Repositório RCAAP

Objetivou-se, com este estudo, identificar os fatores de risco para diabetes tipo 2 numa população de adolescentes de escolas particulares da cidade de Fortaleza.Trata-se de um estudo transversal realizado com 794 alunos de 12 a 17 anos nos meses de maio, junho, agosto e setembro de 2007. Doze escolas particulares das seis regionais que compõem a cidade de Fortaleza foram selecionadas. Utilizou-se um formulário onde se registraram dados pessoais, características sociodemográficas, hábitos alimentares e de exercícios físicos dos consultados. Também se mensurou o peso, a altura, a pressão arterial e a glicemia capilar de todos os alunos. Os pais dos alunos responderam sobre os casos de DM2 em familiares através de um questionário enviado aos respectivos domicílios. Os dados sofreram dupla digitação e foram analisados com base em literatura específica. Este estudo atendeu as exigências das Diretrizes e Normas da Pesquisa em Seres Humanos. Dos 794 adolescentes participantes 57,3% eram do sexo feminino e 42,7% do sexo masculino. A idade variou de 12 a 17 anos, com média de 14 anos, sendo a maioria compreendida na faixa etária de 12 a 14 anos (53,4%). A maior parte deles estava entre o 8º e o 9º ano do ensino fundamental (43,6%). Foram investigados os fatores de risco excesso de peso, sedentarismo, antecedentes familiares de DM2 em parentes de primeiro e segundo graus e níveis elevados de pressão arterial e glicemia capilar. Dos adolescentes participantes 23,7% tinham o IMC elevado, 65,1% eram sedentários, 51,1% tinham antecedentes familiares de DM2, 19,7% tinham pressão arterial elevada e 4,9% tinham glicemia capilar fora dos padrões de normalidade. Os dados, em relação ao número de fatores de risco apresentados por cada adolescente, apontam que 10,5% deles não tinham nenhum dos fatores investigados, mostrando que eles não estavam, portanto, expostos ao risco de adquirir DM2. No entanto, 33,8% dos jovens tinham pelo menos um fator, 39,2% dois, 14,2% três e 2,3% quatro fatores associados. Apenas um adolescente tinha os cinco fatores presentes, estando esse jovem, portanto, com grande chance de adquirir a doença. Essa investigação permitiu à enfermagem ter o conhecimento dos fatores de risco para DM2 nos jovens participantes e os resultados encontrados podem proporcionar ao enfermeiro a atuação no ambiente escolar através da proposta e a atuação efetiva na realização de oficinas educativas com o objetivo de incentivar mudanças de comportamento para combater, sobretudo, o excesso de peso e o sedentarismo, contribuindo dessa forma com a promoção da saúde e a prevenção de DM2 naquela população.

This is a quantitative study, which took place in a public maternity of Fortaleza - CE during the months of March and May of 2004. The aim was to describe the implementation of a visual evaluation during the intern of 114 premature newborns (PN) whose gestation age until birth was under 37 weeks. The babies’ mothers gave their permission to be subject of the study. The evaluation questionnaire consisted of three categories: 1) maternal and newborn history, 2) ocular exam and 3) nursing care. The data was analysed with the help of SPSS software 11.0 version and presented through table charts. To analyse the 2x2 tables it was used Fisher’s tests and for the rxc tables, Fisher-Freeman-Halton’s tests, adopting a significance level of 5%. Under the category maternal history, the data showed that the age’s ratio of the mothers was 23 and 3.8 was the average number of pre - natal consultation. Under family history/ophthalmologic, it stood out deflection errors (17%) followed by diabetes (14%) and in a lower frequency, cataract (4%) and glaucoma (1%). Under personal history it stood out high blood pressure (12%) followed by visual disorder (8%). Under newborn history it was found that 71% of PN were born thought caesarean section, also 52% are female and 68% had an apgar lower than seven during the first minute of their lives. 78% were average PN according to the premature classification. It was found that 112 PN used oxigenotherapy in which 71% of them were between the ages of 1 and 10 days. Also 68 PN were under phototherapy in which 53% were between 1 and 5 days old. The prophylaxis against newborn ophthalmologic disease was done in 27% of the premature newborns. As for the external ocular exam, 27% of those babies showed alteration in the eyelid, 16% in the conjunctiva, 14% in the sclera, 9% in the lachrymal duct, 6% in the cornea and 5% in the pupil (opening of the iris). None of the premature newborns showed any alterations on the eyebrow or iris. There was a meaning variation between the sclera and the ophthalmologic medication used (p=0,055). Thirteen premature newborns (11%) showed variation of the extra-ocular movements (physiologic strabismus) and thirteen (11%) had their red reflex altered. It was found a relevant relation among the red reflex, the apgar in the first minute of the newborns’ lives (p=0,041) and the time of oxigenotherapy treatment (p=0,028). The nursing care, based on visual assessment, was noted on the register book, informed to the nursing team, conducted as an specific treatment for the newborns’ vision, transmitted to their parents and other professionals (if one was to be needed). The results showed that the method used was efficient because it emphasizes and identifies factors that may help cooperate treatments against premature visual disorders. Indeed a technology resource contributes to the knowledge and nursing practice for the newborns’ visual health. The evaluation process came to be useful and necessary during a newborn intern period as one of the nursing treatments to reduce children’s ocular disorders.

