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O trabalho em sa?de como espa?o pedag?gico: desafios e possibilidadesAlves, Thiago Enggle de Ara?jo 26 May 2010 (has links)
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Previous issue date: 2010-05-26 / The ongoing transformations in brazilian society, arising from technical and organizational changes in the working world, are making, with much emphasis, heated debates resurge
related to themes and issues that refer to the relationship between work, skills and education. Thus, this study is inserted in the link between education and work, pointing to the work as an educational principle according to Antonio Gramsci. This paper aims to discuss the interfaces between education and work in the everyday health care teams and learn about the activities developed by health teams related to the learning processes in and with the work to analyze the opportunities and challenges of transforming spaces of health work in an environment of lifelong learning. This is a descriptive, exploratory with a qualitative approach case study developed from semi-structured interviews with the health staff professionals of the Unidade de Terapia Intensiva da Casa de Sa?de Dix-Sept Rosado in Mossor? / RN , who answered
open questions about the relationship between education and work. The interviews were conducted during the month of January 2010, the same being recorded, transcribed and
analyzed, culminating in the production of new knowledge on the subject. It is understood that work and education activities are eminently human, therefore only the human being works and educates. Given the statements of participants, it is noticed that all work processes in health are learning moments. This happens through new demands imposed by the everyday
of the services, by interaction with a multidisciplinary team, participation in educational activities and individual study. It was noticed that the institution in this case does not promote
study courses related to Intensive Care and that there are obstacles to the realization of educational activities on and with the work, such as: excessive workload, inability to release
staff to participate in events, low pay, which leads the worker to have more than one employment, rejection of new knowledge by some workers and lack of physical infrastructure and incentives for the activities. The daily situations must be transformed in learning, selfanalyzing the problems of practice and valuing the work process itself in its intrinsic context.
We conclude that dealing with the web of relationships between educational processes and production processes of health services, unraveling the intricacies of the world of work and
education requirements in this sector are increasingly on the agenda of Sistema ?nico de
Sa?de workers and managers. The continuing consideration of this issue becomes an essential
condition for the proper discharge of their responsibilities. We consider that bringing the
education to everyday life is the result of recognition of the educational potential of the work
situation / As transforma??es em curso na sociedade brasileira, decorrentes das mudan?as t?cnicoorganizacionais no mundo do trabalho, est?o fazendo ressurgir, com muita ?nfase, acalorados
debates relativos a temas e problemas que remetem ?s rela??es entre trabalho, qualifica??o e educa??o. Diante disso, este estudo encontra-se inserido no ?mbito da articula??o entre
educa??o e trabalho, apontando para o trabalho como princ?pio educativo na perspectiva de Antonio Gramsci. Este trabalho tem por objetivos discutir as interfaces entre educa??o e trabalho no cotidiano de equipes de sa?de e conhecer as atividades desenvolvidas por equipes de sa?de relacionadas com os processos de aprendizagem no e com o trabalho para analisar as
possibilidades e os desafios de transformar os espa?os de trabalho em sa?de em ambientes de aprendizado permanente. Trata-se de um estudo de caso de car?ter descritivo, explorat?rio, de abordagem qualitativa e desenvolvido a partir de entrevistas semi-estruturadas com os profissionais da equipe de sa?de da Unidade de Terapia Intensiva da Casa de Sa?de Dix-Sept Rosado em Mossor?/RN, os quais responderam quest?es abertas sobre a articula??o entre educa??o e trabalho. As entrevistas foram realizadas durante o m?s de janeiro de 2010, sendo as mesmas gravadas, transcritas e analisadas, culminando com a produ??o de novos
conhecimentos sobre o tema. Entende-se que trabalho e educa??o s?o atividades eminentemente humanas; logo, somente o ser humano trabalha e educa. Diante das falas dos
participantes da pesquisa, conclui-se que todos os processos de trabalho em sa?de s?o momentos de aprendizado. Este acontece por meio de novas demandas impostas pelo
cotidiano dos servi?os, pela intera??o com a equipe multiprofissional, pela participa??o em atividades educativas e estudo individual. Percebeu-se que a institui??o em estudo n?o
promove cursos relacionados ? Terapia Intensiva e que existem entraves ? realiza??o de atividades educativas no e com o trabalho, tais como: excesso de carga hor?ria de trabalho,
impossibilidade de libera??o do funcion?rio para participa??o em eventos, m? remunera??o, o que leva o trabalhador a ter mais de um v?nculo empregat?cio, rejei??o ? aquisi??o de novos
conhecimentos por parte de alguns trabalhadores e falta de estrutura f?sica e incentivos para realiza??o de atividades. Deve-se transformar as situa??es di?rias em aprendizagem,
analisando reflexivamente os problemas da pr?tica e valorizando o pr?prio processo de trabalho no seu contexto intr?nseco. Conclui-se que lidar com a teia de rela??es entre os processos educacionais e os processos de produ??o de servi?os de sa?de, desvendando os meandros do mundo do trabalho e da educa??o nesse setor s?o exig?ncias a cada dia mais presentes na agenda dos trabalhadores e gestores do Sistema ?nico de Sa?de. A an?lise permanente dessa problem?tica torna-se um exerc?cio indispens?vel para o bom desempenho de suas responsabilidades. Considera-se que aproximar a educa??o da vida cotidiana ? fruto do reconhecimento do potencial educativo da situa??o de trabalho
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Fatores da satisfa??o, fidelidade e recomenda??o em servi?o de sa?de: estudo em setor ambulatorial de hospital / Factors affecting satisfaction, loyalty and recommendation in health care: a study on a hospital ambulatory sectorSilva, Arivalda Bezerra da 09 September 2009 (has links)
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Previous issue date: 2009-09-09 / This thesis deals with the factors affecting customer satisfaction, loyalty and recommendation in the health care sector. It is adapted a model proposed by Johnson et al.
