caracterizada pelo etnocentrismo, tecnicismo, biologicismo, curativismo, individualismo e especialismo, com pouca participa??o dos moradores e desconsidera??o dos saberes e pr?ticas de cuidado tradicionais, n?o alcan?ando a resolutividade esperada. A aten??o psicossocial n?o funciona de forma articulada apresentando problemas quanto ao seguimento e continuidade de cuidados. O cuidado psicossocial em sa?de mental em contextos rurais tem como desafios a serem enfrentados a reorganiza??o das redes de aten??o, o estabelecimento de cuidados prim?rios pr?ximos do cotidiano das popula??es, a constru??o de pr?ticas intersetoriais tendo em vista a multidetermina??o da sa?de, e a educa??o em sa?de conectada com estes contextos espec?ficos. Em fun??o do desconhecimento das especificidades da popula??o assentada e da fragmenta??o da rede de aten??o psicossocial, essas equipes n?o conseguem acolher e responder ?s necessidades em sa?de mental de modo a interferir nas iniquidades em sa?de. / Dwellers of agrarian reform settlements have a life conditioned by poor living and work conditions, difficulties accessing health programs, social assistance and other public policies and by this exacerbating their psychosocial and environmental vulnerability, which has an impact on their mental health. This research investigates the availability of support by the health and social assistance staff, regarding the demands of common mental disorders and alcohol abuse of dwellers of nine settlements in Rio Grande do Norte. Fifty three experts from different professional categories were interviewed individually or in groups. The results indicate that the workers suffer from poor working conditions, attributes of patrimonial heritage and welfare, which still survives in Brazilian social policies and particularly at local administrations of the countryside. The staffs have little knowledge of the local conditions and of the mental health needs, which has a negative impact on the reception and offered care. The implemented health care still corresponds to the biomedical logic, characterized by ethnocentrism, technicality, biology, cure, individualism and specialization, with little participation of the dwellers and disregarding the traditional knowledge and practices of local health care and by this not achieving the expected results. The psychosocial attendance is not well coordinated, presenting problems with the follow-up and continuity of care. The psychosocial mental health care in rural context has to face the challenge of the reorganization of the health care networks, the establishment of primary health care close to the people?s everyday life, building intersectional practices considering a health multidetermination and health education connected to these specific contexts. Due to the lack of knowledge of the specifics of the life conditions of the dwellers and the fragmentation of the psychosocial health care network, these staffs do not abide and are not ready to face the mental health needs in order to interfere with these health iniquities.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-07-26T20:50:39Z No. of bitstreams: 1 AdemarAlexandreDeMorais_DISSERT.pdf: 3935521 bytes, checksum: 00b3deb50f3fbc802c3f664e7d1ba391 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-08-08T22:41:20Z (GMT) No. of bitstreams: 1 AdemarAlexandreDeMorais_DISSERT.pdf: 3935521 bytes, checksum: 00b3deb50f3fbc802c3f664e7d1ba391 (MD5) / Made available in DSpace on 2016-08-08T22:41:20Z (GMT). No. of bitstreams: 1 AdemarAlexandreDeMorais_DISSERT.pdf: 3935521 bytes, checksum: 00b3deb50f3fbc802c3f664e7d1ba391 (MD5) Previous issue date: 2015-12-15 / Diversos estudos t?m demonstrado que o residente exerce informalmente o papel de docente. Estima-se que at? 25 % do tempo dos residentes ? dedicado ao ensino, contribuindo principalmente como facilitador. Apesar dessa contribui??o, a quase totalidade dos programas de resid?ncia m?dica do Brasil n?o oferecem capacita??o docente, justamente o inverso que ocorre em programas de demais pa?ses, sobretudo Am?rica do Norte e Europa. Este trabalho tem como objetivo elaborar uma estrat?gia de capacita??o pedag?gica do residente que possa ser inserida formalmente na estrutura curricular