Spinal cord injury represents great problem in public health, which affects physically the body, leading to paraplegia or tetraplegia, bringing consequences that modify family’s dynamics, which determine a new life style to its members. This context takes family to organize itself and to reconfigure its shapes, in search for understanding the individual and learning how to live with the injury implications. We aimed, in this study, to understand the meaning of caring given by the family to a person with spinal cord injury; to find out the feelings that surround the care relationship of the spinal cord injury person’s family based on the considerations of Jean Watson’s Theory; and to analyze the family attitudes face to caring process. This study is a descriptive type, with a qualitative approach, developed at an institution reference on trauma assistance, settled on Fortaleza-CE. Seven family caregivers participated to this study. The data were collected in September to October 2007, by a semi-structured interview. The speeches were analyzed using the content analysis method. We interpreted and inferred the information supported by Jean Watson’s Transpersonal Caring Theory. We concluded that the caring meaning for the family member’s perception is expressed by difficulties related to knowledge deficit, to the fact of caring is supposed to be an exhaustive activity and to the resignation of the new role of caregiver. About the feelings aroused in response to this neurological lesion, highlighted affection, faith, sadness, anxiety and fear, preoccupation and hope. As attitudes patterns face to caring process, we pointed the aspects linked to responsibility, resignation, non-acceptance and attitudes ambivalence. Thus, we realized that it is also necessary to focus Nursing care on the family of those people affected by spinal cord injury.

NETO, Isaac Vilanova e Silva. A teoria das pulsões em Freud e Lacan: pontos de convergência e de divergência. 2009. 81f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2009.

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The modeling of the traffic flow on the urban road infrastructure have become one of the most important tools to analyze the performance of new strategies and policies of traffic control aimed at improving the efficiency of the transportation system. However, to model the traffic flow in a solid way it is essential that the stages of calibration and validation of the simulation model are satisfactorily accomplished. This work presents a procedure, with an eminently practical focus, for the calibration and validation of simulation models to analyze tactical and operational interventions in the urban road network. This procedure comprises the following stages: i) definition of the road network to be modeled; ii) selection of the simulation model; iii) definition of the simulation network; and iv) calibration and validation of the simulation model. After specifying the tasks necessary to develop each one of these stages, this procedure was applied in an area of the city of Fortaleza-Ceará, using a traffic microsimulation software (INTEGRATION) and a mesosimulation package (TransCAD), to compare the calibration processes in each one, emphasizing their specificities. Nowadays, the use of traffic simulation models is not very spread in the Brazilian technical community and there are no calibration and validation procedures to facilitate the use of these programs. The author hopes that the procedure proposed in this research, as well as the discussions about its application, help to diffuse the use of traffic simulation to support the evaluation of interventions that provide a better use of the actual transportation infrastructure.

This study approaches deaf people’s social representations in the concerning to sexually transmissible diseases, due to the difficulty deafness causes in communication and, consequently, in the acquisition of contents on STD, strengthening susceptibility to such diseases. The research was carried out in a basic education deaf school. It aimed at: learning deaf students’ social representations on STD; identifying representations related to information acquirement, ways of STD contamination and prevention; interpreting their own social representations face to others and to themselves. The exploratory study was carried out with stratified sample with students from 6th to 9th grades studying in the three times. To data collection, the researcher used the Word Association Test (WAT), the draw-a-story theme based test survey and reports in field diary. Population consisted of 174 students and the sample of 107. Statiscal Package for Science Program, version 13.0 organized qualitative WAT and survey data. WAT data interpretation was proceeded with correspondence analysis and survey data with content correspondence. Results show that about 50% are male or female, with average age of 21. A little more than a half of them report knowing STD topic, and two are the ways of acquiring such information: alone, through books and magazines, and through other people (friends, neighbors etc) followed by school. Family members reported as responsible for information students highlighted mother, and mother and father together. AIDS is the most known disease, followed by hepatitis B and syphilis. Furthermore, they believe that diseases like dengue, leishmaniasis and yellow fever, that are transmitted by insect bite, are also sexually transmissible. Related to contamination, they have reported genital, oral and anal sex, as well as syringe sharing with drugs use; a significant number of students reported sneezing and cough, mouth kiss and sharing cutlery can improve the risk for STD, because they involve spittle. The primary preventive method students report is condom, and they believe that using condoms is being hygienic. They show to believe that STD have a strong semantic relationship with sex, condom, penis, disease and AIDS, while STD itself is represented by the words/expressions: I don’t, condom, cannot date, disease, sick, weak, penis, vagina, mouth (the three latter as both organs from body and sick organs). The expression “I don’t” shows STD deny for themselves, so it is the other’s sickness. The study is an evidence for the knowledge that deaf students realize STD in couples and sexual organs, that is, the very sexual act.