(2001) of quality and loyalty antecedent factors and it is conducted a survey with a sample of 109 customers of a hospital on the ambulatory in Natal city, a capital of a Northeastern State of Brazil. It is carried descriptive and multiple regression statistical analysis. The main findings related to satisfaction are that quality factors of doctor professionalism, clerical staff efficiency, consultancy room comfort, time to provide the medical consultancy but also hospital localization are the most significant factors affecting
satisfaction. Regarding personal full loyalty, satisfaction with the hospital and affective commitment are the main factors yet for partial loyalty image and calculate commitment
play the main role. For recommendation satisfaction, image and brand are the main factors. The overall model used fairly explains the satisfaction, loyalty and recommendation
outcomes with varying factors regarding each final purpose, e.g. loyalty or recommendation / Esta Tese de Mestrado investiga os fatores que afetam a satisfa??o, a fidelidade e a recomenda??o de clientes no setor de servi?os de sa?de. Utiliza-se um modelo estrutural
baseado no modelo proposto por Johnson et al. (2001) contendo fatores antecedentes da satisfa??o e da fidelidade/ recomenda??o. A pesquisa consiste em question?rios com
vari?veis e escala de 10 pontos aplicados a uma amostra de 109 pacientes de ambulat?rio de hospital em Natal-RN. Conduz-se uma an?lise descritiva e multivariada, usando-se
an?lise de regress?o m?ltipla para cada vari?vel dependente satisfa??o, fidelidade, recomenda??o. Os principais achados relacionados ? satisfa??o s?o que os fatores de qualidade de profissionalismo dos m?dicos, efici?ncia dos funcion?rios, conforto da sala de consulta, al?m de outros fatores como tempo para o atendimento e localiza??o do hospital, foram os mais significativos. Em rela??o ? fidelidade pessoal, os fatores mais significativos foram satisfa??o com o hospital ou funcion?rios e comprometimento afetivo com o hospital. Para recomenda??o, apareceram como os principais fatores satisfa??o, imagem e marca. O modelo geral usado explica satisfatoriamente os resultados de satisfa??o, fidelidade e recomenda??o, com fatores diferentes para fidelidade e recomenda??o
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Associa??o entre as narrativas em sa?de bucal e condi??es socioecon?mico-culturais: a denti??o como reflexo da desigualdade socialMoreira, Thiago Pel?cio 07 May 2007 (has links)
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Previous issue date: 2007-05-07 / This anthropological study investigates the lived-experience of oral diseases in the context of poverty in Northeast Brazil. During six months in 2004???, ethnographic interviews, narratives and participant-observation with 31 residents of the low-income community, Dend?, located in Fortaleza, Cear? were conducted and analyzed utilizing a hermeneutic-dialetic method. It is revealed that precarious life conditions make prioritizing caretaking a difficult task. Despite suffering tooth pain, seeking a dentist's care is perceived as "a luxury" not a citzens' right. Difficulties in accessing services and poor quality restorations, favor tooth extractions as the most effective intervention. The deterioration of one's oral health is lamented by community members who seek help from popular clinics, politicians and traditional healers. The experience of dental disease differs according to social class, leaves oral scars of inequity, harms self-esteem and inhibits social inclusion. In this context, "treating" the Teeth of Inequity demands that we deepen our comprehension of the social determinants of health, reduce injustice in the access to quality care, remove demoralizing stigmas and empower the community to confront structural forces which affect its life / Esse estudo antropol?gico investiga a experi?ncia vivida das doen?as bucais no contexto da pobreza do Nordeste brasileiro, com ?nfase nas desigualdades e exclus?o
social. Foram realizadas entrevistas etnogr?ficas, narrativas e observa??o participante com 31 moradores do Dend?, comunidade de baixa renda em Fortaleza, Cear?,
analisadas pelo m?todo hermen?utico-dial?tico. Resultados indicam que as prec?rias condi??es de vida e suporte social dificultam priorizar o cuidado em sa?de. Os informantes percebem as doen?as bucais especialmente no caso de dor, indicando a extra??o como mais resolutiva e principal demanda no dif?cil acesso aos servi?os. A deteriora??o da sa?de bucal ? lamentada, revelando marcas desiguais que impactam na auto-estima e no acesso ?s oportunidades de ascens?o social. A an?lise aponta que os fatores s?cio-econ?mico-culturais potencializadores da pobreza t?m rela??o com a experi?ncia em sa?de e doen?a e as formas de acesso aos servi?os. ? necess?rio intensificar a equidade melhorando as habilidades de comunica??o dos profissionais
com o saber popular, atrav?s da redu??o das barreiras de acesso e aumento do poder de vocaliza??o da comunidade, criando redes de apoio ao processo decis?rio na busca
por servi?os de qualidade
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Aten??o ? crian?a no per?odo neonatal: chamada neonatal, Rio Grande do Norte, 2010Pinheiro, Josilene Maria Ferreira 04 June 2014 (has links)
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Previous issue date: 2014-06-04 / O per?odo neonatal, que compreende os primeiros 27 dias p?s-parto, ? uma fase considerada de vulnerabilidade ? sa?de infantil, fazendo-se necess?rio uma maior vigil?ncia pelo profissional de sa?de atrav?s de a??es que valorizam o bin?mio m?e/filho e o atendimento integral ao rec?m-nascido. Para tanto, esse trabalho objetivou avaliar as a??es de aten??o, a partir das estrat?gias preconizadas pelo Minist?rio da Sa?de. Trata-se de um estudo de corte transversal realizado a partir do banco de dados da pesquisa nacional de base populacional intitulada ?Chamada Neonatal: avalia??o da aten??o ao pr?-natal e aos menores de um ano nas regi?es Norte e Nordeste?. Utilizou-se como unidade amostral as m?es e as crian?as menores de 1 ano que compareceram a campanha de vacina??o do dia 12 de junho de 2010 nos nove munic?pios potiguares priorit?rios para o Pacto de Redu??o da Mortalidade Infantil e Neonatal. Para compor as vari?veis de estudo foram selecionadas as quest?es/a??es referentes ao per?odo neonatal e aos fatores sociodemogr?ficos, seguidas de uma an?lise descritiva e inferencial. Obteve-se uma amostra de 837 pares m?e/filho, sendo 57,6% na capital e 42,4% no conjunto dos interiores, que foi ponderada para representar os munic?pios do Estado. Predominaram as m?es com idade entre 20-29 anos, ensino m?dio completo, n?o benefici?rio de programa de transfer?ncia de renda; e crian?as do sexo masculino (51,2%). A freq??ncia das a??es de ?mbito hospitalar variou de 35% a 96% e as realizadas na Unidade B?sica de Sa?de (UBS) de 57% a 91,2%. A maioria das a??es teve associa??o com os hospitais de natureza p?blica e com a capital do estado (p<0,05). Os resultados para a maioria das a??es est?o abaixo do preconizado nos programas e pol?ticas de aten??o ? crian?a, e revelam as iniq?idades regionais em sa?de e a necessidade de envolvimento dos servi?os e dos profissionais na busca da integralidade do cuidado para possibilitarem melhor assist?ncia atrav?s de pr?ticas humanizadas nesse per?odo de maior vulnerabilidade. / The neonatal period, which includes the first 27 da
ys postpartum, is a vulnerability phase in
child health, making it necessary for a greater mon
itoring by health professional through
actions that add value to the binomial mother/child
and comprehensive care to the newborn.