do programa de resid?ncia m?dica do HUOL. Trata-se de estudo explorat?rio, prospectivo e descritivo, realizado HUOL da Universidade Federal do Rio Grande do Norte. Tr?s etapas foram idealizadas: (1) elabora??o e planejamento de um workshop de capacita??o pedag?gica para o residente, associado a um conte?do t?cnico motivador (suporte b?sico e a avan?ado ? vida); (2) primeira interven??o com estudantes do curso de medicina e residentes, para testagem do modelo pedag?gico escolhido, proporcionando ajustes no planejamento para a interven??o com residentes; e (3) segunda interven??o com replica??o do curso para residentes. Nas interven??es foram feitas duas esta??es de pr?tica de suporte ? vida com a avalia??o do desempenho em atividade pr?tica atrav?s do OSPE (Objective and Structured Practical Examination). A capacita??o pedag?gica foi pautada na t?cnica de ensino preceptoria minuto e feedback. A avalia??o de desempenho nas esta??es foi feita atrav?s de um checklist e das demais atividades da capacita??o, atrav?s de uma ficha de avalia??o preenchida no final do curso. As esta??es de suporte ? vida foram bem avaliadas pelos participantes nas duas interven??es e permitiu o ensino da t?cnica de feedback positivo e corretivo. A t?cnica de preceptoria minuto foi feita atrav?s de dramatiza??o, aula expositiva dialogada e v?deos. As duas t?cnicas de ensino foram avaliadas como importante para o aprendizado e ensino. Aspectos positivos citados pelos participantes foram mais relacionados a interven??o pedag?gica, do que ao conte?do t?cnico. Assim acreditamos que a estrat?gia de workshop de capacita??o pedag?gica elaborada para os residentes foi fact?vel e bem aceita pelos participantes. Assim, tais conte?dos pedag?gicos representam uma op??o para inser??o pioneira no curr?culo formal dos programas de resid?ncia m?dica do HUOL. / Studies have shown that resident informally plays the role of teacher. It is estimated that up to 25% of the residents of the time is devoted to teaching, mainly contributing as a facilitator, however, almost the entire medical residency programs in Brazil did not offer teacher training during residency education. This paper aims to introduce educational content initiation to teaching as part of the training of resident physician inserted in residency program of the University Hospital Onofre Lopes (HUOL). It is an exploratory, descriptive and prospective study in HUOL the Federal University of Rio Grande do Norte. Three steps were developed: preparation and planning of a pedagogic course, associated with a motivating technical content (basic and advanced life support); second stage, testing of pedagogical model for medical students; and finally, replication to residents. The interventions were made two practice stations life support with performance evaluation in practical activity through OSPE (Objective Structured Practical Examination). The techniques presented teachings were one-minute preceptor and feedback. Data collection was conducted through a structured evaluation form during the life support stations and at the end of the course, and analyzed using descriptive statistics. The results showed that the feedback and one minute preceptor were considered important for teaching and learning for more than 85% of participants. The feedback from evaluators practices stations added information about the performance and were held appreciatively way, according to 100% of the participants. Positive aspects highlighted by the participants were related to educational content, especially the participants of the first intervention. The time of the lectures of motivating technical content was the most repeated negative. Based on the good acceptance of pedagogical contents, this pioneer teacher training strategy was included in the formal residency program in Cardiology of our institution. It is considered therefore that the educational training model with motivating technical content was feasible and had a good evaluation and acceptance by most participants in both interventions. Thus, we believe that the educational content can be inserted in the formal curriculum of medical residency of other programs at HUOL through the training model developed in this study.