The implantation of the management systems has always been a challenge for the functioning parts which are responsible for the roads of a region. Such challenge becomes even bigger when the implantation of this kind of management has to be applied to roads which are not paved. It is important to consider, in this case, the bigger extension when compared with roads with some kind of overlay. We may also consider the scarcity of studies and works published in this area which complicates even more its practical application. The present work aims to contribute for the arrangement of the pavement management system (PMS), focusing its first stage, the field survey, besides the posterior analysis of the data obtained. We have as a basis the research accomplished in the USA as the ones by Eaton et al. (1987), we also tried to adapt and innovate new techniques of field survey, aiming to facilitate the achievement of data which must be inserted in methods of evaluation of the bearing conditions of the unpaved roads. The roads AQZ-01, AQZ-02 and AQZ-03, located in the district of Aquiraz, were chosen for the accomplishment of this research, once they had already been used in previous works which followed the same line of research, the management of unpaved roads. As a conclusion for this work, we hope to close this research cycle which was started in 2003 with the studies of Correia (2003), Moreira (2003) and Nunes (2003) and were recaptured in 2006 by Almeida (2006) and Santana (2006); each of them working at a specific stage of a PMS directed to the unpaved roads and that is applicable to the reality of the roads in Ceará and which can also be used by the municipal organs, helping in the management of the roads in general as well as of the unpaved ones.

The prevalence of infections sexually transmitted in adolescents has been presenting high numbers when it comes to the cases of HIV contamination. Among the factors that contribute to the increase of vulnerability the knowledge stands out, sometimes inadequate and inconsistent, what constitutes an important aspect in the adoption of preventive measures against HIV, being the school an important space to investigate what information these adolescents have on this epidemic. Facing this, it was aimed to identify the nursing diagnosis, the deficient knowledge concerning HIV/AIDS in male adolescents. This is a descriptive study of the transversal type with quantitative approach. The population consisted of male adolescents, from 12 to 18 years, of one public school and one private. The sample was composed by 326 students. The data were collected in the months of June and July 2008, through a questionnaire containing the data data referring to the identification of the nursing diagnosis in study. The age averages of the students were of 15.25 and 14.52 years, for thoses in the public and private institutions respectively. Most were single. The diagnosis was identified in 97.2% of the researched, being the inadequate performance in a test the most present defining characteristic. The performance inferior to 80.0% in the indicators used to this evaluation was of 68.4% regarding the knowledge on general aspects of HIV/AIDS; 72.1% to the contamination forms; and the referring percentages to the correct use of the male preservative and the prevention forms were respectively 52.5% and 61.3%. Concerning the referring factors it was frequently found the lack of familiarity with the information resources. Among the means mentioned to the knowledge acquisition on HIV/AIDS, we have the health professionals, the lectures, the hospitals and the teachers. About the searched resources, it was seen that the lectures, the internet, the teachers and the parents are among the most mentioned. The friends were the option of few adolescents. Regarding the referring factor - lack of interest in learning - the students that told never had looked for information justified such conduct mainly because of the lack of opportunity, indifference and because they don’t give importance to the theme. It was concluded that the knowledge deficiencies found were related with the use of the term bearer as reference to the soropositives, the existence of differences between being contaminated and develop or not AIDS, the virus transmission through the sexual act with only one partner without the use of preservative, as well as the contaminated mother to the child, the sexual relationship with vaginal and anal penetration without condom, and through blood donation. About the use of condom, the alternatives that presented smaller percentage of success were referring to the use of lubricants, the storage and the insertion. Therefore, the nursing interventions of educational nature should reinforce the existent knowledge and give priority the found deficits, in a way to focus the nursing actions in the acquisition of favorable results to increase the knowledge of these adolescents regarding HIV/AIDS.