To this end, this study aimed to evaluate the care
actions the neonato from the strategies
recommended by the Ministry of Health. This is a cr
oss-sectional study carried out from the
database of the national survey of population base
entitled "Call Neonatal: evaluation of
prenatal care and to children younger than one year
old in the North and Northeast regions". It
used as the sample unit the mothers and children yo
unger than 1-year-old, costal residents of
Rio Grande do Norte, Natal, Brazil, who attended th
e vaccination campaign on June 12, 2010
in nine municipality?s priority for the Pact to Red
uce Infant and Neonatal Mortality. To
compose the study variables were selected issues/ac
tions regarding the neonatal period and
socio-demographic factors, followed by a descriptiv
e and inferential analysis. A sample of
837 mother/child pairs was obtained, being 57.6% in
capital and 42.4% in the whole from the
interiors, which was weighted to represent the muni
cipalities of the State. It was predominated
by mothers aged between 20-29 years, complete high
school, not entitled to income transfer
program and male children (51.2%). The frequency of
the actions of the hospital ranged from
35% to 96% and those performed at the Basic Health
Unit (BHU) from 57% to 91.2%. Most
actions had an association with hospitals and publi
c nature of the state capital (p<0.05). The
results for most of the actions are recommended in
the care programs and policies for
children, and reveal the regional inequities in hea
lth and the need for the involvement of
services and professionals in search of comprehensi
ve care for enabling better care through
humanized practices during this increased vulnerabi
lity period.
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Perfis e pr?ticas dos profissionais de sa?de mental em dois hospitais psiqui?tricos de grande portePessoa J?nior, Jo?o M?rio 11 December 2014 (has links)
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Previous issue date: 2014-12-11 / Na rede de aten??o psicossocial brasileira, os profissionais de sa?de s?o atores importantes no
processo de transforma??o das pol?ticas p?blicas em sa?de mental entre os diversos servi?os.
Na realidade do hospital psiqui?trico, entende-se a necessidade de ampliar o debate em torno
do atual contexto de pr?ticas desenvolvidas. O estudo objetivou analisar o processo de
reforma psiqui?trica e a pol?tica de sa?de mental no Estado do Rio Grande do Norte (RN) a
partir dos perfis e pr?ticas dos profissionais de n?vel superior em dois hospitais psiqui?tricos.
Pesquisa transversal e descritiva, com dados quantitativos e qualitativos, realizada em dois
hospitais psiqui?tricos do RN. O universo da popula??o alvo foi de 95 profissionais,
considerando-se a margem de erro de 8%, taxa de n?o resposta e os crit?rios de inclus?o:
possuir v?nculo efetivo com a institui??o por meio de aprova??o em concurso p?blico por, no
m?nimo, seis meses, sendo servidor estadual ou municipal; possuir uma carga hor?ria semanal
m?nima de 20 horas no servi?o; participar diretamente de atendimento e/ou atividades com
pacientes e familiares. A amostra final foi de 60 profissionais. Utilizou-se como instrumento de
coleta de dados um question?rio de perguntas fechadas e semiabertas sobre o perfil
socioecon?mico, as pol?ticas, as pr?ticas e a forma??o em sa?de mental. Tabularam-se os
dados quantitativos no software estat?stico SPSS e para an?lise utilizou-se estat?stica simples e
bivariada, do tipo qui-quadrado, adotando-se o n?vel de signific?ncia valor p<0,05. Para
an?lise dos dados utilizou-se a an?lise de conte?do de Bardin. Os achados qualitativos obtidos
com as quest?es semiabertas no Analyse Lexicale par Contexte d'un Ensemble de Segment de
Texte (ALCESTE) foram agrupados em quatro eixos tem?ticos: Atua??o profissional em
sa?de mental; Forma??o em sa?de mental; Cen?rios da reforma psiqui?trica e o hospital
psiqui?trico; Pol?ticas e pr?ticas em sa?de mental: desafios para profissionais no hospital. O
perfil dos profissionais revelou a maioria do sexo feminino (89,7%), enfermeiras (36,7%),
faixa et?ria de 50-59 anos (42,9%), carga hor?ria de 40 horas semanais (52,4%), tempo de
conclus?o da gradua??o de seis a 15 anos (57%) e 21,4% mencionaram ter especializa??o em
sa?de mental. Sobre as pr?ticas desenvolvidas, no atendimento individual encontrou-se
associa??o entre quem n?o constr?i ou faz parcialmente o projeto terap?utico associado a
quem realiza cuidados de observa??o e anota??o. No atendimento familiar, obteve-se cuidado
de consulta na crise; e, no atendimento de grupo a recrea??o. Na an?lise dos eixos tem?ticos
observou-se que apesar de mudan?as identificadas nos perfis e pr?ticas dos profissionais de
n?vel superior nos servi?os de aten??o ? sa?de mental, com a implementa??o de novas
pol?ticas p?blicas para a ?rea, os achados sugerem a conflu?ncia de assimetrias e diverg?ncias
na atua??o das equipes nos hospitais psiqui?tricos, ? dificuldades na gest?o do servi?os, as
reinterna??es frequentes, reduzido quantitativo de servi?os e equipamentos dispon?veis, ? alta
demanda de usu?rios, desarticula??o da rede de aten??o psicossocial, e a pr?pria escassez de
recursos humanos qualificados para compor esses servi?os. Assim, os cen?rios evidenciados
circunscrevem, em parte, o descompasso pol?tico e ideol?gico atual do processo de reforma
psiqui?trica nacional que nega o papel da assist?ncia realizada no ambiente hospitalar, embora
n?o tenha avan?ando o suficiente com a cria??o de novos servi?os que justifiquem a extin??o
total dessa institui??o / In the Brazilian network of psychosocial care, health professionals are important actors in the
process of transformation of mental health public policies among various services. In the
reality of psychiatric hospitals, one should understand the need to expand the debate about the
current context of practices developed. This study aimed at analyzing the process of
psychiatric reform and the mental health policy in the State of Rio Grande do Norte (RN)
from the profiles and practices of higher-level professionals in two psychiatric hospitals. This
is a cross-sectional and descriptive research, with quantitative and qualitative data, conducted
in two psychiatric hospitals of RN. The universe of the target population was 95
professionals, taking into account the margin of error of 8%, non-response rate and the
inclusion criteria: holding effective link with the institution by means of approval in public