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

Made available in DSpace on 2014-12-17T14:52:46Z (GMT). No. of bitstreams: 1 JoaoGLN.pdf: 2558791 bytes, checksum: 5098c1dc063d3f942b0c3012d872d0ac (MD5) Previous issue date: 2008-12-06 / This dissertation presents a discussion on the level of risk awareness of students who have welding practice in the laboratories at CEFET/PI, both in Teresina and Floriano. Its main goal is to investigate risk factors involving students, teachers and employees that work in these laboratories. It s an empirical survey, held among a certain amount of students from the course in Mechanic Technology. For data analysis, the concept of risk was compared to the students direct measure of perception. The main results suggest the students must be better informed, more risk aware and more competent, in order to avoid accidents. They also point to a strong need for a more formal and effective performance to assure full consciousness about the risks involving the welding practice. / Este trabalho apresenta uma discuss?o sobre a conscientiza??o dos alunos que exercitam tarefas pratica de soldagem no laborat?rio da Institui??o de Ensino CEFET-Pi em Teresina e Floriano e tem como objetivo principal investigar os fatores de riscos aos alunos, professores e funcion?rios que trabalham no laborat?rio. Trata-se de uma pesquisa emp?rica do tipo survey com uma amostra de n alunos do curso t?cnico profissionalizante de Tecnologia Mec?nica do Centro Federal de Educa??o Tecnol?gica do Piau?, na sua sede em Teresina em sua UNED de Floriano. Para a an?lise da conscientiza??o foi utilizado o conceito de risco e comparado com uma medida direta de percep??o dos alunos. Os principais resultados sugerem que os alunos tenham mais conhecimento, compet?ncia e conscientiza??o para que n?o venha acontecer nenhum tipo de acidente com os mesmos. Estes resultados apontam para a pesquisa que mostra os riscos e que apontando para uma dire??o importante relacionada ? necessidade de uma atua??o mais direta e formalizada de assegurar a plena conscientiza??o dos alunos para os riscos da atividade de soldagem

Made available in DSpace on 2014-12-17T14:52:55Z (GMT). No. of bitstreams: 1 EdilsonRS_DISSERT.pdf: 1084961 bytes, checksum: a36827966d945375759fc611528e7d2f (MD5) Previous issue date: 2008-12-11 / This Master s Thesis deals with an analysis of the Regulatory Standards NR-9 e NR-13 on the perspective of occupational health and safety management systems (OHSMS) such as ILO deployed ILO/OSH-2001. Since the revamped OHSAS 18001:2007 complies with the ILO/OSH-2001 model it is used as benchmark to compare against the NR-9 and NR-13. The analysis suggests that the NR-9 has some important features present on the OHSAS 18001:2007 but lacks important others. The NR-13 turns out to be far from a modern model of OHSMS such as OHSAS 18001:2007 and a deep reformulation should be done in order to achieve the Brazil commitment with ILO to adopt OHSMS. Also, a small survey with companies with ISO 9000 certificates suggests that a NR-13 revised toward OHSMS would be welcome, but also that some more advanced issues present in ILO/OSH-2001 should be imposed by law in order to be achieved / Esta tese realiza uma an?lise das Normas Regulamentadoras NR-9 e NR-13 na perspectiva de sistema de gest?o de seguran?a e sa?de ocupacional tal como definido pela OIT em seu modelo ILO/OSH-2001. Dado que a OHSAS 18001:2007 foi reformulada e atende ao modelo ILO/OSH-2001 e ? o modelo de gest?o difundido no mercado, a an?lise ? feita de modo comparativo a esse modelo. A an?lise mostra que a NR-9 possui elementos importantes presentes na OHSAS 18001:2007, mas faltam outros tamb?m muito importantes. Todavia, a NR-9 tem uma base para melhoria. A an?lise da NR-13 mostra que esta est? muito longe de um modelo moderno de SGSSO ou para ajustar-se a ele. Por fim, uma pesquisa com empresas que tem ISO 9000 sugere que uma reformula??o da NR-13 na dire??o da OHSAS 18001 seria bem vinda, mas que alguns elementos novos de maior exig?ncia n?o seriam rapidamente adotados sem imposi??o legal