Among the complications caused by infection by the immunodeficiency virus, those which compromise the visual system, that sometimes occur unexpectedly and can cause blindness, are highlighted. This study evaluated the efficacy of an educational technology aiming at the promotion of the eye health of people with HIV/AIDS. This evaluation research was carried out at the outpatient clinic in a referral hospital for treatment of infectious diseases, with 130 patients with HIV/AIDS, between May and August 2010. Data were collected through interview and observation, using three forms which approached, respectively, the socioeconomic profile, understanding of the booklet and accomplishment of self-examination. Predictive Analytics Software (PASW), version 18.0, was used. The association analyses were carried out using the X2 test and the likelihood ratio. Student’s t test was used to compare the averages and, when statistically significant, multiple comparisons were performed with Tukey test. All analysis were considered statistically significant when p<0.05. Of the 130 interviewed participants, 100 (23.1%) were male, 98 (75.4%) single and 76 (58.5%) had completed secondary education. Most, 95 (73.1%), had formal or informal jobs, 59 (45.4%) had incomes up to one minimum wage, with average of R$928.54 (SD= ±R$919.38). The age of the analyzed group varied from 19 to 56 years, with average of 35 ± 8 years. As for the time of diagnosis, 36 (27.7%) had between two and five years, which was the same time of treatment carried out by 51 (39.2%) participants. Concerning the evaluation of the understanding of the text – the adequacy of the booklet regarding the drawings and the difficulty during the use of the referred material, it was observed that most participants evaluated the booklet positively, although there was lack of concordance in relation to some aspects. Participants reported that the language should be simpler and that some of the names used were technical terms, limiting the understanding. Among the examinations carried out, there were lower scores for verification of distant visual acuity, in which 68.4% of the participants presented poor or totally poor conduct. They were related to the non accomplishment of some guidelines, such as hand washing before the start of the evaluation, setting of the optometric scale below and above the height of the eyes and the lack of registering of the findings at the end of each stage. On the other hand, the best performance of the group was observed in the evaluation of the eye movement (45.4%) and of the peripheral vision (38.5%), the latter having its steps executed completely correct. Comparing the results of the eye evaluation found by the group and by the researchers, the only item with significant difference was the one regarding the eyelid examination (p=0.036). It is concluded, therefore, that the booklet for self-examination is efficient, although it still needs to go through some changes for adequacy, both in the writing and in the drawings, as to make its use easier.

A partir de nossa experiência como enfermeira da Estratégia Saúde da Família- ESF, desenvolveu-se este estudo, realizando atividades educativas em saúde mediada por tecnologias educativas, junto a mulheres adultas jovens, assistidas pela ESF, com o intuito de contribuir para o exercício da autonomia e emancipação destas mulheres, estabelecendo-se uma relação dialógica e participativa. OBJETIVO descrever experiências de mudanças comportamentais adotadas por um grupo de mulheres adultas jovens, como resultado da utilização de tecnologias educativas para a promoção da saúde deste grupo de usuárias. METODOLOGIA estudo de abordagem qualitativa, cujo referencial foi Community-based participatory research – CBPR. Formou-se um grupo com onze mulheres adultas jovens (entre 20 e 38 anos), residentes no Conjunto Habitacional Novo Barroso em Fortaleza-CE, com o intuito de desenvolver atividades educativas em saúde e discutir sobre os principais problemas de saúde das mulheres naquela comunidade, planejar e desenvolver ações visando contribuir para a prevenção e promoção da saúde. As três agentes comunitárias de saúde do bairro também participaram do estudo. Ocorreram 16 encontros com o grupo, no período de julho a outubro de 2009. As técnicas e instrumentos de coleta de informações foram: registros dos encontros de grupo, diário de campo da pesquisadora e entrevistas. A coleta e a análise das informações ocorreram de forma simultânea, no decurso dos encontros no grupo de mulheres. Os aspectos éticos foram respeitados, buscando-se nortear corretamente o estudo, tendo sido submetido e aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Ceará, sob protocolo nº 153/ 09. RESULTADOS a maioria das participantes mantinha um relacionamento conjugal estável e tinha filhos, possuía renda familiar de até um salário mínimo. Elas escolheram um nome para o grupo que foi Supermulher: a saúde cor-de-rosa. Nos encontros educativos, houve a participação de profissionais, como educadora física, nutricionista e dentista, contribuindo para a prática da interdisciplinaridade. As mulheres sugeriram temas para discussão, como gravidez na adolescência, câncer de mama e infertilidade. O grupo elegeu como tema prioritário em saúde da mulher para aquela comunidade a gravidez na adolescência. Assim empregou-se o conhecimento das participantes para identificar as potencialidades locais e planejar conjuntamente as intervenções que poderiam amenizar a gravidez na adolescência. As mulheres, então, fizeram um filme sobre gravidez na adolescência, que foi apresentado à comunidade no I Encontro de Adolescentes do Novo Barroso. Acredita-se que o estudo contribuiu para o aumento da autonomia, emancipação e fortalecimento da cidadania e consciência crítica dessas mulheres, mediante as evidências percebidas. As mulheres participantes deste estudo já ‘deram marcas’ de mudanças de comportamento, por tudo o que foi evidenciado durante os encontros com o grupo. CONSIDERAÇÕES FINAIS A CBPR mostrou-se uma estratégia positiva para o reconhecimento dos problemas comunitários, envolvimento e mobilização comunitária na superação dessa realidade. Nas práticas educativas, é preciso inovar e criar parceria com a comunidade, sendo para isso necessário ultrapassar os limites físicos do CSF e ir para o território, conhecer a comunidade, as famílias, os sujeitos e as suas necessidades e potencialidades. As tecnologias educativas devem ser utilizadas no processo educativo, no sentido de incluir os sujeitos na aprendizagem e facilitar o diálogo entre saber científico e popular, pois neste estudo foram imprescindíveis para o envolvimento e participação dos sujeitos, assim, favorecendo sua aprendizagem e consequentes mudanças de comportamento.