examination for, at least, six months, being state or municipal servant; having a minimum
weekly workload of 20 hours in service; participating in care and/or activities with patients
and families in a direct way. The final sample consisted of 60 professionals. The tool for data
collection was a questionnaire with closed and semi-open questions about socioeconomic
profile, and mental health policies, practices and training. Quantitative data were tabulated in
the statistical software SPSS, and simple and bivariate statistics, chi-square type, was used for
analysis by adopting the significance level with the value p<0,05. In order to analyze data, the
content analysis of Bardin was used. The qualitative findings obtained with the semi-open
questions in Analyse Lexicale par Context d'un Ensemble de Segments de Texte (ALCESTE)
were grouped into four thematic axes: Professional action in mental health; Mental health
training; Scenarios of psychiatric reform and psychiatric hospitals; Mental health policies and
practices: challenges for professionals in hospitals. The profile of professionals has revealed
the majority of women (89,7%), nurses (36,7%), aged 50-59 years (42,9%), weekly workload
of 40 hours (52,4% ), time of completion of graduation from six to 15 years (57%), and
21,4% reported to have specialization in mental health. Regarding the practices developed in
individual care, it was found an association between those who do not build or partially
conducts the therapeutic project and those who conduct care related to observation and
annotation. In family care, it was obtained care consultation during crisis; and, in group care,
recreational activities. In the analysis of thematic axes, it was noted that, despite changes
identified in the profiles and practices of higher-level professionals in care services for mental
health, with the implementation of new public policies for this field, the findings indicate the
confluence of asymmetries and divergences in the actions of the teams in psychiatric
hospitals, difficulties in managing services, frequent readmissions, reduced quantitative of
available services and equipment, high demand of users, disarticulation of the network of
psychosocial care, and the very shortage of skilled human resources to compose these
services. Accordingly, the evidenced scenarios partially outline the current political and
ideological mismatch of the national process of psychiatric reform that denies the role of care
actions conducted within hospitals, although it has not gone far enough with the creation of
new services that justify the total extinction of this institution
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Atua??o dos profissionais no atendimento ?s fam?lias nos centros de aten??o psicossocial / Work of professionals to care for families in Care Centers PsychosocialOliveira, Kalyane Kelly Duarte de 10 December 2014 (has links)
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Previous issue date: 2014-12-10 / Este estudo objetivou avaliar a atua??o dos profissionais no atendimento as fam?lias nos Centros de Aten??o Psicosocial (CAPS) do Rio Grande do Norte (RN), a partir dos pap?is e fun??es desempenhados pelos profissionais nestes servi?os. Para isso, apontou-se como objetivos espec?ficos: Descrever o perfil e as atividades desenvolvidas pelas equipes de sa?de mental nos CAPS do RN; Conhecer a opini?o dos profissionais das equipes de sa?de mental quanto ? pol?tica, ?s pr?ticas e ? forma??o em sa?de mental; Verificar a adequabilidade dos papeis e fun??es dos profissionais que atuam nos CAPS do RN em rela??o ao atendimento as fam?lias. Trata-se de um estudo anal?tico, transversal, de abordagem quantitativa e qualitativa. Coletaram-se os dados por meio de question?rio, em 33 CAPS do RN, entre mar?o e outubro de 2014, ap?s a aprova??o pelo Comit? de ?tica em Pesquisa/UFRN, parecer n?217.808, CAAE: 10650612.8.1001.5537, em 1 de mar?o de 2013. Adotou-se a amostra, definida atrav?s de crit?rios de inclus?o e exclus?o, compondo-se de 183 profissionais. A prepara??o do banco de dados seguiu dois passos: 1. Preparo e tratamento dos dados das quest?es fechadas do instrumento de pesquisa relativas ? caracteriza??o e pr?ticas em sa?de mental dos sujeitos da pesquisa por meio do recurso informacional do Statistical Package for the Social Scienses (SPSS) Statistics vers?o 20.0; 2. Para verificar o n?vel de signific?ncia optou-se pela aplica??o do teste Qui-quadrado e o Kruskal Wallis Test. Preparo e tratamento do corpus formado pelas respostas ?s quest?es abertas relativas ?s pol?ticas, pr?ticas e forma??o na psiquiatria por meio do software Analyse Lexicale par Contexte d?un Ensemble de Segments de Texte (ALCESTE) e categorizados conjuntamente pela t?cnica de An?lise de Conte?do. A an?lise de dados apoia-se na literatura pertinente. Explicitaram-se os resultados atrav?s de tr?s artigos que enceram os seguintes resultados: O primeiro artigo, perfil dos participantes, caracterizou-se por predomin?ncia do sexo feminino (76,5%), na faixa et?ria de 40 a 58 anos (61,7%). Trabalham entre 30 e 40 horas semanais (63,5%), com atua??o na sa?de mental h? mais de 10 anos (98,4%). A amostra estudada direciona o atendimento a grupos familiares (65,7%), predominando o atendimento em equipe entre os assistentes sociais, enfermeiros, psic?logos e terapeutas ocupacionais. O m?dico realiza os atendimentos sem intera??o com a equipe (48,6%). Sobre as dificuldades encontradas nos servi?os ordenam-se em: materiais e insumos (75,1%), financeiras (78,5%) e estruturais (66,9%). O segundo artigo encerra dados qualitativos organizados em cinco categorias: Promo??o da reabilita??o dos usu?rios dos CAPS; Necessidades de capacita??es; Conflitos e satisfa??es do trabalho em equipe; Pr?ticas desenvolvidas nos CAPS; Dificuldades de efetiva??o da Pol?tica de Sa?de Mental. O terceiro artigo evidencia a inadequabilidade do atendimento destinado as fam?lias (93,4%) e comparando-se os atendimentos as fam?lias e aos grupos nos CAPS os dois tipos mostram-se inadequados: fam?lia (92,63%), grupos (92,60%). Os principais dados obtidos revelam a necessidade urgente de transforma??o na aten??o psicossocial. Evidencia-se ainda, a import?ncia de investimentos em insumos, estrutura f?sica e na capacita??o de recursos humanos para os CAPS. / This
study aimed to evaluate
the work of professionals
to care for families
in
Psychosocial
Care Centers (
C
APS)
of Rio
Grande do Norte
(
RN),
from the
roles and
functions
performed by
these
professional
services.