Made available in DSpace on 2014-12-17T14:52:58Z (GMT). No. of bitstreams: 1 TamaraOS.pdf: 1049856 bytes, checksum: 9700dbe6e8dc2bd4fcf9d5bbdb0d90e8 (MD5) Previous issue date: 2006-05-19 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / This Thesis deals with a study on customer satisfaction and loyalty measurement focusing on a model of factors antecedents of customer satisfaction and loyalty. The model is based on a Satisfaction Index model adopted in Norway developed by Johnson et al.(2001) and the service quality drivers from the literature. It is surveyed a sample of 130 patients of a gynecology clinical. It is used a multiple regression analysis as the main statistical method in order to verify the factors affecting satisfaction and loyalty. The main findings are that the quality model explain 54% of the satisfaction but the whole model explain only 31% of the loyalty. Although the results are consistent with the literature in term of quality as the main driver of the satisfaction and that the satisfaction is not only one factor to explain loyalty, both the quality model to satisfaction and the factors model affecting loyalty should be improved to explain better the satisfaction and loyalty in health care service / Esta tese apresenta uma contribui??o a modelos de satisfa??o do cliente, investigando as rela??es entre vari?veis antecedentes (qualidade, pre?o, gest?o de reclama??es, imagem da empresa e compromisso afetivo e calculado) ? satisfa??o e a fidelidade do cliente, tendo por objeto de estudo clientes de cl?nicas de sa?de. A pesquisa te?rica abrangeu conceitos de satisfa??o do cliente, modelos de sistemas de gest?o e modelos de ?ndices de medi??o de satisfa??o do cliente. Para a pesquisa de campo foi realizada uma pesquisa tipo survey abrangendo 130 question?rios respondidos pelos clientes da cl?nica. As an?lises dos dados foram feitas atrav?s da estat?stica descritiva e an?lise de regress?o m?ltipla. Os principais resultados evidenciam que o modelo dos direcionadores de qualidade ? satisfa??o explicam 54,69% da varia??o na satisfa??o com a cl?nica, mas o modelo explicativo da fidelidade explica apenas 31%. Apesar dos resultados de satisfa??o serem consistentes com a literatura, o grau de explica??o da satisfa??o e da fidelidade mostram a necessidade de melhorar os modelos para aumentar seu poder explicativo neste tipo de servi?o

Made available in DSpace on 2014-12-17T14:53:09Z (GMT). No. of bitstreams: 1 CyntiaMGL_DISSERT.pdf: 5124160 bytes, checksum: 5e100956adeec8571891b078093b51f4 (MD5) Previous issue date: 2013-04-26 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / This Masters degree dissertation presents a research that aims at analyzing the activities regarding within a hotel managers work in Natal/RN - Brazil, This Masters degree dissertation presents the research that aims at analyzing the activities regarding the hotel managers work in Natal / RN - Brazil, performing diagnosis of their activities and relating the aspects that impact the quality and productivity of hotel services and managers occupational health. This research is characterized as a case study with a qualitative approach, taking the method of Ergonomic Work Analysis which is the analysis of the managers work activity as a reference to the focus; and combining the use of observational and interactional methods. Ergonomics and macroergonomics are used in this study not only to understand the physical, cognitive and organizational constraints of the manager s duties, but also to characterize the work organizational architecture and design of that hotel. High workload, accumulation of tasks and diversion of functions performed by managers were noticed, increasing thereby the physical and psychological suffering for them. It was found that the activity of managers is characterized by the ambivalence of power, limited autonomy, cooperation, interdependence between managers and the fear of incompetence. It was also noticed that managers devote more time to the day job (37%), another time to sleep (30%), while only 33% of the rest of the day are meant for activities like taking care of health, family, social life and study. Although there are few studies addressing the health and safety of hotel managers, this research revealed that 84% of the surveyed hotel managers complain of musculoskeletal pain which 50% are obese and are 100% sedentary. It was also observed that managers adopt unsuitable postures for carrying out the work activities that contribute to becoming injured or work-related musculoskeletal disorders in the near future. Ergonomic measures were recommended as an investment in the skills and the training of managers, encouraging cooperative work, appropriateness of workload, limiting overtime, preserving the enjoyment of breaks during work and weekly holidays, changing the layout of the work sector , usage of communication technology to prevent displacement, compensatory physical activities, furniture adaptation, among others / A presente Disserta??o de Mestrado apresenta uma pesquisa que tem como objetivo analisar as atividades de trabalho dos gerentes de um hotel na cidade de Natal/RN - Brasil, realizando um diagn?stico de suas atividades e relacionando os aspectos que impactam a qualidade e a produtividade dos servi?os hoteleiros e a sa?de ocupacional dos gerentes. Esta pesquisa caracteriza-se como estudo de caso com abordagem qualitativa, tomando como refer?ncia o m?todo da An?lise Ergon?mica do Trabalho, que tem a an?lise da atividade de trabalho dos