This is an exploratory and descriptive research, primarily aiming at the analysis of factors that interfere in clean intermittent catheterization (CIC) procedure in children with neurogenic bladder, secondary to myelomeningocele (MMC), under caregiver’s perception. Fifty five 29-days-old to 11 years and 11 months-old children participated in the study. They were engaged to a child general hospital in Fortaleza City – CE; they should be using assisted clean intermittent catheterization (CIC) and they had accomplished the rehabilitation program. Most of children were students (74.5%) and female (58.2%), receiving continued social benefit-cost (78.2%) and their family incomes were until 2 minimum wages. Most of caregivers in the study had 32 to 39 years-old (38.2%), were women (96.4%), married (69.1%), had the Mid Level concluded (58.2%) and did not have outdoor occupation (89.1%). Concerning to the house infrastructure, most of residences had treated water (90.9%), basic sanitation (69.1), bathroom (100%), from 4 to 5 rooms (50.9%), door in the place where the CIC was administered (63.6%) and from 4 to 5 people cohabitating the same environment (47.3). Related to the factors that interfere in the CIC procedure, positively interfered: child’s age (p=0.047); caregiver without outdoor occupation (p=0.038); perception of continued social benefit-cost (p=0.0001); reception of material used in CIC from Municipal District or State (p=0.0001); good caregiver’s visual acuity (p=0.0001) and dexterity (p=0.0001); acceptation from child (p=0.0001) and caregiver (p=0.0001) related to the procedure (p=0.0001); absence of intercurrence during CIC administration (p=0.0001). Related to the negative factors, it is related: urethral sensibility (p=0.002), urinary losses in the intervals of CIC; continuous use of diapers and the presence of urethral sensibility in these children (p=0.0001). Two investigated factors did not present any interference: amount of rooms and number of people cohabitating with child in the house (p=0.0001). These results suggest that the number of variables positively interfering in CIC administration was superior to the negative ones. So, findings are extremely relevant so they enable the inference that the adhesion to CIC is made easy by the presence of such factors.

The Assessment Scale of the Ability to take Care of Children Exposed to HIV (EACCC-HIV) estimates mothers’ care delivery to children born in conditions of HIV. The goal was to assess mothers’ ability to take care of children exposed to HIV through the EACCC-HIV and to verify the association between scale dimensions and maternal characteristics. This cross-sectional study was carried out in Fortaleza-CE in 2010. Participants were 62 HIV+ caregivers (mothers) with 64 children (two twins) exposed to HIV at birth and younger than one year. The mothers and children’s characteristics were evaluated; strategies to reduce vertical HIV transmission: Family Apgar and EACCC-HIV. The scale contains 52 items and five factors, used for certain ages between zero and 1 year: Factor 1: ability to administer AZT syrup (children up to 42 days of life); Factor 2: ability to prepare and administer powder milk (children up to 1 year); Factor 3: ability to prepare and administer complementary feeding (children > 4 months); Factor 4: ability to administer prophylaxis with sulfamethoxazole and trimethoprim (children > 42 days); Factor 5: ability to guarantee adherence to clinical monitoring and vaccination (all children). Answers are mediated by a factor or by the sum of all items, indicating the degree of care the mother develops. STATA 11.0 software was used for analysis, with significance set at 5%. Maternal age ranged between 18 and 42 years, 33.9% suffering from aids, 61.3% in lower socioeconomic classes. One of the children had aids (1.6%), 98.4% had starting AZT in the first hours of life, 3.1% was breastfed, 61.3% showed inadequate artificial milk consumption and 36.2% inadequate complementary feeding consumption. The Family Apgar indicated 34.4% severely functional. While factor 1 of the EACCC-HIV assessed 11 children, 72.7% of whom received adequate care, factor 2 assessed 64 children and indicated high ability for care delivery in 86.0% of the mothers. According to factor 3, care was concentrated between moderate (44.4%) and high (50%). Factor 4 estimated the care offered to 53 children, indicating high ability for care delivery in 76.5%, and factor 5 assessed the 62 mothers’ answers on the 64 children. In total, 95.3% showed high ability for adherence to clinical monitoring and vaccination. According to the global assessment, 29.7% of care was considered adequate (high ability for care delivery). The association between variables indicated significance between family Apgar and ability to administer powder milk (factor 2); parity and ability to administer prophylaxis with sulfamethoxazole and trimethropim; parity and education level and ability to guarantee adherence to clinical monitoring and vaccination: and staging and diagnosis time with global assessment of the scale. Through the EACCC-HIV, maternal care for the children could be assessed and interventions could be made to enhance child health, with a view to maintaining quality of life in cases of exposure to or contamination by HIV.