For this,
it was pointed out
the
following objectives:
To describe the profile
and the activities conducted
by
mental
health teams
in
the
RN
CAPS
;
Know
the opinion
of professionals in the
mental health
teams
of the poli
ti
c
, practices
and training
in
mental
health;
Check
the suitability of
the
roles and functions
of professionals working
in
the
RN
CAPS
in relation to
care
for families
.
This is
an analytic
al
cross
-
sectional study
of
quantitative and qualitative
approach
.
Data were c
ollected
through a questionnaire
in
33
CAPS
RN,
between
March and October
2014
,
after
being approved by the
Research Ethics Committee
/
UFRN
,
opinion
n?217.808
,
CAAE
:
10650612.8.
1001.5537
,
on March 1
2013.
T
he
sample
was adopted
,
defined by
inclusion and exclusion
criteria
,
and is composed
of
183
professionals.
The
database
preparation
followed two
steps: 1.
Preparation and
processing of data of
closed questions
of the questionnai
re
concerning the
characterization
and practices in
mental health
research subjects
through
informational
resource
Statistical Package for
Social
Scienses
(SPSS)
Statistics
version
20.0
;
2.
To check the
significance level
was chosen
by applying the
chi
-
squ
are test.
Preparation and
treatment
of the
corpus
formed by the
answers
to open
questions
relating
to the policies,
practices
and training
in psychiatry
through
Analyse
lexicale
pair
Contexte
software
d'
un
Ensemble
of
Segments
of
Texte
(
ALCESTE)
together
a
nd
categorized by
content analysis
technique
, Bardin (2004)
.
The
data
analysis is supported
in the literature
.
It
m
ade explicit
the results
through three
articles
waxing
the following results.
In the first,
participants profile
was characterized
by
a predo
minance of females
(76.5
%), aged
40
-
58
years (
61.7
%).
They work
between 30 and
40 hours per week
(63.5
%), working
in
mental
health
for over 10
years (
98.4%).
The sample
directs
the care of
family groups
(
65.7%), predominantly
the
care team
of
social worke
rs,
nurses, psychologists
and occupational therapists
.
The
doctor performs
emergency care
without
interaction with the staff
(48.6%)
.
On
the difficulties encountered
in services
are ranked
in
:
materials and supplies
(
75.1%),
financial
(
78.5%)
and structura
l
(
66.9%).
The second article
contains
qualitative data
organized
into five categories
: Promoting the
rehabilitation of
users
of
CAPS
;
Needs
training
;
Conflicts
and satisfactions
of teamwork
;
Practices developed in
CAPS
;
Effective
difficulties of
Mental He
alth Policy
.
The third article
highlights the
inadequacy
of care
for
families
(
93.4%) and
comparing the
care
families
and groups
in CAPS
both types
show
to be inadequate
:
family
(
92.63%),
groups
(
92,
60%).
The
main data
obtained reveal
the urgent
need for
transformation
in psychosocial care
.
It shows
also the importance
of investments in
inputs,
physical structure
and training of
human resources for
the CAPS.
|
47 |
Fatores condicionantes da utiliza??o da Internet na compra de servi?os de viagens e turismo: estudo com turistas brasileiros em visita ? Natal-RN / Conditioning factors for Internet use bying tourism and travel services: a study about brazilian tourist visiting Natal-RNGuardia, Mabel Simone de Ara?jo Bezerra 19 May 2006 (has links)
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Previous issue date: 2006-05-19 / In today s global society, companies have become even more competitive with the abundance of information that prospective clients have available to them. This way the tourist services has appropriate the distribution using electronics ways as information for doing acquirement services. This work, shows the adopted provision of on-line tourist services does have suited apportionment for factors and buy decisions. The method used is a survey applied to the tourists, at international airport Augusto Severo, no matter why the visit reason to Natal city, at all, they were 210 people, being the chief variables evaluated the tourist perception of facility, utility, benefits, amenity and pleasure from the Internet s use, under the terms at the tourists experiences from the WEB about to acquisitions and researches. The results acquaint that the younger tourists or less experts tourists, in visit to Natal, demonstrated greater bias to the Internet s use than the other people. By the way women have a larger representation as a consumer from the WEB and finally, people along greater study tends to adopt. The work s contribution provides greater knowledge for the tourism executives about how might use the Internet, as well as bring forward a scene propitious for the on-line diffuseness service / A sociedade vive atualmente uma competitividade constante entre as empresas, uma vez que os clientes disp?em cada vez mais de informa??es para fazer aquisi??o de servi?os. Desta forma a presta??o de servi?os tur?sticos tem adequado sua distribui??o por meio eletr?nico. Este estudo descreve o perfil de ado??o da Internet, assim como fatores que afetam a decis?o de compra de servi?os tur?sticos on line. A metodologia utilizada foi um survey aplicado junto aos turistas, no aeroporto Augusto Severo, independente do motivo da visita ? cidade do Natal-RN, totalizando 210 entrevistados, sendo as principais vari?veis analisadas a percep??o do turista quanto a facilidade, utilidade, divers?o e benef?cios do uso da Internet, com base nas experi?ncias dos turistas e ado??o da rede para compras e pesquisas. Os resultados revelaram que os turistas, que visitam Natal, mais jovens com menos experi?ncia, demonstraram maior propens?o quanto ao uso da Internet do que o restante, a mulher por sua vez tem uma maior representa??o como consumidora da rede e as pessoas com maior grau de instru??o t?m maior tend?ncia a adotar. A contribui??o desse estudo ? a de propiciar um maior conhecimento para os executivos de turismo sobre como podem utilizar a Internet, bem como apresentar um cen?rio prop?cio para a difus?o de servi?os on line
|
48 |
Evid?ncia de valida??o do instrumento de avalia??o de necessida de sa?de de pessoas com defici?ncia f?sica auditiva e visualBelmiro, S?mara Sird?nia Duarte de Ros?rio 30 June 2016 (has links)