gerentes como foco e combina a aplica??o de m?todos observacionais e interacionais. A Ergonomia e a Macroergonomia s?o utilizadas neste estudo para compreender os contrantes f?sicos, cognitivos e organizacionais das atividades dos gerentes e caracterizar a arquitetura organizacional e o projeto de trabalho do referido hotel. Constatou-se uma alta carga de trabalho, ac?mulo e do desvio de fun??es exercidas pelos gerentes, aumentando, dessa forma, o desgaste f?sico e ps?quico sofrido por eles. Identificou-se que a atividade dos gerentes ? marcada por ambival?ncias de poder, restrita autonomia, coopera??o, interdepend?ncia entre as ger?ncias e medo da incompet?ncia. Percebeu-se, tamb?m, que os gerentes dedicam o maior tempo do dia ao trabalho (37%), outro tempo ao sono (30%), restando apenas 33% do restante do dia para as atividades destinadas ? alimenta??o, aos cuidados com a sa?de, fam?lia, estudo e vida social. Apesar de existirem poucos estudos abordando a sa?de e a seguran?a de gerentes de hot?is, esta pesquisa revelou que 84% dos gerentes do hotel pesquisado queixam-se de dores musculoesquel?ticas que 50% s?o obesos e que 100% s?o sedent?rios. Observou-se ainda que os gerentes adotam posturas corporais inadequadas durante a realiza??o das atividades de trabalho que contribuem para que ocorram les?es ou dist?rbios osteomusculares relacionados ao trabalho, em um futuro pr?ximo. Foram recomendadas medidas ergon?micas como investimento na qualifica??o e treinamento dos gerentes, est?mulo ao trabalho cooperativo, adequa??o da carga de trabalho, limita??o de horas-extras, preserva??o do gozo das pausas durante o trabalho e da folga semanal, mudan?a do layout do setor de trabalho, utiliza??o de tecnologia de comunica??o para evitar deslocamentos, atividades f?sicas compensat?rias, adequa??o do mobili?rio entre outras

Made available in DSpace on 2014-12-17T15:25:13Z (GMT). No. of bitstreams: 1 YumaF.pdf: 3104176 bytes, checksum: 62ac4ae0e04437dcb68b0baa42c44181 (MD5) Previous issue date: 2009-07-08 / The first years of the twentieth century in Natal is characterized by several urban interventions that aim was to change the feature of the city basically rural to another that was in line with cities as models of modernity and civilization. In this case all individuals would have to play important social roles, which included men, women and especially children. It was in this atmosphere of bright future that the children were taken as key parts of an idealized society. Some processes were essential in triggering changes in natal s childhood, among them, operated within the families, that this historic moment in public life sought other possibilities of existence, the school education and the construction of which would be the model for urban education the School Groups, propagators of science as mediators of all knowledge, and finally, the medical interventions that disseminating health and hygiene practices has enabled not only the conservation of child life, but also the possibility of building their individuality in a body healthy. If these processes on the one hand tried to crystallize an ideal image of a child making a child identity directly linked to education and the "body hygiene" on the other, giving specific reflexive autonomy to children, providing them see the world through eyes of subject. / Os primeiros anos do s?culo XX em Natal se caracterizaram pelas v?rias interven??es urbanas que tinham como prop?sito modificar a fei??o da cidade quase rural numa outra que estivesse em conson?ncia com as cidades consideradas modelos de modernidade e civiliza??o. Nesse processo, todos os indiv?duos passariam a ter pap?is sociais importantes a desempenhar, o que inclu?am homens, mulheres e, sobretudo, crian?as. Foi nessa atmosfera de futuro promissor que as crian?as foram tomadas como pe?as-chaves de uma sociedade profundamente idealizada. Alguns processos foram indispens?veis no desencadeamento das transforma??es da inf?ncia natalense, entre elas, as operadas no interior das fam?lias que, nesse momento hist?rico, buscaram na vida p?blica outras possibilidades de exist?ncia: a educa??o escolar e a constru??o dos que viriam a ser o modelo de educa??o urbana os Grupos Escolares, propagadores das ci?ncias como mediadoras de todo conhecimento e, por fim, as interven??es m?dicas que, divulgando pr?ticas de higiene e sa?de, possibilitaram n?o apenas a conserva??o da vida infantil, como tamb?m a possibilidade de constru??o da sua individualidade em um corpo saud?vel. Se por um lado esses processos tentaram cristalizar uma imagem ideal de crian?a estabelecendo uma identidade infantil diretamente ligada ? educa??o escolar e ao corpo higi?nico , por outro, deu ?s crian?as determinada autonomia reflexiva proporcionando a elas verem o mundo atrav?s de olhos de sujeito.