Cerebral palsy is a cronic, irreversible, non-progressive patology that occurs during the fetal development of the brain, provoking motor-sensorial changes which limit the development of a child when accomplishing daily tasks. These changes affect not only the child’s life quality, but also the whole family envolved. The moment a child is diagnosed as having brain paralysis is a painful one and is always surrounded by fear and uncertainties. Considering this context, greater attention should be devoted to the mother since, she’s the one who is responsible for childcare and household tasks. Therefore, this study has as a main goal, to analyse, from the mother’s perception, the uncertainty in her brain paralysis affected child, based on Uncertainty During Desease Theory, of Mishel. Such theory deals with the uncertainties, anxiety and questionings, provoking stress in those envolved, since they don’t know about their child’s future. It is a descriptive study, based on a qualitative, investigative perspective, accomplished at the Núcleo de Tratamento e Estimulação Precoce – NUTEP and at the children’s hospital Albert Sabin between July and August 2009.Twelve mothers took part in the study about brain paralysis affected children who were under care in the services mentioned above. The gathering of data was made through forms filled with social and demographics information about the mothers and also through a semi-structured interview composed by data related to Mishel’s Theory according to a parents/children version. Data was analysed based on the Content Analysis proposed by Bardin. Among the studies, twelve thematic categories have been highlighted as follows: The awereness of the mother about her child’s diagnosis as well as its severity, the moment of the diagnosis and its future implications, future plans, help during childcare, improvemnt of explanation about the illness, knowledge about the professional’s proposes, presence of questionings, previews and changes in the chid’s health situation. During the research we have noticed that the mothers lack information and show feelings of uncertainty about their children’s patology, mainly about the future. Such uncertainties may be reduced by the professionals of health, promoting a better relationship with the mothers, clarifying their questions, as well as aquiring information about the patology and all the process of treatment and even giving opportunities for a feedback about the child’s evolution. These aspects will work as a tool to reduce their questions and, consequently their uncertainties. The study is a contribution of knowing in the scene of the neurological nursing, since anchored in the questions of the promotion of the health aiming the improvement of the quality of life of these children and his family.

The Spinal Cord Injury (SCI) is one of the main causes of serious sequels in trauma patient. After any type of spinal cord injury, the person will need to face a detailed process of rehabilitation, to reacquire the capacity to do its activities of life, and to live in independent way. The aim of this study was to analyze the effectiveness of the nursing care based on the Model of Nursing Roper-Logan-Tierney to people with spinal cord injury, as well as, knowing the contribution of the use of a theoretical model for the care directed to people with SCI in their home. It is a convergent-assistencial research. The participants of the study had been three people, two women and a man, with paraplegia, which are enclosed in a cadastre of participants of researches made by NUPEN. The process of investigating and taking care happened by means of 10 domiciliary visits (for each participant). The meetings were based on the Model of Nursing Roper-Logan-Tierney, using the instrument considered by the authors, in which it was approached and identified the performance of the activities of life, detaching the real and potential problems to be drawn the plan of cares up and to be done the necessary interventions, keeping the constant evaluation. The participant observation, the informal interview and the structuralized interview had been used for getting the information. In the development of the care process, it had been used nursing diagnosis, NANDA, nursing outcomes, NOC, and nursing interventions, NIC. After sum up in detail the data, I tried to give meaning to some information about the performance of the activities of life, trying to contextualize them for expanding for the care directed to people with spinal cord injury. When I was analyzing the behavior of the three participant of the study, I understood that the biggest barrier for the effectiveness of the considered care is the difficulty for change habits; however, with the persistence and the use of clarifications and necessary information important results are gotten. Therefore, I point out the importance of the promotion of the self-responsibility for health, to fortify the search for changes in behaviors. The use of the theoretical model Roper-Logan-Tierney in the domiciliary care directed to these clients contributed intensely for the acquisition of the knowledge about behaviors and beliefs related to each activity of life and up against this, planning and implementing the care. So, the care process leaves of being generalized and becomes individualized, causing better results. It was possible to detect the effectiveness of this process of investigating and taking care, once it was well-known the resultant benefit, by means of the conquest of more independence and more ability to solve problems for the participants of the study and its family. Moreover, the use of a theoretical model for the care directed to people with spinal cord injury in home brought important contributions: it provided the systematization for the assistance, facilitating the approach to the person with paraplegia and its daily and effectiveness of the process of taking care considered for the research; and promoted a consistent theoretical basis for the development of the care.