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Previous issue date: 2016-06-30 / Objetiva-se buscar evid?ncia de validade do instrumento para avalia??o de necessidades em sa?de de pessoas com defici?ncia f?sica, auditiva e visual. Trata-se de um estudo metodol?gico para desenvolvimento, valida??o de conte?do, valida??o sem?ntica e de apar?ncia de um instrumento avaliativo. O processo de constru??o e valida??o segue os preceitos de Pasquali, seguindo as etapas do polo te?rico, atrav?s de duas fases: 1) identifica??o das defini??es constitutivas e operacionais do constructo e elabora??o dos itens que compuseram o instrumento denominado Instrumento de Avalia??o de Necessidades de Sa?de de Pessoas com Defici?ncia F?sica, Auditiva e Visual (IANC-PcDFAV), atrav?s de revis?o integrativa da literatura, realizada no primeiro trimestre de 2015 nas bases de dados CINAHL, MEDLINE, LILACS e SCOPUS; experi?ncia dos pesquisadores; e na Taxonomia das Necessidades de Sa?de de Matsumoto e Cec?lio; 2) A an?lise te?rica dos itens, realizada no per?odo de setembro de 2015 a maio de 2016, atrav?s de duas etapas. Etapa 1 ? valida??o de conte?do, atrav?s de t?cnica Delphi. Nesta etapa, realizou-se busca por meio da plataforma Lattes, para identificar profissionais da ?rea da sa?de com expertise que atuassem como ju?zes do instrumento. A amostra foi de 33 especialistas na fase Delphi 1 e 18 para a Delphi 2. Para a coleta de dados submeteu-se, via online, o formul?rio aos especialistas. Realizou-se a an?lise adotando o ?ndice de Validade de Conte?do (IVC) > 0,80 e Alpha de Cronbach > 0,80. Utilizou-se o teste de Mann-Whitney para investigar as diferen?as entre as fases Delphi 1 e 2 com p > 0,05. Etapa 2 ? A valida??o sem?ntica e de apar?ncia utilizou amostragem n?o probabil?stica por conveni?ncia com oito PcDs, sendo dois com defici?ncia f?sica, quatro com defici?ncia auditiva e dois com defici?ncia visual cadastradas em tr?s institui??es de apoio a PcDs em Mossor?/RN. Foram aplicados tr?s instrumentos: o IANS-PcDFAV, o Question?rio DISABKIDS? - Impress?o geral, e o Question?rio DISABKIDS? - Impress?es espec?ficas. A an?lise deu-se por estat?stica descritiva. Consideraram-se os princ?pios da Resolu??o 466/2012. No processo de valida??o do conte?do, na primeira rodada Delphi verificou-se que cinco itens da dimens?o dados sociodemogr?ficos e dois itens da dimens?o condi??es de vida n?o alcan?aram o ?ndice da validade de conte?do estabelecido. Nos demais itens ocorreu concord?ncia, com IVC variando de 0,82 a 1. Na segunda rodada, depois de acatadas as sugest?es dos especialistas, todos os itens avaliados atingiram ?ndices excelentes. Apresentaram-se diferen?as significativas nas dimens?es dados sociodemogr?ficos, condi??es de vida e no dom?nio 1. No que diz respeito ? m?dia dos requisitos de avalia??o, todos os itens obtiveram m?dias melhores na segunda avalia??o, com signific?ncia estat?stica (p=
0,026) no requisito utilidade/pertin?ncia e na avalia??o geral do instrumento (p= 0,031). O alpha de Cronbach foi de 0,884 na fase Delphi 1 e 0,825 na fase Delphi 2. No que concerne ? valida??o sem?ntica e de apar?ncia, o instrumento foi avaliado como importante e os itens do instrumento foram considerados f?ceis de compreender. As respostas geraram modifica??es na constru??o dos itens do instrumento. Assim, se aceita a hip?tese alternativa do estudo, em que IVC, consist?ncia interna e valida??o sem?ntica geral alcan?aram valores acima de 0,80. O instrumento proposto apresenta valores satisfat?rios de validade e consist?ncia interna, servindo como guia para a avalia??o das necessidades de sa?de de pessoas com defici?ncia f?sica, auditiva e/ou visual. / The objective is to seek evidence of validity of the instrument for the assessment of needs in health for people with physical disabilities, auditory and/or visual. This is a methodological study for development, content validation, validation semantics and appearance of an instrument of evaluative dimension. The process of construction and validation follows the precepts of Pasquali, following the steps of the polo theoretician, through two phases: 1) Identification of the settings pane and the operational construct and preparation of items that comprised the instrument called a tool for evaluation of health needs of people with physical disabilities, Auditory and Visual (IANC-PcDFAV), through integrative literature review performed in the first quarter of 2015 in databases CINAHL, MEDLINE, LILACS and SCOPUS; experience of researchers; and in the taxonomy of Health Needs Of Matsumoto and Cec?lio; 2) The theoretical analysis of the items held in the period from September 2015 to May 2016, through two steps. Step 1 - Validation of content through Delphi Technique. In this step, we search through the Lattes platform, to identify health care professionals with expertise who acted as judges of the instrument. The sample consisted of 33 experts in Delphi 1 and 18 for Delphi 2. For data collection submitted via online, the form of specialists. The analysis by adopting the Content Validity Index (CVI) > 0.80 and Cronbach's alpha > 0.80. The Mann-Whitney test was used to investigate the differences between phases Delphi 1 and 2 with p > 0.05. Step 2 - Validation semantics and appearance we used random non-probabilistic by convenience with eight PWD, being two with physical disabilities, four with hearing disabilities and two with visual disabilities enrolled in three institutions to support the PWD in Mossoro/RN. There were applied three instruments: the ians-PcDFAV, the questionnaire DISABKIDS? - overall impression, and the questionnaire DISABKIDS? - specific prints. The analysis was based on descriptive statistics. They considered themselves the principles of Resolution 466/2012. In the process of validation of the content there was established in the first Delphi, it showed that five items of the scale demographic data and two items of the scale living conditions did not reach the index of content validity. The remaining items were agreed, with CVI ranging from 0.82 to 1. In the second round, once accepted the suggestions of the experts, all items assessed have achieved excellence. It showed significant differences in the dimensions of demographic data, living conditions and in domain 1. With respect to the average requirements for evaluation, all items obtained medium best in the second evaluation, with statistical significance (p= 0.026) in requirement usefulness/appropriateness and general assessment of the instrument (p= 0.031). The Cronbach's alpha coefficient was 0.884 in Delphi 1 and 0.825 in Delphi 2. With regard to the semantic validation and appearance, the instrument was evaluated as important and the items of the instrument were considered easy to understand. The answers generated changes in the construction of the items of the instrument. Thus, it is accepted the alternative hypothesis of the study, in which CVI, internal consistency and validation general semantics reached values above 0.80. The proposed instrument presents satisfactory values of validity and internal consistency, serving as a guide for the assessment of health needs of people with physical disabilities, auditory and/or visual.