Technologies for nursing care delivery to blind people include assistive technology (AT). The development and use of this type of technology can be a tool for health promotion and information provision with a view to improving the health communication process. An earlier study developed a health AT on the prevention of psychoactive drugs consumption among blind people, mediated by distance access. As the AT was accepted, the researchers decided to subject it to a deeper expert assessment study. Among different options, Pasquali’s (1999) model is a possible theoretical-methodological reference framework for technology assessment. In this study, the phases of the theoretical pole elaborated by this author will be followed. Thus, the goal was to assess some points of the AT, such as: aspects of content on psychoactive drugs; pedagogical aspects related to accessibility for blind people; and technical aspects related to distance access issues. A descriptive technology assessment research was carried out between March and September 2009, using the infrastructure of the Health Communication Laboratory at Ceará Federal University (LabcomSaúde-UFC). Nine expert judges participated, totalling three for each respective area of content about drugs, special education with emphasis on education for the blind and distance access. Each group of judges worked on one phase, with one phase following the other, as these professionals elaborated their assessments, the researcher made adjustments, which were then resubmitted to the professionals’ assessment. Three assessment instruments were constructed, whose items addressed specificities of each area and its items, with scores ranging from one to four, defined as follows: adequate, partially adequate, inadequate and does not apply. All judges signed the Free and Informed Consent Term. The content experts’ assessments pointed towards the quality of the AT’s content and requested orthographic corrections, improvements in some concepts and clarifications of technical terms. The pedagogical aspect judges considered all aspects as adequate. Nevertheless, they suggested improvements in voice synthesizers, tools needed for the blind to have computer access, as well as the inclusion of audio material, inviting participants to access the technology. Finally, the technical aspect judges indicated the need to include graphic and multimedia tools. These suggestions were not readily accepted because, in a sense, they go against literature on aspects of distance access by blind people. In view of all of these considerations, the AT was properly assessed as a viable and afe means for health information provision about psychoactive drugs to blind people. Thus, as detailed, blind people can access the AT individually, whenever and as many times as they want. The technology was considered interesting, collaborating in the learning process and a useful tool for health promotion and communication mediated by distance access. The suggestions collaborated to strengthen access to this technology.

The issue of communicating with blind patients is observed during the professional performance of the nurses, who, since their undergraduate studies on blindness, is relationship with the communication process still presents some gaps. It is acknowledged that the blind patient presents a sensorial barrier that can compromise the information received during the nursing attendance to the patient. This study is justified by the nurse’s necessity of using verbal communication at all times during the attendance procedure and, for that matter, the necessity of knowing the principles and concepts which refer to the communication process. When this communication process takes place between the nurse and the blind patient, it is important to emphasize is specificity, making the professional develop communication skills to put into effect na assistance of quality. The general aim has been to analyze the verbal communication between the nurse and the diabetic blind patient in the light of Roman Jakobson’s theory and, the specific aims, to identify the addresser of the interaction in the communication between the nurse, the diabetic blind patient and his/her companion, and to outline the addresser’s profile according to the conative function, to the emotive function, the referential, the contact and the code. This is a descriptive and exploratory study, which has utilized a quantitative approach, carried out in a specialized center in diabetes and hypertension in the city Fortaleza, Ceará. This institution is a State reference in health care, provinding specialized attendance to diabetic and hypertensive patients. The subjects center blind peeple presenting blindness in both eyes, who are attended at this specialized center, their companions to diabetic patients, where the researcher, the nurse, the blind patient and a possible companion werw present. The data were recorded through video recording, in February anda March of 2005. Before the video recording, the researcher interviewed the blind patient, collecting data for identification (name, age, sex, city of birth, time of treatment for the control of diabetes, times of attendance in the institution), inquiring also about how and went blind. That took place in the waiting room, before the pacient’s examination. The video recordings were performed during the nursing attendance, lasting, on average, 19 minutes. Five video recordings were performamed, analyzed by three nurse-referees. The scenes were analyzed every 15 seconds, when there was a pause on the video and entry on the data analysis instrument. A total of 1131 verbal interactions between the nurse, the blind patient and the companion were analyzed. As a result of those interactions, it was observed that the nurse took upon himself the role of addresser of the communication in 57.8%, while the blind patient did it in 20%. In what reagards the vocative variable, the mode of action prevailed in 66.2% of the communication. In what concerns the cotent of the information, guidance stood out in 85.4%, were the most utilized channel was hearing ( 53%), followed by sight (40.6%). The most employed language during the attendance was the common type ((96.1%). To the blind patient, the communication of person matters prevailed (42%), while to the nurse it was the treatment (59.8%). The most common emotive fuctions in the interactions were those of sympathy, satisfaction, tranquility and empathy. It has been concluded that the nurse, in the performance setting, still needs to develop communication skills. Even as positive aspects have been found during verbal communication, it has been ascertained that the blind patient das the necessity of verbalizing, aspects that were undervalued by the health professional, and the nurse needs to know and appreciate the specificd related to the attendance to those people. It has been suggested in the end the expansion of studies on the communication bteween the nurses and the blind patients, having as na aim to optimize the attendance.

The family has a leading role in the child health promotion, being the first unity of care that intervenes in the health-sickness process and the is the one that has the greatest influence on the life habits of the child. With regards to feeding, it focus its attention on the quantity of food and not on its quality. The act of feeding the child goes beyond the biologic act, since it is related to the feeding behavior and practices of the family, which are influenced by the historic, social, technological and economic environments. Thus, with the changes in lifestyle of the families, the children can acquire inadequate feeding habits, resulting in child obesity. Starting from this perspective, the study has the goal of understanding the way of life of the families of pre-school age children with obesity risk. For that, it became necessary to use Leininger’s Theory of Diversity and Universality of Cultural Care and the method of Etnonursing, starting by filling an anthropometric evaluation form of 41 children in pre-school age enrolled in two daycares in Fortaleza, where 8 have shown body mass index above the 95 percent (obesity); and by carrying out open interviews with the families of these children during a three-month period, guided by the models Observation-Participation-Reflexion (OPR) and Stranger-Friend. The survey shows that the cultural theme to live with a child with obesity risk: a reality experienced by the families has nuances related with eating is more than satisfying a hunger; being a fat child brings troubles; and family conflicts around a fat child. Therefore, the families believed that feeding the child was a human activity that should be conceded, independently of their socio-economic conditions, of the nutrition value of the food and of the quantity available. The excess weight of the child associated with the stigma of the fat person and to the physical handicaps that it can cause was of little concern to the families, that said it to be characteristic of a child growth phase. The children, being the main target of the care of the family, often were the center of family conflicts, that presented themselves as power disputes between generations and competition between the parents. Faced with these apprehensions, it is understood that the family is the most affective, protective and rewarding universe of the children, being necessary for Nursing to reaches in and involve the remaining contexts – the school and the social ones – in order to develop actions of prevention of child obesity, together with relatives and teachers. That would corroborate the proposal of the Pan-American Organization of Health of creating Health Promotion Schools, starting from a support for the adoption of healthy lifestyles in all contexts of the child’s life.

GARCIA, Tatiane Martins. Macrofauna asssociada a MILLEPORA ALCICORNIS LINNAEUS, 1758 (CNIDARIA: HYDROZOA) em áreas sob diferentes níveis de influência do turismo subaquático na área de proteção ambiental estadual dos Recifes de Coral (RN). 2006. 110 f. Dissertação (Mestrado em Ciências Marinhas Tropicais) - Instituto de Ciências do Mar, Universidade Federal do Ceará, Fortaleza, 2006.

O câncer de colo uterino (CCU), segunda causa de morte por neoplasias em mulheres, caracteriza-se por possuir fatores de risco relacionados a hábitos e estilos de vida que poderiam ser minimizados e/ou eliminados através de ações de promoção da saúde. Para tanto, realizou-se o presente estudo com os objetivos de avaliar as ações de promoção da saúde desenvolvidas por enfermeiras do Programa de Saúde da Família (PSF) no controle do CCU, identificar fatores de risco para CCU e verificar associação entre a promoção de informações sobre os fatores de risco e o conhecimento das usuárias sobre esses fatores. Tratou-se de estudo avaliativo realizado no município de São Gonçalo do Amarante - CE, com 11 enfermeiras e 390 usuárias que compareceram a unidade de saúde para realização do exame de Papanicolaou no período de maio a agosto de 2007. Os dados foram coletados por meio de entrevista, observação indireta da coleta citológica e registros fotográficos e documentais das ações de promoção da saúde. Foram utilizados três instrumentos: um questionário voltado ao levantamento do perfil profissional das enfermeiras; e dois formulários, um abordando as cinco estratégias de promoção da saúde e outro voltado à vulnerabilidade das clientes. Os dois primeiros foram aplicados às enfermeiras e o último às usuárias. O formulário aplicado às enfermeiras teve como base o instrumento de Avaliação para a Melhoria da Qualidade da Estratégia de Saúde da Família (AMQ) adotada pelo Ministério da Saúde. Os dados estatísticos foram analisados através do sistema SPSS 13.0 e discutidos segundo a literatura pertinente. Verificou-se a realização de ações de promoção da saúde principalmente relacionadas às estratégias de promoção de ambientes favoráveis à saúde, desenvolvimento de habilidades pessoais e políticas públicas saudáveis, em detrimento das estratégias de participação comunitária e reorientação dos serviços de saúde. Observou-se a participação multiprofissional nas ações promotoras de saúde e a diversidade de técnicas e recursos utilizados nas atividades educativas. Os fatores de riscos para CCU mais presentes na população feminina estavam relacionados às condições socioculturais, econômicas e à saúde sexual e reprodutiva. A maioria das usuárias (61,28%) referiu conhecer, no mínimo, um fator de risco para CCU. Os fatores de risco mais conhecidos foram: pluralidade de parceiros, higiene íntima inadequada, desuso de condom e infecções genitais de repetição. A enfermeira foi reconhecida como a principal fonte de informação, pelas clientes. As mudanças, mais citadas, ocasionadas pelo conhecimento dos fatores de risco foram: realização periódica do exame de Papanicolaou, monogamia e uso de condom. Verificou-se associação estatisticamente relevante entre as ações educativas desenvolvidas pelas enfermeiras no controle do CCU e o conhecimento das usuárias sobre os fatores de risco. Portanto, o estudo demonstrou a atuação das enfermeiras como as principais agentes promotoras de saúde. Contudo, ainda existe a necessidade de envolver a comunidade e os demais setores da sociedade na discussão e enfrentamento dos problemas de saúde, o que justificaria estudos nessa área.