|
49 |
Estado nutricional bioqu?mico de vitamina A de parturientes atendidas na cidade de Natal-RNGurgel, Cristiane Santos S?nzio 28 June 2016 (has links)
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Previous issue date: 2016-06-28 / Este estudo objetivou avaliar o estado de vitamina A de pu?rperas atendidas durante o parto na cidade de Natal/RN. Foram recrutadas no estudo 793 mulheres, 60.1% (n=485) da rede p?blica e 39.0% (n=310) a rede privada. Amostras de soro (n=619) e leite colostro (n=656) foram coletadas em ambiente hospitalar, ap?s jejum noturno. O leite maduro (n=154) foi coletado trinta dias ap?s o parto, em visita domiciliar. Os indicadores bioqu?micos (retinol no soro e leite materno) foram avaliados por local de moradia (capital vs interior) e por rede de atendimento em sa?de (p?blico vs privado). O consumo de vitamina A foi avaliado referente ao ?ltimo trimestre gestacional. Para avaliar as diferentes formas de suplementa??o materna com vitamina A e suas associa??es com os indicadores bioqu?micos (soro e leite materno) formaram-se subgrupos baseados nas suplementa??es que ocorreram durante a gesta??o: GC, F1, F2, F3 e no p?s-parto: GM. O retinol das amostras foi quantificado por cromatografia l?quida de alta efici?ncia (CLAE). Para o total de mulheres, a concentra??o m?dia de retinol s?rico foi de 41.8 ? 12.9?g/dL e a preval?ncia da DVA foi de 5.3% (n= 33) com retinol (<20 ?g/dL), com diferen?a significativa entre o retinol s?rico das mulheres provenientes da capital e do interior (p<0,01). Em Natal, as preval?ncias de defici?ncia encontradas nas regi?es norte, sul, leste e oeste foram respectivamente: 4.3% (n=6), 5.6% (n=7), 2.9% (n=3) e 11.9% (n=8). A m?dia de retinol no colostro no grupo total foi de 95,3+ 53.7?g/dL, entretanto 27.3% (n=179) apresentaram valores inadequados (<60 ?g/dL). Os valores m?dios estimados de retinol fornecido aos rec?m-nascidos atrav?s do colostro, n?o atingiram a recomenda??o m?nima de 400?g/RAE/dia da AI (Adequate Intake) para rec?m-nascidos, considerando a ingest?o de 396mL/dia. Houve diferen?a significativa entre o retinol no colostro das mulheres da capital e aquelas provenientes do interior (p<0.01). Ambos os grupos n?o forneceram a AI de vitamina A para o rec?m-nascido e tamb?m o mesmo foi observado com as lactantes das regi?es norte e oeste da cidade de Natal. No leite maduro, nenhum dos grupos de mulheres das diferentes regi?es atingiu a recomenda??o, considerando a ingest?o de 780mL/dia pelos rec?m-nascidos. Ao avaliar as pu?rperas separadamente por rede de atendimento em sa?de (p?blico vs privado) foi encontrada diferen?a significativa entre o retinol s?rico e retinol no colostro (p<0.0001), mas n?o houve diferen?a para o leite maduro (p>0.05). Na estimativa do fornecimento de retinol atrav?s do colostro e leite maduro, as mulheres da rede p?blica n?o forneceram vitamina A dentro da recomenda??o m?nima para o rec?m-nascido (AI=400?g/RAE/dia), ao contr?rio das mulheres da rede privada, que forneceram. O consumo diet?tico m?dio total de vitamina A das parturientes foi de 987.1 + 674.4 ?gRAE/dia, sendo 872.2 + 639.2 ?gRAE/dia na da rede p?blica e 1169.2 + 695.2 ?gRAE/dia na rede privada, com diferen?a altamente significativa (p<0,00001). Na avalia??o individual, 38.4% (n=100) e 17.3% (n=28) das mulheres das redes p?blica e privada tinham ingest?o abaixo da ideal. Ao se estudar as diferentes formas de suplementa??o com vitamina A, n?o foram encontrados casos de DVA nos grupos suplementados com F1, F2 e F3. Ao se analisar o efeito da suplementa??o sobre o retinol do colostro, o grupo F2 (betacaroteno) apresentou mais casos de inadequa??o (40%). Os grupos F2 e GM n?o forneceram a quantidade de retinol m?nima recomendada pela AI aos rec?m-nascidos. No retinol do leite maduro n?o houve diferen?a entre os grupos GC, F1, F2, F3 e GM e com percentuais de inadequa??o mais baixos no GM (14.3%) e os grupos GC e F2 n?o forneceram a quantidade de retinol m?nima recomendada pela AI para os rec?m-nascidos. Concluiu-se que a preval?ncia de DVA entre as pu?rperas atendidas em Natal foi considerada um problema "leve" de sa?de p?blica na popula??o em geral. Os grupos de alto risco neste estudo viviam em cidades do interior, eram atendidos na rede p?blica de sa?de e n?o tomavam vitamina A, como o suplemento regular durante a gesta??o. / This study aimed to evaluate the vitamin A status of women who delivered in Natal/RN. A total of 795 women were enrolled in the study. Serum (n=619) and colostrum (n=656) samples were collected in the hospital after an overnight fast. Mature milk samples (n=15) were collected at the women?s house thirty days after delivery. Biochemical indicators were evaluated according to home location (capital city vs. country towns) and type of health care system (public vs. private). Vitamin A intake was assessed using a food-frequency questionnaire (FFQ) corresponding to the last trimester of pregnancy. In order to evaluate the different forms of maternal supplementation with vitamin A and their associations with biochemical markers (maternal serum and breast milk), subgroups were formed based on the type of supplementation that occurred during pregnancy: GC, F1, F2, F3 and postpartum: GM. Retinol concentrations in the biological samples were quantified by high performance liquid chromatography (HPLC). For the total sample, the mean serum retinol concentration was 41.8 ?12.9?g/dL and the prevalence of VAD was 5.3% (n=33) of women presenting retinol concentrations (<20 ?g/dL), evidencing a significant difference in serum retinol concentrations between women from the capital city and from the countryside (p <0.01). In Natal, the prevalence of disability found in the north, south, east and west were, respectively, 4.3% (n= 6), 5.6% (n= 7), 2.9% (n= 3) and 11.9% (n= 8). The overall mean retinol concentration in colostrum was 95.3 ? 53.7?g/dL; however, 27.3% (n=179) of women presented inadequate values (<60 ?g/dL). The average estimated amounts of retinol provided to newborns through colostrum did not meet the minimum recommendation of 400 ?g/RAE/day of AI (Adequate Intake) for newborns in both groups, considering the intake of 396mL/day. It was found a significant difference in colostrum retinol concentrations between women from the capital city and from the countryside (p<0.01). In Natal, colostrum milk of women from the northern and western regions did not meet the AI. For mature milk, none of the groups from the different regions met the recommendation, considering the intake of 780mL/day. Evaluating the sample separately by childbirth care system (public vs. private), it was found a significant difference in serum and colostrum retinol concentrations between the groups (p <0.0001); there was no difference for the mature milk (p>0.05). Estimating the retinol supply through colostrum and mature milk, women attending the public health system did not provide the minimum vitamin A amount recommended for newborns (AI= 400?g/RAE/day), unlike women's private network, which provided. The average total dietary vitamin A intake of pregnant women was 987.1 ? 674.4 ?gRAE/day, was 872.2 + 639.2 ?gRAE/day for women attending the public health system and 1169.2 + 695.2 ?gRAE/day for those attending the private system, evidencing a highly significant difference (p<0.001). Individually assessing the participants, 38.4% (n=100) e 17.3% (n=28) of women in the public and private systems had vitamin A intakes below the ideal. There was no difference in serum retinol concentrations between the CG, F1, F2, F3 and MG groups (p<0.05), although only the supplemented groups F1, F2 and F3 had no cases of VAD. Regarding colostrum retinol levels, the F2 group (beta-carotene) presented the highest number of inadequate cases (40%). The F2 and MG groups did not provide the minimum amount of retinol recommended by AI for newborns. Regarding retinol concentrations in mature milk, there was no difference between the CG, F1, F2, F3 and MG groups, and the MG group presented the lowest percentage of inadequacy (14.3%), while the CG and F2 groups did not provide the minimum amount of retinol recommended by the AI for infants. It was concluded that the prevalence of VAD among mothers who delivered in Natal was considered a ?mild? public health problem in the overall population. High-risk groups in this study lived in towns, were attended in the public health system and did not take vitamin A as regular supplement during pregnancy.
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Taxa de evapora??o de combust?veis em fun??o da temperatura: an?lise termoecon?mica aplicada a postos de servi?os do RN / Fuel evaporation temperature: analysis economic term applied to gas stations of the RNAndr?, Thiago da Silva 19 December 2016 (has links)
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Previous issue date: 2016-12-19 / Este trabalho ? resultado de um estudo de an?lises experimentais que mediram a taxa de evapora??o, em fun??o da temperatura, de quatro combust?veis, a saber: gasolina comum, ?lcool combust?vel, Diesel S10 e gasolina GRID, realizados para seis n?veis t?rmicos diferentes, seguido de uma an?lise de custos das perdas potenciais por evapora??o, aplicada a tanques subterr?neos de postos de combust?veis. Quando esses combust?veis liberam vapores ? atmosfera podem causar danos ao meio ambiente. Em postos de servi?os, esse vapor ? liberado quando do abastecimento do ve?culo ou pelas linhas de respiro do Sistema de Abastecimento Subterr?neo de Combust?veis - SASC. Quando o posto n?o possui prote??es contra essas emiss?es fugitivas, elas atingem flora, rios, len??is fre?ticos etc. Al?m da polui??o dos recursos naturais, a perda por evapora??o atinge as finan?as do posto de combust?vel, tanto pelas multas geradas pelas contamina??es, quanto pela perda de ativo, os combust?veis. Dos combust?veis avaliados, o que apresentou a maior taxa de evapora??o foi a gasolina GRID, seguido da gasolina comum, ?lcool e diesel S10. / This work is the result of a study of experimental tests that measured the rate of evaporation, temperature, of four fuels, namely: ordinary gasoline, ethanol fuel, Diesel and gas GRID, S10 for six different heat levels, followed by a cost analysis of the potential losses for evaporation, applied to underground tanks of gas stations. When these fuels release vapors into the atmosphere can cause damage to the environment. In service stations, this vapor is released when the supply of the vehicle or the vent lines of Underground fuel supply system-SASC. When the gas station does not have protections against these fugitive emissions, they reach flora, rivers, groundwater etc. Apart from the problem of pollution of natural resources, the loss by evaporation reaches the finances of the gas station, both by the fines generated by the contamination, and the loss of active, fuel. Of fuels evaluated presented the highest evaporation rate was the gas GRID, followed by ordinary gasoline, alcohol and diesel S10.
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